START – evaluating a novel assessment of consultant readiness in paediatrics: The entry not the exit

Abstract

The Royal College of Paediatrics and Child Health (RCPCH) incepted a new end-of-training assessment in 2012, known as START, the Speciality Trainee Assessment of Readiness for Tenure [as a Consultant]. It is a novel, formative, multi-scenario, OSCE-style, out-of-workplace assessment using unseen scenarios with generic, external assessors undertaken in the trainees’ penultimate training year. This study considers whether this assessment assists in preparing senior paediatric trainees for consultant working. A mixed qualitative and quantitative study in the post-positivist paradigm was designed. Subjects were paediatricians who have taken START and completed their paediatric training. Methods were an on-line questionnaire survey and a key informant interview. The assessment is viewed positively, but some trainees report negative experiences. They find value in the formative feedback which generally helps direct trainees towards focussing their training in their final year before ending their training and consultant appointment. For many respondents, the assessment highlighted areas for further development, was relevant for consultant working and useful for consultant interview preparation. Of least value was travelling, cost, assessor performance, feedback quality, feeling like a summative exam and sub-speciality involvement. Many respondents felt the assessment highlighted areas to develop in their subsequent training. Overall START supports transition to consultant working.

Keywords:

• Assessment
• progress testing
• child health
• postgraduate

Acknowledgements

The authors would like to thank the following for their support in the development of the assessment and this manuscript: the late Simon Newell, the RCPCH START Board and assessors, the psychometric team and staff in the Education and Training Division working in Examinations and Assessment at the Royal College of Paediatrics and Child Health specifically Jenni Thompson, John O’Keefe, Stephen Beglin-Witt, Claire Ormandy, and Arveen Kaur. As well as Hannah Baynes, the current START Chair and the college’s Vice President for Education and Training, David Evans.

Disclosure statement

From March 2011 to July 2016, the lead author (AR) held a role as the Chair of the RCPCH’s START Assessment Board. In July 2016, he was appointed the RCPCH Officer for Assessment overseeing the College’s assessments which include START. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

Assessment transition: Medical students or doctors moving from one phase of medical education to the next or from one post to another. Three major transitions are commonly considered on the way to becoming a trained specialist: first, the move from preclinical to clinical training in medical school, second from medical student to specialty training, and finally from specialty training to working as an independent specialist (a consultant in the UK). DOI:10.1093/med/9780199652679.003.0032

Consultant readiness: The preparation alongside specialist training programmes which enables a senior doctor in postgraduate training to feel they have acquired the knowledge, skills, and attitudinal responses necessary to perform safely and competently as an independent, fully registered specialist (consultant level in UK medical training).

Additional information

Notes on contributors

Ashley Reece

Ashley Reece, MBChB, MSc, MA, is a Consultant Paediatrician and Medical Educator. He has been involved in the Royal College of Paediatrics and Child Health examinations and assessments for 15 years and was the first Chair of the START Assessment Board and has been the Officer for Assessment at the college since 2016. He successfully completed an MA in Medical Education in 2017.

Lucy Foard

Lucy Foard, Bsc, MBPsS, is a Psychometric Researcher at the Royal College of Paediatrics and Child Health. She has worked for the psychometric team within the College for 11 years, having previously held the roles of Psychometric Analyst and Psychometrician. She provides psychometric advice and guidance to other Royal Colleges and sat on the panel which developed guidelines for standard setting postgraduate examinations for the Academy of Medical Royal Colleges.