Appraisal & Assessment. Dr Linda Prescott-Clements Educational Projects Manager NHS Education for Scotland. Introduction. Appraisal vs Assessment General principles of appraisal The performance appraisal process (e.g. consultant appraisal) Assessment in the workplace – gathering evidence.
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Dr Linda Prescott-Clements
Educational Projects Manager
NHS Education for Scotland
Usually questionnaire type format, across several topics e.g. teamwork, communication, professionalism, organisation etc
Evaluators may include superiors, peers, subordinates, patients & families
7 – 10 raters recommended for reliability
Feasibility often a challenge, especially data reporting, confidentiality etc (improved if implemented electronically)“Does” - Performance Assessment in vivo
360o Evaluation /
Usually 12 – 20 standardised patient encounter “stations”, each lasting 15-20 minutes (in medicine).
Frequently to assess technical skills
High feasibility but expensive“Shows” - Performance Assessment in vitro
Use of professional actors, with standardised script and options for response.
Can be used to probe for knowledge, decision making etc
Scoring procedures use checklist or ratings form – performance criteria set in advance
e.g. History taking, communication skills, diagnoses, complex cases etc“Shows” - Performance Assessment in vitro
Simulated Patients /
e.g. options for response.
Mannequins & Models
Patient Management Problems
Clinical Case Simulations
Frequently used as part of OSCE examinations
Expensive to create“Shows” - Performance Assessment in vitro
Useful where an aspect of competency can be described as a specific list of steps / behaviours / activities.
Typical response from evaluator “Yes / No” or tick box.
Good for highly specific procedural feedback
Content & scoring rules require consensus by several experts, and trained evaluators needed.
Checklist Evaluation“Shows how” - Performance assessment in vivo
Rater judges general categories of ability, across various context specific cases.
Ratings usually provided on a scale.
Good when professional practice is heterogeneous and not always fitting a single, standardised approach.
Relatively easy to construct and complete.
Global Ratings Evaluation“Shows how” - Performance assessment in vivo
Documentation of each patient encounter by conditions seen, types of case etc.
NOT an assessment, but to document number and scope of cases completed. Does not necessarily indicate competence!
Case Logs“Shows how” - Performance assessment in vivo
Usually focussed on communication, professionalism etc. types of case etc.
Also “satisfaction” surveys including areas such as time spent, etc
Measures ‘softer’ skills from the patients perspective
Can be formative or summative
20 – 40 responses required for a reliability of 0.70 – 0.82.
Questionnaires“Shows how” - Performance assessment in vivo
Trained assessors review patients’ records using protocol & coding form based on predetermined criteria,
e.g. prescribed medications, tests ordered, procedures performed & patient outcomes.
Estimated 8-10 records required for reliable assessment of single procedure / diagnosis etc
Record Review“Shows how” - Performance assessment in vivo