Educators' consideration of learner motivation in ophthalmology education in medical school: Influences on teaching practice and course design.

BACKGROUND: Ophthalmology education in medical school has historically neglected the impact of autonomous motivation on student learning and wellbeing. This study aimed to understand ophthalmology educators' consideration and application of student motivation in ophthalmology medical education. MATERIAL AND METHODS: Lead ophthalmology educators from Australian and New Zealand medical schools participated in an online semi-structured in-depth interview. Interview transcripts were analysed using thematic analysis. Codes were generated and aligned into overarching themes. FINDINGS: Six educators participated in the study. Five main themes arose from the transcripts: the lack of explicit consideration of student motivation, implicit consideration of motivation in curriculum design and in teaching practices, the impact of innovation on motivation and the relationship between teacher and student motivation. Participants also commented on trends in ophthalmology education including generalists' confidence in managing ophthalmic disease, the role of fundoscopy in medical education and time pressure on ophthalmology in medical schools. CONCLUSION: There has only been an implicit instead of explicit consideration of motivation in ophthalmology education in medical school, which leaves an unfulfilled potential for teaching practices to impact the affective along with cognitive and metacognitive aspects of learning. This study highlights the need for motivation to be explicitly incorporated into the development of teaching practices and curriculum reform.

Expert consensus on the attributes and competencies required for rural and remote junior physicians to work effectively in isolated indonesian communities.

Indonesian physicians working in rural and remote areas must be equipped not only with generic competencies but also with the attributes and skills necessary to provide health care services without compromising quality. This study sought to reach a consensus on the attributes and competencies that are viewed as essential and important for working effectively as an early career doctor in rural and remote practice in Indonesia. A two-round Delphi study was conducted by reference to 27 consenting physicians working in rural and remote Indonesia. Forty-three items covering 9 attributes and 34 competencies were sent to these physicians to be rated on a Likert scale ranging from 1 to 5 in terms of their importance for effective rural and remote practice. Nine attributes and 29 competencies progressed to Round 2. All nine attributes and 29 competencies were identified as essential or important for junior physicians' ability to be effective in their practice. The essential attributes included professional quality related to prioritising the rural community. The essential competencies included medical skills, professional behaviour, interprofessional skills, health promotion and connection to the rural community. The consensus thus reached on these essential and important attributes and competencies can inform curriculum development for the undergraduate and postgraduate training of junior rural and remote physicians.

Technology enhanced neuroanatomy teaching techniques: A focused BEME systematic review of current evidence: BEME Guide No. 75.

BACKGROUND: In response to growing curriculum pressures and reduced time dedicated to teaching anatomy, research has been conducted into developing innovative teaching techniques. This raises important questions for neuroanatomy education regarding which teaching techniques are most beneficial for knowledge acquisition and long-term retention, and how they are best implemented. This focused systematic review aims to provide a review of technology-enhanced teaching methods available to neuroanatomy educators, particularly in knowledge acquisition and long-term retention, compared to traditional didactic techniques, and proposes reasons for why they work in some contexts. METHODS: Electronic databases were searched from January 2015 to June 2020 with keywords that included combinations of 'neuroanatomy,' 'technology,' 'teaching,' and 'effectiveness' combined with Boolean phrases 'AND' and 'OR.' The contexts and outcomes for all studies were summarised while coding, and theories for why particular interventions worked were discussed. RESULTS: There were 4287 articles identified for screening, with 13 studies included for final analysis. There were four technologies of interest: stereoscopic views of videos, stereoscopic views of images, augmented reality (AR), and virtual reality (VR). No recommendation for a particular teaching method was made in six studies (46%) while recommendations (from weak to moderate) were made in seven studies (54%). There was weak to moderate evidence for the efficacy of stereoscopic images and AR, and no difference in the use of stereoscopic videos or VR compared to controls. CONCLUSIONS: To date, technology-enhanced teaching is not inferior to teaching by conventional didactic methods. There are promising results for these methods in complex spatial anatomy and reducing cognitive load. Possible reasons for why interventions worked were described including students' engagement with the object, cognitive load theory, complex spatial relationships, and the technology learning curve. Future research may build on the theorised explanations proposed here and develop and test innovative technologies that build on prior research.

