Luan Au¹
My Do1 and Hien Nguyen¹
1 University of Medicine and Pharmacy at Hochiminh City (UMP) 

In competency-based medical education, learners acquire and develop professional competencies through practising. Workplace-based assessment (WPBA) and simulation-based assessment accurately provide stakeholders with evidence of learner competencies. In undergraduate training (UGT), mini-clinical evaluation exercises (mini-CEX) and direct observation of procedural skills (DOPS) accurately reflect learner performance. The portfolio is far from an independent WPBA tool. 

This paper summarises changes in the WPBA strategy for UGT during UMP curriculum renovation and discuss potential solutions that might improve the validity of WPBA. 

In the 2010s, the Department of Ob-Gyn began its journey to find an accurate and suitable WPBA strategy. The first edition included four specific mini-CEXs and two specific DOPS. It enhanced learner performance but increased educator workload, therefore provoking negative educators' reactions. The second edition had only one multipurpose and rubric-based mini- CEX. Its complexity negatively impacted learner orientation and educator acceptance. A digital mini-CEX characterised the third edition and aimed to improve user acceptance rate and database management. Again, time consumption discourages educators from running digitalised mini-CEX. We removed DOPS from the two last WPBA editions due to license requirements. We still consider that portfolio is for formative purposes, therefore asked learners to adequately prepare their portfolios for supporting self-awareness. 

From learned failures, we consider that it is mandatory to reform our WPBA strategy. Mini- CEX is still the primary tool, while a portfolio can be a secondary one. Concerning mini-CEX, a series of specific mini-CEX seems likely better than the 'all-in-one'; mini-CEX should use detailed rubrics, which enhance the correlation score-performance; applying flexible exam agenda gives learners autonomy and sounds helpful; preparing educators to conduct mini-CEX is mandatory. Concerning the portfolio, we prioritise crafting a comprehensive user guide and removing unnecessary fields from the current portfolio. We also support digital design and management, which allow ubiquitous use and effective management. 

References (maximum three) 

1. Al Ansari A. The construct and criterion validity of the mini-CEX: a meta-analysis of the published research. Acad Med. 2013;88:413-420.