15 - A trainee perspective of workplace-based assessments

Summary

The introduction of workplace-based assessments (WPBAs) represented a significant shift in the culture of postgraduate medical education. The assessments became compulsory for specialty trainees in August 2007, at a time of significant upheaval within the profession. Many trainees were already experiencing significant stress (Whelan et al, 2008) following the disasters of specialty selection resulting from the Medical Training Application System (MTAS), and confidence about the ability of the leaders of the profession to make the right decisions for medical training was low. In addition, many trainees were unclear about the role of the Royal College of Psychiatrists in their training since the advent of the Postgraduate Medical Education and Training Board (PMETB). Concurrently, changes were being made to the MRCPsych examinations with the familiar long case, critical appraisal and essay papers being replaced. Changing guidelines about the role of WPBA in the new examination eligibility criteria compounded the confusion for trainees and trainers. Unfortunately, the combination of these circumstances created a negative preconception for many trainees about the implementation of a new form of assessment. Workplace-based assessments were perceived by some trainees as being an unwanted imposition that added additional hurdles to their training.

In this chapter we will outline the benefits and challenges of WPBAs from the perspective of psychiatric trainees. Although we have focused on psychiatry, many of the issues are also relevant to those in other medical specialties. We will consider the WPBA tools in turn, their role in the overall assessment of competence, their impact on the trainee–trainer relationship, and the practicalities of their implementation and delivery, including the online system. Finally, we will highlight areas that need further development. In writing this chapter we have drawn upon our experiences as two trainees who have fallen either side of the Modernising Medical Careers (MMC) reforms. Between us, we have experience of undertaking WPBA as part of the new curriculum and also as assessors for junior colleagues. As past chairs of the College's Psychiatric Trainees’ Committee we have incorporated feedback from trainees throughout the UK about their experience of the implementation of WPBA.