Feedback on work place based assessment wpba barnsley 24 may 2011
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Feedback on Work-Place Based Assessment (WPBA) Barnsley 24 May 2011 PowerPoint PPT Presentation


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Feedback on Work-Place Based Assessment (WPBA) Barnsley 24 May 2011. WPBA:. Case-based Discussion (CbD) Consultation Observation Tool (COT) Multi-Source Feedback (MSF) Patient Satisfaction Questionnaire (PSQ) Direct Observation of Procedural Skills (DOPS) Clinical Supervisors Report (CSR)

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Feedback on Work-Place Based Assessment (WPBA) Barnsley 24 May 2011

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Feedback on Work-Place Based Assessment (WPBA)Barnsley 24 May 2011


WPBA:

  • Case-based Discussion (CbD)

  • Consultation Observation Tool (COT)

  • Multi-Source Feedback (MSF)

  • Patient Satisfaction Questionnaire (PSQ)

  • Direct Observation of Procedural Skills (DOPS)

  • Clinical Supervisors Report (CSR)

  • Mini-CEX

  • ePortfolio


The importance of feedback

  • Always popular with GPRs

  • Generic skill

  • Education

  • Consulting

  • Life

  • Good fit with rules of adult learning


Key principles of adult learning(RCGP Learning and Teaching Guide 2008)

  • Self direction

  • Experiential

  • Needs-based

  • Problem centred


When to use feedback

  • Debriefing after clinical episodes or encounters

  • Significant events: the after-discussion

  • Educational review meetings: COT, CbD etc

  • After any situation where the registrar has learned something


When not to use feedback

  • Medical urgency

  • ‘Wally’ factor

  • Registrar not ready to learn

    (Keep the feedback until later)


A quotation:

‘Let no day pass without discussing goodness’

Socrates – The Apology


Another quotation:

‘Seek ye first the good things of the mind, and the rest will either be supplied or its loss will not be felt’

Francis Bacon


Principles of feedback [1](Middleton and Field. The GP Trainer’s Handbook, 2001)

  • Owned (‘I’ not ‘we’) NOT Implied

  • Planned NOT Impulsive

  • Honest NOT Collusive

  • Valid NOT Irrelevant (c.f. shared agenda)

  • Concerned NOT Destructive

  • Specific NOT Vague

  • Behaviour NOT Person


Principles of feedback [2]

  • Observation NOT Inference

  • Sooner NOT Later

  • Descriptive NOT Judgemental

  • Sharing ideas NOT Giving advice

  • Exploring alternatives NOT Providing answers

  • Good things NOT Only bad things


The ‘drug’ feedback(ibid)

Feedback should be used:

  • At the right time

  • At the right dose

  • With clarity and accuracy

  • When indicated

  • With the registrar’s concordance

  • With follow-up for the registrar’s benefit


The feedback sandwich(ibid)

The meat of constructive criticism…

should be sandwiched between…

two layers of positive comment


Generic feedback models

  • ALOBA (Agenda-Led Outcome-Based Analysis) 12 step approach

    (Kurtz, Silverman and Draper. Teaching and learning communication skills in medicine, 2005)

  • Pendleton 4 step approach

    (Pendleton et al. The Consultation, 1984)


ALOBA 1

Organising the feedback process:

  • Start with the learner’s agenda

  • Look at the outcomes the learner is trying to achieve

  • Encourage self-assessment and self problem-solving first

  • In a group setting, involve the whole group in problem solving


ALOBA 2

Giving useful feedback

  • Use descriptive feedback – encourage a non-judgemental approach

  • Provide balanced feedback

  • Make suggestions rather than prescriptive comments


ALOBA 3

Consolidating the feedback

  • Rehearse suggestions

  • Be well intentioned, valuing and supportive

  • In group settings, encourage others to ‘take the spotlight’ in rehearsing skills

  • Opportunistically introduce theory, research evidence and wider discussion


ALOBA 4

Summarising learning

  • A constructive end point is reached


Pendleton’s Rules

  • Clarify matters of fact

  • The registrar goes first

  • Good points first

  • Recommendations, not criticisms


Areas for COT/CbD feedback

  • Verbal comments on criteria and assessment

  • Filling in the boxes:

    • ‘Feedback and recommendations for further development:’

    • ‘Agreed action:’


Verbal comments

  • Observe ‘rules’ of feedback

  • Refer to descriptors

  • Justify grading, in particular:

    • If ‘Excellent’ explain why

    • If ‘Needs further development’ explain why, and recommendations for future development

      [if you don’t have ideas for future improvement, it isn't NFD]


Feedback and recommendations

  • Thumbnail of case. Computer number

  • Evidence to justify ‘E’ or ‘NFD’

  • Recommendations (how many?) – phrased as Aims


Agreed action

  • Maximum of 2 (? - discuss)

  • Phrased as Learning Objectives: SMART

  • Transfer to PDP

  • Checking achievement


Key Points

  • It is not possible to give your GPStR too much feedback

  • Try and think of something nice to say before putting the boot in

  • If putting the boot in, criticise the behaviour not the person

  • ALOBA is more impressive, but Pendleton is more practical


Take-home Message

You too were once an ignorant incompetent GPStR….

…and just look at you now.


Your mission (should you choose to accept it…)

  • Individually decide on grades, and why

  • Small groups:

    • Share your grades and your reasons

    • Discuss content of verbal feedback

    • What will you put in the ‘Feedback and recommendations box?

    • What will you suggest for the ‘Agreed action’ box?

  • Plenary


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