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The assessment blueprint and framework

The Overarching Blueprint (PDF: 174Kb) demonstrates that the curriculum is consistent with the four domains of Good Medical Practice: knowledge, skills and performance; safety and quality; communication, partnership and teamwork; maintaining trust. The specialty-specific syllabuses specify the knowledge, skills and performance required for different stages of training and have patient safety as their principal consideration. The professional behaviour and leadership skills syllabus specifies the standards for patient safety: communication, partnership and team-working and maintaining trust. The standards have been informed by the Academy Common Competency Framework and the Academy and NHS Leadership Competency Framework.

Curriculum assessment runs throughout training as illustrated in the Assessment Framework (PDF: 16kb) and is common to all disciplines of surgery.

Types of assessment

Assessments can be categorised as for learning or of learning, although there is a link between the two.

Assessment for Learning is primarily aimed at aiding learning through constructive feedback that identifies areas for development. Alternative terms are formative or low-stakes assessment. Lower reliability is acceptable for individual assessments as they can and should be repeated frequently. This increases their reliability and helps to document progress. Such assessments are ideally undertaken in the workplace.

Assessments for learning are used in the curriculum as part of a developmental or on-going teaching and learning process and mainly comprise Workplace Based Assessments. They provide the trainee with educational feedback from skilled clinicians that should result in reflection on practice and an improvement in the quality of care. Assessments are collated in the trainee’s learning portfolio. These are regularly reviewed during each placement, providing evidence that informs the judgement of the Assigned Educational Supervisors’ (AES) reports to the Training Programme Director and the Annual Review of Competence Progression (ARCP). Assessments for learning therefore contribute to summative judgements of the trainee’s progress.

Assessment of Learning is primarily aimed at determining a level of competence to permit progression through training or for certification. Such assessments are undertaken infrequently (e.g. examinations) and must have high reliability as they often form the basis of decisions. Alternative terms are 'summative' or 'high-stakes' assessments [GMC].

Assessments of learning in the curriculum are focussed on the waypoints in the specialty syllabuses. For the most part these comprise the examinations and structured AES end of placement reports which, taken in the round, cover the important elements of the syllabus and ensure that no gaps in achievement are allowed to develop. They are collated at the ARCP panel, which determines progress or otherwise.

The balance between the two assessment approaches principally relates to the relationship between competence and performance. Competence (can do) is necessary but not sufficient for performance (does), and as trainees’ experience increases so performance-based assessment in the workplace becomes more important.