Assessment and evaluation are essential
components of teaching and learning.
Without an effective evaluation program it
is impossible to know whether students
have learned, whether teaching has been
effective, or how best to address student
“Doing Evaluation and doing it well matters
in pragmatic terms because bad products and
services cost lives and health, destroy the
quality of life and waste the resources of
those who cannot afford waste. In ethical
terms, evaluation is a key to in the service of
justice, in programmes as well as in
The outcomes of summative evaluation decisions
have serious implications
For students in terms of self-esteem and
protection of their rights to pursue a lively hood
For patients with regard to protection from unsafe
For teachers concerned with potential charges of
unfair evaluation practices and the legal
repercussions of decisions where students are
wrongly failed (or passed)
Determining the extent to which a student
has achieved the course objectives.
Can occur during a term as well as at the
end of instruction.
Summative assessment methods are the
most traditional ways of evaluating student
To evaluate learner success in retaining
content knowledge through types of
assessment such as traditional paper and
A tool used to evaluate the curriculum and
Assessment for learning
Taken at varying intervals throughout a
course to provide information and feedback
that will help improve
the quality of student learning
the quality of the course itself
Assessment of learning
Generally taken by students at the end of a
unit or semester to demonstrate the "sum"
of what they have or have not learned.
"Good summative assessments must be
demonstrably reliable, valid, and free of
bias" (Angelo and Cross, 1993).
‘… often means no more than
that the assessment is carried
out frequently and is planned at
the same time as teaching.’
(Black and Wiliam, 1999)
‘… provides feedback which
leads to students recognizing
the (learning) gap and closing it
… it is forward looking …’
‘ … includes both feedback and
self-monitoring.’ (Sadler, 1989)
‘… is used essentially to feed
back into the teaching and
learning process.’ (Tunstall and
‘…assessment (that) has
increasingly been used to sum
up learning…’(Black and Wiliam,
‘… looks at past achievements …
adds procedures or tests to
existing work ... involves only
marking and feedback grades to
student … is separated from
teaching … is carried out at
intervals when achievement has
to be summarized and
reported.’ (Harlen, 1998)
The Garden Analogy
If we think of our children as plants …
Summative assessment of the plants is the process
of simply measuring them. It might be interesting
to compare and analyze measurements but, in
themselves, these do not affect the growth of the
Formative assessment is the equivalent of feeding
and watering the plants appropriate to their needs -
directly affecting their growth.
Existing Pattern in Nursing
Educational objectives centered?
Types of questions?
Time (duration) ?
Practical / Clinical Evaluation
“Any institution wanting an overflow
audience for a symposium need only plan a
programme called evaluation of nursing
students in the clinical area” (Woolley
These words are equally relevant today and
perhaps more so as educators struggle with
issues of clinical evaluation.
Practical / Clinical Evaluation
Nursing educators face the dilemma of how to
determine a student’s competence level while at
the same time realising that this cannot be known
directly, exactly and for all time because of the
indeterminate, evolving and contextual nature of
Combining multiple methods adds breadth and
depth to an investigation.
Performance check list
Written exams, etc.
Practical Examination - Issues
Number of students per day
Examiners (Internal / External)
Subjectivity and inconsistency of clinical
Objective structured clinical examination (OSCE)
Designed to objectively assess clinical skills
performance in simulations of actual clinical
The triple-jump exercise or examination (TJE)
Uses case studies to assess a students ability to
identify potential and real patient problems and
develop a plan of care. It provides a means for
observing how a student handles new knowledge and
formulates the information into a management plan.
Oral Examination - Issues
Whole syllabus / case or both ?
Questions - more theory / applications ?
Procedure book / Log book / Subject file ?
Same questions or different ?
Steps for Improvement
Clearly defined objectives/outcomes
Clearly defined evaluation criteria
Authenticity - Assessment that is aligned
with the classroom objectives and that
reflects real-world applications
variety of assessment techniques.
