title: Profiling postgraduate workplace-based assessment implementation in Ireland: a retrospective cohort study.
abstract: In 2010, workplace-based assessment (WBA) was formally integrated as a method of formative trainee assessment into 29 basic and higher specialist medical training (BST/HST) programmes in six postgraduate training bodies in Ireland. The aim of this study is to explore how WBA is being implemented and to examine if WBA is being used formatively as originally intended. A retrospective cohort study was conducted and approved by the institution's Research Ethics Committee. A profile of WBA requirements was obtained from 29 training programme curricula. A data extraction tool was developed to extract anonymous data, including written feedback and timing of assessments, from Year 1 and 2 trainee ePortfolios in 2012-2013. Data were independently quality assessed and compared to the reference standard number of assessments mandated annually where relevant. All 29 training programmes mandated the inclusion of at least one case-based discussion (max = 5; range 1-5). All except two non-clinical programmes (93 %) required at least two mini-Clinical Evaluation Exercise assessments per year and Direct Observation of Procedural Skills assessments were mandated in 27 training programmes over the course of the programme. WBA data were extracted from 50 % of randomly selected BST ePortfolios in four programmes (n = 142) and 70 % of HST ePortfolios (n = 115) in 21 programmes registered for 2012-2013. Four programmes did not have an eligible trainee for that academic year. In total, 1142 WBAs were analysed. A total of 164 trainees (63.8 %) had completed at least one WBA. The average number of WBAs completed by HST trainees was 7.75 (SD 5.8; 95 % CI 6.5-8.9; range 1-34). BST trainees completed an average of 6.1 assessments (SD 9.3; 95 % CI 4.01-8.19; range 1-76). Feedback-of varied length and quality-was provided on 44.9 % of assessments. The majority of WBAs were completed in the second half of the year. There is significant heterogeneity with respect to the frequency and quality of feedback provided during WBAs. The completion of WBAs later in the year may limit available time for feedback, performance improvement and re-evaluation. This study sets the scene for further work to explore the value of formative assessment in postgraduate medical education.
authors.affiliation: Education and Professional Development Unit, Royal College of Physicians of Ireland, Frederick House, 19 South Frederick St, Dublin 2, Ireland ; School of Medicine, College of Medicine and Health Sciences, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland.
authors.forename: Aileen
authors.initials: A
authors.lastname: Barrett
authors.affiliation: Discipline of Physiotherapy, Department of Clinical Therapies, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
authors.forename: Rose
authors.initials: R
authors.lastname: Galvin
authors.affiliation: Centre for Medical Education, Faculty of Medicine, McGill University, Lady Meredith House, 1110 Pine Avenue West, Montreal, QC H3A 1A3 Canada.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Steinert
authors.affiliation: Faculty of Health, Medicine and Life Sciences, University of Maastricht, Universiteitssingel 60, 6229 ER Maastricht, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Scherpbier
authors.affiliation: Education and Professional Development Unit, Royal College of Physicians of Ireland, Frederick House, 19 South Frederick St, Dublin 2, Ireland.
authors.forename: Ann
authors.initials: A
authors.lastname: O'Shaughnessy
authors.affiliation: Education and Professional Development Unit, Royal College of Physicians of Ireland, Frederick House, 19 South Frederick St, Dublin 2, Ireland.
authors.forename: Gillian
authors.initials: G
authors.lastname: Walsh
authors.affiliation: School of Medicine, College of Medicine and Health Sciences, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: Horgan
keywords: Postgraduate medical education; Retrospective cohort study; Workplace-based assessment