Advertisement

Advances in Health Sciences Education

, Volume 21, Issue 2, pp 455–473 | Cite as

Workplace-based assessment: a review of user perceptions and strategies to address the identified shortcomings

  • Jonathan Massie
  • Jason M. AliEmail author
Review

Abstract

Workplace based assessments (WBAs) are now commonplace in postgraduate medical training. User acceptability and engagement is essential to the success of any medical education innovation. To this end, possessing an insight into trainee and trainer perceptions towards WBAs will help identify the major problems, permitting strategies to be introduced to improve WBA implementation. A review of literature was performed to identify studies examining trainee and trainer perceptions towards WBAs. Studies were excluded if non-English or sampling a non-medical/dental population. The identified literature was synthesised for the purpose of this critical narrative review. It is clear that there is widespread negativity towards WBAs in the workplace. This has negatively impacted on the effectiveness of WBA tools as learning aids. This negativity exists in trainees but also to an extent in their trainers. Insight gained from the literature reveals three dominant problems with WBA implementation: poor understanding as to the purpose of WBAs; insufficient time available for undertaking these assessments; and inadequate training of trainers. Approaches to addressing these three problems with WBA implementation are discussed. It is likely that a variety of solutions will be required. The prevalence of negativity towards WBAs is substantial in both trainees and trainers, eroding the effectiveness of learning that is consequent upon them. The educational community must now listen to the concerns being raised by the users and consider the range of strategies being proposed to improve the experiences of trainees, and their trainers.

Keywords

Workplace based assessment Perceptions Engagement Trainers Trainees Implementation Supervised learning events WBAs SLEs 

