Sabey Abigail, Harris Michael
University of the West of England, Bristol, UK.
Educ Prim Care. 2012 Jul;23(4):263-9. doi: 10.1080/14739879.2012.11494119.
Workplace-based assessment (WPBA) is now a central feature of postgraduate training and required for Membership of the Royal College of General Practitioners (MRCGP). A previous study established that many GP trainees question the validity and usefulness of WPBA during hospital posts. Many of the factors identified, for example superficial feedback, leniency and a 'tick box' culture, suggested that assessors may hold some of the answers about how to improve the system.
To explore the views of hospital-based assessors across a range of specialities about how WPBA works with GP trainees.
A qualitative approach was taken to explore views in-depth by means of one-to-one interviews.
Three training locations within Severn Deanery.
Consultants were sampled purposively and 15 took part in semi-structured interviews between November 2010 and May 2011. Interviews were recorded and transcribed, and analysed using a thematic framework approach.
While WPBA provides a mandate for giving feedback to trainees, assessors say that honesty can be lacking and they find giving negative feedback hard to handle. Nonetheless, the verbal and qualitative elements of the process are valued and bring a crucial depth to the process. Assessors are not familiar with GP training requirements and would benefit from more contact with GP leads and supervisors.
The views of assessors in this study echo those of the GP trainees in the earlier study, emphasising areas where action should be taken to strengthen the system of assessment so that WPBA improves the performance of doctors. The professional conversation and scope for free text comments hold the most potential for adding value to the process. Sharing information across hospital and GP supervisors could also help recognise high-achieving trainees, not just those who are struggling. This would help to address a central criticism that WPBA is focused on a minimum standard of competence rather than excellence, thus losing an important motivation among trainees and weakening the effect of WPBA in helping to deliver better doctors.
基于工作场所的评估（WPBA）现已成为研究生培训的核心特征，也是皇家全科医师学院会员资格（MRCGP）的必备条件。先前的一项研究表明，许多全科医生培训学员对在医院岗位期间WPBA的有效性和实用性提出质疑。所确定的许多因素，例如表面化的反馈、宽松态度和“打勾”文化，表明评估者可能掌握一些关于如何改进该系统的答案。
探讨各专业的医院评估者对于WPBA如何应用于全科医生培训学员的看法。
采用定性方法，通过一对一访谈深入探讨观点。
塞文教区的三个培训地点。
有目的地抽取顾问医生作为样本，15人在2010年11月至2011年5月期间参与了半结构化访谈。访谈进行了录音和转录，并采用主题框架方法进行分析。
虽然WPBA为向培训学员提供反馈提供了授权，但评估者表示可能缺乏坦诚，并且他们发现给出负面反馈很难处理。尽管如此，该过程的口头和定性要素受到重视，并为该过程带来了至关重要的深度。评估者不熟悉全科医生培训要求，与全科医生负责人和导师增加接触会有所帮助。
本研究中评估者的观点与早期研究中全科医生培训学员的观点相呼应，强调了应采取行动加强评估系统的领域，以便WPBA提高医生的表现。专业对话和自由文本评论的空间最有可能为该过程增添价值。跨医院和全科医生导师共享信息也有助于识别表现优异的培训学员，而不仅仅是那些有困难的学员。这将有助于解决一个核心批评，即WPBA关注的是最低能力标准而非卓越标准，从而失去了培训学员的重要动力，并削弱了WPBA在培养更优秀医生方面的作用。
