Profiling postgraduate workplace-based assessment implementation in Ireland: a retrospective cohort study.

Albert Scherpbier,Yvonne Steinert,Gillian Walsh,Ann O’Shaughnessy,Aileen Barrett,Rose Galvin,Mary Horgan

doi:10.1186/s40064-016-1748-x

Abstract

In 2010, workplace-based assessment (WBA) was formally integrated as a method of formative trainee assessment into 29 basic and higher specialist medical training (BST/HST) programmes in six postgraduate training bodies in Ireland. The aim of this study is to explore how WBA is being implemented and to examine if WBA is being used formatively as originally intended. A retrospective cohort study was conducted and approved by the institution’s Research Ethics Committee. A profile of WBA requirements was obtained from 29 training programme curricula. A data extraction tool was developed to extract anonymous data, including written feedback and timing of assessments, from Year 1 and 2 trainee ePortfolios in 2012–2013. Data were independently quality assessed and compared to the reference standard number of assessments mandated annually where relevant. All 29 training programmes mandated the inclusion of at least one case-based discussion (max = 5; range 1–5). All except two non-clinical programmes (93 %) required at least two mini-Clinical Evaluation Exercise assessments per year and Direct Observation of Procedural Skills assessments were mandated in 27 training programmes over the course of the programme. WBA data were extracted from 50 % of randomly selected BST ePortfolios in four programmes (n = 142) and 70 % of HST ePortfolios (n = 115) in 21 programmes registered for 2012–2013. Four programmes did not have an eligible trainee for that academic year. In total, 1142 WBAs were analysed. A total of 164 trainees (63.8 %) had completed at least one WBA. The average number of WBAs completed by HST trainees was 7.75 (SD 5.8; 95 % CI 6.5–8.9; range 1–34). BST trainees completed an average of 6.1 assessments (SD 9.3; 95 % CI 4.01–8.19; range 1–76). Feedback—of varied length and quality—was provided on 44.9 % of assessments. The majority of WBAs were completed in the second half of the year. There is significant heterogeneity with respect to the frequency and quality of feedback provided during WBAs. The completion of WBAs later in the year may limit available time for feedback, performance improvement and re-evaluation. This study sets the scene for further work to explore the value of formative assessment in postgraduate medical education.

Highlights

Workplace-based assessment (WBA) was originally mooted as a formative—or ‘assessment-for-learning’— practice with a primary aim of impacting trainee learning and development and to assist in focusing the trainee’sOver time, the use of WBA has expanded to include a quality assurance role (Black and Welch 2009) and has been mooted as a method of early identification of poor performance (Cohen et al 2009)
Data were extracted from a random selection of 50 % of Basic Specialist Training (BST) ePortfolios in four programmes (n = 142) and 70 % of Higher Specialist Training (HST) ePortfolios (n = 115) in 21 programmes registered for 2012–2013
WBA programme integration profile All 29 programme curricula mandated at least one case-based discussion (CbD) annually

Summary

Introduction

Workplace-based assessment (WBA) was originally mooted as a formative—or ‘assessment-for-learning’— practice with a primary aim of impacting trainee learning and development and to assist in focusing the trainee’sOver time, the use of WBA has expanded to include a quality assurance role (Black and Welch 2009) and has been mooted as a method of early identification of poor performance (Cohen et al 2009). Workplace-based assessment (WBA) was originally mooted as a formative—or ‘assessment-for-learning’— practice with a primary aim of impacting trainee learning and development and to assist in focusing the trainee’s. Barrett et al SpringerPlus (2016) 5:133 of success and acceptability (Fokkema et al 2013) with many ongoing reservations regarding the practical feasibility of performing multiple assessments in order to comply with recommendations for good reliability while attempting to maintain the formative function of these assessments (Bok et al 2013). Poor communication of the formative purpose of WBA has emerged as a critical barrier to successful implementation of these tools (Bok et al 2013). Attempts to communicate the formative nature of the assessments in the UK by changing the name to ‘supervised learning events’ have been met with mixed opinions (Ali 2014)

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