Assessment of students professional behaviour

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Assessment of students professional behaviour
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Professional behavior

• The concept.
• What are we doing in Maastricht?
• Scheltus J. van Luijk
• Dept of Education and Educational Development
• S.vanluijk_at_educ.unimaas.nl
• www.fdg.unimaas.nl/educ/scheltus

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Presentation

• General
• what is professional behaviour
• why should it be assessed
• when should it be assessed
• who should assess
• how should be assessed?
• implementation
• conclusions

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What is a professional?
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Dealing with work
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Dealing with others
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Dealing with yourself
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Traits of the professional

• Dealing with work
• managing work efficiently
• is active, shows leadership
• practises according to guidelines
• participates in continuing medical education
• knows own limitations

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Traits of the professional

• Dealing with others
• puts patients first
• is a team worker
• takes responsibility for other team members
• gives feedback to dysfunctional colleagues

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Traits of the professional

• Dealing with oneself
• critical examination of own behaviour
• is open to feedback
• stimulates peer-assessment and clinical audit

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Professional behaviour versus attitude

• attitude has an inside (feelings, values) and an
  outside (observable behavior)
• professional behaviour refers to observable
  behaviour in a professional situation

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Professional behaviour versus communication skills

• skills belonging to communication skills
• are mostly basic interviewing skills (open ended
  questions, summary, history-taking)
• some specific situations are trained (bringing
  bad news, psychiatric interview)
• they can be assessed at one moment

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Professional behaviour versus communication skills

• skills belonging to professional behavior
• are always applied in a authentic situation
• growth is important, professional behavior cannot
  be assessed at one moment
• the skills underlying professional behavior are
  mostly not considered as communication skills,
  like stress management, self management,
  negotiation skills, supervision etc.

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Why focus on professional behaviour in Maastricht?
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Why focus on professional behaviour in Maastricht?

• Most important reason It is important to give
  students feedback on a regular base
• This will help them in their professional growth.
  Most students -although performing well- can
  still improve their professional behaviour on
  some aspects
• Some students show inadequate professional
  behaviour

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Examples of inadequate behavior

• dealing with work
• dependent, feeling insecure, unable to handle
  stress, lack self-confidence, lack of initiative,
  lack of leadership, lack of energy
• dealing with others
• problems with patients, other health care
  workers, peers, staff
• dealing with oneself
• lack self-reflection, not sensible for feedback

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When should professional behaviour be assessed
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When should professional behaviour be assessed

• In a number of different situations
• from the start of medical education
• until the end of the medical career

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Pyramid of prof. behaviour
education patient care management
c
practical sessions
wards
patient encounters
tutorial group
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When in Maastricht

• Every class
• About 6-8 measurements per student

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Who assesses?
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Who assesses?

• self-assessment
• peer assessment
• assessment by the teacher
• co-assessment

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Who assesses in Maastricht?

• the tutor gives the final judgment after
  listening to the students
• it is up to the tutor if he/she takes these
  comments
• into account

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How is assessed?

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How?

• General conditions
• assessment can only take place if the teacher
  sees the student several times
• more judgements of one student must be gathered
  independently by different teachers
• judgements must be gathered over a longer period
  of time

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How?

• General conditions
• half-term judgements are necessary
• judgements should be established using a checklist

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How in Maastricht?

• Assessing students in
• tutorial groups
• simulated patient contacts
• visits in practice
• clerkships
• by a global checklist

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    ID number .............................
  0 1 2 3 4 5 6 7 8
9 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?
? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?
? ? ? ? ? ? ? ? ? ? ?
    Name student   .............................
.................................   Name
tutor   .........................................
.....................
  Block
  1 2 3 4 5 6 7 ? ? ? ? ? ? ?
? ? ? ?
    Seen (final assessment) Signature
student     Signature tutor
Dealing with work
Interim assessment
Final assessment
Issues concerning students behavior ?
preparation of tasks ? completeness in performing
tasks ? brainstorming tasks ? active
participation in a group ?report back ? other
issues ........................
? deserves attention ? satisfied   explanation

