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

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

  2. 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

  3. The importance of feedback • Always popular with GPRs • Generic skill • Education • Consulting • Life • Good fit with rules of adult learning

  4. Key principles of adult learning(RCGP Learning and Teaching Guide 2008) • Self direction • Experiential • Needs-based • Problem centred

  5. 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

  6. When not to use feedback • Medical urgency • ‘Wally’ factor • Registrar not ready to learn (Keep the feedback until later)

  7. A quotation: ‘Let no day pass without discussing goodness’ Socrates – The Apology

  8. 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

  9. 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

  10. 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

  11. 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

  12. The feedback sandwich(ibid) The meat of constructive criticism… should be sandwiched between… two layers of positive comment

  13. 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)

  14. 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

  15. ALOBA 2 Giving useful feedback • Use descriptive feedback – encourage a non-judgemental approach • Provide balanced feedback • Make suggestions rather than prescriptive comments

  16. 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

  17. ALOBA 4 Summarising learning • A constructive end point is reached

  18. Pendleton’s Rules • Clarify matters of fact • The registrar goes first • Good points first • Recommendations, not criticisms

  19. Areas for COT/CbD feedback • Verbal comments on criteria and assessment • Filling in the boxes: • ‘Feedback and recommendations for further development:’ • ‘Agreed action:’

  20. 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]

  21. Feedback and recommendations • Thumbnail of case. Computer number • Evidence to justify ‘E’ or ‘NFD’ • Recommendations (how many?) – phrased as Aims

  22. Agreed action • Maximum of 2 (? - discuss) • Phrased as Learning Objectives: SMART • Transfer to PDP • Checking achievement

  23. 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

  24. Take-home Message You too were once an ignorant incompetent GPStR…. …and just look at you now.

  25. 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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