Factors influencing General Practitioners in their attribution of a Global Assessment in medical training

Le résumé fourni par la source

Global Assessments (GAs) are used in Australian General Practice (GP) training during selection, in-training reviews, and within summative assessment. This project aimed to determine factors influencing assessors in their assignment of a GA score. A modified Delphi process was used with participants recruited from GP Supervisor and Medical Educator groups nationwide. Consensus information obtained via questionnaires was reflected to the group for comment in subsequent Delphi rounds. Demographic items collected included educator role, level of experience, and total number of doctors supervised. Participants were asked where they had performed GAs, and the factors they considered when making a GA. Participants ranked these factors independently, and in relation to training level of the doctor being observed, as well as commenting on consensus rankings. Participants rated their confidence in GAs as an accurate determinant of GP competence. Participants were asked to identify personal biases, and their approach to discrepancies in GA scores. Of the 28 participants engaging in four Delphi rounds, most were female, aged over 40, and had roles as Medical Educators. GAs were most commonly used in direct observation of practice, formatively and summatively. Clinical knowledge, conscious incompetence, communication skills and help-seeking practices were ranked highly in considering GA. There was good agreement amongst participants regarding criteria significance across the training continuum and the robustness of GA. There was conflicting opinion about what skills and factors can be learnt versus what should be inherent characteristics of a doctor. The factors contributing to a GA are broad and not limited to assessment of knowledge and skills, but include the non-clinical domains, namely communication, professionalism and organisational skills. Trust in the validity of GA by participants was strong, particularly when multiple assessors are involved. Personal biases do exist, and it is unknown at this stage whether or how they are overcome by assessors when making final judgment. The strength of GA appears to be drawn from the breadth of factors considered that go beyond ‘clinical’ checklists by allowing for overall impressions and gut feeling, providing a ‘rounded approach’ to competency.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.