Real-time assessment and feedback of junior doctors improves clinical performance

摘要

I was sitting in the National Association of Clinical Tutors' Autumn Meeting in 2004, wondering why we assess our juniors in artificial circumstances that might not always not reflect real work, and take up so much of our time. I began to wonder why we do not assess our juniors in the real workplace, in the way that a driving test examiner assesses- learner drivers in real traffic situations. I remembered Professor Janet Grant of the Open University saying that, if some authority asks if you are doing something (for example, theassessment of junior doctors), one should reply Yes', and then find out in what ways you are already doing it! So I reasoned, 'Why not observe my juniors at work on the post-take ward round, without the need for extra time to be spent on assessment?' On my way home from the meeting, I designed my first 'team assessment' form, and used it the next day. I have modified the form over time, and the 'scoring' system too, because I have learned that feedback is ultimately far more important to students than being given a score.