Expert validation of fit-for-purpose guidelines for designing programmes of assessment.

BACKGROUND: An assessment programme, a purposeful mix of assessment activities, is necessary to achieve a complete picture of assessee competence. High quality assessment programmes exist, however, design requirements for such programmes are still unclear. We developed guidelines for design based on an earlier developed framework which identified areas to be covered. A fitness-for-purpose approach defining quality was adopted to develop and validate guidelines. METHODS: First, in a brainstorm, ideas were generated, followed by structured interviews with 9 international assessment experts. Then, guidelines were fine-tuned through analysis of the interviews. Finally, validation was based on expert consensus via member checking. RESULTS: In total 72 guidelines were developed and in this paper the most salient guidelines are discussed. The guidelines are related and grouped per layer of the framework. Some guidelines were so generic that these are applicable in any design consideration. These are: the principle of proportionality, rationales should underpin each decisions, and requirement of expertise. Logically, many guidelines focus on practical aspects of assessment. Some guidelines were found to be clear and concrete, others were less straightforward and were phrased more as issues for contemplation. CONCLUSIONS: The set of guidelines is comprehensive and not bound to a specific context or educational approach. From the fitness-for-purpose principle, guidelines are eclectic, requiring expertise judgement to use them appropriately in different contexts. Further validation studies to test practicality are required.

Developing assessments of surgical skills for the GMC Performance Procedures.

INTRODUCTION: The objectives were to: (i) establish how 'typical' consultant surgeons perform on 'generic' (non-specialist) surgical simulations before their use in the General Medical Council's Performance Procedures (PPs); (ii) measure any differences in performance between specialties; and (iii) compare the performance of group of surgeons in the PPs with the 'typical' group. VOLUNTEERS AND METHODS: Seventy-four consultant volunteers in gastrointestinal surgery (n=21), vascular surgery (n=11), urology (n=10), orthopaedics (n=15), cardiothoracic surgery (n=10) and plastic surgery (n=7), plus 9 surgeons undertaking phase 2 of the PPs undertook 7 simple simulations in the skills laboratory. The scores of the volunteers were analysed by simulation and specialty using ANOVA. The scores of the volunteers were then compared with the scores of the surgeons in the PPs. RESULTS: There were significant differences between simulations, but most volunteers achieved scores of 75-100%. There was a significant simulation by specialty interaction indicating that the scores of some specialties differed on some simulations. The scores of the group of surgeons in the PPs were significantly lower than the reference group for most simulations. CONCLUSIONS: Simple simulations can be used to assess the basic technical skills of consultant surgeons. The simulation by specialty interaction suggests that whilst some skills may be generic, others are not. The lower scores of the surgeons in the PPs suggest that these tests possess criterion validity, i.e. they may help to determine when poor performance is due to lack of technical competence.