Network principles for prevocational medical training - HETI

Trainee assessment
Workplace-based assessment: As far as possible, assessment should be based on real work
activities, or accurate simulation of work activities. The goal of formative assessment is to give
trainees feedback that will help them improve their real-world performance. The goal of summative
assessment is to measure their level of performance in actual clinical practice.
Workplace-based assessment can be unstructured, based on general observation of work activity,
but there is evidence that repeated, specific, structured assessments (eg, mini clinical examinations,
direct observation of procedural skills) is more reliable.
Trainee observation by supervisors: The key to meaningful assessment is direct observation
of trainee performance. Term supervisors are charged with the responsibility to assess trainee
performance. They can and should talk to other members of the clinical team about the trainee,
seeking their observations and opinions, but this cannot be a substitute for direct observation.
Self-assessment: Self-assessment was introduced as a formal component of prevocational
assessment with the new progress review forms in 2009 after consultation (especially with trainees)
indicated that this was desirable. Doctors must be able to recognise their strengths and limitations
if they are going to provide safe and effective patient care. Skill in self-assessment is fundamental
to self-directed continuing medical education, which in turn is essential for maintaining competence
and improving professional practice throughout a clinical career.
DPETs and supervisors can encourage self-assessment by:
• z modelling self-awareness and reflective practice themselves
• z inviting trainees to comment on their own performance and using trainee self-assessment as
the starting point of dialogues about performance (“How do you think you went with that?”)
• z asking to see trainee logbooks, journals or other written evidence of reflective practice.
Team-based assessment: Term supervisors should seek the opinion of other team members about
the performance of trainees and use this information to augment their own observations.
Team-based assessment works best in clinical teams that practise open communications and
mutually respectful professional discourse.
Term orientation: For assessment purposes, Term Supervisors should arrange (at least) three
meetings with each prevocational trainee in each term. The first of these occurs at term orientation in
week 1, when the Term Supervisor reviews the term description with the trainee and discusses:
• z the major focus and goals of the clinical unit and the expectations of the trainee’s role
• z term learning objectives and skills training goals
• z supervision needs and the process of performance assessment
• z the trainee’s current level of knowledge and experience (the trainee should be invited to show
evidence, and an individual learning plan for the term should be developed).
Mid-term formative appraisal: HETI asks that trainees and term supervisors complete a midterm
formative appraisal form in week 5 of each training term. The trainee completes their written
self-assessment before meeting with the Term Supervisor. Self-assessment provides a basis for
discussing progress and planning the future direction of training during the term. The trainee is
asked to outline personal strengths and achievements and identify weaknesses or needs for further
development. The Supervisor then offers feedback in the same manner, and completes their written
appraisal of the trainee.
There is no pass or fail mark in formative assessment, but if performance problems are identified in
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