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Work Place Based Assessment

Work Place Based Assessment. Dr Stephen Hailey. Aims. Why WPBA? A bit of theory Pros and cons What tools? When applied? How to apply them? A bit of practice. Miller’s Triangle. Pros: measuring actual performance. Assessing the unmeasurable?

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Work Place Based Assessment

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  1. Work Place Based Assessment Dr Stephen Hailey

  2. Aims • Why WPBA? • A bit of theory • Pros and cons • What tools? • When applied? • How to apply them? • A bit of practice....

  3. Miller’s Triangle

  4. Pros: measuring actual performance • Assessing the unmeasurable? • What doctors do in controlled assessment conditions does not always collate with actual performance. • Placing the assessment in the workplace helps to find out what a clinician actually DOES.

  5. Pros: High educational impact • Traditional assessments maximise reliability or reproducibility • Negative educational impact as no meaningful feedback • WPBA less reliable but can have high educational impact • Assessment is ‘built in’ rather than ‘bolt on’

  6. Pros: Multiple sampling • The more measurements you take the more reliable the overall picture • WPBA use multiple methods and multiple sampling

  7. Cons: poor reliability • Inter & Intra observer variability • Poor application of criteria • Poorly trained assessors • Poor calibration of assessors

  8. Cons: trainer vs. assessor

  9. Trainer vs. assessor • Potential for conflict of roles • Being assessed by someone who has a vested interest in your performance • It is vital that both trainer and the trainee understand the distinction of these roles • Assessment needs to clearly defined from teaching

  10. The tools • MSF • COT • Mini CEX • DOPs • CbD • PSQ • CSR

  11. ST1

  12. DOPS: Direct Observation of Procedural Skills There are eight mandatory procedures to be covered: • Application of simple dressing • Breast examination • Cervical cytology • Female genital examination • Male genital examination • Prostate examination • Rectal examination • Testing for blood glucose Some of these procedures may be combined e.g. prostate and rectal examinations

  13. Case Based Discussion • A structured interview designed to explore professional judgement exercised in clinical cases • GPStR is responsible for selecting cases • Ensure that a balance of cases

  14. CBD • ST1 and 2, the GPStR will select two cases • ST3, the GPStR will select four cases • Including all documentation • 1 week prior to discussion • Trainer will select cases to be discussed

  15. CBD • About 20min for each discussion with 10min feedback

  16. CBD • Important points • Selecting the cases • Quality of record keeping • Planning the questions • Documenting the outcomes • Structured feedback

  17. Consultation Observation Tool

  18. Multi-source feedback • The MSF highlights two things: • performance (areas to be commended) • possible suggested areas for development •  Need to do • 2 SETS OF 5 PER YEAR IN ST1 (clinicians only) • NONE IN ST2 • 2 SETS OF 10 in ST3 (5 clinicians and 5 non-clinicians)

  19. MSF and feedback • Preparation • ECO model • Specific • Describe not judge • Empathy

  20. Patient satisfaction questionnaire • 40 questionnaires • Inputted by practice • Results released to trainer • Shared in meeting with trainee • Feedback guidance applies

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