When the wheels fall off - Medical students' experiences of interrupted academic progression.

INTRODUCTION: There is limited published research on medical students' perspectives of a significant interruption to their academic progression. This study sought to identify the factors that contribute to difficulties with academic progression and to understand how medical students successfully respond. METHODS: This interpretive phenomenological study reports on the findings from in-depth interviews of 38 final year medical students who had experienced a significant academic interruption. RESULTS: The two superordinate themes were: the factors contributing to the interruption and their experience of the interruption. Factors identified as contributing to the interruption were: workload, learning in medicine, motivation for medicine, isolation, adapting to local culture, health and external factors. Their experience of the interruption focused on stages of working through the process: 'what happened,' 'how it felt,' 'managing the failure,' 'accepting the failure' and 'making some changes.' DISCUSSION: Each factor affected how the participants reacted and responded to the interruption. Regardless of the origins of the interruption, most reacted and responded in a comparable process, albeit with varying timespans. These reactions and responses were in a state of fluctuation. In order to succeed many stated they shifted their motivation from external to internal, in direct response to the interruption, resulting in changed learning behaviours. CONCLUSIONS: The process of working through an interruption to academic progression for students may benefit from a model of interval debriefing, restorative academic and personal development support. Facilitation of this process could enable students to face an interruption constructively rather than as an insurmountable emotionally burdensome barrier. Medical schools could utilise these findings to implement further support strategies to reduce the number of significant academic disruptions.

Twelve tips for medical students experiencing an interruption in their academic progress.

For every commencing cohort of medical students, a small but significant number will experience an interruption to their academic progression because of academic difficulties, health concerns or external influences outside of the students' control. During the process of researching the factors surrounding difficulties with academic progression, students told us many ways that they have learned from that experience, which then allowed most of them to graduate. This paper combines the shared experiences of students who have had an interruption, and those of the authors as medical educators.

Measuring impostor phenomenon in healthcare simulation educators: a validation of the clance impostor phenomenon scale and leary impostorism scale.

BACKGROUND: Impostor phenomenon is a term used to describe feelings of intellectual and professional fraudulence. The Clance Impostor Phenomenon Scale and the Leary Impostorism Scale are two self-report measures used to determine whether an individual experiences impostor phenomenon. This study examined the psychometric properties of both measures in healthcare simulation educators. METHODS: The study sample comprised 148 educators, 114 (77%) females, 34 (23%) males, who completed an online version of each instrument. Exploratory factor analysis was used to examine the factor structure of the Clance Impostor Phenomenon Scale and the Leary Impostorism Scale. RESULTS: Exploratory factor analysis revealed that for both instruments a one-factor solution best fit the data, suggesting all items in both measures fit onto a single theoretical construct. Both instruments demonstrated high internal reliability, with the Cronbach's alpha for the Clance Impostor Phenomenon Scale being α = .96 and the Leary Impostorism Scale α = .95. CONCLUSIONS: This study suggests that impostor phenomenon as measured by the Clance Impostor Phenomenon Scale and the Leary Impostorism Scale is a unidimensional construct among healthcare simulation educators. With a growing interest in impostor phenomenon, the present findings will assist researchers to evaluate the phenomenon in healthcare settings.

InspirE5: a participatory, internationally informed framework for health humanities curricula in health professions education.

