Development of TOEKAN, a 360° evaluation tool for the clinical learning environment in General Practice postgraduate training

Lotta Coenen, Laura Daman, Guy Gielis, An Stockmans, Arne Van Renterghem, Marc Van Nuland, Nele R Michels

Keywords: workplace learning, clinical learning environment, evaluation tool


The General Practice (GP) postgraduate program exists for 80% out of workplace learning. The quality of the clinical learning environment (CLE) has a direct effect on the quality of training and the professional development of GP trainees.


Participatory research was used to involve all stakeholders in the development process of a 360° evaluation tool that should improve the average quality of GP training practices, guide GP trainees towards the best training practices and detect and remediate GP trainers of lower quality.


TOEKAN (Tool for Communication and Evaluation of Quality Standards) was developed, which consists of a 72-item questionnaire for GP trainees and GP trainers and an 18-item question naire for those who coach and remediate GP trainers. The outcomes of the TOEKAN questionnaires are visualized in an online dashboard.


TOEKAN is the first 360° evaluation tool for CLE in GP education. All stakeholders will complete the survey on a regular basis and have access to the results. By creating intrinsic and extrinsic motivation as well as mediation measures, the quality of CLE will improve. Continuous monitoring of the use and outcomes of TOEKAN will allow to critically review and improve this new evaluation tool as well as support the broader implementation.

Points for discussion:

Involving all stakeholders in the designing process of the 360° evaluation tool allowed us to create a feasible and comprehensive tool.

By involving all stakeholders in the evaluation of the clinical learning environment we generate overall awareness on the importance of a quality clinical learning environment.

The visualisation of TOEKAN-results facilitates immediate implementation and aims to increase intrinsic motivation as well as extrinsic motivation and responsibility.


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