1) Medical education has progressed with more rigorous and scientific teaching based on sound pedagogical principles like problem-based learning.
2) Assessment methods have also evolved over the past decades to evaluate a wide range of skills beyond just knowledge, like communication, teamwork, and evidence-based care.
3) Valid and reliable assessment is important to provide feedback to students and evaluate competencies required of physicians, and different methods like OSCEs, checklists, and portfolios are used for this purpose.
This document discusses key issues in assessing clinical competence in medical education. It addresses the need for tests of clinical competence to serve both formative and summative purposes. It also explores various assessment methods and how they measure different levels of competence, from basic knowledge to direct observation of performance. Reliability and validity are important considerations when designing assessments. The document recommends using multiple assessment methods and cases to reliably measure clinical competence.
This document discusses key issues in assessing clinical competence in medical education. It addresses the need for tests of clinical competence to serve both formative and summative purposes. It also explores various assessment methods and how they measure different levels of competence, from basic knowledge to direct observation of performance. Specifically, it notes that direct observation through methods like objective structured clinical examinations is needed to properly assess clinical skills but that reliability can be improved by using multiple examiners and cases. The goal is to develop valid, reliable and educational assessments of student performance that predict future clinical competence.
This document discusses assessment methods in medical education. It defines competence as the habitual use of skills like communication, knowledge, reasoning, and reflection to benefit patients. Competence is developmental, contextual, and content-specific. Assessment goals are to guide learning, protect the public, and select trainees. Common assessment methods include written exams, direct observation, simulation, and multisource feedback. Each method has strengths and limitations, so using multiple methods over time provides a better evaluation.
Objective Structured Clinical Examination (OSCE) assesses clinical skills through multiple stations evaluating tasks like history taking and physical examinations using standardized patients and scoring rubrics. Mini-Clinical Evaluation Exercise (Mini-CEX) directly observes clinical encounters and assesses competencies like medical interviewing and clinical judgment. Direct Observation of Procedural Skills (DOPS) evaluates technical and interpersonal skills during medical procedures. Formative workplace-based assessments like these provide better measures of clinical competence compared to summative exams.
- Standardized tests are formal assessments administered under standardized conditions to large groups of students. They provide norm-referenced scores allowing comparison between students. Teacher-made tests are informal classroom assessments created by teachers.
- Standardized tests have established reliability and validity ensured through rigorous test construction procedures. Teacher tests may vary in reliability and validity.
- Standardized test results provide information on student achievement compared to peers. Teacher tests provide information on mastery of specific classroom content.
This document discusses summative evaluation in nursing education. Summative evaluation determines if students have achieved course objectives and can occur during or at the end of instruction. It is used to evaluate student success and curriculum effectiveness. Current methods include written, practical, and oral exams, but have issues like subjectivity. Steps to improve include defining clear objectives and criteria, using authentic assessments, and involving students in the evaluation process. The goal of evaluation is to incentivize learning, provide feedback, and protect society.
This document discusses tools for assessing medical students' competencies in three domains: knowledge, attitude, and practice. It describes Miller's pyramid model of competency levels from "knows" to "knows how" to "shows" to "does". Written assessments like multiple choice questions evaluate cognitive knowledge, while objective structured clinical exams assess performance skills through simulations. A combination of tools is recommended to evaluate the three competencies, like using observations and feedback from multiple sources to assess professional attitudes. Workplace assessments in clinical settings can evaluate students' ability to apply their knowledge and skills in practice.
1. Assessment refers to the methods used by educators to evaluate students' academic readiness, learning progress, skills, and needs. It is an ongoing process involving collecting, analyzing, and interpreting data.
2. Bloom's taxonomy classifies cognitive objectives into different levels including knowledge, comprehension, application, analysis, synthesis, and evaluation.
3. Common assessment methods mentioned include written responses, product ratings, performance tests, oral questioning, observation, and self-reports. Objective tests are suitable for lower levels while performance tests involve demonstrating a skill.
This document discusses key issues in assessing clinical competence in medical education. It addresses the need for tests of clinical competence to serve both formative and summative purposes. It also explores various assessment methods and how they measure different levels of competence, from basic knowledge to direct observation of performance. Reliability and validity are important considerations when designing assessments. The document recommends using multiple assessment methods and cases to reliably measure clinical competence.
This document discusses key issues in assessing clinical competence in medical education. It addresses the need for tests of clinical competence to serve both formative and summative purposes. It also explores various assessment methods and how they measure different levels of competence, from basic knowledge to direct observation of performance. Specifically, it notes that direct observation through methods like objective structured clinical examinations is needed to properly assess clinical skills but that reliability can be improved by using multiple examiners and cases. The goal is to develop valid, reliable and educational assessments of student performance that predict future clinical competence.
This document discusses assessment methods in medical education. It defines competence as the habitual use of skills like communication, knowledge, reasoning, and reflection to benefit patients. Competence is developmental, contextual, and content-specific. Assessment goals are to guide learning, protect the public, and select trainees. Common assessment methods include written exams, direct observation, simulation, and multisource feedback. Each method has strengths and limitations, so using multiple methods over time provides a better evaluation.
