Educational impact of in-training assessment (ITA) in postgraduate medical education: a qualitative study of an ITA programme in actual practice
Objectives To investigate the experiences and opinions of programme directors, clinical supervisors and trainees on an in‐training assessment (ITA) programme on a broad spectrum of competence for first year training in anaesthesiology. How does the programme work in practice and what are the benefi...
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Published in | Medical education Vol. 38; no. 7; pp. 767 - 777 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Blackwell Science Ltd
01.07.2004
Blackwell Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
ISSN | 0308-0110 1365-2923 |
DOI | 10.1111/j.1365-2929.2004.01841.x |
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Abstract | Objectives To investigate the experiences and opinions of programme directors, clinical supervisors and trainees on an in‐training assessment (ITA) programme on a broad spectrum of competence for first year training in anaesthesiology. How does the programme work in practice and what are the benefits and barriers? What are the users' experiences and thoughts about its effect on training, teaching and learning? What are their attitudes towards this concept of assessment?
Methods Semistructured interviews were conducted with programme directors, supervisors and trainees from 3 departments. Interviews were audiotaped and transcribed. The content of the interviews was analysed in a consensus process among the authors.
Results The programme was of benefit in making goals and objectives clear, in structuring training, teaching and learning, and in monitoring progress and managing problem trainees. There was a generally positive attitude towards assessment. Trainees especially appreciated the coupling of theory with practice and, in general, the programme inspired an academic dialogue. Issues of uncertainty regarding standards of performance and conflict with service declined over time and experience with the programme, and departments tended to resolve practical problems through structured planning.
Discussion Three interrelated factors appeared to influence the perceived value of assessment in postgraduate education: (1) the link between patient safety and individual practice when assessment is used as a licence to practise without supervision rather than as an end‐of‐training examination; (2) its benefits to educators and learners as an educational process rather than as merely a method of documenting competence, and (3) the attitude and rigour of assessment practice. |
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AbstractList | Objectives To investigate the experiences and opinions of programme directors, clinical supervisors and trainees on an in‐training assessment (ITA) programme on a broad spectrum of competence for first year training in anaesthesiology. How does the programme work in practice and what are the benefits and barriers? What are the users' experiences and thoughts about its effect on training, teaching and learning? What are their attitudes towards this concept of assessment?
Methods Semistructured interviews were conducted with programme directors, supervisors and trainees from 3 departments. Interviews were audiotaped and transcribed. The content of the interviews was analysed in a consensus process among the authors.
Results The programme was of benefit in making goals and objectives clear, in structuring training, teaching and learning, and in monitoring progress and managing problem trainees. There was a generally positive attitude towards assessment. Trainees especially appreciated the coupling of theory with practice and, in general, the programme inspired an academic dialogue. Issues of uncertainty regarding standards of performance and conflict with service declined over time and experience with the programme, and departments tended to resolve practical problems through structured planning.
