This document discusses internal and formative assessment in medical education. It defines internal assessment as assessment done by teachers who have taught a subject, and notes its benefits include overcoming day-to-day variability and allowing for larger sampling of topics. Formative assessment is defined as assessment for learning that provides ongoing feedback to both teachers and students. The key elements of effective formative assessment are identifying learning goals, involving students in self-assessment, and providing timely feedback. The document provides examples of how to incorporate more formative assessment into an existing system focused on summative assessment and internal exams.

1. Internal Assessment
and
Formative Assessment
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES
Dr Munmun Das(Sarkar)
Professor, Microbiology
CNMC&H

2. Learning Objectives
1. What are the different types of
assessments?
2. How to formulate a plan for internal
and formative assessment?
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES

3. Why do we assess ?
• To help the teachers decide if the students have acquired the
desired competencies,
• To help the students acquire and improve their competencies.
• We need to assess the medical students because we are to
certify them to deal with human life.
• Quality assurance requires quality assessment.

4. Types of Assessment, we are used to…..
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES
University
Prof Exam
Semester
Exam
Part Completion
Exam
Item
clearance
Ward
Completion

5. Types
•Summative Assessment
•Formative Assessment
•Internal Assessment(IA)
•Continuous Internal Assessment (CIA)
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES

6. Summative Assessment
•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.
•Summative assessment methods are the
most traditional way of evaluating
student work.
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES

7. Formative Assessment
•Assessment for Learning
•Monitor students’ learning and provides
ongoing feedback
•Feedback applicable to the
Teacher/Student as well as the teaching-
learning process
•No pass/fail system
•No marking/gradation- IDEAL
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES

8. LESS SALT !!!
FORMATIVE
ASSESSMENT
SUMMATIVE
ASSESSMENT
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES

9. • Formative and summative assessment are interconnected.
They seldom stand alone in construction or effect.
• The vast majority of genuine formative assessment is
informal, with interactive and timely feedback and
response.
• Formative assessment has the greatest impact on learning
and achievement.
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES

10. Effective Formative Assessment
•Students should be able to answer three
basic questions:
•Where am I going?
•Where am I now?
•How can I close the gap?
• Sadler (1989)
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES

11. Where am I going?
•Strategy 1: Provide a clear and
understandable learning target.
•Strategy 2: Use examples of strong and
weak work.
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES
“Students that can identify what they are learning
significantly outscore those who cannot.” Marzano, 2005

12. Where am I now?
•Strategy 1: Offer regular descriptive
feedback.
•Strategy 2: Also teach students to
self-assess and set goals.
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES

13. How do I close the gap?
•Strategy 1: Design lessons to focus on one
aspect of quality at a time.
•Strategy 2: Engage students in self-
reflection and let them document and share
their learning.
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES

14. Identify the
learning
goals
Criteria to
achieve
these
Rich
conversations
between
teachers &
students
Should include
their intentions &
outcomes
Provide effective, &
timely feedback to
students
Active involvement
of students in their
own learning
Teachers modifying
their teaching
approach(es)
Key Elements of Formative Assessment
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES
DECIDE/
SET
PROMOTE

15. Formative Assessment Summative Assessment

16. What FA is
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES
 It is a PLANNED process.
 It is used by both teachers & students
 Takes place DURING instruction.
 It provides assessment-based feedback
to both teachers & students.
 It helps teachers & students make
adjustments that will improve student
achievement.
v

17. What FA is NOT
 It is not a graded test.
 It is not a part of the grading system.
 It is not just probing and charting.
 It is not random observations.
 It is not just good instruction.
Feedback = the promise of FA

18. Assessment in our System
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES
What actually happened
Professional Exams,
are the Ending Exam
for a Subject.
Marking is there.
No scope of feedback
Summative
Assessment

19. Assessment in our System
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES
What actually happened
50% of IA marks
comes from Semester
Exams/(IA Exam).
50% of IA marks
comes from CIA.
Was added in the
final marksheet as
part of university
result under IA

20. RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES
What happens after GMER 2019
Internal Assessments to be used for appearing in the
University Exam.
Marks will not be added in the final marks
[IA marks will reflect as a separate head of passing at the University exam.]
***
35% - appearance
50% - result publication
Less than 50% - remedial measures
[In subjects that have two papers - at least 40% marks in each paper with
minimum 50% of marks in aggregate to pass]

21. RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES
What happens after GMER 2019
The performance in the final university
exam is the only summative exam
IA CAN be used as Formative Assessment,
with constructive FEEDBACK

22. Internal Assessment
• Assessment is done by the teachers who have taught the subject.
(-all faculty members including Residents can be involved)
• Overcomes the limitations of day-to-day variability and allows larger
sampling of topics, competencies and skills.
• Can provide useful avenues for both formative and summative
assessment.
• Focuses on the content and process of learning i.e. what and how
students have learnt throughout the course.

