“We’re all there to learn”: The experience of novice workplace-based assessors in anaesthesia training

Authors

DOI:

https://doi.org/10.11157/fohpe.v23i4.603

Keywords:

clinical competence, competency-based assessment, medical education, educational measurement, anaesthesiology, qualitative research

Abstract

Introduction: Workplace-based assessments (WBAs) are used in competency-based training programs to facilitate learning and inform decisions on trainees’ progression. Competency in assessing WBAs is generally assumed; how assessors develop these skills remains largely unknown. This study explored how novice assessors acquire WBA skills to generate insights to inform future faculty development.

Methods: We conducted seven semi-structured interviews with provisional fellows, who are final-year trainees of the Australian and New Zealand College of Anaesthetists. Provisional fellows assess junior trainees as part of their preparation for consultant practice. We used constructivist grounded theory methods to analyse their experience of learning to perform WBAs.

Results: Participants primarily learned WBA skills through experiential learning and self-reflection on their practice. They developed practical skills to accommodate WBA into clinical practice, including finding time to facilitate WBAs and selecting appropriate cases. Simultaneously, participants developed expertise in the critical aspects of the assessment, particularly learning to determine the standard required of trainees and improving their feedback skills. This learning engendered an increased appreciation of the purpose of WBA, helped participants develop their clinical expertise and prompted them to envision themselves in the consultant role. Participants felt underprepared for their assessor role and appreciated access to the “safety net” ongoing supervision provided.

Conclusion: This study provides valuable insights into what is learned in becoming a WBA assessor and how it is learned. These insights could inform future faculty development initiatives to help improve graduating consultants’ development in this important area of consultant practice.

References

Australian and New Zealand College of Anaesthetists (ANZCA). (2020). Anaesthesia training program curriculum 2020. http://www.anzca.edu.au/documents/anaesthesia-training-program-curriculum.pdf

Billett, S. (2014). Mimetic learning at work: Learning in the circumstances of practice. Springer. https://doi.org/10.1007/978-3-319-09277-5

Billett, S., & Sweet, L. (2018). Understanding and appraising medical students’ learning through clinical experiences: Participatory practices at work. In S. Loo (Ed.), Dimensions of teaching and learning for occupational practice (pp. 201–216). Routledge.

Bindal, N., Goodyear, H., Bindal, T., & Wall, D. (2013). DOPS assessment: A study to evaluate the experience and opinions of trainees and assessors. Medical Teacher, 35(6), e1230–e1234. https://doi.org/10.3109/0142159x.2012.746447

Castanelli, D. J., Jowsey, T., Chen, Y., & Weller, J. M. (2016). Perceptions of purpose, value, and process of the mini-Clinical Evaluation Exercise in anesthesia training. Canadian Journal of Anesthesia/Journal Canadien D’anesthésie, 63(12), 1345–1356. https://doi.org/10.1007/s12630-016-0740-9

Charmaz, K. (2008). Constructionism and the grounded theory method. In J. A. Holstein & J. F. Gubrium (Eds.), Handbook of constructionist research (pp. 397–412). Guilford.

Charmaz, K. (2014). Constructing grounded theory (2nd ed.). Sage.

Cleland, J., Leaman, J., & Billett, S. (2014). Developing medical capacities and dispositions through practice-based experiences. In C. Harteis, A., Rausch, & J. Seifried (Eds.), Discourses on professional learning (pp. 211–230). Springer.

College of Anaesthesiologists of Ireland. (2020). Curriculum for the national specialist anaesthesiology training programme. https://www.anaesthesia.ie/wp-content/uploads/2020/07/CAI-Curriculum-2020.pdf

Dannefer, E. F. (2013). Beyond assessment of learning toward assessment for learning: Educating tomorrow’s physicians. Medical Teacher, 35(7), 560–563. https://doi.org/10.3109/0142159x.2013.787141

Dornan, T. (2012). Workplace learning. Perspectives on Medical Education, 1(1), 15–23. https://doi.org/10.1007/s40037-012-0005-4

Gingerich, A., Kogan, J., Yeates, P., Govaerts, M., & Holmboe, E. (2014). Seeing the “black box” differently: Assessor cognition from three research perspectives. Medical Education, 48(11), 1055–1068. https://doi.org/10.1111/medu.12546

Harris, P., Bhanji, F., Topps, M., Ross, S., Lieberman, S., Frank, J. R., Snell, L., & Sherbino, J. (2017). Evolving concepts of assessment in a competency-based world. Medical Teacher, 39(6), 603–608. https://doi.org/10.1080/0142159x.2017.1315071

Harrison, C. J., Könings, K. D., Schuwirth, L. W. T., Wass, V., & van der Vleuten, C. P. M. (2017). Changing the culture of assessment: The dominance of the summative assessment paradigm. BMC Medical Education, 17(1), Article 73. https://doi.org/10.1186/s12909-017-0912-5

Kvale, S., & Brinkmann, S. (2008). InterViews: Learning the craft of qualitative research interviewing (2nd ed.). Sage.

