Assessment methods in respiratory medicine training in Europe: current status and future needs

Abstract

There is a perceived need for harmonisation of training standards in medicine across Europe. Assessment methodology is a fundamental part of this harmonisation. Assessment may be: summative, measuring competency at the end of training, usually in a pass/fail mode; or formative, assessing strengths and weaknesses during training with a view to optimising performance. A survey of experienced respiratory medicine trainers in Europe was undertaken to discover the formative and summative assessment methods being used, and to explore the use of workplace-based assessments (WBAs). Structured interviews were sought with experienced trainers in adult and paediatric respiratory medicine. 35 trainers from 22 (71%) out of 31 countries were interviewed.The number of types of summative assessments required at the end of training varied from 0 to 4 including clinical (25%), written (44%) and oral (47%) examinations. Four respondents required a research thesis as a proof of clinical competence.WBA was not commonly used. Only 14% of respondents reported using a formal case-based discussion, 20% used a form of multisource feedback and 25% described some form of formal assessment of procedural skills. However, 77% of all respondents expressed a wish to have access to case-based discussion and 72% wanted to have a facility for multisource feedback. The majority also wanted training in the use of these tools. Almost half of the respondents had received no formal training in educational supervision and 80% of all respondents expressed a wish to receive such training.The findings suggest that there is no adequate process of ensuring uniform standards for specialist accreditation in Europe, and demonstrate a need and desire among trainers for more WBA tools and training in their use to be made available.

Meaningful in-training and end-of-training assessment: The need for implementing a continuous workplace-based formative assessment system in our training programs

“…Portfolios make one of the essential tools to evaluate the progress of a trainee in addition to the fact that they help the trainees to assess themselves by reflection and keep them focused on their learning goals. 12 Our trainees were alien to the concept of portfolios with no access to reflective learning and have long been entangled in the concept of spoon-feeding and apprenticeship. This cycle of self-pity and holding others responsible for personal failure and lack of goals needs to be terminated with objectivisation of assessment programs.…”