Discussion Three interrelated factors appeared to influence the perceived value of assessment in postgraduate education: (1) the link between patient safety and individual practice when assessment is used as a licence to practise without supervision rather than as an end‐of‐training examination; (2) its benefits to educators and learners as an educational process rather than as merely a method of documenting competence, and (3) the attitude and rigour of assessment practice. OBJECTIVESTo investigate the experiences and opinions of programme directors, clinical supervisors and trainees on an in-training assessment (ITA) programme on a broad spectrum of competence for first year training in anaesthesiology. How does the programme work in practice and what are the benefits and barriers? What are the users' experiences and thoughts about its effect on training, teaching and learning? What are their attitudes towards this concept of assessment?METHODSSemistructured interviews were conducted with programme directors, supervisors and trainees from 3 departments. Interviews were audiotaped and transcribed. The content of the interviews was analysed in a consensus process among the authors.RESULTSThe programme was of benefit in making goals and objectives clear, in structuring training, teaching and learning, and in monitoring progress and managing problem trainees. There was a generally positive attitude towards assessment. Trainees especially appreciated the coupling of theory with practice and, in general, the programme inspired an academic dialogue. Issues of uncertainty regarding standards of performance and conflict with service declined over time and experience with the programme, and departments tended to resolve practical problems through structured planning.DISCUSSIONThree interrelated factors appeared to influence the perceived value of assessment in postgraduate education: (1) the link between patient safety and individual practice when assessment is used as a licence to practise without supervision rather than as an end-of-training examination; (2) its benefits to educators and learners as an educational process rather than as merely a method of documenting competence, and (3) the attitude and rigour of assessment practice. To investigate the experiences and opinions of programme directors, clinical supervisors and trainees on an in-training assessment (ITA) programme on a broad spectrum of competence for first year training in anaesthesiology. How does the programme work in practice and what are the benefits and barriers? What are the users' experiences and thoughts about its effect on training, teaching and learning? What are their attitudes towards this concept of assessment? Semistructured interviews were conducted with programme directors, supervisors and trainees from 3 departments. Interviews were audiotaped and transcribed. The content of the interviews was analysed in a consensus process among the authors. The programme was of benefit in making goals and objectives clear, in structuring training, teaching and learning, and in monitoring progress and managing problem trainees. There was a generally positive attitude towards assessment. Trainees especially appreciated the coupling of theory with practice and, in general, the programme inspired an academic dialogue. Issues of uncertainty regarding standards of performance and conflict with service declined over time and experience with the programme, and departments tended to resolve practical problems through structured planning. Three interrelated factors appeared to influence the perceived value of assessment in postgraduate education: (1) the link between patient safety and individual practice when assessment is used as a licence to practise without supervision rather than as an end-of-training examination; (2) its benefits to educators and learners as an educational process rather than as merely a method of documenting competence, and (3) the attitude and rigour of assessment practice. |
Author | Henriksen, A H Ringsted, C Van der Vleuten, C P M Skaarup, A M |
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References | Finucane PM, Barron SR, Davies HA, Hadfield-Jones RS, Kaigas TM. Towards an acceptance of performance assessment. Med Educ 2002;36: 959-64. Turnbull F, MacFadyen J, Van Barneveld C, Norman G. Clinical work sampling. A new approach to the problem of in-training evaluation. J Gen Intern Med 2000;15: 556-61. Spike N, Alexander H, Elliott S, Hazlett C, Kilminster S, Prideaux D, Roberts T. In-training assessment - its potential in enhancing clinical teaching. Med Educ 2000;34: 858-61. Baker JD, Cooke JE, Contoy JM, Bromley HR, Hollon MF, Alpert CC. Beyond career choice: the role of learning style analysis in residency training. Med Educ 1988;22: 527-32. Friedman Ben-David M. The role of assessment in expanding professional horizons. Med Teach 2000;22: 472-7. Miller GE. The assessment of clinical skills/competence/performance. Acad Med 1990;65 (Suppl):63-7. Patel