1
|
Dart J, Rees C, Ash S, McCall L, Palermo C. Shifting the narrative and practice of assessing professionalism in dietetics education: An Australasian qualitative study. Nutr Diet 2023. [PMID: 36916155 DOI: 10.1111/1747-0080.12804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/10/2023] [Accepted: 02/01/2023] [Indexed: 03/16/2023]
Abstract
AIM We aimed to explore current approaches to assessing professionalism in dietetics education in Australia and New Zealand, and asked the questions what is working well and what needs to improve? METHOD We employed a qualitative interpretive approach and conducted interviews with academic and practitioner (workplace-based) educators (total sample n = 78) with a key stake in dietetics education across Australia and New Zealand. Data were analysed using team-based, framework analysis. RESULTS Our findings suggest significant shifts in dietetics education in the area of professionalism assessment. Professionalism assessment is embedded in formal curricula of dietetics programs and is occurring in university and placement settings. In particular, advances have been demonstrated in those programs assessing professionalism as part of the programmatic assessment. Progress has been enabled by philosophical and curricula shifts; clearer articulation and shared understandings of professionalism standards; enhanced learner agency and reduced power distance; early identification and intervention of professionalism lapses; and increased confidence and capabilities of educators. CONCLUSIONS These findings suggest there have been considerable advances in professionalism assessment in recent years with shifts in practice in approaching professionalism through a more interpretivist lens, holistically and more student-centred. Professionalism assessment in dietetics education is a shared responsibility and requires further development and transformation to more fully embed and strengthen curricula approaches across programs. Further work should investigate strategies to build safer learning cultures and capacity for professionalism conversations and in strengthening approaches to remediation.
Collapse
Affiliation(s)
- Janeane Dart
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Charlotte Rees
- Head of School, School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Susan Ash
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Louise McCall
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Claire Palermo
- Office of the Deputy Dean Education, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Jamieson J, Gibson S, Hay M, Palermo C. Teacher, Gatekeeper, or Team Member: supervisor positioning in programmatic assessment. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022:10.1007/s10459-022-10193-9. [PMID: 36469231 DOI: 10.1007/s10459-022-10193-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
Competency-based assessment is undergoing an evolution with the popularisation of programmatic assessment. Fundamental to programmatic assessment are the attributes and buy-in of the people participating in the system. Our previous research revealed unspoken, yet influential, cultural and relationship dynamics that interact with programmatic assessment to influence success. Pulling at this thread, we conducted secondary analysis of focus groups and interviews (n = 44 supervisors) using the critical lens of Positioning Theory to explore how workplace supervisors experienced and perceived their positioning within programmatic assessment. We found that supervisors positioned themselves in two of three ways. First, supervisors universally positioned themselves as a Teacher, describing an inherent duty to educate students. Enactment of this position was dichotomous, with some supervisors ascribing a passive and disempowered position onto students while others empowered students by cultivating an egalitarian teaching relationship. Second, two mutually exclusive positions were described-either Gatekeeper or Team Member. Supervisors positioning themselves as Gatekeepers had a duty to protect the community and were vigilant to the detection of inadequate student performance. Programmatic assessment challenged this positioning by reorientating supervisor rights and duties which diminished their perceived authority and led to frustration and resistance. In contrast, Team Members enacted a right to make a valuable contribution to programmatic assessment and felt liberated from the burden of assessment, enabling them to assent power shifts towards students and the university. Identifying supervisor positions revealed how programmatic assessment challenged traditional structures and ideologies, impeding success, and provides insights into supporting supervisors in programmatic assessment.
Collapse
Affiliation(s)
- Janica Jamieson
- Monash University, Melbourne, Australia.
