Abstract:WBAs provide trainees with a justified reason to approach trainers for feedback. WBAs, however, are not being reified as the formative assessments originally intended. A culture change may be required to change the focus of WBA research and reconceptualise this set of tools and methods as a workplace learning .
“…Some trainees noted that assessors might concentrate on unrepresentative episodes or be “deficit‐focused”, noting that feedback delivered poorly can be ‘demotivating’ and, if too negative, counterproductive …”
Section: Resultsmentioning
confidence: 99%
“…These perspectives led to a view of such assessments as ‘form‐filling’ or ‘tick‐box’ initiatives:Now it is just so people can tick the boxes. The inspiration and pride in our profession has gone.…”
Section: Resultsmentioning
confidence: 99%
“…The lack of engagement, in part related to ongoing resentment at their being ‘dropped on trainees and [assessors]’, may be reduced by reorientation to the assessments, with the close involvement of trainees and assessors. This should include gaining their input in defining the purpose of the assessment in each training context and so minimise a tick‐box view of them . Addressing trainee desires for written and verbal comments on their performance and increasing emphasis on constructive comments is important, and others have also reported that feedback is often lacking .…”
Objectives
This study was designed as a narrative systematic literature review of medical specialist trainees’ perspectives of the assessment messages they receive in the context of clinical performance assessments. The aim of the study was to determine if trainees value the information they receive through the formats designed to promote their development and, if not, the reasons for this.
Methods
The authors searched the ERIC, EMBASE, Ovid MEDLINE and PsycINFO databases for articles published up to 16 June 2018 that present original data on trainees’ perspectives of the assessment messages they receive in the context of work‐based assessments (WBAs) and in‐training assessments (ITAs) used within their training programmes. All authors screened 938 abstracts and 139 full‐text articles were assessed after this. Descriptions of quantitative data and thematic analysis of qualitative data were used to present the opinions of trainees.
Results
Thirty‐three articles met the inclusion criteria. Twenty‐six articles (79%) described trainees’ perspectives in the context of WBA and the remaining articles referred to ITA formats. Wide‐ranging opinions were reported. The analysis categorised these into three themes: trainees value developmental assessment messages; trainees become disengaged when assessment messages are not developmental, and trainees’ views depend on the environment, the assessor and themselves. Some trainees reported that the assessment messages were valuable and provided input on their performance to guide their development, but many disagreed. In particular, the trainee's own level of engagement with the assessments influenced his or her perspectives on the messages received.
Conclusions
Trainees do not universally perceive that clinical performance assessments provide them with the valuable developmental input on their performance they were designed to do. Factors related to the environment, the assessor and themselves influence their perspectives.
“…Some trainees noted that assessors might concentrate on unrepresentative episodes or be “deficit‐focused”, noting that feedback delivered poorly can be ‘demotivating’ and, if too negative, counterproductive …”
Section: Resultsmentioning
confidence: 99%
“…These perspectives led to a view of such assessments as ‘form‐filling’ or ‘tick‐box’ initiatives:Now it is just so people can tick the boxes. The inspiration and pride in our profession has gone.…”
Section: Resultsmentioning
confidence: 99%
“…The lack of engagement, in part related to ongoing resentment at their being ‘dropped on trainees and [assessors]’, may be reduced by reorientation to the assessments, with the close involvement of trainees and assessors. This should include gaining their input in defining the purpose of the assessment in each training context and so minimise a tick‐box view of them . Addressing trainee desires for written and verbal comments on their performance and increasing emphasis on constructive comments is important, and others have also reported that feedback is often lacking .…”
Objectives
This study was designed as a narrative systematic literature review of medical specialist trainees’ perspectives of the assessment messages they receive in the context of clinical performance assessments. The aim of the study was to determine if trainees value the information they receive through the formats designed to promote their development and, if not, the reasons for this.
Methods
The authors searched the ERIC, EMBASE, Ovid MEDLINE and PsycINFO databases for articles published up to 16 June 2018 that present original data on trainees’ perspectives of the assessment messages they receive in the context of work‐based assessments (WBAs) and in‐training assessments (ITAs) used within their training programmes. All authors screened 938 abstracts and 139 full‐text articles were assessed after this. Descriptions of quantitative data and thematic analysis of qualitative data were used to present the opinions of trainees.
Results
Thirty‐three articles met the inclusion criteria. Twenty‐six articles (79%) described trainees’ perspectives in the context of WBA and the remaining articles referred to ITA formats. Wide‐ranging opinions were reported. The analysis categorised these into three themes: trainees value developmental assessment messages; trainees become disengaged when assessment messages are not developmental, and trainees’ views depend on the environment, the assessor and themselves. Some trainees reported that the assessment messages were valuable and provided input on their performance to guide their development, but many disagreed. In particular, the trainee's own level of engagement with the assessments influenced his or her perspectives on the messages received.
Conclusions
Trainees do not universally perceive that clinical performance assessments provide them with the valuable developmental input on their performance they were designed to do. Factors related to the environment, the assessor and themselves influence their perspectives.
“…There are a number of important considerations for organisations when planning to introduce WPBA. The challenges undermining the effectiveness of WPBA are more often associated with implementation than with tool design …”
Section: Wpba At the Organisational Levelmentioning
“…Others report that using WBA (mini‐CEX) had a profoundly negative effect on learning communication skills, in part because of a lack of alignment between trainees’ learning goals and feedback received. In another study trainees described that feedback from WBA was beneficial for learning in theory rather than in practice …”
Trainees' perceptions of the purpose of WBA and their relationship with their trainer informed when they chose to seek feedback. Trainees who perceived WBA as a test were led to 'play the game' by seeking positive and avoiding negative feedback. Outside of WBA, trainees sought negative feedback, which was most important for change in practice.
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