After reading the article titled, "The Quarter Model: a
proposed approach for in-training assessment of
undergraduate students in Indian medical schools" [1], I
would like to add the element of workplace based assessments
(WBAs) as a complement to this model.
It is beyond doubt that the traditional
way of assessing successful postgraduate pediatrics training
is no more considered a valid process in many institutes in
India [2,3]. Having done a postgraduate degree in pediatrics
myself from a prestigious institute in India, I personally
feel there is desperate need for a more robust,
comprehensive and standard way of assessment. I am finishing
my training in United Kingdom now, where the assessment
process fulfils many of the criteria you have outlined in
your article. I couldn’t agree more that the assessments
should be multi-sourced i.e. from different members
of the team with appropriate weightage given to each
assessor.
Although the concept of the quarter model
is fantastic, it lacks the objective component at many
levels. This is why, I would like to introduce the concept
of Workplace based assessments (WBAs) which could be used in
addition to the model proposed by you. These are a set of
tools which can be combined with trainees daily activities
and heavily rely on constructive feedback in a more
objective manner. According to Royal College of Paediatrics
and Child Health [4], "WBAs connect teaching, learning and
assessment in the teaching cycle. They provide formative
feedback in a constructive environment to help trainees
develop and progress through their training programme by
helping them set their development plan and take ownership
of their learning objectives giving the resources to improve
self-evaluation, self-assessment, reflection and goal
setting skills. Workplace based assessments are designed to
show progress, so should be used to reveal areas that need
to be worked on, so should be spread throughout the year and
through all posts."
Each trainee will have an online account
with a service called ASSET (www.asset.rcpch.ac.uk) and
assessments must be completed online using this facility.
Trainees can view their completed online assessments and
trainers are able to see the progress of their trainees
online. Presently, the following WBAs are being used in the
UK based on national curriculum.
1. Pediatric Mini Clinical Evaluation
Exercise (ePaed Mini-CeX)
2. Pediatric Case Based Discussion (ePaedCbD)
3. Directly Observed Procedural
Skills (DOPS)
4. Sheffield Assessment Instrument
for Letters (SAIL)
5. Pediatric Multisource Feedback (ePaedMSF)
A certain number of satisfactory WBAs in
each category need to be completed each year. These, along
with other training issues, are reviewed at the end of each
year by an independent panel in the presence of trainee.
This process makes sure that training needs are identified
mutually and an action plan is set. In addition to this,
trainees will formally meet their educational supervisors on
a quarterly basis to discuss the progress and any other
issues.
I would like to add here that this
process is complemented by formal exams and regular
appraisals. I propose that this method can be combined with
the quarter model to be used as an objective assessment
although will need to be modified based on the present
requirements in India.
1. Singh T, Anshu, Modi J. The Quarter
Model: A proposed approach for in-training assessment of
undergraduate students in Indian medical schools. Indian
Pediatr. 2012;49:871-6.
2. Singh T, Anshu. Internal assessment
revisited. Natl Med J India. 2009;22:82-4.
3. Gitanjali B. Academic dishonesty in
Indian medical colleges. J Postgrad Med. 2004;50:281-4.
4. Royal College of Paediatrics and Child Health, London.
Available from: URL:
http://www.rcpch.ac.uk/training-examinations-professional-development/examinations/assessment-tools/assessment-tools.