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Chapter Highlights
This chapter defines workplace-based assessment (WBA) and characterizes its purpose within a program of assessment to describe learners’ interactions with patients and teams and performance of essential tasks in the workplace.
Many available tools for WBA exist, and educators select tools based on the skills deemed important to observe and feasibility and acceptability of the tool for the learners and observers in a particular educational and clinical context.
Successful implementation of WBA requires a change in learning culture to promote learners’ and supervisors’ understanding of and skill with direct observation and feedback.
Feedback represents dialogue centered within the learner–supervisor relationship where supervisors use WBA data to guide learners in reflecting on their performance, identifying gaps, and generating plans for improvement.
Quality assurance of the WBA system requires communicating the purpose and use of WBA to participants, monitoring data quality, and creating and assessing a plan for aggregating data to make decisions about learner competence.
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ORIENTATION TO THE CHAPTER
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This chapter focuses on the use of WBA as part of a program of assessment within a medical education curriculum. The chapter begins with a general overview and definitions of key terms related to WBA. The introduction is followed by a focus on feedback because effective feedback discussions are essential for learners to achieve learning benefit from WBA experiences. Training in effective feedback should emphasize the importance of placing the learner at the center of a feedback conversation and establishing trusting learner–teacher relationships for feedback to promote learner growth and performance change. Next, the chapter turns to implementation issues, including tool selection or development, and capturing information through ratings and narrative comments. Implementation considerations also tackle the many components of the context in which the tool is used, including the local culture, clinical and educational context, systems, people and technology. Introducing WBA into an educational program requires a robust communication plan so that educational program leaders, learners and teachers are aligned in their understanding of what is to be done, why it is being done, and how it should be done. Faculty and all assessors must receive training that includes expectations for learner performance, strategies to incorporate WBA into a clinical workflow, and methods of engaging in feedback discussions. The chapter concludes by addressing considerations for using WBA information to make judgments about learner performance and guide future learning, including how to synthesize information for these purposes. Programs must also attend to quality assurance by monitoring the data collected and procedures used. Case examples throughout the chapter serve as examples to illustrate key points about WBA.
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Defining Workplace-Based Assessment
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Workplace-based assessment entails assessment of performance in practice [1]. WBA targets the highest level on Miller’s pyramid of assessment [2]: What the learner does in actual practice (see Figure 4-1 from previous chapter). Collecting and ...