Joining the dots: Conditional pass and programmatic assessment enhances recognition of problems with professionalism and factors hampering student progress

Abstract

BackgroundProgrammatic assessment that looks across a whole year may contribute to better decisions compared with those made from isolated assessments alone. The aim of this study is to describe and evaluate a programmatic system to handle student assessment results that is aligned not only with learning and remediation, but also with defensibility. The key components are standards based assessments, use of "Conditional Pass", and regular progress meetings.MethodsThe new assessment system is described. The evaluation is based on years 4-6 of a 6-year medical course. The types of concerns staff had about students were clustered into themes alongside any interventions and outcomes for the students concerned. The likelihoods of passing the year according to type of problem were compared before and after phasing in of the new assessment system.ResultsThe new system was phased in over four years. In the fourth year of implementation 701 students had 3539 assessment results, of which 4.1% were Conditional Pass. More in-depth analysis for 1516 results available from 447 students revealed the odds ratio (95% confidence intervals) for failure was highest for students with problems identified in more than one part of the course (18.8 (7.7-46.2) p < 0.0001) or with problems with professionalism (17.2 (9.1-33.3) p < 0.0001). The odds ratio for failure was lowest for problems with assignments (0.7 (0.1-5.2) NS). Compared with the previous system, more students failed the year under the new system on the basis of performance during the year (20 or 4.5% compared with four or 1.1% under the previous system (p < 0.01)).ConclusionsThe new system detects more students in difficulty and has resulted in less "failure to fail". The requirement to state conditions required to pass has contributed to a paper trail that should improve defensibility. Most importantly it has helped detect and act on some of the more difficult areas to assess such as professionalism.

Struggle and failure on clinical placement: a critical narrative review

“…, Garrud and Yates , Yates , Yates and James , , Wilkinson et al . , Cleland et al . , Corcoran et al .…”

Medical school benchmarking – From tools to programmes

“…To rebalance these effects, more programmatic approaches have been developed and successfully implemented. These programmatic approaches use a suite of assessment tools over time to provide a more comprehensive picture of competence, carefully balancing formative and summative, and quantitative and qualitative assessments (van der Vleuten & Schuwirth 2005;Wilkinson et al 2011). The choice of tools is made by deliberately considering validity, reliability, feasibility, acceptability, and educational impact (van der Vleuten 1996), and thus their contributions to the purpose of the whole assessment programme.…”

A Review of the Medical Education Literature for Graduate Medical Education Teachers

“…From this group, we selected a final list of 12 articles. [1][2][3][4][5][6][7][8][9][10][11][12] A search of the National Library of Medicine's PubMed database yielded 97 articles, none of which were selected for this review from our perceptions of their relevance and quality after reading the title and abstract. The 12 chosen articles were grouped into 4 themes, shown in T A B L E 2 , and are presented below.…”

“…This study from New Zealand describes the impact of a new grade of ''conditional pass'' to replace ''borderline'' in the evaluation structure for medical students. 3 Students receiving conditional pass were given information about specific steps for converting this standing to ''pass after conditions met.'' Course directors met regularly with the dean and associate dean for student affairs and fed forward information about student progress.…”