Journal of Universal Surgery

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Feedback in Procedure Based Assessment (PBA): Does It Help Trainee Progression?

Mothe BS* and Davison IW

Objectives: To investigate the impact of feedback as well as the attitudes and experiences of trainees and trainers regarding Procedure Based Assessment (PBA).

Methods: Initially, one focus group discussion followed by semi-structured interviews was conducted involving higher surgical trainees who are at different levels on their surgical training pathway across 3 United Kingdom (UK) deaneries. Secondly, PBA with audio/video adjuncts was introduced on a trial basis with the help of trainee participants, and these trainees were re-interviewed after they had used the new system. Two trainers were interviewed separately to collect their views on the assessment process, including the contemporaneous/real-time PBA. Individual audio interviews were transcribed, and thematic analysis was conducted after applying open/axial coding.

Results: The study found that both trainers and trainees widely accept PBA as a valid and reliable tool for procedural assessment of surgical skills. The constructive feedback provided by the clinical supervisors/assessors was beneficial in identifying areas for further development and also helped trainees set future goals. Trainees were concerned about insufficient support from trainers for completing the PBAs, making the process a 'tick box' exercise. Trainers particularly perceived that the PBA process enhanced their ability to assess surgical skills. To some extent, everyone found that PBA can drive surgical education progression when used for formative purposes. However, the educational value of PBA was more limited, when used as a summative tool to fulfill the number requirement of GMC/JCST. The lack of variation in PBAs available to different levels of training was a further limitation.

Conclusion: Based on the responses received in this study, trainees benefit most, when they are used for formative not summative purposes. Contemporaneous/ real-time recording of feedback in Procedure based assessment (informal & formal) along with other existing assessment methods could be beneficial for Higher Surgical Training progression.