Lave, J., & Wenger, E. (1991). Situated learning: Legitimate peripheral participation. Cambridge University Press. https://doi.org/10.1017/CBO9780511815355

Lee, V., Brain, K., & Martin, J. (2017). Factors influencing mini-CEX rater judgments and their practical implications: A systematic literature review. Academic Medicine, 92(6), 880–887. https://doi.org/10.1097/acm.0000000000001537

Lockyer, J., Carraccio, C., Chan, M. K., Hart, D., Smee, S., Touchie, C., Holmboe, E. S., & Frank, J. R. (2017). Core principles of assessment in competency-based medical education. Medical Teacher, 39(6), 609–616. https://doi.org/10.1080/0142159x.2017.1315082

Rogers, A. P., Reagan, E. M., & Ward, C. (2020). Preservice teacher performance assessment and novice teacher assessment literacy. Teaching Education, 33(2), 175-193. https://doi.org/10.1080/10476210.2020.1840544

Ross, S., Hauer, K. E., Wycliffe-Jones, K., Hall, A. K., Molgaard, L., Richardson, D., Oswald, A., & Bhanji, F. (2021). Key considerations in planning and designing programmatic assessment in competency-based medical education [Special issue]. Medical Teacher, 43(7), 758–764. https://doi.org/10.1080/0142159x.2021.1925099

Royal College of Anaesthetists. (2010). Curriculum for a CCT in anaesthetics (2nd ed.). https://rcoa.ac.uk/sites/default/files/documents/2019-08/TRG-CU-CCT-ANAES2010.pdf

Schut, S., Heeneman, S., Bierer, B., Driessen, E., Tartwijk, J., & van der Vleuten, C. (2020). Between trust and control: Teachers’ assessment conceptualisations within programmatic assessment. Medical Education, 54(6), 528–537. https://doi.org/10.1111/medu.14075

Schuwirth, L. W., & van der Vleuten, C. P. M. (2019). How “testing” has become “programmatic assessment for learning.” Health Professions Education, 5(3), 177–184. https://doi.org/10.1016/j.hpe.2018.06.005

Torre, D. M., Schuwirth, L. W. T., & van der Vleuten, C. P. M. (2019). Theoretical considerations on programmatic assessment. Medical Teacher, 42(2), 213–220. https://doi.org/10.1080/0142159x.2019.1672863

van der Vleuten, C. P. M., Schuwirth, L. W. T., Driessen, E. W., Dijkstra, J., Tigelaar, D., Baartman, L. K. J., & van Tartwijk, J. (2012). A model for programmatic assessment fit for purpose. Medical Teacher, 34(3), 205–214. https://doi.org/10.3109/0142159x.2012.652239

Weller, J., Jones, A., Merry, A., Jolly, B., & Saunders, D. (2009). Investigation of trainee and specialist reactions to the mini-Clinical Evaluation Exercise in anaesthesia: Implications for implementation. British Journal of Anaesthesia, 103(4), 524–530. https://doi.org/10.1093/bja/aep211

Weller, J., Misur, M., Nicolson, S., Morris, J., Ure, S., Crossley, J., & Jolly, B. (2014). Can I leave the theatre? A key to more reliable workplace-based assessment. British Journal of Anaesthesia, 112(6), 1083–1091. https://doi.org/10.1093/bja/aeu052

Wenger, E. (1998). Communities of practice: Learning, meaning, and identity. Cambridge University Press. https://doi.org/10.1017/CBO9780511803932

Wragg, A., Wade, W., Fuller, G., Cowan, G., & Mills, P. (2003). Assessing the performance of specialist registrars. Clinical Medicine, 3(2), 131–134. https://doi.org/10.7861/clinmedicine.3-2-131

Xu, Y., & Brown, G. T. L. (2016). Teacher assessment literacy in practice: A reconceptualization. Teaching and Teacher Education, 58(1), 149–162. https://doi.org/10.1016/j.tate.2016.05.010

Downloads

Published

2022-12-16

How to Cite

Marshall, L., & Castanelli, D. (2022). “We’re all there to learn”: The experience of novice workplace-based assessors in anaesthesia training. Focus on Health Professional Education: A Multi-Professional Journal, 23(4), 1–15. https://doi.org/10.11157/fohpe.v23i4.603

Issue

Section

Articles