References

  1. Academy of Medical Royal Colleges. (2009). Improving assessment. London: Academy of Medical Royal Colleges.Google Scholar
  2. Ali, J. M. (2013). Getting lost in translation? Workplace based assessments in surgical training. The Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland, 11(5), 286–289. doi: 10.1016/j.surge.2013.03.001.CrossRefGoogle Scholar
  3. Al-Kadri, H. M., Al-Kadi, M. T., & Van Der Vleuten, C. P. M. (2013). Workplace-based assessment and students’ approaches to learning: A qualitative inquiry. Medical Teacher, 35(Suppl 1), S31–S38. doi: 10.3109/0142159X.2013.765547.CrossRefGoogle Scholar
  4. Babu, K. S., Htike, M. M., & Cleak, V. E. (2009). Workplace-based assessments in Wessex: The first 6 months. Psychiatric Bulletin, 33(12), 474–478. doi: 10.1192/pb.bp.108.022889.CrossRefGoogle Scholar
  5. Barton, J. R., Corbett, S., & van der Vleuten, C. P. (2012). The validity and reliability of a direct observation of procedural skills assessment tool: Assessing colonoscopic skills of senior endoscopists. Gastrointestinal Endoscopy, 75(3), 591–597. doi: 10.1016/j.gie.2011.09.053.CrossRefGoogle Scholar
  6. Basu, I., Parvizi, S., & Chin, K. (2013). The perception of online work-based assessments. The Clinical Teacher, 10(2), 73–77. doi: 10.1111/j.1743-498X.2012.00609.x.CrossRefGoogle Scholar
  7. Beard, J. (2011). Workplace-based assessment: The need for continued evaluation and refinement. The Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland, 9(Suppl 1), S12–S13. doi: 10.1016/j.surge.2010.11.014.CrossRefGoogle Scholar
  8. Bindal, N., Goodyear, H., Bindal, T., & Wall, D. (2013). DOPS assessment: A study to evaluate the experience and opinions of trainees and assessors. Medical Teacher, 35(6), e1230–e1234. doi: 10.3109/0142159X.2012.746447.CrossRefGoogle Scholar
  9. Bindal, T., Wall, D., & Goodyear, H. M. (2011). Trainee doctors’ views on workplace-based assessments: Are they just a tick box exercise? Medical Teacher, 33(11), 919–927. doi: 10.3109/0142159X.2011.558140.CrossRefGoogle Scholar
  10. Bodle, J. F., Kaufmann, S. J., Bisson, D., Nathanson, B., & Binney, D. M. (2008). Value and face validity of objective structured assessment of technical skills (OSATS) for work based assessment of surgical skills in obstetrics and gynaecology. Medical Teacher, 30(2), 212–216. doi: 10.1080/01421590701881624.CrossRefGoogle Scholar
  11. Bok, H. G., Teunissen, P. W., & Favier, R. P. (2013). Programmatic assessment of competency-based workplace learning: When theory meets practice. BMC Medical Education, 13(1), 123. doi: 10.1186/1472-6920-13-123.CrossRefGoogle Scholar
  12. Canavan, C., Holtman, M. C., Richmond, M., & Katsufrakis, P. J. (2010). The quality of written comments on professional behaviors in a developmental multisource feedback program. Academic Medicine: Journal of the Association of American Medical Colleges, 85(10 Suppl), S106–S109. doi: 10.1097/ACM.0b013e3181ed4cdb.CrossRefGoogle Scholar
  13. Castanelli, D., & Kitto, S. (2011). Perceptions, attitudes, and beliefs of staff anaesthetists related to multi-source feedback used for their performance appraisal. British Journal of Anaesthesia, 107, 372–377. doi: 10.1093/bja/aer152.CrossRefGoogle Scholar
  14. Cho, S. P., Parry, D., & Wade, W. (2014). Lessons learnt from a pilot of assessment for learning. Clinical Medicine, 14(6), 577–584. doi: 10.7861/clinmedicine.14-6-577.CrossRefGoogle Scholar
  15. Cohen, S. N., Farrant, P. B. J., & Taibjee, S. M. (2009). Assessing the assessments: U.K. dermatology trainees’ views of the workplace assessment tools. The British Journal of Dermatology, 161(1), 34–39. doi: 10.1111/j.1365-2133.2009.09097.x.CrossRefGoogle Scholar
  16. Collins, J. (2010). Foundation for excellence: An evaluation of the foundation programme. London: Medical Education England.Google Scholar
  17. Dean, B. J. F., & Duggleby, P. M. (2013). Foundation doctors’ experience of their training: A questionnaire study. JRSM Short Reports, 4(1), 5. doi: 10.1258/shorts.2012.012095.CrossRefGoogle Scholar
  18. Dijksterhuis, M. G. K., Schuwirth, L. W. T., Braat, D. D. M., Teunissen, P. W., & Scheele, F. (2013). A qualitative study on trainees’ and supervisors’ perceptions of assessment for learning in postgraduate medical education. Medical Teacher, 35(8), e1396–e1402. doi: 10.3109/0142159X.2012.756576.CrossRefGoogle Scholar
