TRAINING WORKSHOP ON PERFORMANCE-BASED ASSESSMENT: FEEDBACK OF THE PARTICIPANTS FACULTY

Background : Performance-based assessment (PBA) concentrate on “Does” level of Miller’s Triangle Model of assessment and assess the ability of healthcare professionals to practice safely in different situations and context. It is essential to train faculty members how to conduct PBA. Methods : One-day training workshop on PBA was organized at Liaquat University of Medical & Health Sciences Jamshoro, Sindh Pakistan in November 08, 2017 with objective “participants learn to apply PBA tools in practice”. There were two sessions of training; session one covered basics, levels and tools of assessment and blueprinting for assessment and session two PBA and its tools. Tutorial, brainstorming and activity based small group work were methods utilized for the training. Feedback of the participants was taken on semi-structured questionnaire. Descriptive analysis was done using SPSS. Results : Twenty-two participants selected from basic, clinical, and dental sciences and nursing faculty. The participants rated workshop on scale of 1-10 (1=poor, 10=excellent) for usefulness of training (8.64 ± 1.62), content of training (8.27 ± 1.52), relevance of training & content (8.59 ± 1.40), facilitation of training (8.77 ± 1.34) and overall (8.77 ± 1.38). After training participants were very confident in developing blueprint for assessment (3.91±0.61), using mini-CEX (3.64±0.58), and confident using DOPS (3.63±0.73), MSF (3.55±0.74) and Portfolio (3.68±0.84). More than one third of the participants recommended to arrange more training workshop on different aspects of medical education. Conclusions : It was observed from feedback that participants realize the importance of PBA training and stress to have trainings for various aspects of health profession education.


INTRODUCTION
It is said that "assessment drives the learning". The main purpose of assessment is to enhance the learning of the students and its impact on learning of the students. [1][2][3] The practice of medicine is very complex, composite and multifaceted process; the knowledge, skills, attitude, competence and performance are the key attributes of it. It is noticed that competence may not predict performance, so the performance-based assessment (PBA) at the work place in multiple context and settings, an essential component of the assessment must be the part of students' assessment process. 3,4 PBA based tools focus on "Does" level of Miller's Triangle Model of assessment and assess the ability and capacity of healthcare professionals to practice safely and securely in different settings and context. [1][2][3] The several tools have been developed to assess the performance of students at "Does" level like mini-Clinical Evaluation Exercise (mini-CEX), Directly Observed Procedure Skills (DOPS), 360 degree or Multi Source Feedback (MSF), Portfolio. [5][6][7][8][9][10][11] The objective of this study was to get feedback of the participant faculty members for training workshop on "Performance Based Assessment".

METHODS
One-day training workshop on "Performance Based Assessment" was organized at Directorate of Medical Education, Liaquat University of Medical & Health Sciences (LUMHS) Jamshoro/Hyderabad, Sindh Pakistan in November 08, 2017. The objective of the workshop was "participants learn to apply performance-based assessment tools in practice. •Level two "Knows How"-tools used to test context (understanding) •Level three "Shows How"-tools used to test competence •Level four "Does"-tool used to test performance.
LUMHS selected 22 participants from among the basic sciences, clinical sciences, dental sciences and nursing faculty members. Tutorial, brainstorming and activity based small group work and discussion were methods utilized for the training workshop.
At the end of training workshop, written feedback of the participants was taken with their consent on semi-structured questionnaire. The questionnaire contained nine questions; first six were closed ended and last three were open ended. The question one was on rating the training workshop at scale 1-10 (1=poor and 10=excellent) for its usefulness, content, relevance, facilitation and overall rating. The questions two to six were on the level of confidence of participants after participation in training workshop about developing blueprint for assessment, using miniCEX, using DOPS, using 360 degree (MSF) and using Portfolio respectively. The questions two to six were rated at Likert scale 1-5 (5= highly confident, 4= very confident, 3= confident, 2= to some extent confident 1= not confident). The question seven were about good points of workshop, eight on area of improvement and nine for additional comments.
The collected data was checked for completeness, accuracy and consistency and entered in IBMS SPSS version 21 for analysis. Descriptive analysis was done. The frequency, mean and standard deviation were computed.

RESULTS
Twenty-two faculty members participated in the training workshop on performance-based assessment (PBA).

Question
Highly confident Very confident

Confident
To some extent confident Not confident   education and one each of the participants recommended to improve standard of assessment in university and integrated PBA in the curriculum of university.

DISCUSSION
The performance-based assessment is an essential and fundamental component of overall assessment activities for the students of healthcare professions. It is multifaceted and integral as teaching, learning, assessment and feedback are closely integrated in this process. PBA is implemented at workplace, so it is also called as workplace-based assessment conducted in different context and settings. The trainee students are judged against the certain standard criteria that they are expected to attain at different stages of training. 3,4,6,9,[11][12][13] DOPS, MSF, miniCEX and Portfolio are some the tools used for PBA. 5,7,8,10 During the training workshop on PBA faculty members were briefed about these tools, their importance and use.
Blueprint is a map with specification that links assessment with learning objectives and deals with the sampling content, competencies and assessment tools for the assessment with a logical and balanced approach.14, 15 The participants during this training workshop on PBA were sensitized about the blueprinting, its importance, weightage and use. Participants suggested to management of Directorate of Medical Education of LUMHS arrange backup for power supply, provide quality food, extend time for such workshop, provide handout of proceedings, arrange good audiovisual aids and improve overall management while suggestions for the resource person were explain basics of assessment in little bit detail, provide more time for group work and explain subject in diagram.
More than one third of the participants recommended to management to arrange more such sort of training workshop on different aspects of medical education.
It is observed and noticed from feedback of the participants that they realize the importance of training, demand and need training for various aspects of health profession education including assessment and eager and keen to learn about health profession education.