Workplace Based Assessment continues to strengthen

The Workplace Based Assessment (WBA) pathway provides international medical graduates with an alternative assessment pathway to the AMC Clinical Examination and leads to the award of an AMC Certificate. In the WBA pathway, international medical graduates are assessed using the AMC Computer Adaptive Test (CAT) Multiple Choice Question (MCQ) Examination, followed by a 6 to 12 month program of workplace based assessment of clinical skills and knowledge by an AMC-accredited provider.

The policy approach has been to enable the development of bespoke programs to support the assessment and placement of doctors in areas that have had difficulty recruiting medical workforce. The increase in providers to 10 (a 30% increase over the last 12 months) indicates that the WBA assessment pathway is valued by local health services that are investing in them.

Map: Location of WBA accredited providers as at June 2019

Click on the WBA Accredited Providers List to view on map

NSW

Central Coast Local Health District – Gosford and Wyong

Hunter New England Local Health District (HNELHD) – Newcastle

Illawarra Shoalhaven Local Health District (ISLHD) – Wollongong

Mid North Coast Local Health District (MNCKHD) – Kempsey

SA

Flinders Rural Health SA (FRHSA) – Mount Gambier

TAS

Launceston General Hospital (LGH) – statewide program

VIC

Monash Health – Dandenong

Rural and Outer Metropolitan United Alliance (ROMUA) – Shepparton

WA

WA Country Health Service (WACHS) – Bunbury, Geraldton and Kalgoorlie

QLD

Wide Bay Hospital and Health Service (WBHHS) – Hervey Bay

Given that it had been nearly 10 years since the development of the WBA pathway, in September 2018 the AMC held a national WBA workshop which brought together 65 participants from across Australia, representing WBA providers, assessors, regulators, jurisdictions and trainees. The purpose of the workshop was to inform the national agenda for the development of the WBA program, describe AMC expectations, promote sharing of good practice and challenges and strengthen relationships between key stakeholders. A report outlining key benefits, challenges and priorities for WBA program development was drafted with four emerging themes:

1. Developing an evidence base: The need to evaluate WBA and develop a research base, including longitudinal measurement of outcomes and data
2. Continuous quality improvement: The identification of a number of areas for quality improvement including calibration of assessors and tools, training of assessors, standardised forms, conflict of interest and minimising bias in assessment
3. Engagement with providers: The opportunities for better collaboration between stakeholders, particularly between WBA providers and a need to encourage sharing of resources
4. Promoting WBA The recognised need for further promotion of the WBA program, particularly within health services and the community

Progress has been made in a number of areas, including continuous improvement of AMC processes and work towards the standardisation of WBA assessment forms across providers. In February 2019 the AMC released national assessment forms for providers to pilot in their programs during 2019. The forms cover the three required assessment methods for WBA programs: mini-clinical evaluation exercise (Mini-CEX); case-based discussion (CBD); and multi-source feedback (MSF); as well as direct observation of procedural skills (DOPS), which is a common additional method used by providers. The initial feedback from a number of providers has been positive, in particular with regard to the introduction of a five-point marking scale and the simple presentation of the forms. Some providers made a number of modifications to the forms, and feedback will continue to be sought during 2019 with a view to finalising the content of the forms later in the year.