Crane, Rebecca

Koerbel, Lynn

Sansom, Sophie

Yiangou, Alison

English

Inclusion of assessment of teaching competence in Mindfulness-Based Program (MBP) teacher training enables international benchmarking of standards, which in turn underpins the integrity of this emerging field and the potential to deliver effective, transformative interventions. However, there is a risk that the inclusion of competence assessment could lead to reductionism and undermining of the pedagogical features that make mindfulness-based teaching distinct. It can also make the costs of training prohibitive. The science underpinning the integrity of competence assessment is not yet robust enough to justify wide scale implementation, but when feasible, including the option for assessment enables trainees to engage in rigorous and effective training processes. When assessment is included, it is critically important that the process is held with awareness and sensitivity, and is implemented by experienced assessors with thoughtful governance. Navigating these issues involves balancing rigour with accessibility and pragmatism. This paper lays out some guidelines for good practice for MBP teaching assessment, and raises unresolved dilemmas and questions

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   PRIFYSGOL BANGOR / BANGOR UNIVERSITY  Assessing Mindfulness-Based Teaching Competence: Good PracticeGuidanceCrane, Rebecca; Koerbel, Lynn; Sansom, Sophie; Yiangou, AlisonGlobal Advances in Health and MedicineDOI:https://doi.org/10.1177%2F2164956120973627Published: 01/01/2020Publisher's PDF, also known as Version of recordCyswllt i'r cyhoeddiad / Link to publicationDyfyniad o'r fersiwn a gyhoeddwyd / Citation for published version (APA):Crane, R., Koerbel, L., Sansom, S., & Yiangou, A. (2020). Assessing Mindfulness-BasedTeaching Competence: Good Practice Guidance. Global Advances in Health and Medicine, 9.https://doi.org/10.1177%2F2164956120973627Hawliau Cyffredinol / General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/orother copyright owners and it is a condition of accessing publications that users recognise and abide by the legalrequirements associated with these rights.            • Users may download and print one copy of any publication from the public portal for the purpose of privatestudy or research.            • You may not further distribute the material or use it for any profit-making activity or commercial gain            • You may freely distribute the URL identifying the publication in the public portal ?Take down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access tothe work immediately and investigate your claim. 12. Nov. 2021ViewpointAssessing Mindfulness-Based TeachingCompetence: Good Practice GuidanceRebecca Crane, PhD1 , Lynn Koerbel, MPH2,Sophie Sansom, PhD1 and Alison Yiangou, MA1AbstractInclusion of assessment of teaching competence in Mindfulness-Based Program (MBP) teacher training enables internationalbenchmarking of standards, which in turn underpins the integrity of this emerging field and the potential to deliver effective,transformative interventions. However, there is a risk that the inclusion of competence assessment could lead to reduc-tionism and undermining of the pedagogical features that make mindfulness-based teaching distinct. It can also make thecosts of training prohibitive. The science underpinning the integrity of competence assessment is not yet robust enough tojustify wide scale implementation, but when feasible, including the option for assessment enables trainees to engage inrigorous and effective training processes. When assessment is included, it is critically important that the process is held withawareness and sensitivity, and is implemented by experienced assessors with thoughtful governance. Navigating these issuesinvolves balancing rigour with accessibility and pragmatism. This paper lays out some guidelines for good practice for MBPteaching assessment, and raises unresolved dilemmas and questions.Keywordsassessment, fidelity, competence, MBI:TAC, mindfulness-based programs, mindfulness-based interventions: teaching assess-ment criteriaReceived May 5, 2020. Accepted for publication October 7, 2020IntroductionThis paper offers a synthesis of understanding from threeuniversity-based training centers in the UK and the US,on good practice for integrating teaching competenceassessment into mindfulness-based program (MBP)teacher training and research. It draws on practice-based evidence (of integrating assessment into MBPteacher training pathways), and evidenced-based prac-tice.1 It