BACKGROUND: Reporting on the effect of health humanities teaching in health professions education courses to facilitate sharing and mutual exchange internationally, and the generation of a more interconnected body of evidence surrounding health humanities curricula is needed. This study asked, what could an internationally informed curriculum and evaluation framework for the implementation of health humanities for health professions education look like? METHODS: The participatory action research approach applied was based on three iterative phases 1. Perspective sharing and collaboration building. 2. Evidence gathering 3. Development of an internationally relevant curriculum and evaluation framework for health humanities. Over 2 years, a series of online meetings, virtual workshops and follow up communications resulted in the production of the curriculum framework. RESULTS: Following the perspective sharing and evidence gathering, the InspirE5 model of curriculum design and evaluation framework for health humanities in health professions education was developed. Five principal foci shaped the design of the framework. ENVIRONMENT: Learning and political environment surrounding the program. Expectations: Graduate capabilities that are clearly articulated for all, integrated into core curricula and relevant to graduate destinations and associated professional standards. EXPERIENCE: Learning and teaching experience that supports learners' achievement of the stated graduate capabilities. EVIDENCE: Assessment of learning (formative and/or summative) with feedback for learners around the development of capabilities. Enhancement: Program evaluation of the students and teachers learning experiences and achievement. In all, 11 Graduate Capabilities for Health Humanities were suggested along with a summary of common core content and guiding principles for assessment of health humanities learning. DISCUSSION: Concern about objectifying, reductive biomedical approaches to health professions education has led to a growing expansion of health humanities teaching and learning around the world. The InspirE5 curriculum and evaluation framework provides a foundation for a standardised approach to describe or compare health humanities education in different contexts and across a range of health professions courses and may be adapted around the world to progress health humanities education.

Health Humanities curriculum and evaluation in health professions education: a scoping review.

BACKGROUND: The articulation of learning goals, processes and outcomes related to health humanities teaching currently lacks comparability of curricula and outcomes, and requires synthesis to provide a basis for developing a curriculum and evaluation framework for health humanities teaching and learning. This scoping review sought to answer how and why the health humanities are used in health professions education. It also sought to explore how health humanities curricula are evaluated and whether the programme evaluation aligns with the desired learning outcomes. METHODS: A focused scoping review of qualitative and mixed-methods studies that included the influence of integrated health humanities curricula in pre-registration health professions education with programme evaluate of outcomes was completed. Studies of students not enrolled in a pre-registration course, with only ad-hoc health humanities learning experiences that were not assessed or evaluated were excluded. Four databases were searched (CINAHL), (ERIC), PubMed, and Medline. RESULTS: The search over a 5 year period, identified 8621 publications. Title and abstract screening, followed by full-text screening, resulted in 24 articles selected for inclusion. Learning outcomes, learning activities and evaluation data were extracted from each included publication. DISCUSSION: Reported health humanities curricula focused on developing students' capacity for perspective, reflexivity, self- reflection and person-centred approaches to communication. However, the learning outcomes were not consistently described, identifying a limited capacity to compare health humanities curricula across programmes. A set of clearly stated generic capabilities or outcomes from learning in health humanities would be a helpful next step for benchmarking, clarification and comparison of evaluation strategy.

Likelihood of rural practice in medical school entrants with prior tertiary experience.

Background: Workforce decisions of medical students with prior tertiary education, relative to those without, are not known. Methods: Rural workforce outcomes for three separate streams of medical students were compared: school leaver entry (SLE) entered medical school direct (N = 682), non-standard entry (NSE) had some prior tertiary education (N = 123), and graduate entry (GE) (N = 317), had a prior completed degree. All students were at least in postgraduate year 3 in 2018, when current urban or rural medical workforce participation was ascertained. Results: Multivariate logistic regression allowing for the influences of rural background, rural clinical school participation, gender, being born overseas, socioeconomic status, and being a bonded rural scholar, showed that NSE students and GE students had increased odds of being in rural practice relative to SLE students. This increase was more than three-fold for NSE students (OR = 3.41, 95% CI 1.94, 5.99, p < 0.001) and greater than two-fold for GE students (OR = 2.54, 95% CI 1.57, 4.10, p < 0.001). Conclusion: Graduates with prior tertiary education were more likely to enter the rural medical workforce than direct school entrants. This suggests that increasing graduate entry programs may augment the rural medical workforce and that undergraduate programs allowing non-standard entry may have the same benefit.