Objective Structured Clinical Examination (OSCE) assesses clinical skills through multiple stations evaluating tasks like history taking and physical examinations using standardized patients and scoring rubrics. Mini-Clinical Evaluation Exercise (Mini-CEX) directly observes clinical encounters and assesses competencies like medical interviewing and clinical judgment. Direct Observation of Procedural Skills (DOPS) evaluates technical and interpersonal skills during medical procedures. Formative workplace-based assessments like these provide better measures of clinical competence compared to summative exams.
- Standardized tests are formal assessments administered under standardized conditions to large groups of students. They provide norm-referenced scores allowing comparison between students. Teacher-made tests are informal classroom assessments created by teachers.
- Standardized tests have established reliability and validity ensured through rigorous test construction procedures. Teacher tests may vary in reliability and validity.
- Standardized test results provide information on student achievement compared to peers. Teacher tests provide information on mastery of specific classroom content.
This document discusses summative evaluation in nursing education. Summative evaluation determines if students have achieved course objectives and can occur during or at the end of instruction. It is used to evaluate student success and curriculum effectiveness. Current methods include written, practical, and oral exams, but have issues like subjectivity. Steps to improve include defining clear objectives and criteria, using authentic assessments, and involving students in the evaluation process. The goal of evaluation is to incentivize learning, provide feedback, and protect society.
This document discusses tools for assessing medical students' competencies in three domains: knowledge, attitude, and practice. It describes Miller's pyramid model of competency levels from "knows" to "knows how" to "shows" to "does". Written assessments like multiple choice questions evaluate cognitive knowledge, while objective structured clinical exams assess performance skills through simulations. A combination of tools is recommended to evaluate the three competencies, like using observations and feedback from multiple sources to assess professional attitudes. Workplace assessments in clinical settings can evaluate students' ability to apply their knowledge and skills in practice.
1. Assessment refers to the methods used by educators to evaluate students' academic readiness, learning progress, skills, and needs. It is an ongoing process involving collecting, analyzing, and interpreting data.
2. Bloom's taxonomy classifies cognitive objectives into different levels including knowledge, comprehension, application, analysis, synthesis, and evaluation.
3. Common assessment methods mentioned include written responses, product ratings, performance tests, oral questioning, observation, and self-reports. Objective tests are suitable for lower levels while performance tests involve demonstrating a skill.
This document discusses reliability and validity, which are two important concepts for evaluating data collection methods in human services. Reliability refers to the consistency and dependability of measurements or assessments, and there are different types of reliability such as inter-rater reliability and test-retest reliability. Validity refers to whether a measurement or assessment accurately measures what it claims to measure. The document emphasizes that reliability and validity are crucial for human services to obtain accurate information through effective data collection methods when evaluating programs and services.
You will be asked or may volunteer to participate in developing standardized tests for nursing. Standardized tests are commonly used in nursing education but have faced scrutiny regarding their validity and appropriateness. Two common standardized tests used in nursing are the ATI and NCLEX exams.
This document summarizes assessment methods that have been developed in medical education since the 1950s. It discusses how assessments have shifted from primarily written and oral exams to also include performance-based assessments of clinical skills, communication skills, and professionalism. The document provides examples of different types of performance-based assessments that have been implemented, including standardized patient exams and computer-based simulations. It discusses factors to consider when selecting assessment methods, such as validity, reliability, educational effect, feasibility, and acceptability.
Introduction of Objective Structured Clinical Examination as assessment tool ...iosrjce
This document describes a study that introduced Objective Structured Clinical Examinations (OSCEs) as an assessment tool in formative examinations for the Dermatology, Venereology and Leprology department at a medical college in India. The study aimed to assess the feasibility and acceptability of OSCEs by students and faculty. Students and faculty were oriented to OSCEs and then 15 stations were used to assess students' clinical skills over 15 days. Feedback found that over 90% of students and faculty found OSCEs acceptable, feasible, improved clinical skills, and were better than conventional assessment methods. The study concluded that introducing OSCEs increased reliable assessment and student confidence in clinical skills.
Essential Skills: Critical Thinking For College Studentsnoblex1
The document discusses critical thinking instruction and assessment. It notes that while critical thinking skills can be taught, studies demonstrating their efficacy face practical challenges. It advocates teaching thinking as specific skills like evaluating assumptions and analyzing relationships. When skills are taught for transfer across domains with feedback, they do transfer. The document also discusses developing valid, meaningful and cost-effective ways to assess critical thinking skills. Large randomized controlled trials are needed but also present difficulties; alternative evidence like meta-analyses should also be considered. Strong causal evidence of thinking skills instruction improving performance does exist from some large trials.
Web2 Locating Evidence Brisbane W Onotes Aug28guestb146316
An intra-campus partnership at New York University developed an evidence-based health services management curriculum and credit course for nurse leaders. The course teaches students to frame answerable questions, search specialized databases, develop effective search strategies, and critically appraise literature. Students gain competence in locating, organizing, and communicating evidence to support decision making in healthcare organizations. Feedback indicated the course empowered nurse managers with lifelong skills to retrieve and apply research evidence.
