A Scoping Review of Assessment in Competency-Based Medical Education

• In Event: 63.017 - The Canadian Committee of Graduate Students in Education Research Symposium

Abstract

Assessment has been part of various societies for more than 2000 years (Gipps, 1999). In medical education, specifically in the newly introduced competency-based medical education (CBME), assessment is based on one-way feedback by observing the routine encounters in the clinical setting, and not learner centered. Assessment in this context is closely linked with the maintenance of professional standards and with accountability – both to the individual and to society – which reinforces the need to have clear criteria for good assessment. Meeting established criteria for good assessment is critical to both value and credibility for all stakeholders. The purpose of this scoping review is to develop a theoretical understanding of assessment in CBME over the last two decades and to expand on the characteristics of good assessment, purpose, and methods of assessment in CBME. Methodology: This review was conducted using the Arksey and O’Malley (2005) framework for scoping studies, taking into consideration recommendations by Levac, Colquhoun, and O’Brien (2010). The scoping review is a strategy designed to provide conceptual clarity about a specific topic or field of literature through the synthesis and analysis of a wider range of literature. This approach is particularly helpful for complicated topics and topics that have not been systematically reviewed before, it comprises of six stages: (1) identifying the research questions, (2) identifying relevant studies, (3) study selection, (4) charting the data, (5) summarizing and reporting results, and (6) Consultation. Data Sources: The following databases were searched for refereed and non-refereed articles on the conceptual, empirical and practical applications of assessment in CBME: Ovid, PubMed, Education Resource Information Center (ERIC), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Source, and Google Scholar. The search conducted with the assistance of a library expert, included relevant English literature published between January 1990 and December 2017. This time frame was chosen to reflect the 1990 launch of CBE and work-based assessment (WBA) in the field of Medical Education in North America. Results of this review suggested that assessment in CBME needs to be “Multi-Modal” - there is no single best assessment tool - using multiple tools to get an overall impression of the learner. A considerable shift in thinking has occurred from assessment of learning to assessment for learning. This has important implications for the conceptual framework from which to approach the issue of assessment. The main conceptual changes pertain to programmes of assessment. Results also suggested that meaningful competency-based assessment should include: (1) timely ongoing assessments, with comprehensive periodic reviews to ensure continued progress; (2) the best use of multiple assessors and assessments to enable the right assessment to be made at the right time for the right purpose, while avoiding assessor fatigue; (3) a synthesis of data collected through group processes to reach judgments about competence; (4) faculty development for all assessors, who, as observers of trainees in the workplace, are the true measurement instrument; and (5) reproducibility or consistency, where the results of the assessment would be the same if repeated under similar circumstances.

Author

• Hasan Kettaneh, Queen's University