DE04 How do dermatology trainees experience workplace-based assessments in a dermatology department?

Abstract

Workplace-based assessments (WBAs) were introduced to provide a more comprehensive view of trainee progress, through regular observations and immediate, actionable feedback to promote learning over time. However, evidence suggests they are not being used effectively, leading to a gap between the potential and reality. Little in-depth data relating to trainees’ current lived experiences of WBAs exist. The current study addresses this gap, exploring trainees’ experiences of WBAs to illuminate current challenges, dilemmas faced in practice and opportunities for improving WBAs. Much of the research examining WBAs relies on predetermined questions and Likert scales, which limits discussion into the reasons behind responses. This study used the framework of interpretive phenomenology to illuminate and better understand lived experiences of trainees in dermatology. This rigorous methodology in qualitative research ensured meaningful coherence and, through purposive sampling, allowed diverse descriptions of lived experiences. To this end, eight in-depth, semistructured interviews were conducted with dermatology trainees. The findings uniquely showed that trainees found WBAs to inhabit dual roles, as an assessment tool and to assess their own juniors. No previous literature exists examining this experience of duality. Trainees also felt that WBAs are pulled in different directions, trying to fulfil contradictory roles simultaneously: supporting learning, while also acting as a hurdle or tick-box exercise, the balance being hugely dependent on the assessor. Trainees wanted effective feedback and a better assessment of their abilities, but were concerned that WBAs in their current role are not an accurate assessment modality. Encouragingly, the results also showed that trainees acknowledged the value of WBAs for learning. There is evidence that such a perspective can foster increased engagement and more meaningful use of WBAs. In conclusion, this study highlights factors affecting the effective use of WBAs, which can help us learn to make WBAs more educational and fulfil their full potential.