Supervised Learning Events Explained: Mini-CEX, CbD and DOPS
Mini-CEX, DOPS, CbD and the MRCF are the four tools used to assess observed clinical activities in the foundation year. You'll find what each one is for, who can complete them and how many every activity needs.
By Umar Majid ·
Supervised learning events (SLEs) are the four tools used to assess observed clinical activities in the foundation trainee pharmacist year: mini-CEX, DOPS, case-based discussion (CbD) and the MRCF. Under the NHS England assessment strategy, each observed clinical activity has to be assessed with an SLE at least three times, using the tools permitted for that activity.
If you're a designated supervisor (DS) or a trainee trying to get your head around which tool to use and when, this should help.
What is an SLE?
NHS England describes SLEs as trainee-led, formative assessments. Trainee-led means you, the trainee, plan and request them. Your supervisor doesn't chase you for them. Formative means they're for learning and feedback, so a single SLE isn't a pass or fail. The summative decision is final sign-off by the DS.
Each SLE is judged against what you'd expect from someone at the trainee's stage, not against an experienced pharmacist.
They should be spread evenly across the year, cover a variety of scenarios and be scheduled while the trainee is in the relevant clinical setting or rotation.
How do the four tools differ?
| Tool | Full name | Observed live? | Best for | Example in pharmacy |
|---|---|---|---|---|
| Mini-CEX | Mini-clinical evaluation exercise | Yes, usually planned | How the trainee identifies, acts on and resolves issues in patient care | Reviewing a patient's medicines on a ward and agreeing a change with the team |
| DOPS | Direct observation of practical skills | Yes, usually planned | Tasks that follow a defined protocol or process | Clinically checking and validating a prescription, or a structured medicines reconciliation |
| CbD | Case-based discussion | No, retrospective | Knowledge and clinical reasoning behind a decision | Talking through how the trainee handled an interaction query yesterday |
| MRCF | Medicines related consultation framework | Yes | Consultation skills, based on the Calgary-Cambridge guide | A New Medicine Service consultation or a counselling session |
NHS England also lets you use other recognised consultation tools in place of the MRCF, as long as the trainee has been trained or briefed on them.
Which tool goes with which activity?
Each observed clinical activity has a short menu of permitted SLEs. This is the mapping in the 2025/26 Assessment Activities and Tools Guide.
| Observed clinical activity | Permitted SLEs |
|---|---|
| Medicines reconciliation | Mini-CEX, DOPS |
| Patient consultation | Mini-CEX, MRCF |
| Medicines optimisation | Mini-CEX, CbD |
| Public health intervention | DOPS, CbD |
| Medicines safety | DOPS, CbD |
| Responding to a medicines query | DOPS, CbD |
| History taking (prescribing) | Mini-CEX, DOPS |
| Physical and clinical examination skills (prescribing) | DOPS |
| Prescribing consultation (prescribing) | Mini-CEX, MRCF |
| Prescription writing (prescribing) | DOPS, CbD |
The last four are prescribing activities for trainees on the full learning outcomes, and the log of 90 hours must include SLEs from all four. Every activity also needs at least one piece of other evidence, such as a CPD entry, contribution to care log or reflective account.
How many SLEs do you need?
It helps to separate the two ideas. The observed clinical activity is the what, for example medicines reconciliation. The SLE is how it's assessed, for example a DOPS.
| Learning outcomes pathway | Observed clinical activities | Minimum SLEs (3 per activity) |
|---|---|---|
| Interim learning outcomes | 6 | 18 |
| Full learning outcomes | 10 (6 core plus 4 prescribing) | 30 |
These are minimums. Three near-identical SLEs don't show much. Aim for different patients, settings and levels of complexity, so your DS can see real progress.
Regional NHS England teams also expect at least 3 observed clinical activities by week 13 and 6 by week 26 on the interim outcomes, or 5 and 10 on the full outcomes. Our 26-week review guide explains how these fit into the progress reviews.
Who can complete an SLE?
The DS can complete any SLE and keeps responsibility for final sign-off. The designated prescribing practitioner (DPP) decides whether the prescribing activities are satisfactory. Our guide to independent prescribing in the foundation year covers that side in more detail.
Practice supervisors can complete SLEs too, if they're appropriately experienced and trained to assess. They're usually registered healthcare professionals, but NHS England notes that for some clinical skills a suitably skilled team member, such as a healthcare assistant, may supervise. For some prescribing activities, the practice supervisor doesn't need to be a prescriber.
Whoever it is, the DS or DPP must be satisfied that anyone they delegate to is competent to assess. Practice supervisors can give their feedback through the ticketed supervisor function in the e-portfolio.
Tips for trainees
- Plan SLEs with your supervisor in advance. Mini-CEX and DOPS are usually booked, not grabbed at the end of a shift.
- Pick the tool before the task. Check the mapping table so you don't complete a DOPS on an activity that doesn't permit it.
- Use CbD for the cases nobody could watch. It's the only retrospective tool, so it suits busy days or out-of-hours work.
- Keep a rolling tally of SLEs per activity so nothing is still at zero by week 26.
- Act on the feedback. If a mini-CEX picks up a gap, repeat the same type of activity later to show you've improved.
Tips for designated supervisors
Brief your practice supervisors on the tools and the standard you expect at each stage of the year. When you make a decision in front of your trainee, talk through why, so they see good practice in action.
Write specific feedback. "Good consultation" helps no one. Name what went well and one clear next step. Our guide to giving feedback to a foundation trainee has simple models you can use.
NHS England's indicative mapping tool is useful for checking which learning outcomes an activity is likely to cover. Treat it as a guide, not a rule. And at every progress review, look at the spread of SLEs, not just the count.
Common questions
Are SLEs pass or fail? No. They're formative, so they're about learning and feedback. Final sign-off by the DS is the summative decision.
How many SLEs does each observed clinical activity need? At least three, using the SLE tools permitted for that activity.
Can a pharmacy technician complete an SLE? Potentially, yes. Practice supervisors are usually registered healthcare professionals, and pharmacy technicians are registered, but the DS must be satisfied they're experienced and trained to assess that activity.
Which SLE isn't directly observed? Case-based discussion. It's a structured, retrospective discussion of a case the trainee managed.
Is the MRCF compulsory? No. It's one permitted tool for consultation activities, and NHS England allows other recognised consultation tools if the trainee has been briefed on them.
Plan your evidence early
Most portfolio stress comes from leaving SLEs too late or mapping them badly. Our Foundation Pharmacist Training Programme includes e-portfolio support and a 1:1 planning session where trainees build a year plan around their rota, with activity ideas and write-up guidance. We support designated supervisors through the year as well.
Explore our programme resources or see the programme plans.
Sources
- NHS England: Foundation Trainee Pharmacist Assessment Activities and Tools Guide 2025/26 (V1.2, July 2025)
- NHS England: practice-based assessment strategy, tools guide and indicative mapping
- NHS England: Practice-based Assessment Strategy 2025/26
- The Pharmaceutical Journal: creating effective assessment activities for foundation trainees
- NHS England South West bulletin, April 2026 (evidence targets)