Developing a self-appraisal tool for intern medical officers in Sri Lanka
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Date
2016-11-05
Authors
Mudiyanse, R.M.
Pallegama, R.
Alwis, S.B.
Olupeliyawa, A.
Marambe, K.
Chandratilake, M.
Krupat, E.
Journal Title
Journal ISSN
Volume Title
Publisher
University of Peradeniya
Abstract
Medical graduates are expected to have a wide spectrum of competencies that extend beyond knowledge and skills. Current practices of evaluation in medical education do not support assessment of the entire spectrum of competencies, hindering the possible drive of assessment for learning and teaching, resulting in marginalized attention to competencies other than knowledge and skills. The practice of compulsory workplace based assessment during internship, which assesses all doctors during a period of six months by a senior consultant, would provide valuable feedback to medical faculties. Therefore, developing a comprehensive tool for appraisal of intern doctors was undertaken. A tool for appraisal of competencies was developed by three stages. Initially, a 30-item tool was developed following a literature review. Secondly, it was refined by expert opinion and thirdly, further improvement after field-testing and discussion with stakeholders was done. The research team further refined the checklist to 20-items after several informal focus group discussions. A suitable guide to express responses in a Likert scale was developed. The items in the final tool includes: demonstrating and applying basic and clinical sciences knowledge; history taking and examination skills; managing emergencies, non-emergency patient management of common conditions, procedural skills related to patient care; written communication skills, solving non-medical problems, communication with patients, parents and relatives; showing empathy and compassion for patients, showing respect for patients and other health care workers; effective collaboration with the team, interest in non-medical activities, administrative and managerial skills; teaching students, colleagues, and other health workers; research, audit and critical thinking skills; commitment for work, commitment for further learning, acknowledging own limitations and seeking help when appropriate; and taking responsibilities according to the role as an intern. The appraisal checklist was administered to 540 intern doctors as filed testing. Results show a segregation of items into 4 groups: core knowledge, psychosocial aspects, scholarship and commitment for work. Results of this study were presented to a forum representing all the medical faculties, the Sri Lanka Medical Council (SLMC) and the Ministry of Health. The workshop participants evaluated the tool and modified items and suggested developing a shorter version with 18 items with evaluation of feasibility and expression of personal opinion. A useful tool for self-appraisal of intern medical officers’ competencies was developed that could be used for appraisal on intern doctors’ performances. Information gathered could be utilized to monitor teaching programs in medical faculties. This study is limited only to self-appraisal, but the real value of the tool would be harnessed only when a supervisor completes it after the observation of performance as a doctor over a period of time.
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Keywords
Intern medical officers , Sri Lanka Medical Council , Self-appraisal tool