  19. Eraut, M. (2005). Mapping the problems facing the new surgical curriculum. Bulletin of the Royal College of Surgeons of England, 87(7), 230–235. doi: 10.1308/147363505X53558.CrossRefGoogle Scholar
  20. Finall, A. (2012). Trainers’ perceptions of the direct observation of practical skills assessment in histopathology training: A qualitative pilot study. Journal of Clinical Pathology, 65, 538–540. doi: 10.1136/jclinpath-2012-200682.CrossRefGoogle Scholar
  21. Fokkema, J. P. I., Scheele, F., Westerman, M., van Exel, J., Scherpbier, A. J. J. A., van der Vleuten, C. P. M., et al. (2014). Perceived effects of innovations in postgraduate medical education: AQ study focusing on workplace-based assessment. Academic Medicine: Journal of the Association of American Medical Colleges, 89(9), 1259–1266. doi: 10.1097/ACM.0000000000000394.CrossRefGoogle Scholar
  22. Fokkema, J. P. I., Teunissen, P. W., Westerman, M., van der Lee, N., van der Vleuten, C. P. M., Scherpbier, A. J. J., et al. (2013). Exploration of perceived effects of innovations in postgraduate medical education. Medical Education, 47, 271–281. doi: 10.1111/medu.12081.CrossRefGoogle Scholar
  23. General Medical Council. (2010). Workplace based assessment: A guide for implementation. London: GMC.Google Scholar
  24. General Medical Council. (2011). National trainer survey 2011. http://www.gmc-uk.org/education/national_summary_reports.asp
  25. Goodyear, H., Wall, D., & Bindal, T. (2013). Annual review of competence: Trainees’ perspective. The Clinical Teacher, 10(6), 394–398. doi: 10.1111/tct.12040.CrossRefGoogle Scholar
  26. Grieveson, B., Kirton, J. A., Palmer, N. O. A., & Balmer, M. C. (2011). Evaluation of workplace based assessment tools in dental foundation training. British Dental Journal, 211(4), E8. doi: 10.1038/sj.bdj.2011.681.CrossRefGoogle Scholar
  27. Hattie, J., & Timperley, H. (2007). The power of feedback. Review of Educational Research, 77(1), 81–112. doi: 10.3102/003465430298487.CrossRefGoogle Scholar
  28. Holmboe, E. S. (2004). Faculty and the observation of trainees’ clinical skills: Problems and opportunities. Academic Medicine: Journal of the Association of American Medical Colleges, 79(1), 16–22.CrossRefGoogle Scholar
  29. Hrisos, S., Illing, J. C., & Burford, B. C. (2008). Portfolio learning for foundation doctors: Early feedback on its use in the clinical workplace. Medical Education, 42(2), 214–223. doi: 10.1111/j.1365-2923.2007.02960.x.CrossRefGoogle Scholar
  30. Jenkins, L., Mash, B., & Derese, A. (2013). The national portfolio of learning for postgraduate family medicine training in South Africa: Experiences of registrars and supervisors in clinical practice. BMC Medical Education, 13, 149. doi: 10.1186/1472-6920-13-149.CrossRefGoogle Scholar
  31. Julyan, T. E. (2009). Educational supervision and the impact of workplace-based assessments: A survey of psychiatry trainees and their supervisors. BMC Medical Education, 9, 51. doi: 10.1186/1472-6920-9-51.CrossRefGoogle Scholar
  32. Jyothirmayi, R. (2012). Case-based discussion: Assessment tool or teaching aid? Clinical Oncology, 24(10), 649–653. doi: 10.1016/j.clon.2012.07.008.CrossRefGoogle Scholar
  33. Kessel, D., Jenkins, J., & Neville, E. (2012). Workplace based assessments are no more. BMJ Careers. http://careers.bmj.com/careers/advice/view-article.html?id=20009002. Accessed 20 Aug 2014.
  34. Kirton, J., Palmer, N., Grieveson, B., & Balmer, M. (2013). A national evaluation of workplace-based assessment tools (WPBAs) in foundation dental training: A UK study. Effective and useful but do they provide an equitable. British Dental Journal, 214(6), 305–309. doi: 10.1038/sj.bdj.2013.302.CrossRefGoogle Scholar
  35. Marriott, J., Purdie, H., Crossley, J., & Beard, J. D. (2011). Evaluation of procedure-based assessment for assessing trainees’ skills in the operating theatre. The British Journal of Surgery, 98(3), 450–457. doi: 10.1002/bjs.7342.CrossRefGoogle Scholar
  36. McKavanagh, P., Smyth, A., & Carragher, A. (2012). Hospital consultants and workplace based assessments: How foundation doctors view these educational interactions? Postgraduate Medical Journal, 88(1037), 119–124. doi: 10.1136/postgradmedj-2011-130121.CrossRefGoogle Scholar
