LETTER TO THE EDITOR
Work-Based Assessments: Do Not Forget The Formative!
As UK core surgical trainees, we regularly undertake workbased assessments (WBAs). From our training outset, we have been taught the message of Munsch, who, as Chairman of the Joint Committee on Surgical Training, in 2009 stated that WBAs are “feedback tools to guide and direct training, rather than summative competency-based assessments.”1 To differentiate between candidates in a highly competitive environment, some higher training application forms now require applicants to state numbers of WBAs completed per year of training, accompanied by statements regarding the ratio of below average, satisfactory, and above average ratings.2 An application scoring system that includes criteria such as “majority of reports satisfactory with none below average”2 would disincentivize trainees from undertaking any WBAs early in a learning process. Using WBAs as “numbers” to score points threatens to undermine their formative and educational value at a stage where directional feedback is most valuable. Objective evidence demonstrating the achievement of high-performance levels and clinical expertise is important within specialty-selection processes. However, there remains significant concern that current WBAs lack sufficient evidence of validity or reliability to support their use as an objective summative measure of ability in the context of surgery.3 The use of WBAs, believed to be formative at completion, to make high-stakes judgments, is misleading and a
movement of the goalposts. We question the policy of introducing such a scoring system into competitive ST3 applications as a harmful misapplication of learning tools undermining their usefulness as “feedback tools to guide and direct training.”1
Rebecca Nicholas John Whitaker Royal London Hospital, London, United Kingdom E-mail: [email protected] (J. Whitaker)
REFERENCES 1. Munsch C. British surgeons’ experiences of mandatory
online workplace-based assessment—reply to authors. J R Soc Med. 2009;102(9):357-358. 2. Shared Services. National Plastic Surgery Recruitment.
〈Available at: http://www.londondeanery.ac.uk/var/ recruitment/specialtyrecruitment/national-plastic-surgeryrecruitment〉 Accessed 20.08.13.
3. Pereira EA, Dean BJ. British surgeons’ experiences of a
mandatory online workplace based assessment portfolio resurveyed three years on. J Surg Educ. 2013;70(1): 59-67.
Correspondence: Inquiries to John Whitaker, Royal London Hospital, Whitechapel Road, London E11BB, United Kingdom;
Journal of Surgical Education & 2014 Association of Program Directors in Surgery. Published by 1931-7204/$30.00 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jsurg.2014.01.016
281
Work-Based Assessments: Do Not Forget The Formative!
As UK core surgical trainees, we regularly undertake workbased assessments (WBAs). From our training outset, we have been taught the message of Munsch, who, as Chairman of the Joint Committee on Surgical Training, in 2009 stated that WBAs are “feedback tools to guide and direct training, rather than summative competency-based assessments.”1 To differentiate between candidates in a highly competitive environment, some higher training application forms now require applicants to state numbers of WBAs completed per year of training, accompanied by statements regarding the ratio of below average, satisfactory, and above average ratings.2 An application scoring system that includes criteria such as “majority of reports satisfactory with none below average”2 would disincentivize trainees from undertaking any WBAs early in a learning process. Using WBAs as “numbers” to score points threatens to undermine their formative and educational value at a stage where directional feedback is most valuable. Objective evidence demonstrating the achievement of high-performance levels and clinical expertise is important within specialty-selection processes. However, there remains significant concern that current WBAs lack sufficient evidence of validity or reliability to support their use as an objective summative measure of ability in the context of surgery.3 The use of WBAs, believed to be formative at completion, to make high-stakes judgments, is misleading and a
movement of the goalposts. We question the policy of introducing such a scoring system into competitive ST3 applications as a harmful misapplication of learning tools undermining their usefulness as “feedback tools to guide and direct training.”1
Rebecca Nicholas John Whitaker Royal London Hospital, London, United Kingdom E-mail: [email protected] (J. Whitaker)
REFERENCES 1. Munsch C. British surgeons’ experiences of mandatory
online workplace-based assessment—reply to authors. J R Soc Med. 2009;102(9):357-358. 2. Shared Services. National Plastic Surgery Recruitment.
〈Available at: http://www.londondeanery.ac.uk/var/ recruitment/specialtyrecruitment/national-plastic-surgeryrecruitment〉 Accessed 20.08.13.
3. Pereira EA, Dean BJ. British surgeons’ experiences of a
mandatory online workplace based assessment portfolio resurveyed three years on. J Surg Educ. 2013;70(1): 59-67.
Correspondence: Inquiries to John Whitaker, Royal London Hospital, Whitechapel Road, London E11BB, United Kingdom;
Journal of Surgical Education & 2014 Association of Program Directors in Surgery. Published by 1931-7204/$30.00 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jsurg.2014.01.016
281
