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Discordance Persists Between Trainers’ and Trainees’ Perceptions of Workplace-Based Assessment

Ali, Jason M. MB BChir, MA (Med Ed), MRCS

doi: 10.1097/ACM.0000000000000746
Letters to the Editor

Academic clinical fellow, Department of Surgery, University of Cambridge, Cambridge, United Kingdom;

Disclosures: None reported.

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To the Editor:

I read with great interest the recent article by Fokkema and colleagues.1 It is remarkable to see participants—both trainees and trainers—continuing to demonstrate perceptions as disparate as “enthusiasm” and “skepticism” towards workplace-based assessment (WBA) tools, which are now widely integrated in postgraduate medical training. I found it particularly intriguing that, of those 11 participants who demonstrated “enthusiasm,” 10 were trainers. This is in keeping with other literature comparing trainer and trainee perceptions that have identified trainers, in general, to be more positive than trainees towards WBAs.2–4 It was also interesting to note that none of the five viewpoints described demonstrated overall agreement with the statement “WBAs tally with my own ideas about what education should be like.” This work highlights the ongoing discordance between trainees and trainers as to the value of WBAs towards postgraduate training. If trainees don’t “buy in” to the process of WBA, this will only perpetuate the misuse that is reportedly widespread in the workplace.5

A lack of understanding of the purpose and aims of WBAs is thought to underlie trainees’ prevalent negative perceptions. Indeed, there are a number of approaches being introduced in an attempt to improve trainee understanding of WBAs. For example, it has been proposed to rebrand WBAs as “supervised learning events” so as to emphasize their formative intent.6

Perhaps experience with WBAs highlights the importance of providing comprehensive instruction to trainees, ensuring full understanding, to maximize engagement when considering implementing future innovations in medical education.

Jason M. Ali, MB BChir, MA (Med Ed), MRCS

Academic clinical fellow, Department of Surgery, University of Cambridge, Cambridge, United Kingdom;

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1. Fokkema JP, Scheele F, Westerman M, et al. Perceived effects of innovations in postgraduate medical education: A Q study focusing on workplace-based assessment. Acad Med. 2014;89:1259–1266
2. Basu I, Parvizi S, Chin K.. The perception of online work-based assessments. Clin Teach. 2013;10:73–77
3. Bodle JF, Kaufmann SJ, Bisson D, Nathanson B, Binney DM.. Value and face validity of objective structured assessment of technical skills (OSATS) for work based assessment of surgical skills in obstetrics and gynaecology. Med Teach. 2008;30:212–216
4. Barton JR, Corbett S, van der Vleuten CPEnglish Bowel Cancer Screening Programme; UK Joint Advisory Group for Gastrointestinal Endoscopy. . The validity and reliability of a direct observation of procedural skills assessment tool: Assessing colonoscopic skills of senior endoscopists. Gastrointest Endosc. 2012;75:591–597
5. Ali JM.. Getting lost in translation? Workplace based assessments in surgical training. Surgeon. 2013;11:286–289
6. General Medical Council. Workplace Based Assessment: A Guide for Implementation. 2010 London, UK General Medical Council
© 2015 by the Association of American Medical Colleges