Division of Medical Education, Dalhousie University, Halifax, Nova Scotia, Canada.
Department of Emergency Medicine, Stanford University , Palo Alto, California, USA.
Perspect Med Educ. 2020 Aug;9(4):201-209. doi: 10.1007/s40037-020-00594-0.
Competency-based medical education (CBME) hinges on robust assessment. However, integrating regular workplace-based assessment within demanding and sometimes chaotic clinical environments remains challenging. Many faculty lack assessment expertise, and some programs lack the infrastructure and faculty numbers to fulfill CBME's mandate. Recognizing this, we designed and implemented an assessment innovation that trains and deploys a cadre of faculty to assess in specialties outside their own. Specifically, we explored trainees' perceptions of and receptiveness to this novel assessment approach.
Within Western University's Surgical Foundations program, 27 PGY‑1 trainees were formatively assessed by trained non-surgeons on a basic laparoscopic surgical skill. These assessments did not impact trainees' progression. Four focus groups were conducted to gauge residents' sentiments about the experience of cross-specialty assessment. Data were then analyzed using a thematic analysis approach.
While a few trainees found the experience motivating, more often trainees questioned the feedback they received and the practicality of this assessment approach to advance their procedural skill acquisition. What trainees wanted were strategies for improvement, not merely an assessment of performance.
Trainees' trepidation at the idea of using outside assessors to meet increased assessment demands appeared grounded in their expectations for assessment. What trainees appeared to desire was a coach-someone who could break their performance into its critical individual components-as opposed to an assessor whose role was limited to scoring their performance. Understanding trainees' receptivity to new assessment approaches is crucial; otherwise training programs run the risk of generating more assessments without added value.
基于能力的医学教育（CBME）取决于强大的评估。然而，在要求苛刻且有时混乱的临床环境中，将常规的基于工作场所的评估纳入其中仍然具有挑战性。许多教师缺乏评估专业知识，而有些课程缺乏基础设施和教师人数来满足 CBME 的要求。认识到这一点，我们设计并实施了一项评估创新，培训并部署了一批教师来评估其自身专业以外的其他专业。具体来说，我们探讨了学员对这种新颖评估方法的看法和接受程度。
在西安大略大学的外科基础课程中，27 名 PGY-1 受训者接受了受过培训的非外科医生对基本腹腔镜手术技能的形成性评估。这些评估不会影响学员的进展。进行了四次焦点小组讨论，以了解学员对跨专业评估这一新评估方法的感受。然后使用主题分析方法对数据进行分析。
尽管有少数学员认为这种体验很有动力，但更多的学员对他们收到的反馈以及这种评估方法对推进他们程序技能获取的实用性提出了质疑。学员们想要的是改进策略，而不仅仅是对表现的评估。
学员对使用外部评估员来满足增加评估需求的想法感到担忧，这似乎是基于他们对评估的期望。学员似乎渴望的是一位教练——可以将他们的表现分解为关键的单个组成部分的人——而不是仅负责评分的评估员。了解学员对新评估方法的接受程度至关重要；否则，培训计划可能会在没有增加价值的情况下生成更多评估。
