Abstract
ObjectivesThe purpose of this study was to explore residents' and assessors' perception of a new group assessment concept. MethodsThis qualitative study consists of observations of four group assessment sessions, followed by semi-structured interviews with six residents and four assessors (specialists in internal medicine), who all volunteered to be interviewed. All residents at a medical department (eleven to fifteen each time) and four assessors participated in four group assessments, where the residents' clinical skills were assessed through case-based discussions. An external consultant (an anthropologist) performed the observations and the interviews. Notes from the observations and the interviews were analyzed using an inductive approach. ResultsEight of the ten interviewed participants preferred group assessment to individual assessment. Results from the interviews suggested that the group assessments were more consistent and that the level of discussion was perceived to be higher in the group discussions compared to the one-to-one discussions. All residents indicated that they had acquired new knowledge during their assessment and reported having learned from listening to the assessment of their peers. Assessors similarly reported gaining new knowledge. ConclusionsThe residents and assessors expressed very favourable attitudes toward the new group assessment concept. The assessment process was perceived to be higher in quality and more consistent, contributing to learning for all participating doctors in the department. Group assessment is feasible and acceptable, and provides a promising tool for assessment of clinical skills in the future.
Highlights
The assessors were active to varying degrees, especially with respect to follow-up questions for assessment of satisfactory clinical competencies of the resident, suggesting a different understanding of the role of assessor, which was confirmed during the interviews
Discussions among the assessors regarding whether or not a resident had the necessary competence to get approval contributed to the assessor's knowledge and skills as assessors and led to a common understanding of the concept of case-based discussions (CbDs), and how it was to be used in this specific department
The group assessment concept seems to offer an acceptable, feasible and efficient model for CbD used as a formative assessment of residents' competences in internal medicine
Summary
Along with the implementation of competency-based education, workplace-based assessment (WPBA) has been widely adopted in many countries.[1,2,3,4] the validity and reliability of WPBA methods has been discussed, evidence for their utility seems well-established for a number of assessment methods including case-based discussions (CbDs).[5,6,7,8] Case-based discussions are well suited to assess trainees' clinical reasoning, decision-making and application of medical knowledge in patient care.[6,7,8,9] The assessments contribute to learning, especially if the assessments include formative feedback.[8,10] many specialties have included CbD in their assessment program.[5,7,8,11]The validity of WPBAs, including CbDs, is increased by choosing assessors who are most fit to judge the performance[12]; their value depends on trainer enthusiasm[13,14] and the training of the assessors.[15,16,17,18,19,20,21] Assessor training is especially important for the assessment to be perceived as more than a tick-box exercise by both trainees and assessors.[6,7,14,15,22,23] The reliability of CbD increases with the number of assessments and assessors involved.[5,24] the involvement of multiple assessors may lead to fairer assessment, due to decreased risk of bias that could be caused by personal relations.[16].
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