Gersten Jonker

136   Chapter 6 Classification of training programs From preliminary qualitative analysis of the data from nine countries by one of the authors (GJ), a proposed classification in four categories (groups A – D) emerged that subsequently allowed grouping of countries with similar certification processes. From the assessment and certification perspective, countries in Group A typically focus on securing the level of acquired knowledge of trainees by having a final exam (usually oral or written). Often few other assessment methods are used. Characteristically, curricula in Group A elaborate on the knowledge to be attained (cognitive domain) and competencies are not mentioned. In Group B, assessment focuses on the completion of specified numbers of procedures (e.g. xx general anesthetics, xx upper extremity regional blocks, etcetera), as evidenced by a logbook. This is typically the main type of evaluation and there is not much emphasis on other techniques to assess trainees. Curriculum descriptions and expectations are largely knowledge and skill based and not competency oriented. In Group C certification is granted on the basis of gathered evidence of competence at the end of training. Typically, multimodal assessment, with an emphasis on workplace assessment, is in place. Often there is a blueprint and/or a competency-based curriculum on which assessment is based. A fourth category that emerged from the preliminary analysis of the first survey results was Group D, a hybrid group harboring countries with training programs that have features from Group A or B, but also resemble programs from group C to a certain extent. This preliminary classification is summarized in Table 2. TABLE 2: Preliminary categories of training programs Group Description A Curriculum: knowledge-based Assessment: focus on knowledge, final exam is main method B Curriculum: knowledge and skills-based Assessment: completion of number of procedures (e.g. general anaesthetics) C Curriculum: competency-based Assessment: often multiple methods, focus on workplace assessment D Curriculum and assessment share features from at least two categories (A-C) The subsequent step of qualitative analysis of survey data consisted of categorization of the 35 European training programs according to this classification (Table 2) by three researchers independently.