The aim of the WBA working group is to produce a WBA-course on line enabling workplace-based assessment (WBA) of medical performance, communication, professionalism and collaboration in authentic working settings by observation of medical consultations and actual behaviour of students / trainees within a team to provide narrative feedback for learning. Both assessment procedures and instruments have been developed for use in each European country.

Definition WBA

WBA has been defined as a direct observation in authentic clinical environments of a specific element of interconnected competencies performed by a (learning) professional.  WBA is typically brief, criterion-based and low-stakes prompting an immediate feedback encounter. WBA is an essential part of programmatic assessment, a systematic method to collect data across learner’s training from multiple domains of competence. WBA supports educators to tailor future instruction to assist with remediation or acceleration of learning.  So, WBA assesses performance on the “does-level” of Miller’s pyramid. It has to be undertaken in the workplace to facilitate learning through constructive feedback. It should be undertaken frequently to increase reliability. WBA identifies areas for development to help trainees and trainers. If desired, WBA contributes to evidence for summative judgements on the progress of the trainee.

The benefits of WBA within EBMA

The blueprint of the EBMA WBA has been based on both CanMEDS and Good Medical Practice competency frameworks. WBA focuses on observable performance and is based on specific criteria. It encompasses integrated skills, knowledge, behaviour and attitudes (competencies) regarding medical performance, communication with patients, collaboration within a team and leadership. WBA on line samples across important workplace tasks or activities (including Entrustable professional activities) and provides descriptors / profiles to aid the assessor’s judgement and feedback.

EBMA WBA on line encourages trainee/trainer dialogue, reflection by trainee / trainer, and provides a personal trajectory of progress by a trainee to improve practice.

Products of the WBA working group – work in progress –

We have developed a number of slides (PPT) for our clients to support development and implementation of WBA in their country. Moreover, we produce assessment instruments and manuals:

  • Video assessment of clinical encounters (VAC).
  • The clinical reasoning and reflecting form (CRRF), helps trainee in the reflecting process, a worthwhile add-on to the tool and the process of both the VAC and the Mini-CEX.
  • Mini-CEX: instrument for direct observation of clinical encounters
  • Multi Source Feedback (MSF)
  • E-Portfolio: for reflection, feedback, uploading video encounters etc.

The clinical reasoning and reflecting form (CRRF)

In September 2017 we presented the Video Assessment of Clinical performance and the clinical reasoning and reflecting form (CRRF) at the AMEE conference in Helsinki. It is an instrument to assess patient related skills by videoing real life consultations. We showed an online video system (within EPASS) for submitting the consultations by the candidate, allowing assessors to review, score, provide feedback and make a decision about the candidate’s performance. The overall conclusion was that the instruments fulfills needs, participants were positive about the content of the instruments and about using it. It helps to give feedback in a proper and complete way. Remarks were on legal and on cultural matters. It is ready for use by partner institutions of EBMA.

In November 2017 we piloted the Mini-CEX instrument at the EBMA Conference in Egmond and we presented our Multi Source Feedback instrument as well. Developments will be made to improve content and clarity of scales used.

Future plans

Next year a pilot is planned with non-GP’s and non-UK doctors for the EBMA WBA instruments and the working group will propose a market plan on how to use, introduce and spread the instruments.

Members of the WBA working group

Dr. Paul Ram (Maastricht University, NL) – Chair

Dr. Thomas Gale (Plymouth University, UK)

Agata Stalmach-Przygoda (Jagiellonian University, Poland)

Magda Szopa (Jagiellonian University, Poland)

Prof. Pauline McAvoy (London, UK)

Prof. Lesley Southgate (London, UK)