The document discusses the process of clinical evaluation for nursing students. It begins by defining evaluation and listing its purposes, which include assessing student performance, reinforcing good performance, and identifying areas for improvement. The document then explains the principles, participants, and steps involved in clinical evaluation. It describes various evaluation methods like observational techniques, written and oral communication methods. Finally, it discusses specific tools used in clinical evaluation like checklists, rating scales, and problem-oriented records.
An Introduction to Contemporary Educational Testing and MeasurementIrene Rose Villote
1. Tests are tools that can be appropriately or inappropriately used depending on their technical adequacy and the purpose and population they are being used for.
2. Testing is different from assessment in that testing involves administering and scoring tests, while assessment is a comprehensive process that considers test results alongside other information.
3. In recent history, educational testing has increased in use for accountability purposes in response to concerns about education standards, but there are ongoing debates around high-stakes testing and ensuring tests are valid and reliable for different populations.
Don't tell me show me ! - Lambert, Foley, Moore and Hindsmdxaltc
This document discusses the use of Objective Structured Clinical Examinations (OSCEs) in education. OSCEs aim to objectively assess students' demonstration of clinical skills and application of professional knowledge through a series of simulated scenarios. The document outlines the key components of OSCEs, including that they assess interpersonal skills, empathy, clinical reasoning and safe practice. Both the advantages and disadvantages of OSCEs are presented, such as their ability to evaluate a wide range of skills but also their resource intensiveness. Recommendations for ensuring quality in OSCE implementation include involving service users, using standardized patients, and providing students with practice and feedback opportunities.
Newer Methods of Assessment in Medical EducationSwati Deshpande
The document discusses various methods for assessing clinical skills in medical education, including mini-clinical evaluation exercises (MiniCEX), direct observation of procedural skills (DOPS), multi-source feedback (MSF), logbooks, portfolios, simulations, record reviews, and patient surveys. It emphasizes that the assessment method should be tailored based on the domain and level being tested, available resources, and whether the goal is formative or summative. Objective methods are preferred over traditional methods to reduce bias. A variety of approaches can provide insights into different aspects of clinical competency.
This document provides a detailed overview of the systematic process for developing and validating questionnaires for survey research. It outlines 7 key steps: 1) Set clear aims; 2) Define attributes; 3) Write a plan; 4) Develop and write items; 5) Select items; 6) Assess reliability; and 7) Evaluate validity. The first 4 steps focus on designing the questionnaire, while the last 3 steps deal with validation. Validation involves content validation, cognitive interviews, pilot testing, and psychometric evaluation including factor analysis and reliability testing. Following these steps helps ensure a rigorous and valid questionnaire is developed.
The Value of Competency-based Medical Education Across the ContinuumMedCouncilCan
The document discusses competency-based medical education across the continuum of training. It begins by outlining the speaker's conflicts of interest in assessment-related organizations. The objectives are then stated as discussing the roles of assessment in a competency-based program, developing approaches to effective assessment, and integrating assessment into Memorial University's education system. Milestones and entrustable professional activities are presented as frameworks to assess competency development longitudinally. Challenges of assessment across training levels and principles of competency-based assessment are also addressed.
This document discusses various types of tests that can be used as data gathering tools in educational research. It describes parametric tests as standardized tests used for large populations, while non-parametric tests are designed for smaller, specific populations. The document also discusses commercially produced tests versus researcher produced tests, as well as different types of tests like aptitude tests, achievement tests, and psychological tests that measure traits like attitudes. Reliability and validity are important concepts for tests developed by researchers.
This document provides an overview of workplace-based assessment methods. It discusses several competency frameworks used in medical education and outlines typical assessment methods used, including direct observation methods like the Mini-CEX. It examines the reliability of various assessment methods and how reliability increases with larger sample sizes and aggregation of data. Factors that influence reliability, such as examiner effects and test length, are also reviewed. The document concludes by discussing portfolio-based assessment and highlights considerations for effective implementation.
This document discusses assessment in education. It defines assessment as gathering evidence of student learning to make judgements and improve instruction. Some key purposes of assessment mentioned are to identify student strengths and weaknesses, evaluate progress, drive instruction, and provide feedback. The document also discusses different types of assessments, including selected response, extended written response, performance assessments, and personal communication. It emphasizes that assessment should be ongoing and part of the instructional process to best support student learning.
Evaluation and measurement nursing educationparvathysree
This document discusses evaluation and measurement in nursing education. It defines evaluation as determining the extent to which educational objectives are being realized, and measurement as assigning a numerical index to a characteristic. The purposes of evaluation are described, including diagnosis, prediction, grading, selection, guidance and determining program/teacher effectiveness. Principles of evaluation include clarifying what is evaluated and using appropriate techniques. Measurement functions include prognosis, diagnosis and research. Validity and reliability are important criteria for evaluative devices. The differences between measurement and evaluation are that measurement describes attainment quantitatively while evaluation makes qualitative value judgements.
