Several surveys conducted in the first year after the introduction of workplace-based assessments (WPBAs) in 2007 show poor satisfaction with this process. Reference Menon, Winston and Sullivan1-Reference Babu, Htike and Cleak3 Our survey of trainees conducted in 2009 shows ongoing concerns with WPBAs 2 years on.
Of the 146 trainees who participated in our electronic survey, 40% did not feel that WPBAs had led to improvements in patient care, with 31% unsure. Furthermore, 68% considered that WPBAs did not help/were only slightly helpful to them in passing their MRCPsych examination. Of those who were in psychiatric training before WPBAs were introduced (67%), 70% reported no improvement in their training!
However, 88% of trainees rated their satisfaction reasonably high on the quality of feedback they received (at 3 or above on a 5-point Likert scale). Norcini & Burch Reference Pathan and Salter4 stress that formative assessment and feedback are a powerful means for changing behaviour in trainees, and that feedback can have a major influence on learning. On the face of it, our results seem strange, as trainees do not seem to acknowledge or recognise the helpfulness of this new method of assessment on their training experience.
The online filing of WPBA has improved greatly in 2008. The faulty Healthcare Assessment and Training computer system (originally in use to record WPBAs) can no longer be blamed for trainee dissatisfaction, as in earlier surveys. Reference Menon, Winston and Sullivan1 Our concurrent survey of 50 consultant trainers showed that they too had ongoing concerns about WPBAs. In particular, 80% of trainers felt that WPBAs had an impact on their work commitments. If trainers were more positive about these assessments, perhaps this would influence their trainees' perceptions.
Parallel with the WPBA, the annual review of competence progression (ARCP) panels have been introduced. The ARCP should be an important formative and summative part of training. In our survey, 44% of trainees and 20% of trainers felt ARCPs were not meaningful, with 30% of trainees and 42% of trainers not sure.
We acknowledge that the interpretation of our survey is limited by the reasonably low take-up among trainees and trainers. Yet our results concur with those of Menon et al's 2008 study Reference Menon, Winston and Sullivan1 and therefore we feel that our survey cannot be simply ignored because of the low response rate.
We agree with Menon et al Reference Menon, Winston and Sullivan1 that these new tools for evaluation and feedback should not be abandoned. However, further training of both trainers and trainees is needed to achieve better usage and a clearer understanding of the constructive role they should play in training, particularly with respect to the role of feedback.
Employers need to recognise that consultant psychiatrists require more time in their job plans for training future psychiatrists.