Student motivation to learn: is self-belief the key to transition and first year performance in an undergraduate health professions program?

BACKGROUND: Student motivation to learn has been undervalued to date though has been identified as an area influencing student success and retention at university. The transition into university has been highlighted as a key period affecting student outcomes as well as well-being. Early identification of those students at risk may assist the transition for many students moving into higher education. Previous research has identified the Motivation and Engagement Scale - University/College (MES-UC) as a valid instrument for measuring motivation to learn in physiotherapy students. The aim of this study was to determine the relationship between a student's motivation to learn on entry into an undergraduate physiotherapy program and their performance through first year. The relationship of admissions scores, to motivation to learn on entry, were also considered, to determine any link between these measures. METHODS: An observational longitudinal study was conducted on one cohort of undergraduate physiotherapy students commencing their studies in 2015 with a response rate of 67%. Correlations were performed between admission variables and Year 1 MES-UC scoring; and between Year 1 MES-UC scoring and subsequent academic performance across first year, taking into consideration gender and age. RESULTS: Self-belief was identified as the key dimension of motivation influencing student success in the transition into university. Results identified the link between self-belief scores on entry and academic performance in first year, including grade point average and performance in six of nine courses. Courses where there was no significant relationship were identified as curriculum areas where students may be less motivated. There was a relationship between the admissions interview and MES-UC scoring, demonstrating a link between non-cognitive selection measures and student motivation to learn on entry into the program. CONCLUSION: Motivation to learn and specifically self-belief with learning, may be influential in the transition into higher education. Undertaking measures of academic motivation may be useful to determine student engagement with curriculum, through identifying any link between student self-belief and performance in specific courses. Changes to curriculum based on student motivation as well as targeting early those students with reduced self-belief may improve student success, psychosocial wellbeing and retention.

Relative progress and academic performance of graduate vs undergraduate entrants to an Australian medical school.

BACKGROUND: Whether graduate entrants to medical school perform better academically than undergraduate entrants remains controversial. Differences in the discipline backgrounds of graduates may, at least in part, have accounted for differences in the results of comparative studies reported to date. This study aimed to address the dual issues of whether academic performance and progression rates were different between GE and UG students and the extent to which the discipline background of GE students may underpin any differences observed. METHODS: Relative academic performance as well as indicators of student progression (supplementary examinations, repeat years, leave of absence, withdrawal from the programme) were compared between graduate entrants (GE) (N = 410) and both school leaver entrants (SLE) (N = 865) and non-standard entrants (some prior tertiary education) (NSE) (N = 148) who combined for the final 4 yr. of a 6 yr. MBBS undergraduate programme in 8 consecutive cohorts from 2006 to 2013 in Western Australia. RESULTS: Examination scores were generally at or very close to a distinction grade or higher across all groups. Higher mean examination scores were seen for GE versus both SLE and NSE in the first 2 years with no significant differences in the final 2 years. GE from biological science / science backgrounds (N = 241) or physical science backgrounds (N = 26) performed the same as SLE and NSE throughout the programme. GE with a health / allied health background (N = 91), however, performed better throughout. They also performed better when compared to their GE counterparts from a humanities (N = 32) or a biological science / science background. GE had increased odds of withdrawing when compared to SLE (OR 2.50, 95% CI 1.30, 4.79, P = 0.006), but not compared to NSE. NSE had increased odds of repeating at least one level when compared to either GE (OR 2.74, 95% CI 1.21, 6.21, P = 0.016) or SLE (OR 4.10, 95% CI 1.93, 8.70, P < 0.001). There were no differences by entry category in the odds of sitting at least one supplementary examination during the programme. There was an increase in the odds of taking at least one leave of absence in both SLE (OR 2.55, 95% CI 1.79, 3.63, P < 0.001) and NSE (OR 2.47, 95% CI 1.50, 4.07, P < 0.001) compared to GE. CONCLUSIONS: Better academic performance by GE compared to SLE and NSE was predominantly due to higher scores for GE with a health / allied health background. GE were also less likely to have impeded progress during the course.

