Assessor discomfort and failure to fail in clinical performance assessments.

Clinical supervisor Failure to fail Feedback In-training assessment Judgement Workplace assessment

Journal

BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679

Informations de publication

Date de publication:
27 Nov 2023
Historique:
received: 31 03 2023
accepted: 14 09 2023
medline: 29 11 2023
pubmed: 28 11 2023
entrez: 28 11 2023
Statut: epublish

Résumé

Assessment of trainee performance in the workplace is critical to ensuring high standards of clinical care. However, some supervisors find the task to be challenging, and may feel unable to deliver their true judgement on a trainee's performance. They may 'keep MUM' (that is, keep mum about undesirable messages) and fail to fail an underperforming trainee. In this study, we explore the effect of discomfort on assessors. Using a survey method, supervisors of trainees in the Australasian College of Dermatologists were asked to self-report experiences of discomfort in various aspects of trainee workplace assessment and for their engagement in MUM behaviours including failure to fail. Sixty-one responses were received from 135 eligible assessors. 12.5% of assessors self-reported they had failed to fail a trainee and 18% admitted they had grade inflated a trainee's score on a clinical performance assessment in the previous 12-month period. Assessors who reported higher levels of discomfort in the clinical performance assessment context were significantly more likely to report previously failing to fail a trainee. The study did not reveal significant associations with assessor demographics and self-reports of discomfort or MUM behaviours. This study reveals the impact of assessor discomfort on the accuracy of assessment information and feedback to trainees, including as a contributing factor to the failure to fail phenomenon. Addressing assessor experience of discomfort offers one opportunity to impact on the complex and multifactorial issue that failure to fail represents.

Sections du résumé

BACKGROUND BACKGROUND
Assessment of trainee performance in the workplace is critical to ensuring high standards of clinical care. However, some supervisors find the task to be challenging, and may feel unable to deliver their true judgement on a trainee's performance. They may 'keep MUM' (that is, keep mum about undesirable messages) and fail to fail an underperforming trainee. In this study, we explore the effect of discomfort on assessors.
METHODS METHODS
Using a survey method, supervisors of trainees in the Australasian College of Dermatologists were asked to self-report experiences of discomfort in various aspects of trainee workplace assessment and for their engagement in MUM behaviours including failure to fail.
RESULTS RESULTS
Sixty-one responses were received from 135 eligible assessors. 12.5% of assessors self-reported they had failed to fail a trainee and 18% admitted they had grade inflated a trainee's score on a clinical performance assessment in the previous 12-month period. Assessors who reported higher levels of discomfort in the clinical performance assessment context were significantly more likely to report previously failing to fail a trainee. The study did not reveal significant associations with assessor demographics and self-reports of discomfort or MUM behaviours.
CONCLUSIONS CONCLUSIONS
This study reveals the impact of assessor discomfort on the accuracy of assessment information and feedback to trainees, including as a contributing factor to the failure to fail phenomenon. Addressing assessor experience of discomfort offers one opportunity to impact on the complex and multifactorial issue that failure to fail represents.

Identifiants

pubmed: 38012637
doi: 10.1186/s12909-023-04688-1
pii: 10.1186/s12909-023-04688-1
pmc: PMC10680261
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

901

Informations de copyright

© 2023. The Author(s).

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Auteurs

Catherine E Scarff (CE)

Department of Medical Education, Melbourne Medical School, University of Melbourne, Room N722, Level 7 North Medical Building Grattan Street, Melbourne, VIC, Australia. catherine.scarff@unimelb.edu.au.

Margaret Bearman (M)

Centre for Research in Assessment and Digital Learning (CRADLE), Deakin University, Melbourne, VIC, Australia.

Neville Chiavaroli (N)

Department of Medical Education, Melbourne Medical School, University of Melbourne, Room N722, Level 7 North Medical Building Grattan Street, Melbourne, VIC, Australia.
Australian Council for Educational Research, Camberwell, Australia.

Stephen Trumble (S)

Department of Medical Education, Melbourne Medical School, University of Melbourne, Room N722, Level 7 North Medical Building Grattan Street, Melbourne, VIC, Australia.

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