How To Write Mini-Mas

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1 Mini-MAS: A Work Based Assessment Tool to Assess Milestones Author: Moyez B. Ladhani Date: October 25,2014

2 I do not have an affiliation (financial or otherwise) with a pharmaceutical, medical device or communications organization. Je n ai aucune affiliation (financière ou autre) avec une entreprise pharmaceutique, un fabricant d appareils médicaux ou un cabinet de communication. Author: Lorem ipsum dolor sit Date: Dolor sit am

3 CBME and Assessment The success of competency-based education relies on frequent assessment and feedback. Intrinsic skills such as communication, collaboration etc. remain difficult to measure yet will be integral in the desired competencies. The learner s advancement will rely on effective assessment methods. 3

4 CBME and Assessment Competency-based education will require formative over summative assessment. (Carraccio, Wolfsthal, Englander, Ferentz, & Martin, 2002). Effective coaching, mentoring and feedback will be required. (Holmboe, Sherbino, Long, Swing, & Frank, 2010). Learner can use the feedback for meaningful selfassessment that is crucial in competency-based education. Frequent observation will be required of the learners. Eva and Regehr (2008) 4

5 Work Based Assessment Knowledge, skills and attitudes should be assessed using a multi-faceted longitudinal approach (Sherbino & Frank, 2011). The use of a multi-modal assessment strategy can overcome the limitations of any one-assessment format. Longitudinal assessment monitors ongoing development and avoids excessive testing at any one point (Cox, Irby, & Epstein, 2007). 5

6 Miller (1990) suggests the achievement of competence progresses from knows to knows how to shows how to does. 6

7 WBA Kogan and Holmboe (2013) define WBA: WBA is the assessment of trainees and physicians across the continuum of day to day competencies and practice in authentic, clinical environments..it enables the evaluation of performance in context (p. S68). 7

8 WBA The In-Training Evaluation Report (ITER):» Does not discriminate (Gray, 1996; Holmboe & Hawkins, 1998 )» Completed retrospectively (Turnbull et al., 1998).» Often faculty who have not observed are completing the form (Epstein, 2007)» Halo effect (Wilkinson & Wade, 2007)» Raters fail to use the entire scale (Gray, 1996) 8

9 Mini-CEX The scale used in the mini-cex is designed for linear gradations of performance. The scores do not give the evaluators a point of reference to help align a trainee to a category or score (Crossley & Jolly, 2012). Faculty assessors resort to norm-referencing. 9

10 Mini-CEX Hawkins et al. (2010) The raters did not use the full ninepoint scale, and the distribution is right shifted towards the higher end of the scale, the use of the lower end of the scale was infrequent raising concerns about identifying weaknesses. Individual competencies tended to be highly correlated. This phenomenon is likely related to the fact the rating form had overlapping descriptors 10

11 Designing a Better Tool WBA assessment tools should have anchors linked to the construct of clinical independence, measuring the trainees level of progression and development (Crossley et al., 2011). Assessors make more reliable judgments of performances they can see clearly in a particular context or activity. However, every context does not provide good information for every competency. The tool should focus on the competence relevant to the activity, and avoid having multiple competencies to assess at the same time (Crossley & Jolly, 2012). 11

12 2 a week, one competency at a time, 6 competencies

13 6 Competencies For this study the assessment of competencies was limited to six core competencies:» history taking,» physical exam,» clinical reasoning,» communication with families,» communication with physicians and other health care professionals and» collaboration 13

14 A total of 21 residents were included in the study. 12 PGY 1 residents at McMaster Children s Hospital were required to have completed 40 unique observations in six domains over 22 weeks. In addition, nine PGY 4 residents were also required to be observed for the same competencies over the same time period. This group was required to complete encounters as their general pediatric exposure was less during this final year of training. Faculty and Senior residents assessors were trained-process 14

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25 Resident Comments I do believe this will influence my learning positively, the Mini-MAS book is a good tool for assessing the learners in their visual environment and The Mini-MAS is arguably a good tracking tool given the culture of medicine and the temptation for trainees to avoid supervision 25

26 Conclusion Work based assessment tool should achieve three requirements;» the competences expected as outcomes and the assessment should be aligned;» feedback is provided during and or after the assessment» the assessment is used to guide a trainee towards a desired outcome (Norcini & Burch, 2007). The Mini-MAS tool has achieved these three requirements and has shifted the focus of assessment from assessment of the trainee to learning of the trainee. (Driessen & Scheele, 2013) 26

27 Conclusion The Mini-MAS added as a formative assessment mode to a multi-modal assessment program will benefit the trainee, informing them on where they stand compared to their level of training, what competencies they can improve on and how they can do that. 27

28 Help us improve. Your input matters. Download the ICRE App, Visit the evaluation area in Pre-function Hall B, near Registration, or Go to: icreevaluations to complete the session evaluation. Aidons-nous à nous améliorer. Votre opinion compte. Téléchargez l application de la CIFR Visitez la zone d évaluation, au vestibule de la salle B, près du kiosque d inscription, ou Visitez le afin de remplir une évaluation de la séance. You could be entered to win 1 of 3 $100 gift cards. Vous courrez la chance de gagner l un des trois chèques-cadeaux d une valeur de 100 $.

Optimization of clinical teaching feedback delivery in radiology residency. Colin Mar, MD Silvia Chang, MD Bruce Forster, MD

Optimization of clinical teaching feedback delivery in radiology residency Colin Mar, MD Silvia Chang, MD Bruce Forster, MD I do not have an affiliation (financial or otherwise) with a pharmaceutical,