What are the attributes of excellence in an acute practice occupational therapist?

BACKGROUND/AIM: There is anecdotal recognition within the profession that novice occupational therapists who perform well at interview do not necessarily make the best practising clinicians. Further anecdotal evidence suggests that it is difficult to tell (at interview) which occupational therapists will follow which path and whether further training can achieve excellence in existing staff. What is it that makes the difference? What attributes do those truly 'excellent' clinicians have that makes them better than others? METHOD: A two-round Delphi survey was utilised and 18 expert occupational therapists were purposively recruited from Perth's three adult tertiary hospitals. Panellists rated and ranked sixteen possible attributes that could comprise excellence in an acute practice occupational therapist. RESULTS: The final order of importance (from most to least) of the 16 possible attributes of excellence was determined. Communication, Self-management and Critical Thinking were found to be the three most important attributes, whereas Humility was considered the least important attribute. All attribute rankings achieved at least a low level of consensus. CONCLUSION: We now have a much clearer picture of what excellence looks like in the acute practice setting, giving managers a new understanding. There is now the possibility of integrating this information into both the recruitment of new staff and the professional development of existing staff. In this way we can move forward to a future that includes the active development of occupational therapy excellence in ways that were not possible before these results were available.

Predicting performance of junior doctors: Association of workplace based assessment with demographic characteristics, emotional intelligence, selection scores, and undergraduate academic performance.

INTRODUCTION: Predicting workplace performance of junior doctors from before entry or during medical school is difficult and has limited available evidence. This study explored the association between selected predictor variables and workplace based performance in junior doctors during their first postgraduate year. METHODS: Two cohorts of medical students (n = 200) from one university in Western Australia participated in the longitudinal study. Pearson correlation coefficients and multivariate analyses utilizing linear regression were used to assess the relationships between performance on the Junior Doctor Assessment Tool (JDAT) and its sub-components with demographic characteristics, selection scores for medical school entry, emotional intelligence, and undergraduate academic performance. RESULTS: Grade Point Average (GPA) at the completion of undergraduate studies had the most significant association with better performance on the overall JDAT and each subscale. Increased age was a negative predictor for junior doctor performance on the Clinical management subscale and understanding emotion was a predictor for the JDAT Communication subscale. Secondary school performance measured by Tertiary Entry Rank on entry to medical school score predicted GPA but not junior doctor performance. DISCUSSION: The GPA as a composite measure of ability and performance in medical school is associated with junior doctor assessment scores. Using this variable to identify students at risk of difficulty could assist planning for appropriate supervision, support, and training for medical graduates transitioning to the workplace.

Do photographs, older adults' narratives and collaborative dialogue foster anticipatory reflection ("preflection") in medical students?

BACKGROUND: In changing higher education environments, medical educators are increasingly challenged to prepare new doctors to care for ageing populations. The Depth of Field: Exploring Ageing resource (DOF) uses photographs, reflective questioning prompts, older adults' narratives and collaborative dialogue to foster anticipatory reflection or 'preflection' in medical students prior to their first geriatric medicine clinical placement. The aim of this research is to explore whether photographs, narratives and small group collaborative dialogue fosters reflective learning, enhances reflective capacity and has the potential to shift medical students' attitudes towards caring for older adults. METHODS: This study used a mixed method evaluation design, measuring attitudes using pre and post questionnaire responses and individual written reflections drawn from 128 second year medical students, exploring their perceptions toward older adults. RESULTS: Quantitative and qualitative data indicated that the DOF session generated reflective learning that resulted in positive shifts in medical students' perceptions towards older adults. The qualitative reflections were captured in four main themes: the opportunity provided to Envision working with older adults; the Tension created to challenge learners' misinformed assumptions, and the work of Dismantling those assumptions, leading to Seeing older people as individuals. CONCLUSIONS: These findings highlight how visual and narrative methodologies can be used as an effective reflective learning tool to challenge medical students' assumptions around ageing and how these may influence their care of older adults.

