Workplace-based assessments-Articulating the playbook

Abstract

Introduction: A workplace-based assessment (WBA) is a learning recording device that is widely used in medical education globally. Although entrenched in medical curricula, and despite a substantial body of literature exploring them, it is not yet fully understood how WBAs play out in practice. Adopting a constructivist standpoint, we examine these assessments, in the workplace, using principles based upon naturalist inquiry, drawing from a theoretical framework based on Goffman's dramaturgical analogy for the presentation of self, and using qualitative research methods to articulate what is happening as learners complete them.

Methods: Learners were voluntarily recruited to participate in the study from a single teaching hospital. Data were generated, in-situ, through observations with field notes and audiovisual recording of WBAs, along with accompanying interviews with learners.

Results: Data from six learners was analysed to reveal a set of general principles-the WBA playbook. These four principles were tacit, unwritten, unofficial and learners applied them to complete their WBA proformas: (1) maintain the impression of progression, (2) manage the authenticity of the individual proforma, (3) avoid losing face with the assessor and (4) complete the proforma in an effort-efficient way. By adhering to these principles, learners expressed their understanding of their social position in their world at that time the documents were created.

Discussion: This paper recognises the value of the WBA as a lived experience, and of the WBA document as a social space, where learners engage in a social performance before the readers of the proforma. Such an interpretation better represents what happens as learners undergo and record WBAs in the real-world, recognising WBAs as learner-centred, learner-driven, meaning-making phenomena. In this way, as a record of interpretation and meanings, the subjective nature of the WBA process is a strength to be harnessed, rather than a weakness to be glossed over.