BS, Feerick A. Will competency assessment improve the training and skills of the trainee anaesthetist? Anaesthesia 2002;57: 710-31. Newble DI, Jaeger K. The effect of assessments and examinations on the learning of medical students. Med Educ 1983;17: 165-71. Hays R, Wellard R. In-training assessment in postgraduate training for general practice. Med Educ 1998;32: 507-13. Noel GL, Herbers JE, Caplow MP, Cooper GS, Pangaro JN, Harvey J. How well do internal medicine faculty members evaluate the clinical skills of residents? Ann Intern Med 1992;117: 757-65. Kestin IG. A statistical approach to measuring the competence of anaesthetic trainees at practical procedures. Br J Anaesth 1995;75: 805-9. Rasmussen J. Skills, rules, knowledge, signals, signs and symbols and other distinctions in human performance models. IEEE Trans Systems Man Cybernetics 1983;123: 257-66. Short JP. The importance of strong evaluation standards and procedures in training residents. Acad Med 1993;68: 522-5. Prescott LE, Norcini JJ, McKinlay P, Rennie JS. Facing the challenges of competency-based assessment of postgraduate dental training: longitudinal evaluation of performance (LEP). Med Educ 2002;36: 92-7. Durning SJ, Lannie JC, Markert RJ, Pangaro LN. Assessing the reliability and validity of the mini-clinical evaluation exercise for internal medicine residency training. Acad Med 2002;77: 900-4. Kroboth FJ, Hanusa BH, Parker S, Coulehan JL, Kapoor WN, Brown FH, Karpf M, Levey GS. The interrater reliability and internal consistency of a clinical evaluation exercise. J Gen Intern Med 1992;7: 174-9. Long DM. Competency-based residency training: the next advance in graduate medical education. Acad Med 2000;75: 1178-83. Turnbull J, Gray J, MacFadyen J. Improving in-training evaluation programmes. J Gen Intern Med 1998;13: 317-23. Van der Vleuten CPM. The assessment of professional competence: developments, research and practical implications. Adv Health Sci Educ 1996;1: 41-67. Reisdorff EJ, Hayes OW, Carlson DJ, Walker GL. Assessing the new general competencies for resident education: a model from an emergency medicine programme. Acad Med 2001;76: 753-7. Yukowsky R. Can resident evaluations demonstrate increases in residents' skills over time? Acad Med 1999;74 (Suppl):108-10. McManus IC, Winder BC, Gordon D. UK doctors' attitudes to the General Medical Council's performance procedures, 1997-99. Med Educ 2001;35 (Suppl):60-9. Ringsted C, Østergaard D, Scherpbier A. Embracing the new paradigm of assessment in residency training. An assessment programme for first year residency training in anaesthesiology. Med Teach 2003;25: 54-62. Ringsted C, Østergaard D, Scherpbier A. Consultants' opinion on a new practice-based assessment programme for first year trainees in anaesthesiology. Acta Anaesthesiol Scand 2002;46: 1119-23. Dolmans D, Schmidt A, Van Der Beck J, Beintema M, Gerver WJ. Does a student log provide a means to better structure clinical education? Med Educ 1999;33: 89-94. 1995; 75 1993; 68 2002; 36 2000; 22 2002; 57 2002; 77 1994 2002 1983; 17 1992; 7 1990; 65 1983; 123 2000; 15 2000; 34 2002; 46 2000; 75 2003; 25 1992; 117 2003; 47 1988; 22 1999; 33 1996; 1 1999; 74 1998; 32 2001; 35 1998; 13 2001; 76 Noel GL (b17_190) 1992; 117 Short JP (b2_175) 1993; 68 Turnbull J (b6_179) 2002 Petrusa ER (b27_200) 2002 Rasmussen J (b23_196) 1983; 123 b1_174 b24_197 b13_186 Patel BS (b20_193) 2002; 57 Durning SJ (b14_187) 2002; 77 b3_176 Kroboth FJ (b18_191) 1992; 7 b19_192 b29_202 b12_185 b16_189 Reisdorff EJ (b11_184) 2001; 76 Baker JD (b30_203) 1988; 22 Newble DI (b26_199) 1983; 17 b4_177 Van der Vleuten CPM (b9_182) 1996; 1 Yukowsky R (b15_188) 1999; 74 Long DM (b7_180) 2000; 75 McManus IC (b28_201) 2001; 35 Miller GE (b8_181) 1990; 65 Kestin IG (b22_195) 1995; 75 Feletti G (b5_178) 1994 b21_194 b25_198 b10_183 |
