The review of three years of implementation of WPBA in postgraduate residency program at KGUSMB generated interesting findings which are extremely encouraging. Both faculty and students agreed that WPBA was feasible and objective system of assessing a learner. The review also brought on table the need for optimizing the efforts to institutionalize the WPBA, motivate both faculty and learner through more realistic strategic actions.7,8
Feasibility, acceptability and educational impact of WPBA
Over 70% of both faculty members and students agreed that WPBA was feasible in the postgraduate residency program at KGUMSB. This is similar to the findings from studies in region and internationally.9-11
Further, both faculty members and students reported that existing WPBA tools were effective for both learning and assessment in postgraduate program which is predominantly skills based. This is driven by the concept that WPBA entails direct observation of a performance at the workplace, followed by immediate and contextual feedback.8,9,12-16
Resident SR “Helps prepare for exams; a systematic way of presentation and answering question”
A resident reported the DOPS in particular facilitated in clinical skills development.
Resident DR “DOPS has improved my confidence while performing procedures on patients”.
This is similar to a study in which 70% of the participants reported that DOPS helped improve their clinical skills and a further 65% were of the opinion that undertaking DOPS would improve their future career.14 A study from Bhutan on DOPS in pap smear and intrauterine device insertion reported that DOPS was effective in facilitating students’ learning. Some of the students believed that repeated exposure to DOPS reduced their level of stress.17
Feedback
Resident ST “WPBA involved lots of feedback; Immediate feedback is extremely enriching”.
Both the faculty members and the students confirmed that the principle difference between WPBA and traditional assessment system, was provision of “immediate feedback” with use of standard checklist.7,17,18
Challenges and difficulties associated with WPBA
i. Time constraint and administrative burden
Both faculty members and students shared that WPBA serves as the most authentic source of effective feedback in one’s training. The feedback received serves as a navigation tool towards achieving the intended learning outcomes and enhances clinical competencies in the long run.7,18,19
However, the process of fillings the WPBA checklist forms, scheduling time with assessor and multitasking were labelled as bureaucratic and time-consuming. It was also noted that collation of results was also a significant burden for both faculty members and students .17 Time factor and organizational difficulties were cited most frequently as downside of WPBA.7,16-17
Resident SG “Timing is an issue. Formal scheduling will helpful in making it more feasible”.
Resident NR “Preparing hard copy portfolio consumed more time; e-portfolio will make it more feasible”.
ii. Faculty capacity
A faculty member reported:
“In my Department there are 10-12 of us, WPBA to each of us means different. At times, we disagree in front of our learners”.
Similarly, another faculty stated:
“While undertaking CBD, I am not sure what kind of feedback is to be provided because the as learner becomes aware of his or her shortcoming during the discussion period itself”.
So, capacity development was essential to implement standardized WPBA practice. Similarly, students also agreed that some faculty members did not practice standard WPBA.7,15, 20,21
Strengths and Limitations of the study
This is the first evaluation after 3 years of implementation of WPBA in the postgraduate program with use of convergent type of mixed method design. Over 95% of students who participated in the study had experience with WPBA.
However, only 35% of faculty members could be involved as most faculty members were out of station for temporary duty. Therefore, faculty perspectives may not be representative.