Abstract
ObjectivesTo determine whether an app-based software system to support production and storage of assessment feedback summaries makes workplace-based assessment easier for clinical tutors and enhances the educational impact on medical students. MethodsWe monitored our workplace assessor app’s usage by Year 3 to 5 medical students in 2014-15 and conducted focus groups with Year 4 medical students and interviews with clinical tutors who had used the apps. Analysis was by constant comparison using a framework based on elements of van der Vleuten’s utility index. ResultsThe app may enhance the content of feedback for students. Using a screen may be distracting if the app is used during feedback discussions. Educational impact was reduced by students’ perceptions that an easy-to-produce feedback summary is less valuable than one requiring more tutor time and effort. Tutors’ typing, dictation skills and their familiarity with mobile devices varied. This influenced their willingness to use the assessment and feedback mobile app rather than the equivalent web app. Electronic feedback summaries had more real and perceived uses than anticipated both for tutors and students including perceptions that they were for the school rather than the student. ConclusionsElectronic workplace-based assessment systems can be acceptable to tutors and can make giving detailed written feedback more practical but can interrupt the social interaction required for the feedback conversation. Tutor training and flexible systems will be required to minimise unwanted consequences. The educational impact on both tutors and students of providing pre-formulated advice within the app is worth further study.
Highlights
Clinical tutors often have difficulty in providing feedback to their trainees because of time constraints
The challenge is to present this bank of strategies in a format which is accessible to busy clinicians, enhances the feedback conversation and enables the clinical tutor to add their own ideas
We developed an assessment tool (GeCoS – Generic Consultation Skills) which contains the 59 clinical encounter competencies expected of a graduating doctor in nine domains (Opening, History, Examination, Management, Clinical Reasoning, Building and maintaining the relationship, Organisation, Record Keeping and Case Presentation) which underpin our consultation skills curriculum
Summary
Clinical tutors (or preceptors) often have difficulty in providing feedback to their trainees because of time constraints. The design of workplace-based assessment (WBA) tools can result in a greater focus on assessment than on feedback even when the intention is formative.[1,2,3] One way to manage time pressure and to promote constructive feedback is to assist clinical tutors to scaffold learning for their trainees by providing pre-written strategies for use in the event of various possible predicted competency gaps.[4] The challenge is to present this bank of strategies in a format which is accessible to busy clinicians, enhances the feedback conversation and enables the clinical tutor to add their own ideas. A written summary of each feedback discussion is not essential but could enhance the value of the assessment by providing an aide memoire for reflection and subsequent discussion, as well as documenting that the process has taken place
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