  37. Mehta, F., Brown, J., & Shaw, N. J. (2013). Do trainees value feedback in case-based discussion assessments? Medical Teacher, 35(5), e1166–e1172. doi: 10.3109/0142159X.2012.731100.CrossRefGoogle Scholar
  38. Miller, G. E. (1990). The assessment of clinical skills/competence/performance. Academic Medicine: Journal of the Association of American Medical Colleges, 65(9 Suppl), S63–S67.CrossRefGoogle Scholar
  39. Miller, A., & Archer, J. (2010). Impact of workplace based assessment on doctors’ education and performance: A systematic review. BMJ (Clinical Research Ed.), 341, c5064. doi: 10.1136/bmj.c5064.CrossRefGoogle Scholar
  40. Mitchell, C., Bhat, S., Herbert, A., & Baker, P. (2011). Workplace-based assessments of junior doctors: Do scores predict training difficulties? Medical Education, 45(12), 1190–1198. doi: 10.1111/j.1365-2923.2011.04056.x.CrossRefGoogle Scholar
  41. Nesbitt, A., Baird, F., Canning, B., Griffin, A., & Sturrock, A. (2013). Student perception of workplace-based assessment. The Clinical Teacher, 10(6), 399–404. doi: 10.1111/tct.12057.CrossRefGoogle Scholar
  42. Norcini, J. (2003). Peer assessment of competence. Medical Education, 37(6), 539–543.CrossRefGoogle Scholar
  43. Norcini, J., & Burch, V. (2007). Workplace-based assessment as an educational tool: AMEE Guide No. 31. Medical Teacher, 29(9), 855–871. doi: 10.1080/01421590701775453.CrossRefGoogle Scholar
  44. Olupeliyawa, A. M., O’Sullivan, A. J., Hughes, C., & Balasooriya, C. D. (2014). The teamwork mini-clinical evaluation exercise (T-MEX): A workplace-based assessment focusing on collaborative competencies in health care. Academic Medicine, 89(2), 359–365. doi: 10.1097/acm.0000000000000115.CrossRefGoogle Scholar
  45. Pelgrim, E., Kramer, A., Mokkink, H., & van der Vleuten, C. (2012). The process of feedback in workplace-based assessment: Organisation, delivery, continuity. Medical Education, 46(6), 604–612. doi: 10.1111/j.1365-2923.2012.04266.x.CrossRefGoogle Scholar
  46. Pentlow, A. (2013). Workplace-based assessments in surgery: Are we heading in the wrong direction? Medical Teacher, 35(1), 80. doi: 10.3109/0142159X.2012.716561.CrossRefGoogle Scholar
  47. Pereira, E. A. C., & Dean, B. J. F. (2009). British surgeons’ experiences of mandatory online workplace-based assessment. Journal of the Royal Society of Medicine, 102(7), 287–293. doi: 10.1258/jrsm.2009.080398.CrossRefGoogle Scholar
  48. Pereira, E. A. C., & Dean, B. J. F. (2012). British surgeons’ experiences of a mandatory online workplace based assessment portfolio resurveyed three years on. Journal of Surgical Education, 70(1), 59–67. doi: 10.1016/j.jsurg.2012.06.019.CrossRefGoogle Scholar
  49. Powell, H., DiMarco, A., & Saeed, S. (2014). Trainee and trainer opinion on increasing numbers of workplace-based assessments. Bulletin of the Royal College of Surgeons of England, 96(5), 160–162.CrossRefGoogle Scholar
  50. Rauf, S., Aurangzeb, W., Abbas, S., & Sadiq, N. (2011). Work place based assessment in foundation year: Foundation University Medical College experience. Journal of Ayub Medical College, Abbottabad: JAMC, 23(4), 76–79.Google Scholar
  51. Rees, C. E., Cleland, J. A., Dennis, A., Kelly, N., Mattick, K., & Monrouxe, L. V. (2014). Supervised learning events in the foundation programme: A UK-wide narrative interview study. BMJ Open, 4(10), e005980. doi: 10.1136/bmjopen-2014-005980.CrossRefGoogle Scholar
  52. Royal College of Physicians. (2014). Evaluation of workplace-based assessment pilot. http://openurl.ingenta.com/content/xref?genre=article&issn=1473-6357&volume=93&issue=10&spage=1.
  53. Sabey, A., & Harris, M. (2011). Training in hospitals: What do GP specialist trainees think of workplace-based assessments? Education for Primary Care: An Official Publication of the Association of Course Organisers, National Association of GP Tutors, World Organisation of Family Doctors, 22(2), 90–99.CrossRefGoogle Scholar
  54. Saedon, H., Saedon, M. H. M., & Aggarwal, S. P. (2010). Workplace-based assessment as an educational tool: Guide supplement 31.3-viewpoint. Medical Teacher, 32(9), e369–e372. doi: 10.3109/01421590903548547.CrossRefGoogle Scholar
