Subha Ramani^1,2,3
Balakrishnan Nair^4,5 and James Kwan⁶
1 AMEE
2 Harvard Medical School
3 Brigham and Women's Hospital
4 School of Medicine and Public Health, University of Newcastle
5 Educational Research, Health Education and Training Institute, New South Wales, Australia.
6 Tan Tock Seng Hospital, Singapore

Background: 

In workplace-based assessment (WBA) of clinical trainees, lack of alignment between required outcomes, curricular content and assessment methods could drive poor learning. Reflecting on Miller’s pyramid, what the trainee ‘does’ in real life is placed at the highest level of the pyramid and this necessitates direct observation of trainee’s performance. The Mini-CEX (clinical evaluation exercise) is a formative and time-efficient tool that provides adequate learning opportunities and reliable assessment outcomes. The premise of WBA would be unsuccessful without meaningful feedback conversations that drive behaviour change. 

WBA also relies on assessors’ judgements of trainee competence in complex clinical scenarios. Concerns about rater variability in performance assessments and feedback quality persist. Understanding assessor cognitive processes when judging learner competencies and utilising feedback as an educational alliance could facilitate targeted faculty development in assessment and feedback. 

The approach to feedback is no longer viewed as a unidirectional teacher to learner monologue. Experts strongly recommend engagement of learners in the conversation, a focus on the gap between current and expected clinical performance in specific clinical domains, facilitated self-reflection by learners and formulation of action plans for performance improvement and growth. 

This workshop will be highly interactive combining mini-didactics with brainstorming, facilitated discussions and skills practice. Through training videos of clinical learner-patient interactions, participants will have hands on experience of using the rating forms, assessing trainee performance and contribute to a facilitated calibration discussion. In triads, they will 

apply frameworks and skills discussed in providing feedback for the trainees emphasizing a growth mindset and behaviour change. 

Supervisors of clinical trainees, faculty who design assessment programs or lead staff development. This workshop will update participants on the current theories and practice of workplace-based assessment in authentic clinical contexts. 

Intended outcomes:
1.Practice direct observation and calibrate trainee performance using the Mini-CEX tool 

2.Reflect on information processing by clinical supervisors and discuss reasons for variability in performance assessment 

3.Practice skills of engaging the learner in a constructive feedback conversation. 

Level:
Intermediate 

References (maximum three)