The Case for Integrating Multi-Source Data for a Fairer and Holistic Judgement of Competence in Medical Education & Training Tackling Differential Attainment in Medical Professions - Bridging the Gap Workshop Series 2020

Main Article Content

Subodh Dave
Roshelle Ramkisson
Chelliah R Selvasekar
Indranil Chakravorty

Abstract

Being a doctor in the 21st Century requires a diverse range of skills, a broad base of knowledge and a suite of professional values and attitudes that enable the clinical practice to be safe, effective and caring. Doctors, irrespective of their speciality, need to be knowledgeable and skilful not just in their area of expertise but also need a range of generic skills and capabilities such as communication, leadership, academic scholarship and research, teaching, quality improvement, advocacy, digital literacy to name a few. These capabilities, all relevant to clinical practice, are assessed routinely in clinical settings. This rich information about trainees, available from their formative assessments, does not inform high-stakes judgements about progression. Instead, these judgements are usually made on the basis of summative examinations conducted in simulated settings.


 


Unfortunately, these summative assessments have consistently delivered results with a large magnitude of the differential between the outcomes of candidates, based on factors such as ethnicity, gender, other protected characteristics and also the country of primary medical qualification. Formative assessment during training, however, is individualised and tends not to show this level of difference; leading to a situation where failure in summative examinations comes as a surprise to both trainees and to training programme directors.


 


There is evidence that periodic assessment of trainees’ acquisition of core capabilities can help make balanced, informed judgements about readiness for progression. The move from a pass/fail categorisation to a yet/not yet categorisation when coupled with appropriate remedial measures can improve, both the validity, as well as the fairness of assessments.  


 


The large magnitude of the differential in outcomes of high-stakes assessments cannot be fixed by tweaking current assessment systems. Instead, there needs to be a recognition that high-level of capabilities consistently demonstrated in the workplace need to play a role in judgements about progression. Failure to do so is unfair, wasteful of public finances, and in breach of the trust places by the public, in training safe and competent clinicians.

Article Details

How to Cite
Dave, S., Ramkisson, R., Selvasekar, C. R., & Chakravorty, I. (2020). The Case for Integrating Multi-Source Data for a Fairer and Holistic Judgement of Competence in Medical Education & Training: Tackling Differential Attainment in Medical Professions - Bridging the Gap Workshop Series 2020. Sushruta Journal of Health Policy & Opinion, 14(1), 1-9. https://doi.org/10.38192/14.1.1
Section
Articles
Author Biographies

Subodh Dave, University of Bolton, UK

Professor of Psychiatry,

Consultant Psychiatrist, Royal Derby Hospitals NHS Trust, Derby, UK

Roshelle Ramkisson, Manchester Mental Health Trust, Manchester, UK

Consultant Psychiatrist & Training Program Director, Academic Programmes, Health Education England NW

Chelliah R Selvasekar, Christie Hospital, Manchester, UK

Consultant Oncological Surgeon

Indranil Chakravorty, St Georges University of London, UK

Director of Medical Education

Chair, BAPIO Institute for Health Research, Bedford, UK

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