This document discusses different types of student assessment. It describes pre-assessment, formative assessment, and summative assessment. Pre-assessment evaluates student knowledge and skills before instruction begins. Formative assessment occurs throughout instruction to provide feedback and guide improvement. Summative assessment evaluates learning at the end of an instructional period through tests and assignments. The document also covers qualitative vs. quantitative assessment, reliability, validity, norm-referenced evaluation, criterion-referenced evaluation, and various forms of performance-based assessment such as projects, research papers, presentations, debates, and play-based activities.
Problem Based Learning In Comparison To Traditional Teaching As Perceived By ...iosrjce
Objectives: To compare lecture based learning (LBL) with problem based learning (PBL).
Methods: A cross sectional prospective study was carried out among 145 3rd year MBBS students in
Jawaharlal Nehru Medical College(JNMC), Aligarh. The study was performedfor a period of 60 days. Data was
collected by means of structured questionnaire.
Results: 65 (44.8%) students were girls while 80 (55.2%) were boys. 89 (61.4%) students liked only PBL
followed by both LBL and PBL by 104(71.7%) students. 59(40.7 %) students claimed that PBL has led to better
understanding of subject while 71(48.9%) respondents favored both LBL and PBL. 98(67.6%) respondents
admitted that PBL has led to more clarification of their concepts while 105(72.4%) students appreciated both.
Coverage of sufficient syllabus through PBL and both was claimed by 91(62.8%) and 105(72.4%) students
respectively. Majority 94(64.8%) was satisfied with training of the teacher for traditional teaching while
106(73.1%) were satisfied with training of facilitator for PBL. 69(47.5%) students were satisfied with
availability of resources for PBL while 71(48.9%) were for both methods combined together. 91(62.8%)
respondents preferred present scenario (LBL parallel with PBL)in JNMC.
Conclusion: LBL must be in symbiosis with PBL for better analytical approach and clarification of concepts.
There is need to improve the information resources for PBL and enhancement of practical knowledge of
students.
The document outlines 5 steps for requesting and receiving writing assistance from HelpWriting.net, including creating an account, submitting a request form, reviewing bids from writers, authorizing payment after receiving a satisfactory paper, and having the option to request revisions. The process aims to match clients with qualified writers and ensure high quality original content through revisions and refunds for plagiarized work.
How To Write Your Essays In Less Minutes Using This Website Doy NewsNathan Mathis
This document summarizes steps for writing essays quickly using the website HelpWriting.net:
1. Create an account with a password and email.
2. Complete a 10-minute order form providing instructions, sources, and deadline. Attach sample work to imitate writing style.
3. The website uses a bidding system. Choose a writer based on qualifications, history, and feedback, then pay a deposit to start.
4. Check the paper and authorize full payment if pleased, or request revisions for free using the site's revision policy.
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This document discusses reliability and validity, which are two important concepts for evaluating data collection methods in human services. Reliability refers to the consistency and dependability of measurements or assessments, and there are different types of reliability such as inter-rater reliability and test-retest reliability. Validity refers to whether a measurement or assessment accurately measures what it claims to measure. The document emphasizes that reliability and validity are crucial for human services to obtain accurate information through effective data collection methods when evaluating programs and services.
You will be asked or may volunteer to participate in developing standardized tests for nursing. Standardized tests are commonly used in nursing education but have faced scrutiny regarding their validity and appropriateness. Two common standardized tests used in nursing are the ATI and NCLEX exams.
This document summarizes assessment methods that have been developed in medical education since the 1950s. It discusses how assessments have shifted from primarily written and oral exams to also include performance-based assessments of clinical skills, communication skills, and professionalism. The document provides examples of different types of performance-based assessments that have been implemented, including standardized patient exams and computer-based simulations. It discusses factors to consider when selecting assessment methods, such as validity, reliability, educational effect, feasibility, and acceptability.
Introduction of Objective Structured Clinical Examination as assessment tool ...iosrjce
This document describes a study that introduced Objective Structured Clinical Examinations (OSCEs) as an assessment tool in formative examinations for the Dermatology, Venereology and Leprology department at a medical college in India. The study aimed to assess the feasibility and acceptability of OSCEs by students and faculty. Students and faculty were oriented to OSCEs and then 15 stations were used to assess students' clinical skills over 15 days. Feedback found that over 90% of students and faculty found OSCEs acceptable, feasible, improved clinical skills, and were better than conventional assessment methods. The study concluded that introducing OSCEs increased reliable assessment and student confidence in clinical skills.
Essential Skills: Critical Thinking For College Studentsnoblex1
The document discusses critical thinking instruction and assessment. It notes that while critical thinking skills can be taught, studies demonstrating their efficacy face practical challenges. It advocates teaching thinking as specific skills like evaluating assumptions and analyzing relationships. When skills are taught for transfer across domains with feedback, they do transfer. The document also discusses developing valid, meaningful and cost-effective ways to assess critical thinking skills. Large randomized controlled trials are needed but also present difficulties; alternative evidence like meta-analyses should also be considered. Strong causal evidence of thinking skills instruction improving performance does exist from some large trials.
