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PMETB on assessmentAn assessment systemIn this paper, an assessment system refers to an integrated set of assessments which is in place for the entire postgraduate training programme and which supports the curriculum. It may comprise different methods, and be implemented either as national examinations, or as assessments in the workplace. Competence and performanceThe balance between these two approaches principally relates to the relationship between competence and performance. Competence (can do) is necessary but not sufficient for performance (does do), and as experience increases so performance-based assessment becomes more important.
Principles and standards for an assessment system for postgraduate medical training1. The assessment system must be fit for a range of purposes§ The overall purpose of the assessment system must be documented and in the public domain § The purposes of each and all components of the assessment system must be specified and available to the trainees, educators, employers, professional bodies including the regulatory bodies, and the public § The sequence of assessments must match the progression through the career pathway § Individual assessments within the system should add unique information and build on previous assessments. 2. The content of the assessment [sample of knowledge, skills and attitudes] will be based on curricula for postgraduate training which themselves are referenced to all of the areas of Good Medical Practice§ The programme will be based on an overall specification of the content for all component assessments, in order to avoid overlap or gaps § Assessments will together systematically sample the entire content, appropriate to the stage of training, with reference to the clinical problems that the trainee will encounter in the workplace and to the wider base of knowledge, skills and attitudes that doctors require § The blueprint from which assessments in the workplace or national examinations are drawn will be available to trainees and educators in addition to assessors/examiners 3. The methods used within the programme will be selected in the light of the purpose and content of that component of the assessment framework.§ Methods will be chosen on the basis of validity, reliability, feasibility, cost-effectiveness, opportunities for feedback, and impact on learning. § The rationale for the choice of each assessment method will be documented and evidence-based § Large scale competence tests (e.g., MRCP, MRCGP, MRCPsych)
§ Work-based assessments (e.g., direct observation of consulting, 360 deg assessment, and case based discussions)
4. The methods used to set standards for classification of trainee’s performance/competence must be transparent and in the public domain§ Standards in tests of competence such as national Royal College examinations, will be set using recognised methods based on test content and the judgments of competent assessors § Where the purpose of the test is to provide a pass/fail decision, information from the performance of reference groups of peers should inform, but not determine, the standard § The precision of the pass/fail decision must be reported on the basis of data about the test. The purpose of the test must determine how the error around the pass/fail level affects decisions about borderline candidates. § Reasons for choosing either pass/fail or rank ordering should be described. § Standards for determining successful completion of training to CST level should be stated. 5. Assessments must provide relevant feedback§ The policy and process for providing feedback to trainees following assessments must be documented and in the public domain § The form of feedback must match the purpose of the assessment § Outcomes from assessments must be used to provide feedback on the effectiveness of education and training where consent from all interested parties has been given. 6. Assessors/examiners will be recruited against criteria for performing the tasks they undertake§ The roles of assessors/examiners will be specified and used as the basis for recruitment and appointment § Assessors or examiners must demonstrate their ability to undertake the role § Assessors/examiners should only assess in areas where they have competence. § The relevant professional experience of assessors should be greater than that of candidates being assessed § Equality and diversity training will be a core component of any assessor/examiner training programme 7. There will be Lay input in the development of assessment§ Lay opinion will be sought in relation to appropriate aspects of the development, implementation and use of assessments for classification of candidates. § Lay people may act as assessors/examiners for areas of competence they are capable of assessing. 8. Documentation will be standardised and accessible nationally.§ Documentation will record the results and consequences of assessments and the trainee’s progress through the assessment system § Information will be recorded in such a way as to be disc losable and available for appropriate access, within the confines of data protection. § Uniform documentation will be suitable not only for recording progress through the assessment system but also for submission for purposes of registration and performance review § Documentation should provide evidence for revalidation and compliance with Good Medical Practice § Documentation should be transferable and accessible as the trainee moves location § Documentation should be comprehensive and accessible to both to the trainee and to those responsible for training. 9. There will be resources sufficient to support assessment§ Resources will be made available for the proper training of assessors § Resources and expertise will be made available to develop and implement appropriate assessment methods § Resources will support the assessment of trainees at national and local levels § Appropriate infrastructure at national, deanery and Trust levels will support assessment.
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