What Stops Fairness from Emerging in Assessment? The Forces on a Complex Adaptive System.

Introduction: Workplace-based assessment occurs in authentic, dynamic clinical environments where reproducible, measurement-based assessments can often not be implemented. In these environments, research approaches that respect these multiple dynamic interactions, such as complexity perspectives, are encouraged. Previous research has shown that fairness in assessment is a nonlinear phenomenon that emerges from interactions between its components and behaves like a complex adaptative system.

Fairness in Assessment: Identifying a Complex Adaptive System.

Introduction: Assessment design in health professions education is continuously evolving. There is an increasing desire to better embrace human judgement in assessment. Thus, it is essential to understand what makes this judgement fair.

Making it fair: Learners' and assessors' perspectives of the attributes of fair judgement.

Introduction: Optimising the use of subjective human judgement in assessment requires understanding what makes judgement fair. Whilst fairness cannot be simplistically defined, the underpinnings of fair judgement within the literature have been previously combined to create a theoretically-constructed conceptual model. However understanding assessors' and learners' perceptions of what is fair human judgement is also necessary.

Fairness in human judgement in assessment: a hermeneutic literature review and conceptual framework.

Human judgement is widely used in workplace-based assessment despite criticism that it does not meet standards of objectivity. There is an ongoing push within the literature to better embrace subjective human judgement in assessment not as a 'problem' to be corrected psychometrically but as legitimate perceptions of performance. Taking a step back and changing perspectives to focus on the fundamental underlying value of fairness in assessment may help re-set the traditional objective approach and provide a more relevant way to determine the appropriateness of subjective human judgements.

Entrustable professional activities for workplace assessment of general practice trainees.

Objective: To assess whether entrustment levels for junior trainees with respect to entrustable professional activities (EPAs) increase over time; whether entrustment levels for senior trainees are higher than for junior trainees; and whether self-assessment of entrustment levels by senior trainees more closely matches supervisor assessment than self-assessment by junior trainees.

Design, Setting, Participants: Observational study of 130 junior and 153 senior community-based general practice trainees in South Australia, 2017.

Main Outcome Measures: Differences in entrustment levels between junior and senior trainees; change in entrustment levels for junior trainees over 9 months; concordance of supervisor and trainee assessment of entrustment level over 9 months.

Identifying the narrative used by educators in articulating judgement of performance.

Introduction: Modern assessment in medical education is increasingly reliant on human judgement, as it is clear that quantitative scales have limitations in fully assessing registrars' development of competence and providing them with meaningful feedback to assist learning. For this, possession of an expert vocabulary is essential.

Aim: This study aims to explore how medical education experts voice their subjective judgements about learners and to what extent they are using clear, information-rich terminology (high-level semantic qualifiers); and to gain a better understanding of the experts' language used in these subjective judgements.

An application of programmatic assessment for learning (PAL) system for general practice training.

Programmatic assessment for learning (PAL) is becoming more and more popular as a concept but its implementation is not without problems. In this paper we describe the design principles behind a PAL program in a general practice training context. The PAL program was designed to optimise the meaningfulness of assessment information for the registrar and to make him/her use that information to self regulate their learning.

Relative Hyperglycemia, a Marker of Critical Illness: Introducing the Stress Hyperglycemia Ratio.

Context: Hyperglycemia in hospitalized patients is associated with increased morbidity and mortality.

Objective: We examined whether critical illness is more strongly associated with relative or absolute hyperglycemia.

Design: The study was an observational cohort study.

Clinical exposure of interns during a general practice placement.

Background: For more than a decade, junior doctors have undertaken general practice rotations; however, little is known about the breadth of medical conditions seen. This study aims to determine the breadth of clinical presentations encountered by interns during a rotation.

Methods: Data were collected on all patients seen by interns at an RA-2 general practice during 2012-13.

Adenosine-diphosphate (ADP) receptor antagonists for the prevention of cardiovascular disease in type 2 diabetes mellitus.

Background: Cardiovascular disease (CVD) is the most prevalent complication of type 2 diabetes with an estimated 65% of people with type 2 diabetes dying from a cause related to atherosclerosis. Adenosine-diphosphate (ADP) receptor antagonists like clopidogrel, ticlopidine, prasugrel and ticagrelor impair platelet aggregation and fibrinogen-mediated platelet cross-linking and may be effective in preventing CVD.

Objectives: To assess the effects of adenosine-diphosphate (ADP) receptor antagonists for the prevention of cardiovascular disease in type 2 diabetes mellitus.

Detecting undiagnosed diabetes using glycated haemoglobin: an automated screening test in hospitalised patients.

Objective: To assess the utility of glycated haemoglobin (HbA(1c)) level as an automated screening test for undiagnosed diabetes among hospitalised patients and to estimate the prevalence of undiagnosed diabetes among hospitalised patients.

Design, Participants And Setting: A 3-month prospective study of all adult patients admitted to a tertiary hospital. An HbA(1c) test was automatically undertaken on admission for all patients with a random plasma glucose (RPG) level ≥ 5.