Journal Article

Where the rubber meets the road — An integrative review of programmatic assessment in health care professions education

Heeneman, Sylvia, Schut, Suzanne, van Tartwijk, Jan, van der Vleuten, Cees, Driessen, Erik, Maggio, Lauren A.

2021

Overview

Introduction Programmatic assessment was introduced as an approach to design assessment programmes with the aim to simultaneously optimize the decision-making and learning function of assessment. An integrative review was conducted to review and synthesize results from studies investigating programmatic assessment in health care professions education in practice. Methods The authors systematically searched PubMed, Web of Science, and ERIC to identify studies published since 2005 that reported empirical data on programmatic assessment. Characteristics of the included studies were extracted and synthesized, using descriptive statistics and thematic analysis. Results Twenty-seven studies were included, which used quantitative methods ( n  = 10), qualitative methods ( n  = 12) or mixed methods ( n  = 5). Most studies were conducted in clinical settings (77.8%). Programmatic assessment was found to enable meaningful triangulation for robust decision-making and used as a catalyst for learning. However, several problems were identified, including overload in assessment information and the associated workload, counterproductive impact of using strict requirements and summative signals, lack of a shared understanding of the nature and purpose of programmatic assessment, and lack of supportive interpersonal relationships. Thematic analysis revealed that the success and challenges of programmatic assessment were best understood by the interplay between quantity and quality of assessment information, and the influence of social and personal aspects on assessment perceptions. Conclusion Although some of the evidence may seem compelling to support the effectiveness of programmatic assessment in practice, tensions will emerge when simultaneously stimulating the development of competencies and assessing its result. The identified factors and inferred strategies provide guidance for navigating these tensions.

• Publisher: Bohn Stafleu van Loghum,Ubiquity Press
• Subject: Clinical decision making / Committees / Competence / Data analysis / Decision making / Education / Educational Assessment / Educational objectives / Educational Opportunities / Expertise / health care professions education / Health education / Health sciences / Humans / Informal Assessment / Information Seeking / Information Sources / Interpersonal Relationship / knowledge synthesis / Learning / Lifelong Learning / Medical Care Evaluation / Medical Education / Medical research / Outcomes of Education / Outcomes of Treatment / Perceptions / Portfolio Assessment / Pragmatic Clinical Trials as Topic / Principles / Program Implementation / programmatic assessment / Reliability / Review / Review Article / Search Strategies / Supervisors / Teacher Selection