What is assessment?

Assessment is an educational and diagnostic activity, concerned with the identification of strengths and weaknesses. It requires a judgement to be made about performance and it is distinct from a purely descriptive account (e.g. logbooks). The CoBaTrICE assessment methodology is not designed to rank the performance of doctors. Rather, it is about demonstrating achievement (across a range of assessments) and identifying where more practice or support is needed.
Feedback to the trainee on the results of any assessment is a central part of the assessment process. Feedback should be focused and timely (soon after the assessment).

What is work-place based assessment?

Workplace based assessment is the assessment of working practices undertaken in the working environment. It is assessment, usually by observation, of real life, real time practice, under normal working conditions.

What is the difference between formative and summative assessment?

Formative assessment provides feedback during a programme and addresses the question what does the trainee need to do to improve? Summative assessment happens at the end of a programme or placement where a judgement is made about whether the trainee is competent, on the basis of the evidence in their portfolio. However, formative and summative assessments are inter-related, as formative assessment is used to inform summative assessment.

When should a trainee be assessed?

Trainees should be assessed at frequent points during the course of their training, linked to their learning agreement. The main purpose of the assessments is to provide evidence of competence (recorded in the CoBaFolio).

Who should assess the trainee?

This is in part determined by the assessment tool. The trainer (supervisor) will have a significant role in the assessment of the trainee in the workplace as will the trainee themselves. Co-workers - including doctors, nurses and allied health professionals - will also contribute to assessments (e.g. via multi-source feedback). External assessors running simulation assessments, OSCEs or formal examinations may also be involved. The CoBaFolio of evidence will need to be reviewed by the principal trainer. Assessors will need to be adequately prepared / trained for their role.

How should a trainee be assessed?

Workplace based observation is the most simple to conduct (and probably the most familiar) format of assessment. The tool-box includes examples of assessment procedures based on observation. A wide variety of other assessments will complement workplace based observation, according to the needs of the trainee, any concerns of the trainer about a trainee, and national training programme requirements.

Which assessment tool?

Features of a good assessment tool:

• Valid - does the assessment measure what it purports to measure (face validity)? Do the assessment tasks predict future performance accurately (predictive validity)? Other forms of validity include content validity, concurrent validity, intrinsic validity and extrinsic validity.
• Reliable - if an assessment is repeated with the same trainees, they should get the same results. For workplace-based observation we need multiple encounters (a number of observations using a number of observers)
• Feasible - can the assessments be undertaken within time and staff constraints? Assessments should fit well with the training programme and the working day.
• Provides good feedback / encourages learning - does the assessment help the trainee identify strengths and weaknesses? There are strong positive links between assessment, good feedback and further learning.
• Provides an early warning system - does the assessment system detect poor performance early? Poor performance may trigger closer supervision and further assessment or raise questions about the training environment.

What are the assessment roles & responsibilities of the trainer and trainee?

Trainer

• Provides opportunities for the acquisition and assessment of competence in relation to the trainee?s learning agreement & learning needs
• Seeks the opinion of others in the team and collates feedback
• Undertakes assessments & completes relevant documentation
• Provides feedback to the trainee

Trainee

• Identifies learning needs & participates in planning a learning agreement; arranges regular reviews with trainer
• Identifies opportunities for the acquisition and assessment of competence throughout training
• Compiles evidence of competence (documentation) in a portfolio

What is a Portfolio and what should it contain?

A portfolio is a collection of evidence which, taken together demonstrates competence and expertise. In addition to the formal acquisition of competencies which form the core of the CoBaTrICE programme, there are many other aspects of clinical practice and professional development which can be included, such as research and audit activities, teaching received or delivered, courses attended, work-place based assessments, case summaries, log books, personal reflections or letters from patients and relatives. CoBaTrICE has produced the CoBaFolio template as a means of enabling trainees to collate evidence of competence.

What is appraisal?

Appraisal is an educational discussion between trainer and trainee about achievements, strengths and weaknesses. Progress is reviewed and education needs are planned. An analysis of learning needs may be included. Appraisal makes use of evidence collated to date and leads to clarification of learning agreements.

What is a learning agreement?

A learning agreement may also be referred to as a learning plan, personal development plan, learning needs analysis or learning contract. Following discussion, a learning agreement sets out the objectives for training agreed between the trainer and trainee (based on the learning needs of the trainee and the opportunities for the acquisition and assessment of competence within the specific workplace) and facilitates the review of progress at regular intervals. More information is available about learning agreements in the assessment section.