Identification of collaborative competencies for internship and the development of an assessment strategy that facilitates learning

Preparing senior medical students to effectively collaborate with health care teams will support their transition to internship and help minimise patient safety concerns for junior doctors. This thesis aims to clarify the collaborative competencies critical for the safe and effective performance as an intern, and to design, implement and examine the impact of an educational intervention targeting the development of these competencies. A series of studies was conducted towards these aims, in two Medicine programmes (in Australia and Sri Lanka). Critical Incident interviews with intern supervisors explored the behaviours most relevant for collaboration during internship and the relevant clinical contexts. Through an Australia-wide Delphi study, these behaviours were prioritised, the competencies that represent them were confirmed through factor analysis, and the high priority behaviours in all competencies were selected for inclusion in an educational intervention. Student focus groups and the above interviews explored the effective features of educational approaches. These studies informed the development of an educational intervention, a workplace-based assessment, which was implemented in the two Medicine programmes. The intervention was evaluated through pre and post-test surveys and scenario-based worksheets, participant focus groups, assessor interviews, and case studies of participant experiences. The findings establish the collaborative competencies that are required for internship and their critical component behaviours, and identify the effective features for a workplace-based formative assessment. The findings suggest that the workplace-based assessment is valid, reliable and acceptable, and encourages specific feedback and reflection. The evaluation findings highlight the educational impact of the workplace-based assessment on the development of collaborative competencies and its usefulness for promoting informed self-assessment. In addition to these contributions, this research process proposes a systematic method that educators can use to address particular areas of need in medical education. From a theoretical perspective, this thesis contributes to the literature by identifying the stage-specific competencies for an aspect of professionalism, and by demonstrating the educational value of a constructively aligned strategy for situated learning. The findings illuminate the process of student engagement with formative assessments and its consequent educational impact in clinical environments