How We Built Workplace Based Assessment-for-Learning in Irish GP Training.

Introduction: Programmatic Assessment displays the comprehensive picture of a learner's competence through selection of assessment methods and design of organisational systems [1]. This paper describes how the Irish College of GPs (ICGP) designed and implemented a new, national, workplace-based assessment (WBA) system for GP training as part of an ongoing evolution towards Programmatic Assessment, with a focus on assessment-for-learning [1]. Methods: Six overlapping workstreams over five years led to success: iterative consultation and design, entrustable professional activities, software design, stepwise implementation, separation of mentor/assessor roles and WBA training embedded in feedback literacy and growth mindset learning. Results: Our design focused on collecting longitudinal, low stakes assessments organised into core competences in a manner to support learners. 18 entrustable professional activities were developed and implemented, along with a software platform designed to enter and display accumulated data. Competence committees assess both qualitative and quantitative data periodically on the learner's journey to oversee progression and make high stakes decisions. We describe the development of the system along with aids and barriers to its adoption. Discussion: Structured continuous consultation with the training community and constant reference to the educational literature were both important for success. Novel features of our system are the distancing of mentor and assessor roles, the avoidance of recommended minimum numbers of WBA entries, and consideration of the validity and reliability of the system as a whole rather than of the tools.