Skip to main content Accessibility help
×
Home

Contents:

Information:

  • Access
  • Open access

Actions:

      • Send article to Kindle

        To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

        Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

        Find out more about the Kindle Personal Document Service.

        Case-based discussion — focus on feedback, not tick boxes
        Available formats
        ×

        Send article to Dropbox

        To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

        Case-based discussion — focus on feedback, not tick boxes
        Available formats
        ×

        Send article to Google Drive

        To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

        Case-based discussion — focus on feedback, not tick boxes
        Available formats
        ×
Export citation

As a trainee who has gone through Modernising Medical Careers (MMC) and completed numerous workplace-based assessments (WPBAs), including case-based discussions (CbDs), I read with interest the paper by Mynors-Wallis et al 1 on CbD as a tool for revalidation. Their conclusions were that consultants were positive about CbD but research on trainees showed resentment and mistrust. I suspect that the trainees’ views mentioned by the authors are not representative of current opinion, as the study does not acknowledge when the research was done, which was just after the MMC and 6 months after WPBAs were rolled out. This was the time of a seismic change in delivery of training, with both trainees and supervisors adjusting to the new landscape.

I carried out research focusing on the educational value of WPBAs 2 years after their introduction, using a questionnaire and trainee interviews (the results are unpublished, details available on request). The questionnaire was completed by 48% of trainees (41/86 specialist registrars years 1-5) and 41% of educational supervisors (35/86). This showed that 73% of trainees and 79% of supervisors felt that WPBAs had an educational value which was heavily dependent on feedback. Similarly, in the results obtained by Babu et al, 2 CbD was ranked the most useful by trainees, with no difference between higher and lower trainees. Trainees valued the discussion around the case, particularly on diagnosis and management, and supervisors felt that this gave better sense of trainees’ independent functioning. Both supervisors and trainees identified the importance of assessor training, and noted the tension between the formative and summative components, with trainees asking for more focus on feedback rather than scores. This has been previously identified by Malhotra et al, 3 with residents’ perceptions of the WPBA as an assessment v. educational tool and by the Postgraduate Medical Education and Training Board (PMETB) itself, 4 where they state that WPBAs must be used formatively and constructively lest they become no more than hoops to be jumped through, with the educational validity lost.

As a future consultant, I value the opportunity provided by WPBAs to discuss cases in a peer group as CbDs are the cornerstone of professional development and are useful for developing one's clinical practice. Given the concern raised by the PMETB about how WPBAs are used, I would urge the Royal College of Psychiatrists to learn these lessons and use CbD as a developmental ‘formative’ tool, with the focus on discussion, reflection and feedback and not let this become just another tick-box exercise.

1 Mynors-Wallis, L, Cope, D, Brittlebank, A, Palekar, F. Case-based discussion: a useful tool for revalidation. Psychiatrist 2011; 35: 230–4.
2 Babu, KS, Htike, MM, Cleak, VE. Workplace-based assessments in Wessex: the first 6 months. Psychiatr Bull 2009; 33: 474–8.
3 Malhotra, S, Hatala, R, Courneya, CA. Internal medicine residents' perceptions of the Mini-CEX. Med Teacher 2008; 30: 414–9.
4 Postgraduate Medical Education and Training Board. Workplace-Based Assessments: A Guide for Implementation. PMETB, 2009.