Undertaking an assessment
This section provides some advice on how to approach the task of undertaking an assessment. You will find more detailed information on each step in the process under the relevant sections (Preliminary Assessment; Detailed Assessment; Action Planning; Indicator Selection).
The most important thing to remember as you prepare to undertake your assessment is that implementation of the BPCLE Framework is intended as a group activity. Even for small health services, the more staff that can provide input to the self-assessment tasks (preliminary assessment and detailed assessment), the more likely the results will be a true representation of your clinical learning environment.
Therefore, those tasks should be undertaken as a group, facilitated by an appropriate individual who has the ability to keep the group focussed in their discussions and the authority to ensure all voices are heard. While the later tasks (action planning and indicator selection) can be done with a smaller (and probably more senior) group, there is nevertheless a good case to be made for ensuring broad input to those tasks.
The Stakeholder Guidelines include extensive information about which individuals to include in the various tasks and it is recommended that you consult that document for more detailed advice about the composition of your working group.
Of course, the more people you include in your working group, the more likely there will be a range of views about the most appropriate rating for each item being discussed during the preliminary and detailed assessment tasks.
Once you have assembled the working group and have read the relevant background material and watched the video tutorials, you are ready to begin your assessment.
A word about “consensus” in the context of the BPCLEtool assessment process
In both the Preliminary Assessment and the Detailed Assessment, you are asked to record a “consensus rating” for each item being rated.
A number of BPCLEtool users have been unsure about what “consensus” actually means, since it is often the case that different members of the working group have different experiences of the various aspects of the clinical learning environment. Of course, the more people you include in your working group, the more likely there will be a range of views about the most appropriate rating for each item being discussed during the preliminary and detailed assessment tasks.
“Consensus” is usually taken to mean general agreement, or sometimes majority opinion, although in the context of decision-making, “consensus decision-making” is a group decision-making process in which group members develop, and agree to support, a decision in the best interest of the whole.
Thus, while the majority of individuals might rate a particular aspect of the clinical learning environment quite well, if a small number rate that aspect poorly, the group might reach a consensus that the item in question needs to be improved and should be rated accordingly. In this case, the consensus rating might be different from both the majority opinion and the average rating of the group, but the group would agree that a lower consensus rating is warranted to call attention to the need for improvement.
Each organisation can decide for itself how it arrives at a consensus rating. We recommend that groups avoid the temptation to interpret “consensus” to mean “average” or “majority. It is important to remember that the BPCLEtool assessment process is a quality improvement exercise and there is more value in recording a consensus rating that helps to identify opportunities for improvement than in adopting an approach to consensus that obscures those insights.