References_xml | – reference: Long DM. Competency-based residency training: the next advance in graduate medical education. Acad Med 2000;75: 1178-83. – reference: Spike N, Alexander H, Elliott S, Hazlett C, Kilminster S, Prideaux D, Roberts T. In-training assessment - its potential in enhancing clinical teaching. Med Educ 2000;34: 858-61. – reference: Reisdorff EJ, Hayes OW, Carlson DJ, Walker GL. Assessing the new general competencies for resident education: a model from an emergency medicine programme. Acad Med 2001;76: 753-7. – reference: Turnbull F, MacFadyen J, Van Barneveld C, Norman G. Clinical work sampling. A new approach to the problem of in-training evaluation. J Gen Intern Med 2000;15: 556-61. – reference: Dolmans D, Schmidt A, Van Der Beck J, Beintema M, Gerver WJ. Does a student log provide a means to better structure clinical education? Med Educ 1999;33: 89-94. – reference: Miller GE. The assessment of clinical skills/competence/performance. Acad Med 1990;65 (Suppl):63-7. – reference: Noel GL, Herbers JE, Caplow MP, Cooper GS, Pangaro JN, Harvey J. How well do internal medicine faculty members evaluate the clinical skills of residents? Ann Intern Med 1992;117: 757-65. – reference: Kroboth FJ, Hanusa BH, Parker S, Coulehan JL, Kapoor WN, Brown FH, Karpf M, Levey GS. The interrater reliability and internal consistency of a clinical evaluation exercise. J Gen Intern Med 1992;7: 174-9. – reference: Durning SJ, Lannie JC, Markert RJ, Pangaro LN. Assessing the reliability and validity of the mini-clinical evaluation exercise for internal medicine residency training. Acad Med 2002;77: 900-4. – reference: Patel BS, Feerick A. Will competency assessment improve the training and skills of the trainee anaesthetist? Anaesthesia 2002;57: 710-31. – reference: Newble DI, Jaeger K. The effect of assessments and examinations on the learning of medical students. Med Educ 1983;17: 165-71. – reference: Kestin IG. A statistical approach to measuring the competence of anaesthetic trainees at practical procedures. Br J Anaesth 1995;75: 805-9. – reference: Ringsted C, Østergaard D, Scherpbier A. Embracing the new paradigm of assessment in residency training. An assessment programme for first year residency training in anaesthesiology. Med Teach 2003;25: 54-62. – reference: Hays R, Wellard R. In-training assessment in postgraduate training for general practice. Med Educ 1998;32: 507-13. – reference: Friedman Ben-David M. The role of assessment in expanding professional horizons. Med Teach 2000;22: 472-7. – reference: Short JP. The importance of strong evaluation standards and procedures in training residents. Acad Med 1993;68: 522-5. – reference: Rasmussen J. Skills, rules, knowledge, signals, signs and symbols and other distinctions in human performance models. IEEE Trans Systems Man Cybernetics 1983;123: 257-66. – reference: Prescott LE, Norcini JJ, McKinlay P, Rennie JS. Facing the challenges of competency-based assessment of postgraduate dental training: longitudinal evaluation of performance (LEP). Med Educ 2002;36: 92-7. – reference: McManus IC, Winder BC, Gordon D. UK doctors' attitudes to the General Medical Council's performance procedures, 1997-99. Med Educ 2001;35 (Suppl):60-9. – reference: Van der Vleuten CPM. The assessment of professional competence: developments, research and practical implications. Adv Health Sci Educ 1996;1: 41-67. – reference: Finucane PM, Barron SR, Davies HA, Hadfield-Jones RS, Kaigas TM. Towards an acceptance of performance assessment. Med Educ 2002;36: 959-64. – reference: Turnbull J, Gray J, MacFadyen J. Improving in-training evaluation programmes. J Gen Intern Med 1998;13: 317-23. – reference: Baker JD, Cooke JE, Contoy JM, Bromley HR, Hollon MF, Alpert CC. Beyond career choice: the role of learning style analysis in residency training. Med Educ 1988;22: 527-32. – reference: Ringsted C, Østergaard D, Scherpbier A. 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Snippet | Objectives To investigate the experiences and opinions of programme directors, clinical supervisors and trainees on an in‐training assessment (ITA) programme... To investigate the experiences and opinions of programme directors, clinical supervisors and trainees on an in-training assessment (ITA) programme on a broad... OBJECTIVESTo investigate the experiences and opinions of programme directors, clinical supervisors and trainees on an in-training assessment (ITA) programme on... |
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SubjectTerms | Anesthesiology - education Attitude of Health Personnel Clinical Competence - standards Curriculum Curriculum subjects: programmes and methods Denmark education Education, Medical, Graduate - methods educational measurement Educational Measurement - standards Educational sciences Evaluation Studies as Topic Humans Inservice Training - standards medical Medical and paramedical education Program Evaluation students Teaching methods undergraduate/methods |
Title | Educational impact of in-training assessment (ITA) in postgraduate medical education: a qualitative study of an ITA programme in actual practice |
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