"Helping someone with a skill sharpens it in your own mind": a mixed method study exploring health professions students experiences of Peer Assisted Learning (PAL).

BACKGROUND: Peer assisted learning (PAL) has been described as "the development of knowledge and skill through active help and support among status equals or matched companions". To enhance the learning experience of health professions students and improve collaborative and collegial learning, six pilot Peer Assisted Learning (PAL) projects were conducted across a health science faculty. METHODS: A responsive mixed method evaluation design was applied to explore the adequacy of the preparation for PAL, the impact PAL had on student attainment of examination, consultation, communication and feedback skills and to explore students' learning experiences through PAL. RESULTS: The 149 participants agreed the training programme was well organised, offered a safe learning environment and prepared the participant for the PAL activity. The impact of PAL included improvements in students' confidence and ability to give feedback and developed students' teaching, clinical and communication skills. Qualitative analysis revealed participants experienced deeper learning through teaching and learning from their peers, became more open to giving and receiving feedback and valued the comfortable/safe learning environment offered through PAL. CONCLUSION: Providing appropriate training in peer teaching and feedback and the schools engagement and openness to peer learning in the classroom and clinical setting enhances students' peer assisted learning experience.

Descriptive analysis of junior doctor assessment in the first postgraduate year.

INTRODUCTION: Preparing graduates for the role of the junior doctor is the aim of all medical schools. There has been limited published description of junior doctor performance in the workplace within Australia. METHODS: This cohort study describes junior doctors' performance in the first postgraduate year, the influence of gender, rotation type and amount of experience and explores the feedback process used for junior doctors across a two year period. RESULTS: Participants obtained lower scores for performing procedures, managing emergencies and adverse event identification and highest scores for interpersonal skills, teamwork, written communication and professional behavior. There were no observed effects of the amount of experience but, were effects of the discipline in which the rotation occurred. Five juniors doctors, two female and three male, were classified as having overall borderline performance, 2.5% of the respondents. These findings were supported by content analysis of the written feedback. While feedback was documented in 94% of occasions, this was not given to the junior doctor 25% of the time. CONCLUSIONS: The findings in this study support the claim that the tools and processes being used to monitor and assess junior doctor performance could be better. The Australian medical board appears to be looking for an assessment process that will both discriminate the poorly performing doctor and provide educational guidance for the training organization. These two intents of the assessment may be in opposition to each other.

Relationships between academic performance of medical students and their workplace performance as junior doctors.

BACKGROUND: Little recent published evidence explores the relationship between academic performance in medical school and performance as a junior doctor. Although many forms of assessment are used to demonstrate a medical student's knowledge or competence, these measures may not reliably predict performance in clinical practice following graduation. METHODS: This descriptive cohort study explores the relationship between academic performance of medical students and workplace performance as junior doctors, including the influence of age, gender, ethnicity, clinical attachment, assessment type and summary score measures (grade point average) on performance in the workplace as measured by the Junior Doctor Assessment Tool. RESULTS: There were two hundred participants. There were significant correlations between performance as a Junior Doctor (combined overall score) and the grade point average (r = 0.229, P = 0.002), the score from the Year 6 Emergency Medicine attachment (r = 0.361, P < 0.001) and the Written Examination in Year 6 (r = 0.178, P = 0.014). There was no significant effect of any individual method of assessment in medical school, gender or ethnicity on the overall combined score of performance of the junior doctor. CONCLUSION: Performance on integrated assessments from medical school is correlated to performance as a practicing physician as measured by the Junior Doctor Assessment Tool. These findings support the value of combining undergraduate assessment scores to assess competence and predict future performance.

