RBW PPT

1. PRINCIPLES AND TYPES OF
ASSESSMENT IN MEDICAL
EDUCATION
DR.P.MURALIDHARAN
MS OPHTHAL, POST DOCTORAL FELLOWSHIP
IN CORNEA
SENIOR ASSISTANT PROFESSOR
DEPT OF OPHTHALMOLOGY
GOVT THIRUVARUR MEDICAL COLLEGE
MEU GTMCH
NMC REGIONAL
CENTRE

2. OBJECTIVES
ASSESSMENT:
Definition
Goals
Purpose of Assessment
Principles of Assessment
Types of Assessment

3. What is Assessment?

4. INTRODUCTION
• Assess- derived from Latin word “ assidere”
• Means “ To sit with”
• We “do for students ”

5. DEFINITION
Process of gathering, interpreting, recording
the information of the learner responses to
an educational task .
Process employed to make judgement about
the achievements of students over a course
of study

6. ASSESSMENT

7. GOAL OF ASSESSMENT
To optimize the capability of all learners and
practitioners
To protect the public by upholding
professional standards and identifying
incompetent physicians
Meet public expectations
To provide a basis for choosing applicants for
advanced training

8. PURPOSE OF ASSESSMENT
• Drives student learning.
• Whether the learning objectives are met
• Feedback to the students and also teachers
• Monitoring the programme
• Safeguarding the public
• Certification of competency
• Predicting the future performance.

9. ASSESSMENT CYCLE

10. Assessment cycle

14. Evaluation
(Summative)
Assessment
(Formative)

15. Difference between Assessment &
Evaluation
Assessment Evaluation
Timing Formative Summative
Focus of measurement Process oriented Product oriented
Relationship b/w
administrator & recipient
Reflective Prescriptive
Use Diagnostic Judgment
Modification of criteria Flexible Fixed
Standard of measurement Absolute Comparative
Relationship b/w
assessment & evaluation
Cooperative Competitive

18. Validity
Reliability
Washback
Practicality
Authenticity
Principles of assessment

20. What we assess?
• Impossible to assess each & every
educational outcome
• Assess overall professional competence
• Based on Accreditation Council for Graduate
Medical Education model (ACGME)
• Using six interrelated domains of competence
Medical knowledge, patient care,
professionalism, communication skill, practice
based learning and system based practice.

21. WHY ASSESSMENT???

22. LEARNING COMPONENTS
Communication skill
Psychomotor skill.
Clinical competence is demonstrated when a
task is performed using learned skills and
knowledge.
1. KNOWLEDGE Dose the student or doctor know
what he or she should do?
In practice, does the student or doctor
choose to do it when confronted with a
situation?
3. ATTITUDE/ RESPONSE
Is he or she able to do it?
2. SKILLS

24. • Whom to be assessed ???

25. i. Learners
ii. Facilitators
iii. Course/Programme
iv. Institute

26. Why do we assess our students?
How the student can meet the desired
outcome?
What outcomes a student has met

27. LEARNERS
• Diagnostic- detect learning difficulties
• Feedback- adjust learning strategies
• Self evaluation: make judgement of own work
• Motivation: enhance learning
• Preparation for long term learning

28. FACILITATORS
Diagnostic –how well students have
learned
Feedback-adjust teaching strategies
Teaching & Learning programme: make
appropriate modification
Promoting self evaluation

29. Institution & Profession
To categorize the student as pass or fail
To select for future course/ programmes
To grade
To demonstrate institutional standard
To select for employment
To licence for practice
To accredit for professional occupation

30. Types of assessment
Diagnostic assessment
Formative assessment
Summative assessment
Criterion referenced assessment
Norm referenced assessment

31. TYPES OF ASSESSMENT

33. Types of assesment
DIAGNOSTIC
ASSESSMENT
FORMATIVE
ASSESSMENT
SUMMATIVE
ASSESSMENT
Initial ability for the
success in study
Stimulating study
and self-assesment
Final evaluation of
the success in study

34. DIAGNOSTIC ASSESSMENT
Helps to identify the students current
knowledge of a subject before teaching takes
place.
Examples :
Pretests
Self assessment
Interviews

35. Formative assessment (Diagnostic)
 Provide feedback to the student on his/her
progress.
 Done during the course.
 Provide feedback to the teacher with data
for modification of his/her teaching.

36. EXAMPLES:
 Essay/ assignment
 A simple mental note
 Group discussion
 Self and peer assessment
 Feedback forms

37. Summative assessment
(Certifying)
Done at the end of period.
For placing the student in order of
merit.
During giving any certificate

38. EXAMPLES
• A MID TERM EXAM
• A FINAL PROJECT
• A PAPER
• A FINAL EXAM

41. • Criterion-referenced assessment (CRA)--
student performance is assessed against a set
of predetermined standards- Relative ability of
a student in a subject
• Norm-referenced assessment (NRA) -- student
performance is assessed relative to the other
students- Real knowledge of student in a
subject

42. Criterion-Referenced assessment
• Based on a predetermined set of criteria.
• For instance,
– 90% and up = A
– 80% to 89.99% = B
– 70% to 79.99% = C
– 60% to 69.99% = D
– 59.99% and below = F

43. CRITERION REFERENCED TESTING
• Comparing the performance of
students against a fixed criteria
• Results can be pass/fail
• Requires establishment of
absolute standards.
• Objective- Perform CPR
• The student cannot pass if he
does only 60% of the steps
• He is declared pass only when all
the steps are correctly done.

