Workplace-based assessment in Chinese medicine : a case study viewing competency-based medical education through a practice theory lens

• Main Author: Moir, Felicity Clare
• Format: Dissertation
• Language: English
• Published: UCL (University College London) 2020

This thesis explores how workplace-based assessment (WBA) was being conducted in three institutions in different Western countries training students to be practitioners of Chinese Medicine. While competency-based medical education (CBME) as a curriculum model is being globalised, the literature on its application to WBA shows a tension between standardization and authenticity and between atomization and holism. The aim of this thesis was to understand how the constructs of CBME were being enacted and how they might be constraining or enabling WBA in these institutions. Using a multiple embedded case-study design I explored WBA through data gathered from the relevant accreditation documents in each country, institutional documents and interviews with managers and clinical supervisors. My analysis revealed that the different stakeholders manifested quite different stories of assessment. In the accreditation and institutional documents the discourse of measurement predominated; in contrast, while the managers were leaning towards standardization and objectivity, they were also aware of a more complex assessment culture. For the clinical supervisors the psychometric grades being enacted could not be seen as a legitimate measure of objectivity as the authentic and holistic constructs of CBME dominated. The thesis draws on Schatzki’s ‘practice turn’ as an interpretive lens. By viewing WBA as a socio-cultural-material, embodied and interactive phenomenon I show that it was the inter-relationships between institutionalized and disciplinary discourses; between standardized and personalized competencies; between educational and practitioner identities; and the entanglement of artefacts and spatio-temporal arrangements, that enabled or constrained how WBA was enacted. Through this analysis I argue that an understanding of how different assemblances lead to different enactments opens up possibilities of how to develop legitimate and workable assessment processes not just for Chinese medicine but any health profession.