Assessment methods in respiratory medicine training in Europe: current status and future needs

There is a perceived need for harmonisation of training standards in medicine across Europe. Assessment methodology is a fundamental part of this harmonisation. Assessment may be: summative, measuring competency at the end of training, usually in a pass/fail mode; or formative, assessing strengths and weaknesses during training with a view to optimising performance. A survey of experienced respiratory medicine trainers in Europe was undertaken to discover the formative and summative assessment methods being used, and to explore the use of workplace-based assessments (WBAs). Structured interviews were sought with experienced trainers in adult and paediatric respiratory medicine. 35 trainers from 22 (71%) out of 31 countries were interviewed. The number of types of summative assessments required at the end of training varied from 0 to 4 including clinical (25%), written (44%) and oral (47%) examinations. Four respondents required a research thesis as a proof of clinical competence. WBA was not commonly used. Only 14% of respondents reported using a formal case-based discussion, 20% used a form of multisource feedback and 25% described some form of formal assessment of procedural skills. However, 77% of all respondents expressed a wish to have access to case-based discussion and 72% wanted to have a facility for multisource feedback. The majority also wanted training in the use of these tools. Almost half of the respondents had received no formal training in educational supervision and 80% of all respondents expressed a wish to receive such training. The findings suggest that there is no adequate process of ensuring uniform standards for specialist accreditation in Europe, and demonstrate a need and desire among trainers for more WBA tools and training in their use to be made available.