Web2 Locating Evidence Brisbane W Onotes Aug28guestb146316
An intra-campus partnership at New York University developed an evidence-based health services management curriculum and credit course for nurse leaders. The course teaches students to frame answerable questions, search specialized databases, develop effective search strategies, and critically appraise literature. Students gain competence in locating, organizing, and communicating evidence to support decision making in healthcare organizations. Feedback indicated the course empowered nurse managers with lifelong skills to retrieve and apply research evidence.
The document discusses the process of clinical evaluation for nursing students. It begins by defining evaluation and listing its purposes, which include assessing student performance, reinforcing good performance, and identifying areas for improvement. The document then explains the principles, participants, and steps involved in clinical evaluation. It describes various evaluation methods like observational techniques, written and oral communication methods. Finally, it discusses specific tools used in clinical evaluation like checklists, rating scales, and problem-oriented records.
An Introduction to Contemporary Educational Testing and MeasurementIrene Rose Villote
1. Tests are tools that can be appropriately or inappropriately used depending on their technical adequacy and the purpose and population they are being used for.
2. Testing is different from assessment in that testing involves administering and scoring tests, while assessment is a comprehensive process that considers test results alongside other information.
3. In recent history, educational testing has increased in use for accountability purposes in response to concerns about education standards, but there are ongoing debates around high-stakes testing and ensuring tests are valid and reliable for different populations.
Don't tell me show me ! - Lambert, Foley, Moore and Hindsmdxaltc
This document discusses the use of Objective Structured Clinical Examinations (OSCEs) in education. OSCEs aim to objectively assess students' demonstration of clinical skills and application of professional knowledge through a series of simulated scenarios. The document outlines the key components of OSCEs, including that they assess interpersonal skills, empathy, clinical reasoning and safe practice. Both the advantages and disadvantages of OSCEs are presented, such as their ability to evaluate a wide range of skills but also their resource intensiveness. Recommendations for ensuring quality in OSCE implementation include involving service users, using standardized patients, and providing students with practice and feedback opportunities.
Newer Methods of Assessment in Medical EducationSwati Deshpande
The document discusses various methods for assessing clinical skills in medical education, including mini-clinical evaluation exercises (MiniCEX), direct observation of procedural skills (DOPS), multi-source feedback (MSF), logbooks, portfolios, simulations, record reviews, and patient surveys. It emphasizes that the assessment method should be tailored based on the domain and level being tested, available resources, and whether the goal is formative or summative. Objective methods are preferred over traditional methods to reduce bias. A variety of approaches can provide insights into different aspects of clinical competency.
This document provides a detailed overview of the systematic process for developing and validating questionnaires for survey research. It outlines 7 key steps: 1) Set clear aims; 2) Define attributes; 3) Write a plan; 4) Develop and write items; 5) Select items; 6) Assess reliability; and 7) Evaluate validity. The first 4 steps focus on designing the questionnaire, while the last 3 steps deal with validation. Validation involves content validation, cognitive interviews, pilot testing, and psychometric evaluation including factor analysis and reliability testing. Following these steps helps ensure a rigorous and valid questionnaire is developed.
The Value of Competency-based Medical Education Across the ContinuumMedCouncilCan
The document discusses competency-based medical education across the continuum of training. It begins by outlining the speaker's conflicts of interest in assessment-related organizations. The objectives are then stated as discussing the roles of assessment in a competency-based program, developing approaches to effective assessment, and integrating assessment into Memorial University's education system. Milestones and entrustable professional activities are presented as frameworks to assess competency development longitudinally. Challenges of assessment across training levels and principles of competency-based assessment are also addressed.
This document discusses various types of tests that can be used as data gathering tools in educational research. It describes parametric tests as standardized tests used for large populations, while non-parametric tests are designed for smaller, specific populations. The document also discusses commercially produced tests versus researcher produced tests, as well as different types of tests like aptitude tests, achievement tests, and psychological tests that measure traits like attitudes. Reliability and validity are important concepts for tests developed by researchers.
This document provides an overview of workplace-based assessment methods. It discusses several competency frameworks used in medical education and outlines typical assessment methods used, including direct observation methods like the Mini-CEX. It examines the reliability of various assessment methods and how reliability increases with larger sample sizes and aggregation of data. Factors that influence reliability, such as examiner effects and test length, are also reviewed. The document concludes by discussing portfolio-based assessment and highlights considerations for effective implementation.
This document discusses assessment in education. It defines assessment as gathering evidence of student learning to make judgements and improve instruction. Some key purposes of assessment mentioned are to identify student strengths and weaknesses, evaluate progress, drive instruction, and provide feedback. The document also discusses different types of assessments, including selected response, extended written response, performance assessments, and personal communication. It emphasizes that assessment should be ongoing and part of the instructional process to best support student learning.
Evaluation and measurement nursing educationparvathysree
This document discusses evaluation and measurement in nursing education. It defines evaluation as determining the extent to which educational objectives are being realized, and measurement as assigning a numerical index to a characteristic. The purposes of evaluation are described, including diagnosis, prediction, grading, selection, guidance and determining program/teacher effectiveness. Principles of evaluation include clarifying what is evaluated and using appropriate techniques. Measurement functions include prognosis, diagnosis and research. Validity and reliability are important criteria for evaluative devices. The differences between measurement and evaluation are that measurement describes attainment quantitatively while evaluation makes qualitative value judgements.
