How to conduct a workplace-based CBD assessment

Emphasize observation, feedback and documentation

In Competence by Design (CBD), clinical teachers make use of authentic clinical oversight activities to engage in the workplace-based assessment of residents. Workplace-based assessment (WBA) is feasible in a busy clinical program, because of the fact that you are already giving your residents verbal feedback. Now you just need to take a moment to document that feedback.

Frequent and timely coaching conversations between a learner and observer are a critical element of WBA. This is known as Coaching in the Moment and it follows the RX-OCR step-by-step process:

  1. R: Establish educational Rapport between the resident and the clinician (an educational alliance or partnership).
  2. X: Set eXpectations for an encounter (discuss learning goals).
  3. O: Observe the resident. With CBD, the role of clinical teacher is evolving from supervisor to frequent observer and coach. When clinical teachers directly or indirectly observe the work residents do more often, their observations provide greater learning opportunities and a more comprehensive image of trainees’ competence.
  4. C: Engage in a Coaching conversation for the purpose of improvement of that work. As part of this conversation, the clinical teacher gives the trainee "coaching feedback," focusing on specific actionable suggestions for improvement and how such improvements can be accomplished.
  5. R: Report a summary of the encounter, including observation specifics and performance ratings, using an observation form.

Learn more about the CBD Coaching Model and Coaching in the Moment here.

Contact us at to request a copy of the four sample observation templates.


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