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Programmatic assessment of competency-based workplace learning: when theory meets practice
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BACKGROUND: In competency-based medical education emphasis has shifted towards outcomes, capabilities, and learner-centeredness. Together with a focus on sustained evidence of professional competence this calls for new methods of teaching and assessment. Recently, medical educators advocated the use of a holistic, programmatic approach towards assessment. Besides maximum facilitation of learning it should improve the validity and reliability of measurements and documentation of competence development. We explored how, in a competency-based curriculum, current theories on programmatic assessment interacted with educational practice. METHODS: In a development study including evaluation, we investigated the implementation of a theory-based programme of assessment. Between April 2011 and May 2012 quantitative evaluation data were collected and used to guide group interviews that explored the experiences of students and clinical supervisors with the assessment programme. We coded the transcripts and emerging topics were organised into a list of lessons learned. RESULTS: The programme mainly focuses on the integration of learning and assessment by motivating and supporting students to seek and accumulate feedback. The assessment instruments were aligned to cover predefined competencies to enable aggregation of information in a structured and meaningful way. Assessments that were designed as formative learning experiences were increasingly perceived as summative by students. Peer feedback was experienced as a valuable method for formative feedback. Social interaction and external guidance seemed to be of crucial importance to scaffold self-directed learning. Aggregating data from individual assessments into a holistic portfolio judgement required expertise and extensive training and supervision of judges. CONCLUSIONS: A programme of assessment with low-stakes assessments providing simultaneously formative feedback and input for summative decisions proved not easy to implement. Careful preparation and guidance of the implementation process was crucial. Assessment for learning requires meaningful feedback with each assessment. Special attention should be paid to the quality of feedback at individual assessment moments. Comprehensive attention for faculty development and training for students is essential for the successful implementation of an assessment programme.
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“Evidence is now emerging from qualitative evaluations of programmatic assessment curricula which raises questions about the mixing of formative and summative assessment.”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [69]
In the citing paper
“although it has also met some difficulties in implementation [69]”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [69]
In the citing paper
“As Bok et al. showed, durable teacher-learner relationships also prompt learners to seek feedback more readily [69].”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [69]
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“Institutions can create opportunities for longitudinal teacher-learner relationships to flourish, such as extended placements [68–70].”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [69]
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“As a result, the formative assessments did not play the powerful assessment-for-learning role they are meant to have in a curriculum based on programmatic assessment [69].”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [69]
In the citing paper
“A qualitative study with clinical undergraduate veterinary students and their supervisors highlighted that both struggled with formative assessments that are used as ‘data points’ for a final summative judgment.”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [69]
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Metadata
- Authors
- Bok, H. G., Teunissen, P. W., Favier, R. P., Rietbroek, N. J., Theyse, L. F., Brommer, H., Haarhuis, J. C., van Beukelen, P., van der Vleuten, C. P., & Jaarsma, D. A.
- Affiliations
- Utrecht University (NL)
- Maastricht University (NL)
- University of Amsterdam (NL)
- Corresponding author
- Bok, Harold GJ
- Venue
- BMC Medical Education
- Published
- 2013-09-11
- Volume
- 13
- Issue
- 1
- Pages
- 123-123
- ISSN
- 1472-6920 (ISSN-L)
- PMC
- PMC3851012
- OpenAlex
- W2153422278
- Cited by
- 303
- References
- 36
- Citations by year
- 2026: 20 · 2025: 14 · 2024: 24 · 2023: 31 · 2022: 36 · 2021: 24 · 2020: 29 · 2019: 29 · 2018: 25 · 2017: 26 · 2016: 25 · 2015: 13 · 2014: 5
- FWCI
- 14.62
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Medical Education (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, cc-by)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- Flinders University
- Topics
- Social Sciences › Education › Innovations in Medical Education
- Social Sciences › Education › Student Assessment and Feedback
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Competency Development and Evaluation
- Keywords
- competency-based medical education, programmatic assessment, workplace-based assessment, formative assessment, summative assessment, feedback, peer feedback, self-directed learning, portfolio assessment, low-stakes assessment, assessment implementation, faculty development, clinical supervisors, medical students
- MeSH terms
- Competency-Based Education, Curriculum, Education, Medical, Education, Veterinary, Educational Measurement, Humans, Netherlands, Surveys and Questionnaires, Schools, Veterinary
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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