Abstract
I read with interest the article by Dr Abdulla about the use of mini-PAT (
Assessor selection does indeed seem important as a source of bias that can undermine validity, 3 , 4 with less-senior doctors and nurses scoring colleagues more leniently. This informs the online selection process from Healthcare Assessment and Training (HcAT), which is now limited by occupational group. Local training must continue and be targeted correctly, with 60% of assessments currently being assessed by senior trainees, not consultants.
Linking good assessment practices to better patient outcomes will never be a clear outcome measure as the naturalistic world of medical practice is too confounded for such study designs. However, the author quite rightly points out the lack of patient involvement in Foundation assessment, a PMETB assessment principle which does need addressing.
The work on MSF in medicine is in its infancy. Much is yet to be understood and sadly the work is under threat. There appears to be a move towards assessment as simply an ‘add on’ to online portfolios. Without large, regulated databases, further research to assure validity and reliability will simply support the ‘no evidence’ view held by critics of recent postgraduate initiatives. 5
I welcome the opportunity to debate all these issues as I remain concerned about widespread, unsupported implementation of MSF. MSF can be – when well-supported, well-implemented and quality assured – an important educational instrument, but our profession will be quick to dismiss it if it is poorly supported and lacks evidence.
Footnotes