Utility of Workplace-Based Assessment Among Surgical Residents: A Systematic Literature Review
Keywords:Resident Training, Surgical Training, Assessment, Work-based assessment, Direct Observation of Procedural Skills, Clinical Evaluation Exercise, Case based discussion, Procedure based assessment
IMPORTANCE This review article aims to assess the usefulness of Workplace-Based Assessment (WBA) among surgical residents. Multiple studies have been done in the past to determine the utility of WBAs across different fields of medicine. But it hasn’t been done among surgical specialties on large scale, and the present paper fills in this research gap.
METHODS Articles were searched using PubMed and Google Scholar databases up to 30th June 2022. Following headings were used for the literature search i.e work-based assessment or workplace-based assessment or WBAs or direct observation of procedural skills or DOPS or procedure-based assessments or PBA or Case-based discussion or CBD or clinical evaluation exercise or CEX or Mini CEX, and surgical training. The utility formula of Vleuten was used to assess the usefulness of WBA. It is a product of validity, reliability, educational impact, acceptability, cost-effectiveness, and feasibility.
RESULTS For reviewing purposes, 29 studies were selected. There were 8 studies on PBA, 2 on Mini-CEX, 2 on CBD, 6 on DOPS, and 11 studies on multiple methods of WBA. PBA had positive satisfaction levels and was valid, reliable, feasible, and acceptable. CBD. Mini-CEX and CBD had very few studies in which they were proved to be reliable and valid but had mixed responses in terms of satisfaction levels. DOPS had a level 1 educational impact and also proved to be valid. When all components of WBAs were used together, a negative level 1 educational impact was observed. The concerns that were identified include lack of time, training and evidence of validity, design of the tool, and perception of WBA as a summative tool.
DISCUSSION Work-based Assessments should be implemented and used properly after the training of faculty. The focus should be on the quality of the assessments, not on the quantity. Large-scale studies should be done to assess level 3 and 4 of educational impact from WBAs.
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