focuses on the main competence assessment toolin the MBP field – the Mindfulness-Based Intervention:Teaching Assessment Criteria (MBI:TAC).2Good Practice in Using the MBI:TAC toConduct AssessmentsResearch indicates that inclusion of assessment of com-petence in MBP teacher training develops more effectiveteachers.3 Assessment can be conducted in ways thatsupport growth and learning, and are sensitive to theinherent vulnerability of the process; or in ways thatundermine learning and damage confidence – theimpact of which can last for years. It is critical thereforethat the necessary ethical basis, governance and goodpractice for conducting MBP teacher assessment areconsidered. Embedding understanding of these princi-ples into practice is necessary for individual assessorsand for the organization holding the process.Why assess? First, it is important to be clear about therationale for assessing, and what is assessed. Within thecontext of university validated (e.g. Masters) programdelivery, assessment is a necessary and embedded part1Mindfulness Center, School of Public Health, Bangor University, Bangor,UK2Mindfulness Center, School of Public Health, Brown University,Providence, Rhode IslandCorresponding Author:Rebecca Crane, Bangor University, Brigantia Building, College Road,Bangor LL57 2DG, UK.Email: r.crane@bangor.ac.ukGlobal Advances in Health and MedicineVolume 0: 1–4! The Author(s) 2020Article reuse guidelines:sagepub.com/journals-permissionsDOI: 10.1177/2164956120973627journals.sagepub.com/home/gamCreative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distributionof the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).of student monitoring, awarding qualifications and eval-uating the program’s effectiveness. The choice points,therefore relate to the focus of assessments and method-ologies employed. However, most MBP teacher trainingprograms internationally are delivered as professionaldevelopment, so are not surrounded by established uni-versity governance and frameworks. In these contexts,assessment is not a necessity, but is increasingly used toenable trainees and the training program to point tosubstantive evidence of attainment and rigor.Within research contexts, it is necessary to report onintervention integrity.4,5 From a wider field perspective,transparent and consistent systems for ensuring stand-ards support the integrity and credibility of the work.Ultimately, it is only by exposing their teaching to exter-nal review that a teacher can validly represent themselvesas qualified or competent. There are therefore a numberof reasons to build assessment into training processes,but as outlined below there are also a number of coun-terpoint cautions. These include the importance of goodgovernance informing the conduct of assessments, andthe emergent status of the science on MBP teaching com-petence. It is wiser not to include formal assessments intraining processes unless they are implemented withgood practice and thoughtful governance. The MBI:TAC can—and we argue should–still be implementedinformally in a range of ways within training andsupervision.6,7It is important also to remember that an observation-al tool such as the MBI:TAC only assesses one element –i.e. the skills of the teacher observed during a teachingsession. The tool is not designed to assess theoreticalunderstanding, professional ethics and practice, orreflective skills. If assessment is included, it is importanttherefore that varied methods are employed (e.g. writtenassignments testing theoretical and professional knowl-edge, and reflective skills).How are assessments governed and organised? Withinthe context of Master’s assessment there are existing andestablished governance and organizational structuresthat surround the conduct of assessment. These include:learning outcomes aligned to assessment tasks; timelinesfor submission/return; trained assessors conductingassessments with reference to marking criteria and learn-ing outcomes; internal procedures for double marking(two assessors marking the same piece of work, blindto each other’s assessments), and moderation (overarch-ing checks to ensure consistency); procedures for exter-nal scrutiny of assessment processes; and processes forresponding to complaints or student challenges to grad-ing which protect both student and markers. These pro-cesses provide a reassuring context within which toembed the use of the MBI:TAC as an assessment tool,as part of a multi-faceted approach to assessment.When moving towards building assessments intocontexts that do not have these established processes,we