This document discusses different types of student assessment. It describes pre-assessment, formative assessment, and summative assessment. Pre-assessment evaluates student knowledge and skills before instruction begins. Formative assessment occurs throughout instruction to provide feedback and guide improvement. Summative assessment evaluates learning at the end of an instructional period through tests and assignments. The document also covers qualitative vs. quantitative assessment, reliability, validity, norm-referenced evaluation, criterion-referenced evaluation, and various forms of performance-based assessment such as projects, research papers, presentations, debates, and play-based activities.
Problem Based Learning In Comparison To Traditional Teaching As Perceived By ...iosrjce
Objectives: To compare lecture based learning (LBL) with problem based learning (PBL).
Methods: A cross sectional prospective study was carried out among 145 3rd year MBBS students in
Jawaharlal Nehru Medical College(JNMC), Aligarh. The study was performedfor a period of 60 days. Data was
collected by means of structured questionnaire.
Results: 65 (44.8%) students were girls while 80 (55.2%) were boys. 89 (61.4%) students liked only PBL
followed by both LBL and PBL by 104(71.7%) students. 59(40.7 %) students claimed that PBL has led to better
understanding of subject while 71(48.9%) respondents favored both LBL and PBL. 98(67.6%) respondents
admitted that PBL has led to more clarification of their concepts while 105(72.4%) students appreciated both.
Coverage of sufficient syllabus through PBL and both was claimed by 91(62.8%) and 105(72.4%) students
respectively. Majority 94(64.8%) was satisfied with training of the teacher for traditional teaching while
106(73.1%) were satisfied with training of facilitator for PBL. 69(47.5%) students were satisfied with
availability of resources for PBL while 71(48.9%) were for both methods combined together. 91(62.8%)
respondents preferred present scenario (LBL parallel with PBL)in JNMC.
Conclusion: LBL must be in symbiosis with PBL for better analytical approach and clarification of concepts.
There is need to improve the information resources for PBL and enhancement of practical knowledge of
students.
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1. 3
Editorial
Assessment Methods in Medical Education
Medical education, the art and science behind medical learning and teaching, has
progressed remarkably. Teaching and learning have become more scientific and rigorous,
curricula are based on sound pedagogical principles, and Problem Based and other forms
of active and self directed learning have become the mainstream. Teachers have
progressed from the role of problem-identifier to that of the solution-provider.
During the last three decades medical schools have been faced with a variety of
challenges from society, patients, doctors and students. They have responded in several
ways including the development of new curricula, the introduction of new learning
situations, the introduction of the new methods of assessment and a realization of the
importance of staff development. Many effective and interesting innovations have been
forthcoming.
The effective and efficient delivery of healthcare requires not only knowledge and
technical skills but also analytical and communication skills, interdisciplinary care,
counseling, evidence- and system-based care. This warrants our assessment systems to
be comprehensive, sound and robust enough to assess the requisite attributes along with
testing for essential knowledge and skills.
Assessment is entering every phase of professional development. Assessment and
evaluation are crucial steps in educational process. Before making a choice of assessment
method, some important questions must be asked: what should be assessed?, why assess?
For an assessment instrument one must also ask: is it valid? Is it reliable?, is it feasible?
What is assessed and which methods are used will play a significant part in what is learnt.
A wide range of assessment methods currently available include essay questions, patient
management problems, modified essay questions (MEQs) checklists, OSCE, student
projects, Constructed Response Questions (CRQs), MCQs, Critical reading papers, rating
scales, extended matching items, tutor reports, portfolios, short case assessment and long
case assessment, log book, trainer’s report, audit, simulated patient surgeries, video
assessment, simulators, self assessment, peer assessment and standardized patients.
Assessment has a powerful positive steering effect on learning and the curriculum. It
conveys what we value as important and acts as the most cogent motivator of student
learning. Assessment is purpose driven. In planning and designing assessments, it is
essential to recognize the stakes involved in it. The higher the stake, the greater the
implications of the outcome of the assessment. The more sophisticated the assessment
strategies, the more appropriate they become for feedback and learning.
Measuring progress in acquiring core knowledge and competencies may be a problem if
the exams are designed to measure multiple integrated abilities, such as factual
knowledge, problem solving, analysis and synthesis of information. Students may
advance in one ability and not in another. Therefore, progress tests that are designed to
measure growth from the onset of learning until graduation should measure discrete
abilities.
2. 4
Mastery testing (criterion-reflected tests) requires that 100% of the items are measured
correctly to determine whether students have attained a mastery level of achievements. In
non-mastery testing attainment of 65% of a tested material is considered sufficient.
Global rating scales are measurement tool for quantifying behaviors. Raters use the scale
either by directly observing students or by recalling student performance. Raters judge a
global domain of ability for example: clinical skills, problem solving, etc
Self assessment (self regulation) is a vital aspect of the lifelong performance of
physicians. Self monitoring requires that individuals are able not only to work
independently but also to assess their own performance and progress.
