Is it all in the mind? Unravelling stakeholder conceptions on workplace based assessment

Workplace assessments play a central role in medical further education. Workplace assessments serve two functions: to provide feedback to the trainee physician to promote learning and to enable decisions about their performance and progress. Our studies were conducted at the general practitioner training courses in Maastricht, Nijmegen and Leiden. This shows that users' perceptions of workplace assessments can differ and play a role in its use and interpretation. Also, interactions between users from inside and outside the workplace can influence workplace assessments. For example, at the start of the training, educators base their decision to entrust patients to the trainee physician more on their generic qualities (e.g. asking for help in good time) than on estimated clinical skills. Practical observations of doctors-in-training are also mainly performed because educators believe that this is expected of them, for example by patients, the doctor-in-training or the training institute. The use and purpose of field observations is rarely a topic of discussion between educator and trainee physician. As a result, learning opportunities may be missed. Being aware and discussing one's own views and according them with those of other users can increase the yield of workplace assessments.