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
| | | | | | | |
Collapse
|
3
|
Torre D, Rice NE, Ryan A, Bok H, Dawson LJ, Bierer B, Wilkinson TJ, Tait GR, Laughlin T, Veerapen K, Heeneman S, Freeman A, van der Vleuten C. Ottawa 2020 consensus statements for programmatic assessment - 2. Implementation and practice. MEDICAL TEACHER 2021; 43:1149-1160. [PMID: 34330202 DOI: 10.1080/0142159x.2021.1956681] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Programmatic assessment is a longitudinal, developmental approach that fosters and harnesses the learning function of assessment. Yet the implementation, a critical step to translate theory into practice, can be challenging. As part of the Ottawa 2020 consensus statement on programmatic assessment, we sought to provide descriptions of the implementation of the 12 principles of programmatic assessment and to gain insight into enablers and barriers across different institutions and contexts. METHODS After the 2020 Ottawa conference, we surveyed 15 Health Profession Education programmes from six different countries about the implementation of the 12 principles of programmatic assessment. Survey responses were analysed using a deductive thematic analysis. RESULTS AND DISCUSSION A wide range of implementations were reported although the principles remained, for the most part, faithful to the original enunciation and rationale. Enablers included strong leadership support, ongoing faculty development, providing students with clear expectations about assessment, simultaneous curriculum renewal and organisational commitment to change. Most barriers were related to the need for a paradigm shift in the culture of assessment. Descriptions of implementations in relation to the theoretical principles, across multiple educational contexts, coupled with explanations of enablers and barriers, provided new insights and a clearer understanding of the strategic and operational considerations in the implementation of programmatic assessment. Future research is needed to further explore how contextual and cultural factors affect implementation.
Collapse
Affiliation(s)
- Dario Torre
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD, USA
| | - Neil E Rice
- College of Medicine and Health, University of Exeter Medical School, Exeter, UK
| | - Anna Ryan
- Department of Medical Education, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Harold Bok
- Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Luke J Dawson
- School of Dentistry, University of Liverpool, Liverpool, UK
| | - Beth Bierer
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Tim J Wilkinson
- Education unit, University of Otago, Christchurch, New Zealand
| | - Glendon R Tait
- MD Program, Dept. of Psychiatry, and The Wilson Centre, University of Toronto, Toronto, Canada
| | - Tom Laughlin
- Department of Family Medicine, Dalhousie University, Halifax, Canada
| | - Kiran Veerapen
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Sylvia Heeneman
- Department of Educational Development and Research, School of Health Profession Education, Maastricht University, Maastricht, The Netherlands
| | - Adrian Freeman
- College of Medicine and Health, University of Exeter Medical School, Exeter, UK
| | - Cees van der Vleuten
- Department of Educational Development and Research, School of Health Profession Education, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
4
|
Heeneman S, de Jong LH, Dawson LJ, Wilkinson TJ, Ryan A, Tait GR, Rice N, Torre D, Freeman A, van der Vleuten CPM. Ottawa 2020 consensus statement for programmatic assessment - 1. Agreement on the principles. MEDICAL TEACHER 2021; 43:1139-1148. [PMID: 34344274 DOI: 10.1080/0142159x.2021.1957088] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION In the Ottawa 2018 Consensus framework for good assessment, a set of criteria was presented for systems of assessment. Currently, programmatic assessment is being established in an increasing number of programmes. In this Ottawa 2020 consensus statement for programmatic assessment insights from practice and research are used to define the principles of programmatic assessment. METHODS For fifteen programmes in health professions education affiliated with members of an expert group (n = 20), an inventory was completed for the perceived components, rationale, and importance of a programmatic assessment design. Input from attendees of a programmatic assessment workshop and symposium at the 2020 Ottawa conference was included. The outcome is discussed in concurrence with current theory and research. RESULTS AND DISCUSSION Twelve principles are presented that are considered as important and recognisable facets of programmatic assessment. Overall these principles were used in the curriculum and assessment design, albeit with a range of approaches and rigor, suggesting that programmatic assessment is an achievable education and assessment model, embedded both in practice and research. Knowledge on and sharing how programmatic assessment is being operationalized may help support educators charting their own implementation journey of programmatic assessment in their respective programmes.
Collapse
Affiliation(s)
- Sylvia Heeneman
- Department of Pathology, School of Health Profession Education, Maastricht University, Maastricht, The Netherlands
| | - Lubberta H de Jong
- Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Luke J Dawson
- School of Dentistry, University of Liverpool, Liverpool, UK
| | - Tim J Wilkinson
- Education Unit, University of Otago, Christchurch, New Zealand
| | - Anna Ryan
- Department of Medical Education, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Glendon R Tait
- MD Program, Department of Psychiatry, and The Wilson Centre, University of Toronto, Toronto, Canada
| | - Neil Rice
- College of Medicine and Health, University of Exeter Medical School, Exeter, UK
| | - Dario Torre
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD, USA
| | - Adrian Freeman
- College of Medicine and Health, University of Exeter Medical School, Exeter, UK
| | - Cees P M van der Vleuten
- Department of Educational Development and Research, School of Health Profession Education, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|