Composite Reliability of Workplace Based Assessment of International Medical Graduates

Abstract

Introduction All developed countries depend on International Medical Graduates (IMGs) to complement their workforce. However, the assessment of their fitness to practice and acculturation into the new system can be challenging. To improve this, we introduced Workplace Based Assessment (WBA), using a programmatic philosophy. This paper reports the reliability of this new approach. Method Over the past 10 years, we have assessed over 250 IMGs, each cohort assessed over a 6-month period. We used Mini-Cex, Case Based Discussions (CBD) and Multi-Source Feedback (MSF) to assess them. We analysed the reliability of each tool and the composite reliability of 12 Mini-Cex, 5 CBDs and 12 MSF assessments in the tool kit. Results A reliability coefficient of 0.78 with a SEM of 0.19 was obtained for the sample of 236 IMGs. We found the MSF to be the most reliable tool. By adding one more MSF to the assessment on two occasions, we can reach a reliability of 0.8 and SEM of 0.18. Conclusions The current assessment methodology has acceptable reliability. By increasing the MSF, we can improve the reliability. The lessons from this study are generalisable to IMG assessment and other medical education programs.

Keywords

• Composite reliability
• reliability
• programmatic assessment
• International medical graduates
• performance assessment
• Workplace Based Assessment