In this post, Claire Fisher, from Royal (Dick) School of Veterinary Studies, describes how a team involved in teaching a range of clinical disciplines and competency-based education developed a staff training module on work-based assessment, for all staff teaching on clinics. Claire is the final year co-director for the Bachelor of Veterinary Medicine and Surgery (BVM&S) degrees. This post is part of the Mar-May Learning & Teaching Enhancement theme: Assessment and feedback revisited↗️.
Undergraduates in clinical disciplines, such as veterinary medicine, are increasingly being assessed using a variety of workplace-based assessment techniques. Final year (Year 5 for undergrad and year 4 for graduate entry students following the accelerated 4 year program) of the BVM&S degree involves assessment of not just knowledge but clinical and practical skills, and is an entirely practical course with no lecture content. Students participate in clinical rotations in small animal, equine and farm animal hospitals based at the Easter Bush Campus. They see cases from both the general practices in all species and those that are referred to specialist clinicians by other vets. Work-based assessment allows assessment of clinical competence and professional development in a clinical environment.
Mini clinical exercise (miniCE)
At the R(D)SVS, we use a mini clinical exercise (miniCE) to do this, with students being observed while conducting tasks that form part of the normal workflow of the hospital. Their abilities in various domains of competence are graded using an entrustability scale based on how much help the student needed with the task (from ‘I had to do all of the task’ to ‘did not require any help from me’). Written comments are also provided to expand on what they did well and what areas could be improved.
Students select tasks themselves (with some caveats regards species and a number of ‘must do’ areas) allowing them to focus on the areas they feel they require improvement. This work-based assessment allows staff from a range of disciplines working in a clinical environment covering a wide range of species to assess students skills in a way that relates to how they will use these tasks once graduated.
As a highly accredited program, we also have to justify our assessment strategy not just to students but to accreditors from the Royal College of Veterinary Surgeons as well as European, Australian and North American governing bodies. Student feedback alongside our most recent accreditation visit highlighted a need for consistency in the level and quality of feedback given to students.
This is challenging as staff on clinics have a wide range of experience levels from interns to professors, some with decades of teaching experience and some with none, plus we are assessing across a very wide variety of skills and species.
Work-based assessment staff training module
To improve our performance in this area, a team involved in teaching across a range of clinical disciplines and competency-based education developed a staff training module which was rolled out to all staff teaching on clinics. We aimed to explain the concept of work-based assessment and how we are applying it in our course and to provide guidelines for the type and level of feedback that is appropriate. Some staff will be familiar with this concept and perhaps have used it before but, for others, it will be the first encounter they have with assessing students.
The training consists of a 30-minute recorded presentation that is watched beforeattending an in-person session to go over the material, work through some case examples and provide clarification, and answer any questions that might have arisen. The recorded presentation provides detail on the ways we give feedback during the final year, and how students might use that feedback. We explain the terminology used in our feedback system and the benefits of timely and constructive feedback.
The in-person discussions allow us to address any issues or concerns staff may have. Commonly, staff wish to discuss how to deal with giving feedback to students who are not performing well. This allows us to highlight the importance of giving feedback midway through a rotation week so that students have a chance to improve their performance before the final decision about their grade for the week is decided. We also often discuss issues in collating feedback from large teams where each staff member may only spend a small amount of time with each student. We share ideas between teams about what works for them ranging from assigning students a particular staff mentor at the beginning of the week to having time set aside to sit down and discuss student performance.
In addition, these sessions allow an exchange of ideas between people working in areas where they might not meet otherwise, and they foster relationships between different areas of the campus.
To prepare for the 23/24 final year cohort (which started in June 23), we introduced sessions from April 23 and trained over 200 assessors. This meant that by the time the students began clinics there were large numbers of staff able to complete their assessments for them. This has led to positive feedback from students, external examiners and staff on the quality and range of feedback given and the positive impact it has.
Next steps
Going forward, we continue to train new staff and develop our systems with increasing automation of the process to simplify things as far as possible. We also continually review the tools we use for work-based assessment to keep up to date, and prepare our graduates for the systems they will use as qualified vets.
Claire Fisher
Claire Fisher has worked at the R(D)SVS since 2014 initially in a clinical role in the small animal general practice teaching clinical skills. Since 2020, she has been final year co-director, working on updating the assessment and feedback used in clinical teaching. She was part of the team that were awarded the Principal’s medal in 2023. She has been a qualified veterinary surgeon for 24 years and, prior to moving to Edinburgh, worked in general practice in various areas of the UK.