Every form of assessment can be used as a self assessment exercise as long as students
are provided with ‘gold standard’ criteria for comparing their own performance against
an external reliable measure. Self assessment approaches include: written exams (MCQs,
True/False, Essay, MEQs, modified CRQs), performance exams (checklists, global
rating, student logbook, portfolio, video, etc).
Oral examination/Viva has poor content validity, higher inter-rater variability and
inconsistency in marking. The instrument is prone to biases and is inherently unreliable.
Long Essay Questions can be used for assessment of complex learning situations that can
not be assessed by other means (writing skills, ability to present arguments succinctly).
The Short Answer Question (SAQ) is an open ended, semi-structured question format. A
structured predetermined marking scheme improves objectivity. The questions can
incorporate clinical scenarios. A similar format is also known as Modified Essay
Question (MEQ) or Constructed Response Question (CRQ). Equal or higher test
reliabilities can be achieved with fewer SEQs as compared to true/false items. If a large
amount of knowledge is required to be tested, MCQs should be used. SAQs have a better
content coverage as compared to long essay question.
Extended Matching Item is based on a single theme and has a long option list to avoid
cueing. It can be used for the assessment of clinical scenarios with less cueing. It is a
practical alternative to MCQ while maintaining objectivity and consistency. It can be
used in both basic and clinical sciences.
Key Feature Test is a clinical scenario-based paper and pencil test. A description of the
problem is followed by a limited number of questions that focus on critical, challenging
actions or decisions. It has higher content validity with proper blueprinting.
Long Case involves use of a non-standardised real patient. Long case may provide a
unique opportunity to test the physician’s tasks and interaction with a real patient. It has
poor content validity, is less reliable and lacks consistency. Reproducibility of the score is
0.39; meaning 39% of the variability of the score is due to actual performance of students
(signal) and the remaining 61% of the variability is due to errors in measurement (noise)
(Noricine,2002). In high stake summative assessment long case should be avoided.
Short Case involves use of three to four non-standardised real patients with one to two
examiners. It provides opportunity for assessment with real patients and allows greater
sampling than single long cse.
Objective Structured Clinical examination (OSCE) consists of multiple stations where
each candidate is asked to perform a defined task such as taking a focused history or
performing a focused clinical examination of a particular system. A standardized marking
scheme specific for each case is used. It is an effective alternative to unstructured short
cases.
3. 5
Mini-Clinical Evaluation Exercise (Mini-CEX) is a rating scale developed by American
Board of Internal Medicine to assess six core competencies of residents: medical
interviewing skills, physical examination skills, humanistic qualities/professionalism,
clinical judgment, counseling skills, organization and efficiency.
Direct Observation of Procedural Skills (DOPS) is a structured rating scale for assessing
and providing feedback on practical procedures. The competencies that are commonly
assessed include general knowledge about the procedure, informed consent, pre-
procedure preparation, analgesia, technical ability, aseptic technique, post-proicdure
management, and counseling and communication.
Clinical Work Sampling is an in-trainee evaluation method that addresses the issue of
system and rater biases by collecting data on observed behaviour at the same time of
actual performance and by using multiple observers and occasions.
Checklists are used to capture an observed behaviour or action oof a student. Generally
rating is by a five to seven point
360-Degree Evaluation/Multisource Assessment consists of measurement tools
completed by multiple individuals in a person’s sphere of influence. Assessment by
peers, other members of the clinical team, and patients can provide insight into trainees’
work habits, capacity for team work, and interpersonal sensitivity
In the Logbook students keep a record of the patients seen or procedures performed either
in a book or in a computer. It documents the range of patient care and learning experience
of students. Logbook is very useful in focusing students on important objectives that must
be fulfilled within a specified period of time (Blake, 2001).
Portfolio refers to a collection of one’s professional and personal goals, achievements,
and methods of achieving these goals. Portfolios demonstrate a trainees’ development
and technical capacity.
Skill based assessments are designed to measure the knowledge, skills, and judgment
required for competency in a given domain.
Test of clinical competence, which allows decisions to be made about medical
qualification and fitness to practice, must be designed with respect to key issues including
blueprinting, validity, reliability, and standard setting, as well as clarity about their
formative or summative function. MCQs, essays, and oral examinations could be used to
test factual recall and applied knowledge, but more sophisticated methods are needed to
assess clinical performance, including directly observed long and short cases, objective
structure clinical examinations, and the use of standardized patients.
The Objective Structure Clinical examination (OSCE) has been widely adopted as a tool
to assess students, or doctor’s competences in a range of subjects. It measures outcomes
and allows very specific feedback.
Other approaches to skill-based assessment include: traditional (Oral exam/viva, long
case); alternative formats (tackle the problems associated with traditional orals and long
cases by having examiners observe the candidates complete interaction with the patient,
training examiners to a structured assessment process, increasing the number of patient
problems. Traditional unstructured orals and long cases have largely been discontinued in
North America.
