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What is wrong with assessment in postgraduate training? Lessons from clinical practice and educational research
Abstract
Workplace-based assessment is more commonly given a lukewarm than a warm welcome by its prospective users. In this article, we summarise the workplace-based assessment literature as well as our own experiences with workplace-based assessment to derive lessons that can facilitate acceptance of workplace-based assessment in postgraduate specialty training. We propose to shift the emphasis in workplace-based assessment from assessment of trainee performance to the learning of trainees. Workplace-based assessment should focus on supporting supervisors in taking entrustment decisions by complementing their "gut feeling" with information from assessments and focus less on assessment and testability. One of the most stubborn problems with workplace-based assessment is the absence of observation of trainees and the lack of feedback based on observations. Non-standardised observations are used to organise feedback. To make these assessments meaningful for learning, it is essential that they are not perceived as summative by their users, that they provide narrative feedback for the learner and that there is a form of facilitation that helps to integrate the feedback in trainees' self-assessments.
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“Because of the potential for grades to demotivate or to reduce effort, it has been suggested that it might be wisest to avoid giving grades except when formally assessing the learner (in infrequent ‘high stakes’ assessments) [58].”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [58]
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Metadata
- Authors
- Driessen, E., & Scheele, F.
- Affiliations
- Maastricht University (NL)
- Sint Lucas Andreas Hospital (NL)
- Corresponding author
- Driessen, Erik
- Venue
- Medical Teacher
- Publisher
- Informa UK Limited
- Published
- 2013-05-23
- Volume
- 35
- Issue
- 7
- Pages
- 569-574
- ISSN
- 0142-159X (ISSN-L)
- 1466-187X
- OpenAlex
- W2170153256
- Cited by
- 110
- References
- 41
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 2 · 2023: 9 · 2022: 6 · 2021: 8 · 2020: 6 · 2019: 11 · 2018: 13 · 2017: 6 · 2016: 10 · 2015: 18 · 2014: 10 · 2013: 1
- FWCI
- 13.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Teacher (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Social Sciences › Education › Innovations in Medical Education
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Social Sciences › Education › Student Assessment and Feedback
- Keywords
- workplace-based assessment, graduate medical education, specialist training, entrustment decisions, trainee learning, clinical supervision, narrative feedback, summative assessment, self-assessment
- MeSH terms
- Attitude of Health Personnel, Clinical Competence, Education, Medical, Graduate, Educational Measurement, Feedback, Humans, Internship and Residency, Workplace
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