How to undertake an IOCA

IOCAs are one of the essential components of the Clinical Competency Portfolio Review (CCPR), launching in September 2026.

An IOCA takes approximately 2.5 hours. It consists of two parts, with 30 minutes of ‘thinking/reflection’ time in between.  

Before starting the IOCA

• The patient must be informed of the IOCA process and fill out a consent form [PDF; 121 KB] prior to the IOCA.
• The independent assessor must document the patient and setting / context details on the IOCA form in InTrain.

Note: Principal supervisors should not supply patient information to the candidate before the IOCA. 

Part 1

1. The independent assessor observes the trainee while they conduct a comprehensive interview with a patient and formulate an initial management plan appropriate to the circumstances (50 minutes).
2. After the interview, the trainee has time to think and reflect (30 minutes). During this time, the independent assessor gathers feedback from the patient, to support the trainee's learning.

Part 2 

1. The trainee presents their clinical assessment of the patient followed by a viva of clarification questions from the independent assessor (20 minutes).
   • The trainee’s clinical assessment presentation should be a summary of the salient features, an assessment of gaps in the history, other essential information required, a formulation, diagnosis and differential diagnosis.
2. The trainee presents their proposed comprehensive management plan, followed by a viva of clarification questions from the independent assessor (20 minutes).
3. The independent assessor rates the trainee’s performance using the IOCA 5-point rating scale [PDF; 300 KB] and provides feedback to the trainee (20 minutes). They also provide additional feedback on the IOCA form in InTrain. 
   • The independent assessor should make their judgements on competencies and behaviors observed during the IOCA assessment.
   • Feedback should be provided about each domain of the assessment criteria.
   • It should address history taking and examination skills observed during the clinical interview.
4. At the end of the assessment, both the independent assessor and the trainee sign the IOCA form.
5. The trainee discusses their IOCA feedback later with their Principal Supervisor and agrees on the next steps to progress learning.
6. The completed IOCA form is submitted with the relevant end-of-rotation ITA form.

IOCA scoring guide

Download the IOCA and OCA 5-point rating scale and scoring guide [PDF; 300 KB].

Incident form

If an incident occurs during your IOCA assessment that could affect your performance or the outcome of the assessment, please complete an Incident Report form within 5 working days of the assessment.

Help with IOCAs 

Contact assesshelp@ranzcp.org for help with all matters relating to IOCAs.