Basu Indraneil, Parvizi Sahar, Chin Kian
Department of Surgery, Milton Keynes Hospital, Buckinghamshire, UK.
Clin Teach. 2013 Apr;10(2):73-7. doi: 10.1111/j.1743-498X.2012.00609.x.
Work-based assessments (WBAs) and the associated online feedback are fundamental parts of clinical training. Despite years of clinical use there is little evidence suggesting that they have a positive impact on learning or performance.
This observational pilot study investigates the perceptions of online WBAs (OnWBAs) across specialties in an attempt to establish why these tools are not meeting their full academic potential.
Structured questionnaires were given to 90 clinicians. Responses were analysed in excel, and spss 17 was used to test for statistical significance.
All responders felt that OnWBAs were a poor reflection of clinical competency, and did not enhance learning significantly. Consultant OnWBAs rated poorly against those performed by other grades. Consultant OnWBAs were significantly more difficult to obtain and took significantly longer to complete than those from other grades. Several consultants were inadequately trained in the use of OnWBAs, and most were unaware of the number of assessments required by trainees.
This study highlights several issues that may detract from the functionality of OnWBAs. Pockets of consultants are inadequately trained in the use of OnWBAs, and many lack knowledge of trainee requirements. In addition the delay between assessment and completion of feedback is a concern that goes against current recommendations. Simple measures in the workplace and the involvement of educational bodies could remedy some of these issues. Further studies investigating a wider population would help to establish the true extent of the problem and isolate the main causative factors behind these issues.
基于工作的评估（WBAs）及相关在线反馈是临床培训的基本组成部分。尽管已临床使用多年，但几乎没有证据表明它们对学习或表现有积极影响。
这项观察性试点研究调查了各专业对在线WBA（OnWBA）的看法，试图确定为何这些工具未充分发挥其学术潜力。
向90名临床医生发放了结构化问卷。在Excel中分析回复，并使用SPSS 17检验统计学显著性。
所有受访者都认为OnWBA不能很好地反映临床能力，也没有显著促进学习。顾问级别的OnWBA在评分上低于其他级别人员所进行的评估。与其他级别人员的评估相比，顾问级别的OnWBA获取难度显著更高，完成所需时间也显著更长。几位顾问在使用OnWBA方面培训不足，大多数人不清楚实习生所需的评估数量。
本研究突出了几个可能影响OnWBA功能的问题。部分顾问在使用OnWBA方面培训不足，许多人对实习生的要求缺乏了解。此外，评估与反馈完成之间的延迟令人担忧，这与当前建议相悖。工作场所的一些简单措施以及教育机构的参与可以解决其中一些问题。对更广泛人群进行的进一步研究将有助于确定问题的真实程度，并找出这些问题背后的主要成因。