recommend modelling university structures toensure that the assessments are conducted fairly andwith integrity. If governance is poor, there is a risk ofbringing the wider field into disrepute by awardingqualifications inappropriately; of giving students apoor learning experience; and of offering students aninadequate holding environment for the potential vul-nerability of the assessment process. Most of these nec-essary governance structures are internal to theorganisation: for example, establishing clear aims andorganizational structures; ensuring that assessors arewell trained and up to date with developments inassessment protocol; and building in internalmoderation.Future processes potentially require wider collabora-tive design of systems beyond each training organisation.Over time, it would strengthen integrity if the fieldmoved towards setting in place systems for externalmoderation of teaching competence assessments. Thereis the potential to develop on a field level, a centralorganised body of practitioners who are expert in con-ducting assessments held by national or regional associ-ations beyond the auspices of individual trainingorganisations. This would enable organisations tobuild assessment into their training processes with link-age to the wider context; provide the organisation andtheir trainees reassurance that appropriate governance isin place; provide checks to ensure that assessments arealigned to central benchmarks; and strengthen the integ-rity of the wider field by establishing and communicatingconsistency about teaching standards. Graduation witha certificate of competence from one program wouldhave equivalence with other programs. This is onepath that could support global recognition of traininglevel. However, in our view this development is contin-gent on the psychometric properties of assessment strat-egies being supported by the science. Research is inprogress, but we have not yet reached this stage of devel-opment. In addition, aspects of diversity and inclusion inthe field are only beginning to be researched andaddressed.Scaling up the inclusion of assessment within MBPteacher training brings the potential of increasing thequality of program delivery in regions around theworld. However, the challenge of scale-ability and acces-sibility is significant. The two main challenges are train-ing assessors and financial viability for trainees. Ideally,trainees are assessed in their own language by someonefrom their own cultural context. In countries whereMBP training programmes have been more recentlyestablished, it can take years for teachers to gain theexperience required to be eligible for training as an asses-sor. The costs involved in this training may result in2 Global Advances in Health and Medicineassessment not being accessible to trainees from less eco-nomically advantaged areas and backgrounds.How are assessments conducted? The MBI:TACmanual2 and the level 28 in person training detail theprocess of conducting assessments, and assessors needtraining prior to assessing others. It is good practicethat practitioners who assess others have had theirown teaching practice assessed – both to ensure thatthey are familiar with the vulnerability inherent withinthe process, and to ensure that their teaching is at least at‘Proficient’ level. The assessor also needs to be an expe-rienced teacher of the particular MBP curriculum thatthey are assessing, to ensure that they are able to ade-quately assess adherence to curriculum.The quantity of teaching practice material that isreviewed will depend on context and the time pointof the assessment within the training process.Assessment can be staged by lowering the expectedpass level for early trainees (i.e. ‘Advanced Beginner’is an appropriate level for trainees in their first year oftraining whilst, ‘Competent’, is a necessary level forfull graduation from the program). Staging of assess-ments can also be implemented by assessing earlierstudents teaching small elements of the curriculum(e.g. half hour clip of meditation practice guidancefollowed by inquiry). For final competence certificatereview, it is recommended that trainees submit videorecordings of the whole course. Written permissionsfrom participants for the recording and its submissionare needed. Carefully crafted written feedback9 is givenin addition to a competence level. The following pro-cedure is employed:• Markers randomly select two sessions to assess intheir entirety. One session is selected from sessions1–4, and one from sessions 5–8.