Group assessment of residents’ clinical skills using Case-based Discussions is feasible, highly valued and moreover fosters learning

Abstract

Background Assessment of residents’ clinical skills using Case-based Discussion traditionally involves a one-to-one discussion with a supervisor. This entails a subjective, and maybe unequal, assessment of the resident, which can only be overcome with the use of multiple assessors. The purpose of this study was to explore residents’ and assessors’ perception of a group-assessment concept.Methods Eleven to fifteen residents in a medical department met 4 times (every 3rd month) over 1 year for 5 hours each time. The residents took turns presenting clinical cases within a predefined topic and discussed it with peers and assessors (diagnosis, differential diagnosis, ethical considerations etc.). Four assessors (specialists in internal medicine) participated in the discussion and together assessed the residents` clinical skills. An external consultant observed the group-assessment several times and conducted semi-structured interviews with the residents as well as the assessors. Notes from the observations and transcribed interviews were analyzed using an inductive approach looking for participants’ perceptions of the concept.Results Both residents and assessors preferred the group-assessment to the individual assessment. Since there were several assessors, the group-assessments were more consistent and regarded more resource-efficient and manageable than one-to-one assessments. The level of discussion was perceived to be higher in the group discussions compared to one-to-one discussions. All residents gained new knowledge during their assessment and in addition, also reported having learned from listening to the assessment of their peers. Assessors reported gaining new knowledge as well.Conclusions Group-assessment through Case-based Discussions is a good way to structure assessment of residents` clinical skills. The quality of the assessment process seems to be increased and is likely to be more objective than individual assessment. Group-assessment is feasible and acceptable, and additionally fosters learning for all participating doctors in the department.