  55. Saedon, H., Salleh, S., Balakrishnan, A., Imray, C. H. E., & Saedon, M. (2012). The role of feedback in improving the effectiveness of workplace based assessments: A systematic review. BMC Medical Education, 12(1), 25. doi: 10.1186/1472-6920-12-25.CrossRefGoogle Scholar
  56. Sandhu, R. S., Ong, B. N., Cooper, V., & Hassell, A. B. (2010). Attitudes and perceptions of rheumatologists regarding consultation skills training for specialist trainees: A qualitative study. Clinical Medicine (London, England), 10(1), 8–12.CrossRefGoogle Scholar
  57. Shalhoub, J., Vesey, A. T., & Fitzgerald, J. E. F. (2014). What evidence is there for the use of workplace-based assessment in surgical training? Journal of Surgical Education,. doi: 10.1016/j.jsurg.2014.03.013.Google Scholar
  58. Simmons, M. (2013). How are workplace-based assessments viewed by UK psychiatry trainees? Psychiatria Danubina, 25(Suppl 2), S182–S184.Google Scholar
  59. Tailor, A., Dubrey, S., & Das, S. (2014). Opinions of the ePortfolio and workplace-based assessments: A survey of core medical trainees and their supervisors. Clinical Medicine (London, England), 14(5), 510–516. doi: 10.7861/clinmedicine.14-5-510.CrossRefGoogle Scholar
  60. Torre, D. M., Simpson, D. E., Elnicki, D. M., Sebastian, J. L., & Holmboe, E. S. (2007). Feasibility, reliability and user satisfaction with a PDA-based mini-CEX to evaluate the clinical skills of third-year medical students. Teaching and Learning in Medicine, 19(3), 271–277. doi: 10.1080/10401330701366622.CrossRefGoogle Scholar
  61. Tsagkataki, M., & Choudhary, A. (2013). Mersey deanery ophthalmology trainees’ views of the objective assessment of surgical and technical skills (OSATS) workplace-based assessment tool. Perspectives on Medical Education, 2(1), 21–27. doi: 10.1007/s40037-013-0041-8.CrossRefGoogle Scholar
  62. UK Committee of Postgraduate Dental Deans and Directors. (2012). Quality development of postgraduate dental training in the UK 2012. UK Committee of Postgraduate Dental Deans and Directors. http://www.copdend.org/content.aspx?Group=guidance&Page=guidance_qualitydevelopmentofpostgraduatedentaltrainingintheuk2012
  63. UK Foundation Programme Office. (2014). The UK foundation programme curriculum. http://www.foundationprogramme.nhs.uk/pages/home/curriculum-and-assessment/curriculum2012
  64. Van Oers, B. (1998). From context to contextualizing. Learning and Instruction, 8(6), 473–488. doi: 10.1016/S0959-4752(98)00031-0.CrossRefGoogle Scholar
  65. Veloski, J., Boex, J. R., Grasberger, M. J., Evans, A., & Wolfson, D. B. (2006). Systematic review of the literature on assessment, feedback and physicians’ clinical performance: BEME Guide No. 7. Medical Teacher, 28(2), 117–128. doi: 10.1080/01421590600622665.CrossRefGoogle Scholar
  66. Watling, C., Driessen, E., van der Vleuten, C. P. M., & Lingard, L. (2012). Learning from clinical work: The roles of learning cues and credibility judgements. Medical Education, 46(2), 192–200. doi: 10.1111/j.1365-2923.2011.04126.x.CrossRefGoogle Scholar
  67. Weller, J. M., Jolly, B., Misur, M. P., Merry, A. F., Jones, A., Crossley, J. G. M., et al. (2009). Mini-clinical evaluation exercise in anaesthesia training. British Journal of Anaesthesia, 102(5), 633–641. doi: 10.1093/bja/aep055.CrossRefGoogle Scholar
  68. Weston, P. S. J., & Smith, C. A. (2014). The use of mini-CEX in UK foundation training six years following its introduction: Lessons still to be learned and the benefit of formal teaching regarding its utility. Medical Teacher, 36(2), 155–163. doi: 10.3109/0142159X.2013.836267.CrossRefGoogle Scholar
  69. Wilkinson, J. R., Crossley, J. G. M., Wragg, A., Mills, P., Cowan, G., & Wade, W. (2008). Implementing workplace-based assessment across the medical specialties in the United Kingdom. Medical Education, 42(4), 364–373. doi: 10.1111/j.1365-2923.2008.03010.x.CrossRefGoogle Scholar
  70. Wood, L., Wall, D., Bullock, A., Hassell, A., Whitehouse, A., & Campbell, I. (2006). “Team observation”: A six-year study of the development and use of multi-source feedback (360-degree assessment) in obstetrics and gynaecology training in the UK. Medical Teacher, 28(7), e177–e184. doi: 10.1080/01421590600834260.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  1. 1.School of Clinical MedicineUniversity of CambridgeCambridgeUK
  2. 2.Department of SurgeryUniversity of CambridgeCambridgeUK

Personalised recommendations