The purpose of the assessment must be clear.
To plan a workplace-based assessment program, its purpose must be clear. For the assessment of IMGs in the Standard Pathway (workplace-based assessment), the AMC has developed a list of clinical dimensions and clinical areas of practice.
Clinical dimensions for workplace-based assessment
The focus of workplace-based assessment is on IMGs’ application of their knowledge and skills in their clinical work. Specifically, workplace-based assessment should assess the following aspects of their performance:
Clinical skills (history taking, physical examination, investigations and diagnosis, prescribing and management, counselling/patient education and clinical procedures)
Applying clinical knowledge and skills, including a suitable approach to each patient and the ability to take a history, conduct a physical examination, order investigations, interpret physical signs and investigations, formulate a diagnosis and management plans, prescribe therapies and counsel patients.
Synthesising information obtained about and from a patient to prioritise investigations and treatment, demonstrating the safe and effective application of clinical knowledge and skills within Australian health care settings; demonstrating safe practice when dealing with unfamiliar conditions or contexts.
Demonstrating effective oral, non-verbal and written communication skills, including effective listening skills.
Ability to work as an effective member of the health care team:
Demonstrating respect, teamwork and effective communication.
Ability to apply aspects of public health relevant to clinical settings
Recognising the importance of applying public health principles relevant to the Australian health care setting.
Demonstrating an ability to value diversity, to communicate and work effectively in cross-cultural situations and the capacity for cultural self-awareness.5
Professionalism and attention to patient safety
The ability to demonstrate respect, compassion and empathy for the patient; to work safely and effectively within the legal and ethical guidelines for practice within Australia; to recognise the limitations of one’s own knowledge and skills; to recognise the need for continuing professional development; and to meet the responsibilities of positions within the Australian health care setting, including teaching responsibilities.
Clinical areas for workplace-based assessment
The Standard Pathway (workplace-based assessment) should cover the same clinical areas as the Standard Pathway (AMC Examination). These clinical areas comprise:
- Adult health (medicine)—including acute and chronic management
- Adult health (surgery)—including acute and chronic management
- Women’s health
- Child health
- Mental health
- Emergency medicine
It is recognised that whilst workplace-based assessment should cover all of these areas, they may not all be able to be assessed in every clinical setting.
Possible modular model
The AMC has an alternative assessment model under consideration whereby the clinical areas might be assessed partially within the IMGs workplace setting and partially in another setting.
This hybrid model would involve a modular approach to assessment of the clinical areas, combining workplace-based assessment modules (for example, the adult health areas, mental health and emergency medicine) with AMC-examined modules (for example, women’s and child health).
The model has the potential for extending the range of clinical settings for workplace-based assessment.
Assessment methods for workplace-based assessment
Assessment methods need to be selected to ensure that all dimensions of clinical practice are appropriately assessed in the workplace.
The AMC workplace-based assessment accreditation guidelines for IMGs specifies requirements for:
- Direct observation, using a reliable and validated assessment method, to assess those dimensions of clinical performance that can be observed during an IMG’s encounter with a patient; and
- Indirect methods, drawn from the methods outlined in the following lesson, to assess other clinical dimensions.
Methods for workplace-based assessment are described in Lesson 4.
5 Adapted from Cultural competency in health: A guide for policy, partnerships and participation, Australian Government, NHMRC 2006.