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Impact of workplace based assessment on doctors’ education and performance: a systematic review

BMJ 2010; 341 doi: (Published 24 September 2010) Cite this as: BMJ 2010;341:c5064

Clinical meetings are underutilized opportunities for workplace based assessment.

Now that workplace based assessment is well entrenched in
postgraduate medical education in the United Kingdom and the European
Union [1, 2], the evidence of its educational impact and its ability to
change doctors' performance is encouraging [3]. However, workplace based
assessment is time consuming, resources for educational supervision have
not been clearly identified, and there are very significant pressures on
educational supervisors who lack time within their clinical job plans to
supervise and give feedback to trainees [4].

We have developed an innovative workaround by utilizing routine
clinical and educational activity. Medical grand rounds, mortality and
morbidity meetings, results meetings, multidisciplinary meetings, medical
audit and journal clubs present excellent opportunities for trainees and
trainers to undertake certain types of workplace based assessment such as
case-based discussion, teaching observation and audit assessment. By
presenting or discussing clinical cases at these meetings trainees can
complete workplace based assessment in a more supportive, real-life
environment, and receive feedback from their assessor as well as peers and
colleagues. Trainees often invest more effort into their preparation, and
the complexity of cases that is dealt with at these meetings helps to
broaden their education. In our experience this complements conventional
one-to-one supervision and feedback, lends itself to better formative
evaluation, spreads out assessment over the duration of the training post,
and reduces the pressure of time for both trainees and trainers.

Donal Bradley, foundation year 1 doctor

Akheel A. Syed, consultant physician & honorary lecturer,
University of Manchester

Salford Royal NHS Foundation Trust & University Teaching
Hospital, Salford, Greater Manchester M6 8HD

Competing interests: nil


1. Sandars J. Continuing medical education across Europe. BMJ.

2. Horsley T, Grimshaw J, Campbell C. Maintaining the competence of
Europe's workforce. BMJ. 2010;341:c4687.

3. Miller A, Archer J. Impact of workplace based assessment on
doctors' education and performance: systematic review. BMJ 2010;341:c5064

4. General Medical Council. Workplace based assessment: a guide for
implementation. 2010.

Competing interests: No competing interests

02 October 2010
Donal C. Bradley
Foundation Year 1 Doctor
Akheel A. Syed
Salford Royal NHS Foundation Trust & University Teaching Hospital, Salford, Greater Manchester M6 8H