1. Work Place Based Assessment
Dr Stephen Hailey

2. Aims Why WPBA? What tools? When applied? How to apply them?
A bit of theory
Pros and cons
What tools?
When applied?
How to apply them?
A bit of practice....

3. Miller’s Triangle

4. Pros: measuring actual performance
Assessing the unmeasurable?
What doctors do in controlled assessment conditions does not always collate with actual performance.
Placing the assessment in the workplace helps to find out what a clinician actually DOES.

5. Pros: High educational impact
Traditional assessments maximise reliability or reproducibility
Negative educational impact as no meaningful feedback
WPBA less reliable but can have high educational impact
Assessment is ‘built in’ rather than ‘bolt on’

6. Pros: Multiple sampling
The more measurements you take the more reliable the overall picture
WPBA use multiple methods and multiple sampling

7. Cons: poor reliability
Inter & Intra observer variability
Poor application of criteria
Poorly trained assessors
Poor calibration of assessors

8. Cons: trainer vs. assessor

9. Trainer vs. assessor Potential for conflict of roles
Being assessed by someone who has a vested interest in your performance
It is vital that both trainer and the trainee understand the distinction of these roles
Assessment needs to clearly defined from teaching

10. The tools
MSF
COT
Mini CEX
DOPs
CbD
PSQ
CSR

11. Competency area MSF PSQ COT CbD CEX Supervisor structured report
Communication & consultation skills
Practising holistically
Data gathering and interpretation
Making a diagnosis / decisions
Clinical management
Managing medical complexities
Primary care admin & IMT
Working with colleagues & in teams
Community orientation
Maintaining performance, learning & teaching
Maintaining an ethical approach
Fitness to practice

12. ST1

13. DOPS: Direct Observation of Procedural Skills
There are eight mandatory procedures to be covered:
Application of simple dressing
Breast examination
Cervical cytology
Female genital examination
Male genital examination
Prostate examination
Rectal examination
Testing for blood glucose
Some of these procedures may be combined e.g. prostate and rectal examinations

14. Case Based Discussion
A structured interview designed to explore professional judgement exercised in clinical cases
GPStR is responsible for selecting cases
Ensure that a balance of cases

15. CBD ST1 and 2, the GPStR will select two cases
ST3, the GPStR will select four cases
Including all documentation
1 week prior to discussion
Trainer will select cases to be discussed

16. CBD
About 20min for each discussion with 10min feedback

17. CBD Important points Selecting the cases Quality of record keeping
Planning the questions
Documenting the outcomes
Structured feedback

18. Consultation Observation Tool

19. Multi-source feedback
The MSF highlights two things:
performance (areas to be commended)
possible suggested areas for development
 Need to do
2 SETS OF 5 PER YEAR IN ST1 (clinicians only)
NONE IN ST2
2 SETS OF 10 in ST3 (5 clinicians and 5 non-clinicians)

20. MSF and feedback Preparation ECO model Specific Describe not judge
Empathy

21. Patient satisfaction questionnaire
40 questionnaires
Inputted by practice
Results released to trainer
Shared in meeting with trainee
Feedback guidance applies