4. Rubrics and Workplace-based Assessment / 医学教育

This paper discusses learner assessment, introducing a classification based on quantitative and qualitative assessment paradigms while exploring rubrics and Entrustable Professional Activities (EPAs) emphasizing performance-based assessment. Rubrics, with their clear standards and criteria for assessment, can effectively function as formative assessments in both undergraduate education and postgraduate training. Within workplace-based assessments, rubrics permit an analytical assessment of competencies under a shared framework across various fields and clinical departments. In contrast, EPAs assess a bundle of competencies by determining whether supervising physicians can entrust specific professional activities to physicians in training. Various assessment methods exist in medical education, each with its advantages and limitations. Understanding these is crucial for selecting and implementing the most suitable assessment method based on the intended purpose.

Evaluación para el aprendizaje: diseño e implementación de un mini-CEX en el internado profesional de la carrera de kinesiología / Assessment for learning: design and implementation of the Mini-CEX to the physiotherapy clerkship

Introducción: la evaluación kinesiológica contempla la realización de una rigurosa historia clínica y examen físico que orientan a establecer un diagnóstico, un pronóstico funcional, y es la base del plan de intervención. Esta competencia requiere de experiencia y razonamiento clínico para la toma de buenas decisiones terapéuticas. Los resultados históricos de las evaluaciones de aprendizajes del internado, concluyen que esta competencia tiene bajo nivel de desempeño, por lo que se deben mejorar las estrategias utilizadas para su aprendizaje durante el internado. El mini-CEX, es un instrumento de evaluación para el aprendizaje, que promueve la observación y feedback en el sitio de trabajo. Objetivo: diseñar e implementar un instrumento de evaluación para el aprendizaje de la evaluación kinesiológica durante el internado profesional de la Carrera de Kinesiología de la PUC. Método: estudio prospectivo, utilizando la me-todología de investigación acción, diseñado en 4 etapas. Resultados: se obtuvo un instrumento de evaluación para el aprendizaje, el mini-CEX, adaptado a las necesidades del internado profesional de kinesiología. El estudio piloto reportó buena aceptación entre estu-diantes y docentes. La percepción de los internos es que son más observados y que las destrezas asociadas a la evaluación kinesiológica mejoraron luego del estudio. Conclusiones: el instrumento reportó un tiempo de aplicación bajo (35 min.), lo que beneficiaría instancias de observación directa y feedback dentro de los internados. Es necesaria una aplicación a gran escala, que contribuya a determinar su validez y confiabilidad. Se requiere una capacitación formal a los docentes evaluadores y ajustar la escala.

Introduction: The physiotherapy clinical assessment competence includes the performance of a rigorous clinical history and physical examination that guides the establishment of a diagnosis and a functional prognosis, and is the basis of the intervention plan. This competence requires experience and clinical reasoning to make good therapeutic decisions. The historical global clerkship assessments conclude that this competency has a low level of performance, so the strategies used for its learning the clerkship must be improved. The mini-CEX is an assessment for learning, which promotes observation and feedback in the workplace. Objective: To design and im-plement an assessment for learning mini-CEX to the Physiotherapy PUC clerkship. Method: Prospective study, using an action research methodology, designed in 4 stages. Results: The main result was the mini-CEX, adapted to the Physiotherapy clerkship needs. The pilot study reported good acceptance among students and teachers. In addition, clerks' perception is that they feel more observed and that the skills associated with the physiotherapy assessment improved after its implementation.

Workplace based clinical procedural skills assessment using directly observed procedural skills in interns in Otorhinolaryngology rotation

Background: In view of changing requirements in healthcare systems and planned reforms of medical education curricula, effective teaching and assessment of clinical skills in the undergraduate setting has become more and more important. There is a need for implementation of newer methods of evaluation keeping in mind the principles of adult learning and self-directed learning. DOPS (directly observed procedural skills) is a highly structured assessment tool for assessment of the practical work performed by a trainee on a real patient under supervision of experienced faculty. This study aimed to make use of DOPS as a method of workplace based assessment for interns in otorhinolaryngology posting.Methods: 15 interns posted in department of otorhinolaryngology participated in the study. Three clinical procedural skills included were anterior rhinoscopy, otoscopy and indirect laryngoscopy. Three DOPS were undertaken for each skill. The performance was noted as DOPS ratings. The results were tabulated and statistically analysed.Results: A total of 135 DOPS were undertaken for 15 interns. Mean overall DOPS rating improved from DOPS 1 to DOPS 3. The difference in value between DOPS 1 and 3 for anterior rhinoscopy was statistically significant. For otoscopy and indirect laryngology, the difference between DOPS 1 and 2, DOPS 1 and 3 was statistically significant. Both faculty and interns found DOPS to be an efficient tool for assessment.Conclusions: DOPS  is a cost effective assessment tool. It has an effective role in facilitating students’ learning and skill development as it is based on the direct observation of trainees’ procedural skills in real clinical environment.

Specialty Training System and Postgraduate Education in Japan / 医学教育

Medical education towards a specialty is a core stage of training for medical doctors. The specialty training system in Japan was initially organized by various academic societies and was recently integrated under Japan Medical Specialty Board, which was established in 2014. From April 2018, a revised specialty training system will begin and be based on new program guidelines. Its main concepts are professional autonomy, quality assurance of the medical specialty board and trustworthy medical consultation. As with undergraduate education, global standards are recently required in postgraduate education. Consistent outcome policy throughout undergraduate and postgraduate education and workplace-based assessment can hopefully be established.

Specialty Training System and Postgraduate Education in Japan / 医学教育

Medical education towards a specialty is a core stage of training for medical doctors. The specialty training system in Japan was initially organized by various academic societies and was recently integrated under Japan Medical Specialty Board, which was established in 2014. From April 2018, a revised specialty training system will begin and be based on new program guidelines. Its main concepts are professional autonomy, quality assurance of the medical specialty board and trustworthy medical consultation. As with undergraduate education, global standards are recently required in postgraduate education. Consistent outcome policy throughout undergraduate and postgraduate education and workplace-based assessment can hopefully be established.