44. Criterion-Referenced assessment
• Pros:
– Sets minimum
performance
expectations.
– Demonstrate what
students can and cannot
do in relation to
important content-area
standards (e.g, ILS).
• Cons:
– Some times it’s hard to
know just where to set
boundary conditions.
– Lack of comparison data
with other students
and/or schools.

47. NORM REFERENCED TESTING
• Implies rank ordering of
the student
• Tell how the students
did in relation to others
• Does not tell- what they
did?
• No fixed standard

48. Norm and Criterion Compared
• Norm-Referenced:
– Ensures a competitive
classroom atmosphere
– Assumes a standard
normal distribution
– Small-group statistics a
problem
– Assumes “this” class like
all others
• Criterion-Referenced:
– Allows for a cooperative
classroom atmosphere
– No assumptions about
form of distribution
– Small-group statistics not
a problem
– Difficult to know just
where to set criteria

49. 360 degree assessment
• Systematic collection of performance data &
feedback for an individual trainee, using structured
questionnaires completed by a number of
stakeholders- Senior consultants, junior specialist,
nurses and allied health service professionals.
• Self assessment
• Assessment category: good clinical care, practice,
teaching & training, relationship with patients,
working with colleagues.
• Use in PG & practising doctors.

51. How to Assess ???

52. Assessment methods
• Multiple methods , Tools & variety of
environment .
• Repeated, ongoing assessment
• Focused on knowledge, skill and behaviour
• Provide timely feedback

53. Assessment methods
• Written Exercises
• Assessment by Supervising Clinician
• Clinical simulations
• Multisource Assessments

55. Miller’s pyramid for assessment of
clinical skills /competence/performance
Does
(action)
Shows how
(performance)
Knows how
(competence)
Knows
(knowledge)

56. All methods of assessment have strengths and
intrinsic flaws
Van der Vleuten describes five criteria for determining the usefulness of
a method of assessment.
1. Reliability : The degree to which the measurement is accurate and
reproducible
2. Validity : Whether the assessment measures what it claims to measure
3. Impact on Future Learning and Practice:
4. Acceptability : to students and faculty:
5. Costs: To the individual trainee and the institution

57. Assessment tools

58. KNOWLEDGE ASSESSMENT(Cognitive)
TOOLS
Written
• Essay
• Short notes/ very short answers
• MCQ
Viva

59. Psychomotor (skills)
TOOLS
• OSCE
• OSPE
• PRACTICAL EXAMS
• CLINICAL EXAMS

60. AFFECTIVE
TOOLS
• History taking
• Logbook
• Records
• Group discussion

61. Criteria for assessment tools
• Relevance: Appropriateness in the context of the
needs of society
• Validity: does the assessment tool really test
what is intended to test?
• Reliability: does the evaluation tool consistently
test what is intended to test?
• Objectivity: Will the scores obtained by the
candidate be same if evaluated by two or more
independent expert examiners?
• Feasibility: Can the process be implemented in
practice?

62. Assessment Tools
Dr. Shahram Yazdani
Tests of Knowledge:
Clinical Based Tests:
Does
Shows How
Knows How
Knows
Competence Assessment
Performance Assessment:
Real patients,
DOPS, Mini-CEX
OSCEs, ,Long Case,
Short Case, OSPEs,
Essays, Viva, case
scenario
MCQ, SAQ, VIVA

63. ACTIVITY- Hb estimation
Dr. Shahram Yazdani
Miller -learning assessment pyramid
Does
Shows How
Knows How
Knows
methods of Hb estimation-
MCQ/ SAQ
VIVA – disuss the merits
&demerits of Sahli’s method
Demonstrate Sahli’s method(DOPS)
Bed side estimation of Hb (DOPS)

64. Activity-CPR
Dr. Shahram Yazdani
Miller -learning assessment pyramid
Does
Shows How
Knows How
Knows Steps of CPR-MCQ/ SAQ
VIVA/case scenario – Describe CPR,
Methodology, Do’s & Dont’s
Demonstrate CPR ( osce ; role play ;
simulation)
Can do CPR in trauma ward/ICCU
(DOPS)

66. What is self assessment?
the involvement of students in identifying
standards and/or criteria to apply to their work
and making judgements about the extent to
which they have met these criteria and standards.

68. 360 degree assessment
• Systematic collection of performance data &
feedback for an individual trainee, using structured
questionnaires completed by a number of
stakeholders- Senior consultants, junior specialist,
nurses and allied health service professionals.
• Self assessment
• Assessment category: good clinical care, practice,
teaching & training, relationship with patients,
working with colleagues.
• Use in PG & practising doctors.

69. • Objective and Structured
• Simulated environment (shows how)
• Workplace based
• DOPS -Direct Observation of Procedural Skills
• Multi-Source Feedback (MSF) / 360 degree
evaluation
• Mini CEX
• Case based discussions
CURRENT TOOLS

70. CONCLUSION- ASSESSMENT
• For Various domains of competence
• In Integrated, coherent & longitudinal fashion
• Use Multiple methods
• With Provision of frequent & constructive
feedback