Assessment methods

Work-based assessment refers to any kind of assessment regarding how a trainee applies the knowledge and skills previously acquired during traditional training in a real-life work environment, with different groups of people – patients, workmates, etc. Because of the different learning environment, this form of education requires the development of different assessment tools from those used in traditional classroom education. The choice of specific assessment tools for work-based learning is left to the individual national centres responsible for running the course, as it depends on the cultural and organisational context of the country concerned. Specific to this kind of assessment is the evaluation of the integrated skills presented by the learner, rather than of a specific aspect of communication. Thus, both routine interactions with patients and longer periods of the learner’s work with patients can be assessed.

The assessor in work-based learning is not the teacher who delivers the course in the classroom. The assessors can be different people who have had contact with the trainee, e.g. supervisors, workmates, patients, family members of patients and other people with knowledge of the trainee’s work.

Workplace assessment is based on observation of the tasks performed by the trainee. Three categories are generally considered in this assessment:

  • Occurrence – whether determined behaviours were demonstrated
  • Quality – the quality of performance
  • Fitness – whether a performance was satisfactory or fit for purpose.

Four observation-based assessment methods are most used in clinical settings:

  • Mini-clinical evaluation exercise (mini-CEX) – assessors observe a trainee interacting with a patient in a clinical setting;
  • Direct observation of procedural skills (DOPS) – a variation of the mini-CEX, the aim of this method is to assess and provide feedback on procedural skills;
  • Cased-based discussion (CbD) – assesses clinical reasoning and decision-making through discussion of a case managed by the trainee;
  • Multi-source feedback (MSF) – is based on feedback collected from different assessors such as supervisor, peers, patients etc.