Article
Pilot implementation of workplace based assessment in Switzerland: First results and challenges in postgraduate training
Search Medline for
Authors
Published: | May 5, 2009 |
---|
Outline
Poster
Questions: International experiences showed that workplace based assessment (WPBA) offers helpful tools - like the Mini Clinical Evaluation Exercises (Mini-CEX) and Direct Observations of Procedural Skills (DOPS) – to improve postgraduate medical education. In order to level the way for broader implementations of Mini-CEX and DOPS in Switzerland, a feasibility study based on volunteering hospitals was conducted to answer the following questions:
- 1.
- On which conditions are Mini-CEX and DOPS feasible in clinical routine?
- 2.
- How do trainees and teachers appreciate these two tools?
- 3.
- Which barriers have to be considered?
Methods: In 13 clinics from different specialties (4 surgery, 4 internal medicine, 2 ENT, 2 gynaecology, 1 psychiatry) the staff was trained to conduct Mini-CEX and/or DOPS. The training included a workshop at each clinic; additional written instructions and assessment forms were provided. It was recommended to perform 4 Mini-CEX/DOPS per trainee/year. Frequency of assessments and satisfaction of participants were evaluated and an online-survey among participants was conducted: Physicians from pilot clinics were asked to anonymously describe barriers and possible ways to enhance feasibility of WPBA in daily clinical routine. Quantitative data were analysed descriptively, qualitative data were interpreted according to the model of inductive category development (Mayring, 2005).
Results: Ten clinics returned WPBA-forms (206 Mini-CEX, 56 DOPS). In most clinics, it took several months to effectively start the process of WPBA. The participants rated their satisfaction as follows: trainees 6.8 ± 1.8 SD for Mini-CEX, 7.9 ± 1.8 for DOPS; teachers 6.9 ± 1.7 Mini-CEX, 7.6 ± 1.4 DOPS (1 = very low, 10 = highest satisfaction). In the two clinics, which participated for longer than 12 months in the pilot project 1/3 of the trainees took part in more than 1 Mini-CEX and 4% of the trainees were assessed at least 4 times. Participants pointed to specific organisational (e.g. presence of both trainee and teacher, work overload) or personal barriers (e.g. test anxiety, role confusion) and plead for a more structured organisation of assessments.
Conclusions: Workplace based assessment was generally feasible in clinics from varying specialties. It was appreciated by participating trainees and trainers alike. To fully exhaust the positive impact on postgraduate medical education, the assessment frequency has to rise. The discrepancy between the generally high satisfaction with the format and the low number of performed assessments might be explained and resolved if the formative assessment character of WPBA is communicated more clearly. In addition, a more structured approach to organise the assessments might also facilitate the routine conduction of Mini-CEX or DOPS in postgraduate medical education.