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J Surg Educ. 2019 Apr 10. pii: S1931-7204(19)30014-5. doi: 10.1016/j.jsurg.2019.03.015. [Epub ahead of print]

Enhancing Formative Feedback in Orthopaedic Training: Development and Implementation of a Competency-Based Assessment Framework.

Author information

1
Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada.
2
Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
3
Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
4
Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Surgery, Queen's University, Kingston, Ontario, Canada.
5
Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada. Electronic address: info@skillslab.ca.

Abstract

OBJECTIVE:

The purpose of this study was to develop, implement, and evaluate the effectiveness of an assessment framework aimed at improving formative feedback practices in a Canadian orthopaedic postgraduate training program.

METHODS:

Tool development began in 2014 and took place in 4 phases, each building upon the previous and informing the next. The reliability, validity, and educational impact of the tools were assessed on an ongoing basis, and changes were made accordingly.

RESULTS:

One hundred eighty-two tools were completed and analyzed during the study period. Quantitative results suggested moderate to excellent agreement between raters (intraclass correlation coefficient = 0.54-0.93), and an ability of the tools to discriminate between learners at different stages of training (p's < 0.05). Qualitative data suggested that the tools improved both the quality and quantity of formative feedback given by assessors and had begun to foster a culture change around assessment in the program.

CONCLUSIONS:

The tool development, implementation, and evaluation processes detailed in this article can serve as a model for other training programs to consider as they move towards adopting competency-based approaches and refining current assessment practices.

KEYWORDS:

Assessment; Feedback; Formative; Interpersonal and Communication Skills; Medical Education; Medical Knowledge; Orthopaedics; Patient Care; Practice-based Learning and Improvement; Professionalism; Tool development

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