While selecting an assessment instrument it is necessary to know precisely what it is that
is to be measured. This should reflect course outcomes as different learning outcomes
4. 6
require the use of different instruments. It is essential to use an instrument that is valid,
reliable and feasible (calculating the cost of the assessment, both in terms of resources
and time). Full variety of instruments will ensure that the results obtained are a true
reflection of the students’ performance.
Multiple sampling strategies as the accepted methods used in assessment in clinical
competency include OSCE, Short Answer Questions, mini-CEX (Mini Clinical
Evaluation Exerciser), Directly Observed Procedural Skills (DOPS), Clinical work
sampling (CWS), and 360-degree evaluation.
The assessment is an integral component of overall educational activities. Assessment
should be designed prospectively along with learning outcomes. It should be purpose
driven. Assessment methods must provide valid and usable data. Methods must yield
reliable and generalisable data.
Multiple assessment methods are necessary to capture all or most aspects of clinical
competency and any single method is not sufficient to do the job. For knowledge,
concepts, application of knowledge (‘Knows’ and ‘Knows How’ of Miller’s conceptual
pyramid for clinical competence) context-based MCQ, extended matching item and short
answer questions are appropriate. For ‘Shows How” multi-station OSCE is feasible. For
performance-based assessment (‘does’) mini-CEX, DOPS is appropriate. Alternatively
clinical work sampling and portfolio or log book may be used.
Standard setting involves judgment, reaching consensus, and expressing that consensus
as a single score on a test. Norm Referenced Scores are suitable for admission exercise
that requires selection of a predetermined number of candidates. Criterion Referenced
Standard (based on predefined test goals and standards in performance during an
examination where a certain level of knowledge or skill has been determined as required
for passing) is feasible for competency-based examination. Various approaches available
include test-centred approach (Agnoff’s method and its variations), examinee-centred
approach (borderline group method), and several other innovations. Blueprinting refers to
a process emphasizing that test content should be carefully planned against learning
objectives.
The purpose of assessment should direct the choice of instruments. Needs assessment is
the starting point of good assessment that identifies the current status of the students
before the commencement of the actual educational activities. Needs assessment is used
to determine the existing knowledge base, future needs, and priority areas that should be
addressed.
Student assessment is a comprehensive decision making process with many important
implications beyond the measure of students’ success. Student assessment is also related
to program evaluation. It provides important data to determine the program effectiveness,
improves the teaching program, and helps in developing educational concepts.
Good quality assessment not only satisfies the needs of accreditation but also contributes
to student’s learning. Assessment methods should match the competencies being learnt
and the teaching formats being used.
Competence is a habit of lifelong learning, is contextual (e.g. practice setting, the local
prevalence of disease, etc) and developmental (habits of mind and behaviour and
practical wisdom are gained through deliberate practice.
Further Reading
5. 7
ACGME Outcome Project. Accreditaton Council for Graduate Medical Education &
American Board of Medical Specialist. Toolbox for assessment methods, version 1.1.
www.acgme.org/outcomes/assess/toolbox.pdf
Case S M & swanson D B. Constructing Written Test for the Basic & Clinical Sciences,
3rd
. ed. (National Board of Medical Examiners) Philadelphia, PA, USA). 2002.
www.nbme.org/about/itemwriting.asp.
Day S C, Norcini J J, Diserens D, et al. The validity of the essay test of clinical
judgement. Acad Med. 1990;65(9):S39-40.
Epstein RM, and Hundert EM. Defining and assessing clinical competence, JAMA
2002;387:226-35.
Friedman Ben_David M. Standard setting in student assessment, AMEE education Guide
No: 18 (Association for Medical education in Europe, Dundee, UK), 2000.
Miller GE. The assessment of clinical skills/competencies/performance. Acad Med.
1990;65(9):S63-67.
Norcini JJ, Swanson DB, Grosso LJ, Webster GD. Reliability, validity and efficiency of
multiple choice questions and patient management problem item formats in assessment of
clinical competence. Med Edu. 1985;19(3):238-47.
Norman G. Postgraduate assessment – reliability and validity. Trans J. Coll. Med. S. Afri.
2003;47:71-75.
Page G & Bordage G. & Allen T. Developing key feature problem and examination to
assess clinical decision making skills. Acad Med. 1995;70(3): 194-201.
Swanson DB. A measurement framework for performance based test. In: Hart IR, Harden
RM (eds.), Further Development in assessing Clinical Competence. Montreal Can-Heal.
1987.
Wass, Cees Van der Vleuten, John Shatzer, Roger Jones. Assessment of clinical
competence. The Lancet 2001;357:945-49.
Vleuten va der CPM. Validity of final examination in undergraduate medical traning.
BMJ 2000;321:1217-19.
Falchikov N, Boud D. Student Self-assement in higher education: a meta-analysis.
Review of Education Research 1989; S9:345-430.
Van der Vleuten CPM, Swanson DB. Assessment of clinical skills with standardized
patients: state-of-the-art teaching and learning in medicine. 1990;22:58-76.
Syed Amin Tabish
FRC, FRCPE, FACP, FAMS, MD
Editor-in-Chief