Presentation Description
Stephen Tobin1
Caroline Joyce2, Carl Parsons3, Margaret Schnitzler4, Venessa Tsang4 and Nidhi Garg4
1 ANZAHPE, ASME, WSU Medicine
2 Western Sydney Univiersity
3 Western Sydney University
4 Sydney University
Caroline Joyce2, Carl Parsons3, Margaret Schnitzler4, Venessa Tsang4 and Nidhi Garg4
1 ANZAHPE, ASME, WSU Medicine
2 Western Sydney Univiersity
3 Western Sydney University
4 Sydney University
1. Background
There is extensive literature about workplace-based assessment (WBA) and entrustable professional activities (EPA), much of which is positive. There is no doubt that WBAs/EPAs ask more of the student or trainee, provide a structure for feedback, help determine actions for better performance (i.e., patient care) and provide a record of longitudinal progress. As multi- competency tasks, they cover much of clinical practice and can be mapped to graduate outcomes. With all this effort and information provided, could or should they be used to replace formal clinical examinations such as Objective Structured Clinical Examinations (OSCE) and structured vivas or long-cases? What are the trade-offs of attempting to increase authenticity through use of WBA? Challenges include, but are not limited to, assessor training and calibration, volume of assessment, and ‘failure to fail’.
2. Importance for research or practice
Formal clinical examinations, such as the OSCE, have been used for decades, and until recently accepted as the norm. They certainly provide assessment of learning, drive student behaviours and require significant logistical effort. Yet senior medical students contribute to patient care in clinical settings. Demonstration of performance (entrusted by supervision levels) allows assessment ‘for learning’ and ‘of learning’ around authentic tasks. As a result, there has been a shift from structured clinical assessment formats to a portfolio of assessments completed in the workplace in some medical programs. However, there remains a need to evaluate such programs of assessment, considering advantages and disadvantages when compared to more traditional formats, particularly when the accrued data is used for progression decisions.
3. Format and engagement
- Summary of literature
- Western Sydney and The University of Sydney’s experiences with WBA/EPAs, to include a presentation of data and challenges from our experiences.
- Discussion around advantages and disadvantages of WBA/EPA vs traditional assessment methods such as the OSCE, with questions for attendees
We do not pretend this is clear-cut and encourage you to come along, contribute and enjoy the debate(s).
4. Take homes
- Consideration needs to be given to individual contexts and advantages vs disadvantages of any clinical assessment model.
- Formal clinical examinations such as OSCEs work well in early-mid-program stages.
- WBAs such as EPAs are important in senior medical school years, particularly because many postgraduate training programs are also transitioning to this approach.
- Assessment and feedback literacy are essential.
- Dynamic analytics for monitoring is important to track students, and to identify students who are at risk.
5. Outcomes, Research or practice
We will tailor the discussion around attendee discussion points. Possible outcomes to include shared resources, comparison between systems and more. Collaboration through testing these approaches in other contexts
References (maximum three)
Molloy E, Lew S, Woodward-Kron R, et al. Medical student clinical placements as sites of learning and contribution. Melbourne: University of Melbourne; 2018.
Edmiston, N., Hu, W., Tobin, S.et al.“You’re actually part of the team”: a qualitative study of a novel transitional role from medical student to doctor.BMC Med Educ2023; 23: 112-121
Hobday PM, Borman-Shoap E, Cullen MJ, et al. The Minnesota Method: A Learner-Driven, Entrustable Professional Activity-Based Comprehensive Program of Assessment for Medical Students. Acad.Med. 2021; 96: S50-55