The development of the FOAE concept integrates many programmatic needs into one assessment tool.
Our initial implementation of the FOAE tool included a 3 point evaluative anchor of 'suboptimal,' 'adequate,' and 'optimal' but these descriptors lacked specificity and required labeling of a learner as 'suboptimal' if the learner was not yet competent.
The authors were not aware of the existence of the Mini-Clinical Evaluation Exercise (mCEX) of the American Board of Internal Medicine (ABIM) prior to the development, implementation, and subsequent study of the FOAE. (15) Given this fact, the mechanistics of performing focused observation resulted in many similarities in the construction of the evaluations.
(11) In our practice, the intent to complete an FOAE is announced to the learner prior to observation to obviate the possibility of only documenting unsuccessful outcomes.