Abstract
BackgroundWorkplace-based formative assessments using consultation observation are currently conducted during the Australian general practice training program. Assessment reliability is improved by using multiple assessment methods. The aim of this study was to explore experiences of general practice medical educator assessors and registrars (trainees) when adding random case analysis to direct observation (ARCADO) during formative workplace-based assessments.MethodsA sample of general practice medical educators and matched registrars were recruited. Following the ARCADO workplace assessment, semi-structured qualitative interviews were conducted. The data was analysed thematically.ResultsTen registrars and eight medical educators participated. Four major themes emerged - formative versus summative assessment; strengths (acceptability, flexibility, time efficiency, complementarity and authenticity); weaknesses (reduced observation and integrity risks); and contextual factors (variation in assessment content, assessment timing, registrar-medical educator relationship, medical educator’s approach and registrar ability).ConclusionARCADO is a well-accepted workplace-based formative assessment perceived by registrars and assessors to be valid and flexible. The use of ARCADO enabled complementary insights that would not have been achieved with direct observation alone. Whilst there are some contextual factors to be considered in its implementation, ARCADO appears to have utility as formative assessment and, subject to further evaluation, high-stakes assessment.
Highlights
Workplace-based formative assessments using consultation observation are currently conducted during the Australian general practice training program
Two medical educators were interviewed twice resulting in ten external clinical teaching visit (ECTV) adding random case analysis to direct observation (ARCADO) assessments of 10 registrar participants
We have found that the addition of random case analysis (RCA) to direct observation (DO) of consultations is acceptable to both general practice (GP) registrars and medical educator visitors
Summary
Workplace-based formative assessments using consultation observation are currently conducted during the Australian general practice training program. The aim of this study was to explore experiences of general practice medical educator assessors and registrars (trainees) when adding random case analysis to direct observation (ARCADO) during formative workplace-based assessments. Over the last 40 years there has been a shift to competency-based medical education [1] This has been accompanied by new assessment principles and the increasing use of formative assessment and workplace-based assessment [2]. A master plan, or blueprint, should be used that matches assessments against desired outcomes [4]. This purposeful approach improves the overall validity of the assessment program [5]. Overall reliability is increased by using multiple assessment methods [6]
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