The formative role of Workplace based assessments (WPBA)


WPBA are assessments of junior doctors’ performance in the clinical workplace performed by more experienced colleagues. WPBA affects all surgical trainees and trainers, these assessments require a significant amount of time and stress and they lack in evidential basis.  WPBA are said to have a dual purpose, formative (to help trainees to learn) and summative (to assess trainees to allow them to progress in their careers).  This dual meaning creates uncertainty and therefore individuals infer their own meaning.  It is the formative role of WPBA in the provision of feedback to trainees that interests us.  Systematic review data has shown that feedback is one of the most important influences on subsequent clinical performance and there is some evidence that trainees and trainers find this beneficial though the literature also states many problems with giving and receiving feedback in practice.
Research Questions

RQ 1: What factors determine surgeons and surgical trainees’ perceptions and practices of Workplace based assessments (WPBA) along a formative – summative scale?

RQ 2: Why do surgeons and trainees hold these perceptions about WPBA?

RQ 3: What are surgeons and surgical trainees opinions on the structure, delivery and value of feedback generated from WPBA?

RQ 4: Does the current use of WPBA promote or hinder feedback between surgical trainers and trainees?

RQ 5: Does any feedback obtained relating to WPBA alter trainees’ subsequent perceptions of learning achieved?


The research questions asked are a mixture of “what” and “why/how” questions therefore a mixed methods strategy is most appropriate.  In order to triangulate our findings we plan to collect qualitative and quantitative data.  Qualitative data will be analysed using a framework analysis approach based upon theories relating to formative dialogues, situated cognition and sociocultural learning theory.


We plan to undertake a mixed methods study.  Study participants will be surgical trainers, individuals who complete WPBA for surgical trainees, and trainees, individuals utilise WPBA through the ISCP (CT1 – ST6).  This study will follow an explanatory sequential approach with an initial quantitative (questionnaire) phase followed by a qualitative (focus groups) phase.  We have collected pilot questionnaire from a single centre and are aiming to collect pilot data from a second site in the next month (July 2012).  When we have refined the questionnaire we will collect questionnaire data from all recruited sites.  This data will be explored in further detail in the focus groups to gain insight into trainers and trainees perceptions around WPBA.   Qualitative data will be analysed from the start of the focus group data collection in order to allow emergent ideas to be discussed in greater depth in subsequent focus groups.  Data analysis will be performed with the aid of nVivo 9 (Qualitative) and SPSS v 15 (Quantitative).   Qualitative and quantitative data will be integrated at the questionnaire development stage.  We may also go on to collect some observational data based upon the results of the above stages of the project.

Contact us wpba@wmresearch.org.uk

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