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G187(P) Aiming for the apex – real-time assessment of teaching using medical students in a compulsory, multi-station postgraduate assessment to assess the “does” at the top of miller’s pyramid
  1. A Reece1,2,
  2. C Fertleman3,4
  1. 1Department of Paediatrics, West Hertfordshire Hospitals NHS Trust, Watford General Hospital, Watford, UK
  2. 2START Assessment Board, Royal College of Paediatrics and Child Health, London, UK
  3. 3Department of Paediatrics, Whittington Health NHS Trust, The Whittington Hospital, London, UK
  4. 4Whittington Campus, University College London, London, UK


Aims The Royal College of Paediatrics and Child Health’s (RCPCH) START assessment (Specialist Trainee Assessment of Readiness for Tenure) is a multi-station, scenario-based, formative assessment of consultant readiness.1 It is undertaken in the penultimate year of paediatric training and has been held 5 times since 2012. It consists of 12 scenarios (stations) mapping to the General Medical Council’s Good Medical Practice domains. One of the areas assessed is teaching. We report an innovative scenario used in this assessment.

Methods To assess trainees at the top of Miller’s pyramid2 the authors developed a novel station for the START assessment. The trainees were asked to prepare a micro-teach in the 4 min preparation time before the station which they then delivered during the 8 min station to two medical students who were in the first week of their paediatric attachment. Medical students were recruited from University College London Medical School. Topics related to general paediatrics. An assessor observed the teaching delivered by the trainee in the station. Feedback for this scenario and the whole assessment, benchmarked against described standards, is released some weeks later to the trainees’ e-portfolio.

Results Thirty one medical students role-played across 3 sittings. Thirty (97%) responded to a survey about their experience. The majority of students found the experience useful and enjoyable (Figure 1). Only 1 (3%) student said they would not role-play for this assessment again. All replied they would, or may, recommend it to other medical students. Twenty five (83%) wanted to be a paediatrician, 14 (37%) had already decided before this role-play. Only 1 (3%) medical student felt they should not have some part in feeding back to the trainees.

Abstract G187(P) Figure 1

Medical student responses to the question ‘You kindly participated in the START assessment. What did you think of the experience?’

Conclusion Using medical students for a live teaching within a high-stakes, multi-station assessment is novel. It reaches the top of Miller’s pyramid and maps to real life. The medical students who were taught found it worthwhile. For many of them it confirmed their desire to be a paediatrician (Figure 2).



  2. Miller GE. The assessment of clinical skills/competence/performance. Acad Med. 1990:65(9):S64–S67

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