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WBAs: the Northern Ireland School of Surgery Experience. Richard Mayes 1 Robert Gilliland 1, 2 Jeffrey Campbell 1, 2 Helen Holscher 3 Department of Surgery, Ulster Hospital Dundonald , Northern Ireland 1

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Wbas the northern ireland school of surgery experience

WBAs: the Northern Ireland School of Surgery Experience

Richard Mayes1 Robert Gilliland1, 2

Jeffrey Campbell1, 2 Helen Holscher3

Department of Surgery, Ulster Hospital Dundonald, Northern Ireland1

School of Surgery, Northern Ireland Medical & Dental Training Agency2,Royal College of Surgeons of England3.

The Royal College of Surgeons of England

Regional Representatives Meeting

Wednesday 10th November 2010


Introduction of a curriculum
Introduction of a Curriculum

  • Web based curricula

    • Workplace Based Assessments (WBAs)

  • Valid and reliable

  • Formative and summative

  • Clear indicators of professional progress

GMC April 2010


Wbas the northern ireland school of surgery experience
Aims

To determine if WBAs:

  • Differentiate between trainees of different abilities (summative)

  • Demonstrate progression towards competence (summative)

  • Are completed at regular intervals through training (formative)


Methods
Methods

  • Core Surgical trainees appointed Aug 2008

  • Trainees not completing 24 months excluded

  • Trainees were ranked according to interview score (Q1, Q2, Q3 and Q4)

  • 4 x 6 month placements (P1, P2, P3 and P4)

  • Median (range): ANOVA


Methods1
Methods

  • CBDs, DOPS, Mini-CEXs – score 1-6

    • 1-2 - Below expectations

    • 3 - Borderline

    • 4 - Meets expectations

    • 5-6 - Above expectations

  • PBAs – score 0-4

    • Level 0 – Insufficient evidence to support judgement

    • Level 1 – Unable to perform procedure

    • Level 2 – Able to perform procedure, or part under supervision

    • Level 3 – Minimum supervision

    • Level 4 – Unsupervised, able to deal with complications


Results
Results

  • 39 trainees

  • 12 excluded

  • n=27 trainees

  • 1,256 assessments

    • 381 CBDs

    • 408 DOPS

    • 346 Mini-CEXs

    • 121 PBAs




Wbas the northern ireland school of surgery experience

Can WBAs differentiate between trainees of different abilities?

Trainees from Q1 would out perform trainees from Q4

number of assessments performed

scores obtained



Wbas the northern ireland school of surgery experience

Can WBAs demonstrate progression towards competence? abilities?

Scores should show improvement over

4 placements




Wbas the northern ireland school of surgery experience

Are WBAs being used in formative assessment? abilities?

WBAs should be completed at regular intervals through training placements


Summary
Summary abilities?

  • No inter-quartile differences with regards to the numbers of WBAs performed or scores obtained

  • CBD, DOPS, Mini-CEX scores do not improve with time

  • PBAs scores improve with time

  • WBAs are clustered immediately prior to appraisal


Conclusions
Conclusions abilities?

  • WBAs do not fulfil GMC requirements

    • Need modification

    • Assessors require to be more robust in their evaluations



Wbas the northern ireland school of surgery experience

ANOVA p=0.42 abilities?