? deserves attention ? satisfied   explanation

Dealing with others
 
 
Issues concerning students behavior ? working in
a team ? listening to others ? performance as
chair of the group ? summarizing discussions ?
other issues ......................
? deserves attention ? satisfied   explanation

? deserves attention ? satisfied   explanation

Dealing with oneself
 
 
Issues concerning students behavior ? dealing
with feedback ? giving feedback ? the ability to
reflect ? dealing with appointments ? being in
time ? other issues ........................
? deserves attention ? satisfied   explanation

? deserves attention ? satisfied   explanation

  INTERIM JUDGMENT  
FINALJUDGMENT
? unsatisfactory ? satisfactory ?
good ? no judgment, because student was absent to
frequently
? unsatisfactory ? satisfactory ?
good ? no
judgment, because student was absent to
frequently
 
Unsatisfactory below the expected average level
of the tutorial group. Items for improvement are
clear and easy to mention Satisfactory on the
expected average level of the tutorial group.
Some issues for improvement rest. Good
student performs better than the expected
average of the group No judgment the student is
so frequently absent, that no judgment is
possible
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How in Maastricht?

• Procedure in tutorial group (exemplary)
• tutor informs student about procedure
• tutor tells students that there will be an
  intermediate judgement and a final judgement at
  the end
• tutor asks students what they have had as
  feedback in the previous tutorial group

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How in Maastricht?

• Procedure in tutorial group (exemplary)
• For intermediate and final judgment
• tutor starts telling students about his own
  strengths and weaknesses in his role as tutor
• followed by the students (one by one)
• students must also comment on their peers
• the tutor gives feedback to every student
• duration about 30 minutes

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Implementing professional behaviour
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Implementing professional behaviour

• You need money and support!
• Informing staff
• about background of professional behavior
• Training staff
• feedback training sessions
• supervision
• Training students
• feedback training
• Introducing new skills in the curriculum

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Implementing professional behaviour

• when students frequently fail student counsellors
  and examination committee both try to make
  appointments about a remedial teaching programme
  or refer to other professionals

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Implementing professional behaviour

• numbers of failing students are very small (about
  0,5 )
• nevertheless the number of referrals to the
  student counsellors is higher (about 1- 2)
• students also visit the counsellors by themselves

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Implementing professional behaviour

• student comments
• students have different opinions.
• if judgement is taken seriously students are in
  favour for this kind of assessment
• role of the tutor is crucial

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Implementing professional behaviour

• teacher comments
• in general teachers consider this kind of
  assessment relevant for the profession
• they consider it very difficult
• there are many differences between teachers how
  to discuss professional behaviour

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New skills required for professional behaviour

• Dealing with work
• time management
• stress management
• show initiative and leadership
• knowing own limitations
• supervision and supervision

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New skills required for professional behaviour
Dealing with work

• time management
• stress management
• show initiative and leadership
• knowing own limitations
• guiding and to supervise others

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New skills required for professional behaviour
Dealing with others

• humanistic skills
• communication skills
• team working skills
• presentations skills
• negotiating skills

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New skills required for professional behaviour
Dealing with oneself

• receiving and giving feedback
• ability to reflect
• dealing with insecurity

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Conclusions
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Conclusions

• Professional behaviour seen as a way of regular
  feedback of your performance in authentic
  situations is important for all students and not
  only important for the student at risk
• The fact that the judgments are subjective is not
  a major problem if you gather enough judgments of
  students and you a sound procedure.

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Conclusions

• Assessing professional behaviour should be part
  of any assessment system at medical schools
• besides assessment by teachers also self-, peer
  and co-assessment should play an important part
  in assessing professional performance
• Training of teachers (giving feedback!) is
  necessary