The implementation of workplace based assessment in the context of clinical radiology training

Workplace based assessment (WPBA) was introduced into clinical radiology training in 2010. The purpose of the study was to investigate its implementation by addressing research questions concerning the assessments’ day-to-day realisation, the participants’ influence upon their enactment, and the utility of the process. The prior history of the introduction of WPBA into postgraduate medical training and the Royal College of Radiologists’ guidance regarding the assessments’ usage served as reference points for the study findings.
Semi-structured interviews were undertaken with 20 radiologists (12 trainers, 8 trainees) in order to discover their opinions of the implementation and usage of WPBA in radiology. The interview data were subjected to thematic analysis in order to identify issues of importance to interviewees, address the research questions and suggest any means of improving the assessments.
The analysis showed that most interviewees thought that WPBA had a formative purpose, as per central guidance, although some assessors felt it could be used summatively in certain circumstances. The day to day realisation of the assessments was subject to some variation, and although this might be seen as inevitable due to differing circumstances, there was evidence of both trainees and trainers manipulating the process to suit their own purposes. There was also evidence of some trainers frankly adapting the assessments’ usage depending upon trainees’ seniority or time in an attachment.

Interviewees described various weaknesses of the process, including the peremptory nature of some assessments, failure to identify underperforming trainees and poor assessor preparedness when WPBA was introduced. Reference to published literature from other postgraduate medical specialties showed that many of these problems were generic in nature, rather than confined to radiology. Suggested means by which WPBA could be improved included joint trainee and trainer leadership of the process, better training of assessors and refinement of the assessments themselves.