PERFORMANCE-BASED ASSESSMENT IN CONTINUING MEDICAL-EDUCATION FOR GENERAL-PRACTITIONERS - CONSTRUCT-VALIDITY

The use of performance-based assessment has been extended to postgradu ate education and practising doctors, despite criticism of validity. W hile differences in expertise at this level are easily reflected in sc ores on a written test, these differences are relatively small on perf ormance-based tests. However, scores on written tests and performance- based tests of clinical competence generally show moderate correlation s. A study was designed to evaluate construct validity of a performanc e-based test for technical clinical skills in continuing medical educa tion for general practitioners, and to explore the correlation between performance and knowledge of specific skills. A I-day skills training was given to 71 general practitioners, covering four different techni cal clinical skills. The effect of the training on performance was mea sured with a performance-based test using a randomized controlled tria l design, while the effect on knowledge was measured with a written te st administered 1 month before and directly after the training. A trai ning effect could be shown by the performance-based test for all four clinical skills. The written test also demonstrated a training effect for all but one skill. However, correlations between scores on the wri tten test and on the performance-based test were low for all skills. I t is concluded that construct validity of a performance-based test for technical clinical skills of general practitioners was demonstrated, while the knowledge test score was shown to be a poor predictor of com petence for specific technical skills.