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Title: Relatively idiosyncratic : exploring variations in assessors' performance judgements within medical education
Author: Yeates, Peter
ISNI:       0000 0004 2740 4398
Awarding Body: University of Manchester
Current Institution: University of Manchester
Date of Award: 2013
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Background: Whilst direct-observation, workplace-based (or performance) assessments, sit at the conceptual epitome of assessment within medical education, their overall utility is limited by high-inter-assessor score variability. We conceptualised this issue as one of problematic judgements by assessors. Existing literature and evidence about judgements within performance appraisal and impression formation, as well as the small evolving literature on raters’ cognition within medical education, provided the theoretical context to study assessor’s judgement processes.Methods and Results: In this thesis we present three studies. The first study adopted an exploratory approach to studying assessors’ judgements in direct observation performance assessments, by asking assessors to describe their thoughts whilst assessing standard videoed performances by junior doctors. Comments and follow up interviews were analysed qualitatively using grounded theory principles. Results showed that assessors attributed different levels of salience to different aspects of performances, understood criteria differently (often comparing performance against other trainees) and expressed their judgements in unique narrative language. Consequently assessors’ judgements were comparatively idiosyncratic, or unique.The two subsequent follow up studies used experimental, internet based, experimental designs to further investigate the comparative judgements demonstrated in study 1. In study 2, participants were primed with either good or poor performances prior to watching intermediate (borderline) performances. In study 3 a similar design was employed but participants watched identical performances in either increasing or decreasing levels of proficiency. Collectively, the results of these two studies showed that recent experiences influenced assessors’ judgements, repeatedly showing a contrast effect (performances were scored unduly differently from earlier performances). These effects were greater than participants’ consistent tendency to be either lenient or stringent and occurred at multiple levels of performance. The effect appeared to be robust despite our attempting to reduce participants’ reliance on the immediate context. Moreover, assessors appeared to lack insight into the effect on their judgements.Discussion: Collectively, these results indicate that assessors score variations can be substantially explained by idiosyncrasy in cognitive representations of the judgement task, and susceptibility to contrast effects through comparative judgements. Moreover, assessors appear to be incapable of judging in absolute terms, instead judging normatively. These findings have important implications for theory and practice and suggest numerous further lines of research.
Supervisor: O'Neill, Paul; Mann, Karen Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Medical Education ; Assessment ; Judgement ; Rater Cognition ; Workplace Based Assessment