Student and clinical supervisor perceptions of community-based dental educational experiences: A scoping review.

PURPOSE: This scoping review was conducted to map the breadth of experiences in community-based dental education (CBDE), as reported by students and clinical supervisors. METHODS: This scoping review was conducted following the structured framework proposed by Arksey and O'Malley and adhering to PRISMA-SCR guidelines for scoping reviews. Applying specified eligibility criteria, a systematic search of four electronic databases (PubMed, Scopus, Embase, and Web of Science) was followed by data extraction and data synthesis of full-text articles. Research was conducted between June 2022 and September 2022. RESULTS: Sixteen articles were identified for the final full-text review. Utilizing a narrative thematic review, the following five domains emerged: preparation for autonomous practice, understanding of primary care dentistry, understanding of health disparities and patient needs, clinical confidence, clinical diversity, and skill development, and perspectives on quality of teaching and assessment. CONCLUSION: Community/outreach dental education effectively supplements traditional dental school-based education from the perspectives of students and community-based clinical supervisors.

Does self reflection and insight correlate with academic performance in medical students?

BACKGROUND: Medical students in academic difficulty are often described as lacking insight. The Self Reflection and Insight Scale (SRIS) is a tool for measuring insight which has been validated in medical students. We investigated whether self reflection and insight scores correlate with academic performance in Year 4 medical students from a six year undergraduate medical degree, and whether self reflection and insight changes after one year of clinical training. METHODS: Self reflection and insight scores were measured in 162 students at the start of Year 4 at the University of Western Australia. Performance in end of year written and clinical exams was monitored and correlated with SRIS. Seventy of the students were surveyed again at the start of Year 5 to see if scores changed or were stable after one year of full time clinical training. RESULTS: We found no correlation between self reflection or insight and academic performance in written and clinical exams. There was a significant increase in recognition of the need for self reflection in Year 5 compared with Year 4. CONCLUSIONS: While no correlation was found between this measure of self reflection and insight with academic performance, there was an increase in students' recognition of the need for reflection after one year of clinical studies. This study is a valuable first step towards a potentially exciting research domain and warrants further longitudinal evaluation with larger cohorts of students using additional measures of achievement.

Assessment of Junior Doctor performance: a validation study.

BACKGROUND: In recent years, Australia has developed a National Junior Doctor Curriculum Framework that sets out the expected standards and describes areas of performance for junior doctors and through this has allowed a national approach to junior doctor assessment to develop. Given the significance of the judgments made, in terms of patient safety, development of junior doctors, and preventing progression of junior doctors moving to the next stage of training, it is essential to develop and validate assessment tools as rigorously as possible. This paper reports on a validation study of the Junior Doctor Assessment Tool as used for PGY1 doctors to evaluate the psychometric properties of the instrument and to explore the effect of length of experience as a PGY1 on assessment scores. METHODS: This validation study of the Australian developed Junior Doctor Assessment Tool as it was used in three public and other associated hospitals in Western Australia for PGY1 across a two year period addressed two core aims, namely: (1) to evaluate the psychometric properties of the instrument; (2) to explore the effect of length of experience as a PGY1 on assessment scores. RESULTS: The highest mean scores were for professional behaviours, teamwork and interpersonal skills and the lowest were for procedures. Most junior doctors were assessed three or more times and scores were not different in the first rotation compared to subsequent rotations. While statistically significant, there appeared to be little practical influence on scores obtained by the number of times they were assessed. Principal component analysis identified two principal components of junior doctor performance are being assessed rather than the commonly reported three. A Cronbach Alpha of .883 was calculated for the 10 item scale. CONCLUSIONS: Now that the components of the tool have been analysed it will be more meaningful and potentially more influential to consider these factors on the potential educational impact of this assessment process for monitoring junior doctor development and progression.