Assessing professional and clinical competence: the way forward^†

Abstract

Recent developments in postgraduate medical education for the training of junior doctors in the UK necessitate changes in all parts of the curriculum, including the assessment system. There is a move away from the limited, traditional one-off assessment towards multidimensional, broader assessments of a doctor's longer-term performance. This is accompanied by the rapid development of assessment tools, collectively termed workplace-based assessments, and is in keeping with an outcome-based approach to medical education and its increasing professionalisation. In addition to clinical skills, other aspects of being a good practitioner are being assessed, including team-working, working with colleagues and patients, probity and communication skills. Using a combination of tools gives the assessment process high validity. Of the many challenges posed by these changes is the need for data on their reliability in psychiatry. There must be a clear process for applying assessments, national standardisation and training for those using asessment tools.

Investigation of Clinical Medical Teachers’ Opinion about Validity-Feasibility of Clinical Assessment Tools in Medical Sciences Universities in Tehran

“…Also portfolio is often used to assess professional development (Michels, 2009). CSR is to evaluate the trainee's clinical decision-making, reasoning and application of medical knowledge with real patients and DOPS is appropriate for competencies patient care, professionalism, interpersonal skills, communication (Gigante & Swan, 2010) and anywhere practical skills are important (Brown & Doshi, 2006). The results of this study showed that Mini-CEX is the most suitable and the most feasible assessment tool for competencies "Interviewing" and "Develop & Carry out pt.…”

“…A multi-method assessment might include direct observation of the student interacting with several patients at different points during the rotation, a multiple-choice examination with both "key features" and "script-concordance" items to assess clinical reasoning, an encounter with a standardized patient followed by an oral examination to assess clinical skills in a standardized setting, written essays that would require literature searches and synthesis of the medical literature on the basic science or clinical aspects of one or more of the diseases the student encountered, and peer assessments to provide insights into interpersonal skills and work habits (Ronald & Epstein, 2007). Clearly, no single rating is able to provide the whole story about any doctor's ability to practice medicine, as this requires the demonstration of ongoing competence across a number of different general and specific areas (Brown & Doshi, 2006). Multiple assessment methods and multiple perspectives, however, provide rich data that support a resident's ability (or inability) to perform as a medical practitioner upon graduation and finally assessment results provide feedback to both the resident and faculty that the resident is making expected progress in achieving the knowledge, skills, and attitudes outlined by the objectives (Joyce, 2006).…”

“…Mini-CEX is the most feasible method, too and MSF is the most suitable method. Although Mini-CEX because of limitation to one patient and one assessor has limited genera-lisability, it makes a snapshot view for raters (Brown & Doshi, 2006) and it is feasible to use in an inpatient and outpatient medicine clerkship for formative assessment (Kogan et al, 2003). Besides the main strength of mini-CEX is its ability to provide immediate feedback, related to the task, from a knowledgeable assessor (Singh & Sharma, 2010).…”

“…Effective evaluation not only increases the students' motivation but also helps instructors to determine the strength or weakness of their educational activities for improvement of their performance (Baral & Paudel, 2007). And poorly selected assessment methods can lead to passive or rote learning (to get through an examination), which is associated with a rapid decay of knowledge and sometimes an inability to apply it in real situations (Brown & Doshi, 2006). Because of the importance of the topic research, we decided to assess the validity and feasibility of the medical student's assessment tools in view of Iranian academic clinical experts.…”

“…In addition, particularly for junior rotations, many institutions complement the subjective written evaluation of clinical ward performance with some form of cognitive evaluation (Colletti, 2000). Whereas for an assessment method to be acceptable, it needs to be valid, reliable, and practical and have a positive effect on a trainee's learning (Brown & Doshi, 2006). Effective evaluation not only increases the students' motivation but also helps instructors to determine the strength or weakness of their educational activities for improvement of their performance (Baral & Paudel, 2007).…”