Assessment in Paediatrics: the status quo and options for change
Jacob HC, Fertleman CR
Institute of Child Health, University College London, United Kingdom
Background
Results: assessors
Pressure is mounting to standardise assessment for medical
undergraduates in the United Kingdom (UK). Paediatrics is a relatively
small medical specialty which has been leading the way in trying to
develop common assessment tools for medical students.
Of the 21 medical schools included, all (21, 100%) involved Consultant
Paediatricians in assessing undergraduates (see Figure 2). Most (20,
95%) also included clinical academics, many of whom had a minor
clinical role and were primarily involved in research.
There is considerable variation in the content, duration and emphasis of
clinical child health placements in the UK. A national syllabus for
paediatrics is being developed which could form the basis for
standardised assessment in child health. Yet little is known about how
UK medical students are currently being assessed in paediatrics.
8 (38%) medical schools involved senior trainee Paediatricians in
assessment and 6 (29%) also involved General Practitioners (Family
Medicine doctors). One (5%) medical school included Child Psychiatrists
in the assessment faculty.
Aim
This study aimed to establish how child health is currently assessed in UK
medical schools.
Methods
The Consultant Paediatrician responsible for undergraduate paediatrics
at every UK medical school was contacted via email. The aims of the
study were outlined, participation was optional and voluntary.
Semi-structured interviews were conducted with all those agreeing to
participate. These interviews were undertaken on the phone or in
person, depending on participant preference.
Figure 2. Frequency of different paediatric professionals involved in undergraduate
assessment
Participants were asked about the assessment tools used within their
undergraduate course and about who performed this assessment.
Discussion
Results were collated and analysed using Microsoft Excel.
Results: assessment methods
21/31 (68%) Consultant Paediatricians responsible for undergraduate
child health training were interviewed between June and November
2013. When asked about the methods used to assess Paediatrics, 19
(90%) medical schools used Objective Structured Clinical Examinations
(OSCEs) and all (21, 100%) used multiple choice questions of varying
formats (see Figure 1).
Workplace-based assessments (either Case Based Discussions or Clinical
Evaluation Exercises) were used by 12 (57%) medical schools. Skills logs
were used by 14 (67%). Smaller numbers of medical schools used a
traditional ‘long case’ bedside assessment, discharge letters or multisource feedback from allied health professionals.
All medical schools used a combination of methods to assess knowledge,
skills and attitudes in undergraduate Paediatrics.
A wide range of tools is used to assess undergraduate paediatrics across
UK medical schools. The use of both within-placement and end of year
examinations helps interrogate students’ knowledge more thoroughly.
Nevertheless, it is not clear whether these undergraduate assessments
are comparable across medical schools.
While medical schools are in agreement that Consultant Paediatricians
and Clinical Academics should be involved in undergraduate assessment,
the use of senior paediatric trainees and General Practitioners remains
controversial.
The itinerate nature of UK medical graduates across the country makes
parity of paediatric assessment essential to maintain standards
nationally. A common syllabus for undergraduate child health training
could support standardised assessment.
Conclusions
• A national syllabus for undergraduate paediatrics could
be used to develop common assessment tools
• Standardised assessment would help promote high
quality child health training nationwide
Acknowledgements
• Sincerest thanks to all those Paediatricians that agreed to be
interviewed for this project
• National Institute for Health Research (NIHR) for funding the project
• Dr Caroline Fertleman & Dr Will Carroll for all their support
Figure 1. Frequency of assessment methods used to assess undergraduate Paediatrics.
MCQs: Multiple Choice Questions, OSCE: Objective Structured Clinical Examination,
WPBA: Work Place Based Assessment