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Clinical assessors' working conceptualisations of undergraduate consultation skills: a framework analysis of how assessors make expert judgements in practice

Hyde, C; Yardley, S; Lefroy, J; Gay, S; McKinley, RK; (2020) Clinical assessors' working conceptualisations of undergraduate consultation skills: a framework analysis of how assessors make expert judgements in practice. Advances in Health Sciences Education 10.1007/s10459-020-09960-3. Green open access

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Abstract

Undergraduate clinical assessors make expert, multifaceted judgements of consultation skills in concert with medical school OSCE grading rubrics. Assessors are not cognitive machines: their judgements are made in the light of prior experience and social interactions with students. It is important to understand assessors’ working conceptualisations of consultation skills and whether they could be used to develop assessment tools for undergraduate assessment. To identify any working conceptualisations that assessors use while assessing undergraduate medical students’ consultation skills and develop assessment tools based on assessors’ working conceptualisations and natural language for undergraduate consultation skills. In semi-structured interviews, 12 experienced assessors from a UK medical school populated a blank assessment scale with personally meaningful descriptors while describing how they made judgements of students’ consultation skills (at exit standard). A two-step iterative thematic framework analysis was performed drawing on constructionism and interactionism. Five domains were found within working conceptualisations of consultation skills: Application of knowledge; Manner with patients; Getting it done; Safety; and Overall impression. Three mechanisms of judgement about student behaviour were identified: observations, inferences and feelings. Assessment tools drawing on participants’ conceptualisations and natural language were generated, including ‘grade descriptors’ for common conceptualisations in each domain by mechanism of judgement and matched to grading rubrics of Fail, Borderline, Pass, Very good. Utilising working conceptualisations to develop assessment tools is feasible and potentially useful. Work is needed to test impact on assessment quality.

Type: Article
Title: Clinical assessors' working conceptualisations of undergraduate consultation skills: a framework analysis of how assessors make expert judgements in practice
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s10459-020-09960-3
Publisher version: https://doi.org/10.1007/s10459-020-09960-3
Language: English
Additional information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Keywords: Social Sciences, Science & Technology, Life Sciences & Biomedicine, Education & Educational Research, Education, Scientific Disciplines, Health Care Sciences & Services, Clinical skills, Education, medical, undergraduate, professional, Judgement, OSCE, Professional judgment, Qualitative research, Rater cognition, Rater judgments, Theory of expertise, MINI-CEX SCORES, MEDICAL-STUDENTS, COMMUNICATION-SKILLS, EXAMINATION OSCE, BLACK-BOX, PERFORMANCE, COMPETENCE, RESIDENTS, RELIABILITY, EDUCATION
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Marie Curie Palliative Care
URI: https://discovery.ucl.ac.uk/id/eprint/10091643
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