• Markers sample up to an hour of additional materialto enable completion of the assessment. The followingquestions guide the sampling:• Was there an aspect of the teaching process thatwas difficult to fully assess within the 2 sessions?• Perhaps review how week 1 was started and week8 was ended to assess management of beginningand ending (domain 6)?• Was there a domain of competence that was partic-ularly skilful/unskilful? Sample other examples ofthis to see whether this was consistently demonstrat-ed or not.• Have you formed a hypothesis about the teachingthat needs testing by viewing more material? (I.e.the first clips of teaching may give the impressionthat the teacher moves prematurely to make ateaching point. To decide whether this is a patternwhich replicates itself view more inquiry).Risks and cautions: Clearly, the intention behindembedding assessment into training processes is tostrengthen standards and support public access to highquality teaching. However there are some inherent risks.Introducing assessment into the training process canshift the focus from immersion in learning, to focusingon outcome. For example, trainees may have a sense ofneeding to ‘teach to the test’ to get a good grade. Theprocess of teaching could thus become a performance orplaying a role rather than teaching through an embodiedconnectivity to immediacy.It is important therefore that the inclusion of assess-ment within a training process is an integrated part of anoverall approach to cultivating trainee’s capacity toteach authentically.7,10 The MBI:TAC was designedthrough close up observation of the actuality of theteaching process, and its implementation within trainingshould not be shaping the teaching process, but rathershould enable fidelity to its original intentions.Authors’ NoteAlison Yiangou is now affiliated with Oxford MindfulnessCentre, Department of Psychiatry, University of Oxford,England, UK.Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts ofinterest with respect to the research, authorship, and/orpublication of this article: All authors work withinmindfulness-based training centers, which use the MBI:TACwithin their trainingFundingThe author(s) received no financial support for the research,authorship, and/or publication of this article.ORCID iDRebecca Crane https://orcid.org/0000-0003-3605-0256References1. Hecht FM. Predictors of outcomes in MBSR participantsfrom teacher factors (prompt-F), trial registration withNational Institutes of Health. https://clinicaltrials.gov/ct2/show/NCT03384771?term=Hecht+F&draw=2&rank=1. Updated 2018. Accessed February 21, 2020.2. Crane RS, Soulsby JG, Kuyken W, Williams JMG, EamesC. The Bangor, Exeter & Oxford mindfulness-based inter-ventions: teaching assessment criteria (MBI-TAC). http://mbitac.bangor.ac.uk/mbitac-tool.php.en. Updated 2017.Accessed November 15, 2019.3. Ruijgrok-Lupton PE, Crane RS, Dorjee D. Impact ofmindfulness-based teacher training on MBSR participantwell-being outcomes and course satisfaction. Mindfulness.2017:9(1):117–128.4. Crane RS, Hecht FM. Intervention integrity in mindfulness-based research, Mindfulness. 2018;9:1370–1380.Crane et al. 35. Kuyken W, Weare K, Ukoumunne OC, et al. Effectivenessof the mindfulness in schools programme: non-randomisedcontrolled feasibility study. Br J Psychiatry.2013;203:126–131.6. Evans A, Griffiths GM, Sansom S, Crane RS. Using themindfulness-based interventions: teaching assessment cri-teria (MBI:TAC) in supervision. Glob Adv Mental Health.In press.7. Griffith GM, Crane RS, Fernandez E, Giommi F,Herbette G, Koerbel L. Implementing themindfulness-based interventions: teaching assessment cri-teria (MBI:TAC) in mindfulness teacher training pro-grams. Glob Adv Mental Health. In press.8. Crane RS, Koerbel L, Sansom S, Yiangou A. Trainingto use the mindfulness-based interventions: teachingassessment criteria (MBI:TAC) http://mbitac.bangor.ac.uk/training.php.en. Updated 2019. Accessed November15, 2019.9. Sansom S, Crane RS, Evans A, et al. A guide to skilfulfeedback in mindfulness-based programs training andassessment. Updated 2020. Accessed April 17, 2020.10. Crane RS, Reid B. Training mindfulness teachers: princi-ples, practices and challenges. In: McCown D, Reibel D,Micozzi MS, eds. Resources for Teaching Mindfulness: AnInternational Handbook. 1st ed. New York, NY: Springer;2016: 121–142.4 Global Advances in Health and Medicine

Assessing Mindfulness-Based Teaching Competence: Good Practice Guidance

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Assessing Mindfulness-Based Teaching Competence: Good Practice Guidance

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