Experiences with Workplace-Based Assessment in the Block Internship Training in Family Medicine
DOI: 10.3238/zfa.2017.0183-0187german translation / full article
Background: According to the Medical Licensure Act, students have to receive grades for undergraduate internship training in family medicine as well as for all other performance records in the second part of the medical school curriculum. In general, reviews about workplace-based assessment (WBA) are evaluated positively. However, there are also reservations concerning WBA, which lead to a decrease in learning effectiveness. With regard to the lack of exams for practical clinical skills in family medicine we aim to investigate the suitability of WBA.
Methods: During the period from winter semester 2012/13 to winter semester 2013/14, 164 teaching practices of the LMU Munich performed WBA by using a patient encounter card to assess their block interns. This card recorded one patient encounter each and was accessible beforehand to students and teachers. The teacher determined grades for four patient encounters based on a points system with regard to history taking, physical examination and counseling. In addition, one technical examination and the student’s communication and conduct were graded. We also evaluated the most common technical examinations and diagnoses among all encounters.
Results: We obtained 618 assessments for four patient encounters each. The highest score was received more than 400 times, which is equivalent to 65 % of all assessments, and the majority of students ranked very high on the rating scale. Data analysis was performed retrospectively.
Conclusions: The assessment form ensures transparency and consistent expectations. Furthermore, it takes into account various aspects of the students’ skills, which is close to a 360°-assessment. Specific didactical training for the teachers could be a suitable approach to make WBA an ideal instrument for grading the block internship training in family medicine.