Practice Standards for
Nurses in India (by INC)
Used as a parameter for evaluation of
performance and as a measure of quality control
Must be used in conjunction with the code of
ethics and professional conduct for nurses India.
Classified under six practice areas consistent
with areas for code of ethics and professional
Six Practice Areas
1. Professional responsibility and
2. Nursing practice
3. Communication and interpersonal
4. Valuing human being
6. Professional Advancement
Area no. 2 Nursing Practice -
2.1 Nursing care reflects adherence to
2.2 Delivery of Nursing care reflects nursing
2.3 Nursing care is provided in a safe
Clinical Evaluation as Inquiry
Clinical evaluation is the sister of research
The purpose of clinical evaluation as a form
of research is the discovery and verification
of the process and product of the teaching
and learning of nursing practice.
Strengthening Teacher Expertise
Evaluation systems should capitalize on the
teachers professional expertise.
Expert nurse educators should know what
quality clinical practices entails and can
judge both the quality and appropriateness
of a students practice in relation to
individual client situations
Standard of Nursing Practice – 2.3
Nursing care is provided in a safe environment
2.3.1 Ensure safe and therapeutic environment in
2.3.2 Adheres to standard safety measures
2.3.3 Follows guidelines for biomedical waste
2.3.4 Sensitizes co-workers, individuals and groups
about the importance of safe environment
Students are encouraged to be involved in the
formative evaluation process while only teachers are
considered to be eligible to participate in evaluation
decisions of the summative type. (Best et.al 1990,
The assumption is that summative evaluation require
expertise that only resides within the teacher.
Summative evaluation can be easily compromised by
the close teacher student relationships that develop in
clinical teaching. (Lenburg and Mitchell 1991)
Evaluation is a continuous and ongoing
Formative and Summative evaluation are
similarly seamless; there is a formative
element in any summative evaluation
(Schoenhofer and Coffman 1994)
Findings from medical education studies suggest
that performance in one problem or case does not
necessarily predict performance on other
problems or cases, particularly in situations that
test problem solving and clinical reasoning ability.
Several studies have demonstrated a low
correlation between performance course on
simulations and marks from written and oral tests
of knowledge and global ratings of performance in
the clinical settings.
Fourth generation evaluation – Evolved
from a concern that the previous forms did
not fairly and adequately involve
stakeholders in the design of an evaluation
and implementation of its results.
It also requires that educators believe that
students can be knowers of quality nursing
practice and should be involved in
Evaluation is a threatening process and steps
are required to address this reality or else
students cannot be expected to willingly
develop a professional valuing of the
Assessing and Evaluating Learning
Definition of assessment:
Assessment is the process of gathering
information on student learning.
Definition of evaluation:
Evaluation is the process of analyzing, reflecting
upon, and summarizing assessment information,
and making judgments and/or decisions based on
the information collected.
Evaluation is both a process and a product; the
word evaluation refers to the process of
systematically and objectively determining the
merit, worth and value of things and it also
denotes the product of that process.
Aim of Student Evaluation
Incentive to learn
Feedback to student
Modification of learning activities
Selection of students
Success or failure
Feedback to teacher
Protection of society
The artificial separation teaching – evaluating and
formative – summative creates a dichotomy that
serves to maintain distance between teacher and
student and perpetuate a belief that students are
unable to be ‘knowers’ of quality practice and
their own learning.
The issue is how to deal with the teachers
negative feelings when a student’s performance is
substandard and how to counter the reluctance of
teachers to deal definitively with poor
FOURTH GENERATION EVALUATION
According to Guba and Lincoln (1989), the field of
evaluation can be seen to have passed through
three distinct phases or generations.
Early evaluation – strictly technical and based in
The second generation – expanded to include
Third Generation - The purpose of measurement
and description was to inform decisions and
judgments about the merit and worth of the
evaluand (the object of the evaluation that is the