Community and Health Research Unit, School of Health and Social Care, University of Lincoln and Research and Development Lead for Assessment, Royal College of General Practitioners, Lincolnshire, UK.
Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK.
Educ Prim Care. 2024 Sep;35(5):147-159. doi: 10.1080/14739879.2024.2379525. Epub 2024 Aug 8.
Workplace-Based Assessment (WPBA) forms a major component of the UK General Practitioner (GP) licensing, together with knowledge and clinical skills examination. WPBA includes Case-based Discussion, Consultation Observation Tool, Mini-Consultation Exercise, Multisource Feedback, Patient Satisfaction Questionnaire, Clinical Examination and Procedural Skills, Clinical Supervisor's Report, and Educational Supervisor Review. We aimed to investigate GP trainees' and trainers' perceptions and experiences of WPBA regarding validity and fairness.
We used a national online survey, with Likert-scaled and free-text responses, to a convenience sample of GP trainees and trainers, on perceptions and experiences of WPBA. Analysis included descriptive statistics, scale development, and regression models to investigate factors associated with attitudes towards WPBA, with thematic analysis of free text responses supported by NVivo 12.
There were 2,088 responses from 1,176 trainees and 912 trainers. Both groups were generally positive towards WPBA, with trainers more positive or similar to trainees towards individual assessments. In a multivariable regression model, accounting for sex, ethnicity and country of primary medical qualification, trainees were significantly less positive ( < 0.001) while international medical graduates (IMGs) trained outside the European Economic Area (EEA) were significantly more ( < 0.001) positive towards WPBA. Qualitative analysis revealed varying concerns about validity and relevance, assessment burden, potential for bias, fairness to protected characteristics groups, gaps in assessment, and perceptions of individual assessments.
Trainers' greater positivity towards elements of WPBA accords with their role as assessors. Despite concerns about bias, IMGs from outside the EEA were significantly more positive towards WPBA.
基于工作场所的评估 (WPBA) 是英国全科医生 (GP) 执照的主要组成部分，与知识和临床技能考试一起。WPBA 包括基于案例的讨论、咨询观察工具、迷你咨询练习、多方反馈、患者满意度问卷、临床检查和程序技能、临床主管报告和教育主管审查。我们旨在调查 GP 受训者和培训师对 WPBA 的有效性和公平性的看法和经验。
我们使用全国在线调查，对 GP 受训者和培训师的便利性样本进行了李克特量表和自由文本回复，以了解他们对 WPBA 的看法和经验。分析包括描述性统计、量表开发和回归模型，以调查与对 WPBA 的态度相关的因素，并通过 NVivo 12 对自由文本回复进行主题分析。
共有 1176 名受训者和 912 名培训师中的 2088 人做出了回应。这两组人对 WPBA 普遍持积极态度，培训师对个别评估的态度比受训者更积极或相似。在一个多变量回归模型中，考虑到性别、种族和初级医疗资格的国籍，受训者对 WPBA 的态度明显不那么积极（<0.001），而在欧洲经济区（EEA）以外接受培训的国际医学毕业生（IMG）则明显更积极（<0.001）。定性分析揭示了对有效性和相关性、评估负担、潜在偏见、对受保护特征群体的公平性、评估差距以及对个别评估的看法的不同关注。
培训师对 WPBA 各个要素的积极性更高，这与他们作为评估者的角色相符。尽管对偏见存在担忧，但来自 EEA 以外的 IMG 对 WPBA 的态度明显更为积极。
