Inclusive Programmatic Assessment of Professional Body Outcomes in a New Optometry Master’s Programme

Abstract

Background
Outcome based education dictates the behaviours that learners must display at the end of their training, but how do we get them there and how do we track their progress across a programme? The General Optical Council (GOC) revised the educational requirements for new optometry programmes starting in 2023, with 7 overarching categories of behaviour to be demonstrated across all four levels of Miller’s pyramid; Knows, knows how, shows how and does. This work gives an overview of how this can be achieved using a layered online tracking system which allows evidence to be collected in a multitude of ways including summative and formative assessment, patient examination, portfolio, discussion, and situational judgement at different levels. This inclusive, transparent approach gives the learner alternative ways of demonstrating they have met outcomes and was developed in conduction with a medical education developer.

Summary of Work
The aim of this work was to create a robust, transparent, and inclusive system of tracking the GOC outcomes across the four levels of Millers pyramid. Mapping both teaching and assessments to constructively align with learning outcomes is embedded in education; this is a relatively easy task for an individual session, topic or even module, but when it comes to mapping across a whole programme, it becomes more complex, especially in programmes linking academic experience, clinical experience and professional practice in a cohesive and spiral curriculum. A new strategy was needed to map the new GOC outcomes covering Person centred care, communication, clinical practice, ethics and standards, leadership and management and finally lifelong learning. Many of the outcomes are new to the optometry curriculum and require a holistic approach. It was also important that both academic staff, learners and practice-based educators could view and monitor the learner’s progress in real time. In creating a transparent tracking system, the aim was also for the learner to take ownership and develop experiential learning experiences and self-direction.

Summary of Results
To deliver a robust system of programmatic tracking of GOC outcomes, an online medical education platform ‘Meditrek’ was used. In consultation with the developer, a system of layered outcome tracking pages was developed, pulling information from different assessments into one space at the different levels of Millers pyramid. Outcomes are tracked both when achieved and not achieved, allowing areas of weakness to be identified both by the learner and the teacher. 3 pieces of evidence can be linked for each outcome and each level, building an evidence base for each learner across different contexts. The student portfolio was also embedded, allowing learners to map their own experiences and reflections against the outcomes which then flag to academics to review, confirm, or decline. This has the added benefit of familiarising learners with the outcomes from the start of the programme and actively seeking out experiences to meet them. Clinical patient examinations in the eye clinic are also linked, allowing clinical skill-based outcomes to be tracked. Both summative and formative assessments are mapped to the outcomes at the appropriate level and can be signed off both individually or as a group. This system allows a student who has not achieved an outcome in an assessment to achieve it in an alternative way. Additionally, due to the variability of patient exposure in the clinic, there is also flexibility for students to meet outcomes using simulations and situational judgement. Tracking outcomes throughout the programme ensures the learners meet the required outcomes at the appropriate stage of their training before they start their clinical placements and ultimately at the exit point as fully qualified registrants.

Discussion and Conclusion
Layering the different assessment strategies allowed a bespoke tracking system to be developed with the functionality for analysis, monitoring and export of required data including when and how each outcome has been achieved. The system is currently in use for the first cohort of students from September 2023.
In addition to providing a robust system of tracking the GOC outcomes, it is already providing real insights into the student’s practice-based learning, learners are reflecting on their experiences when mapping outcomes and seeking out experiences to meet them. This approach aligns with Kaufmann’s 7 principles of teaching in medicine, including self-directed learning, reflection, problem solving and the learner as an active contributor (Kaufmann. 2003).

Take home message
An inclusive approach to outcome tracking allows learners to demonstrate they have met outcomes in different ways but must be supported by a robust online tracking system across all 4 levels of Milers pyramid which integrates different assessment strategies. Programmatic outcome tracking allows learners progress to be monitored throughout their journey, it identifies strengths and weaknesses whilst embedding professional body outcomes at an early stage of the programme.