23. Internal Assessment
• Priority can be given to psychomotor, communication and
affective domains.[usually not assessed by traditional
assessment methods]
• Can be a very useful tool for assessing the competencies in any
competency based curriculum.
• Multiple tools can be used for a given competency - helps to
improve validity and reliability of the assessment.

24. Phase – 1
• Human Anatomy - 3, Physiology - 3, Biochemistry - 3,
• Community Medicine – 1
One of the 3 tests in preclinical subjects should be
pre-university examination

25. Phase – 2
• Pathology 3, Pharmacology 3, Microbiology 3,
One of the 3 tests in para-clinical subjects should be
pre-university examination
General Medicine & allied
General Surgery & allied
Obstetrics& Gynaecology,
Forensic Medicine & Toxicology
Community Medicine
2 IA
+ End of posting (EOP)
examination at each clinical
posting including allied

26. Phase – 3
• Forensic Medicine &Toxicology -2, Community Medicine -2,
• Ophthalmology- 2, Otorhinolaryngology -2
One of the 2 tests should be pre-university examination
General Medicine & allied
General Surgery & allied
Pediatrics
Obstetrics &Gynaecology
2 IA
+ End of posting (EOP)
examination at each clinical
posting including allied.

27. Phase – 4
• General Medicine - 2, General Surgery - 2, Pediatrics - 2,
Obstetrics & Gynaecology - 2
One of the 2 tests should be pre-university examination
General Medicine & allied
General Surgery & allied
Pediatrics,
Obstetrics &Gynaecology
+
End of posting (EOP) examination at
each clinical posting including allied.

28. Feedback in IA
• Structured Feedback - throughout the course - remedial action in time.
• Sensitization of faculties and students regarding feedback.
• The results of IA - be displayed on notice board within two weeks of the
test.
• Create opportunity for the students to discuss the results and get
feedback (faculty & peer)  better performance.
• Students should sign with date whenever they are shown IA records in
token of having seen and discussed the marks (Recommended).
• Universities should guide Colleges regarding formulating remedial
measures for students - not scored qualifying marks/ missed IA.

29. Continuous Internal Assessment
• Takes place DURING instruction.
• No marks, no grades.
• Structured Feedback.
• Regular, may be unplanned, unstructured.
• Carried on at any day, any time, any where.
• To assess those abilities, which cannot be evaluated
in term-end exam /(IA).
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES
Part of FORMATIVE ASSESSMENT
CIA should be on the process of learning rather than on the product. (MCI)

30. CIA
•Continuous assessment can take place within
various types of contact moments:-
• Practical.
• Workshops.
• Lectures.
• Placements.
• Projects.
• Cases.
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES

31. In addition -
• Continuous assessment can take various forms,
depending on the final objectives and competencies.
like -
• Regular observation and assessment of different skills or
attitudes (eg: Communication skills, team’s
collaboration skills, verbal language skills)
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES

32. CIA
Continuous assessment often goes hand in hand with
information about (+ descriptive structured feedback on):
• the assessment criteria.
• how the student performed.
• what went smoothly.
• what went less smoothly.
• things the student still has to work on.
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES

33. Why continuous internal assessment ?
• Performing a competency like “Chest compression in CPR” well
does not mean that the student can perform “mouth to mouth
respiration in CPR” as well.
• Assessment in demonstration room may not be the same as
assessment at bedside.
• Communication, team work, ethics, professionalism & many
procedural skills can not be assessed at summative exam..
• Competencies can be assessed multiple times and in different
contexts.

34. How will you incorporate Formative part in
your existing assessment system ?
RBC WORKSHOP ON MEDICAL EDUCATION
TECHNOLOGIES

35. Types of Assessment, we are used to…
RBC WORKSHOP ON MEDICAL EDUCATION TECHNOLOGIES
University
Prof Exam
Internal
Assessment
Exam
Part Completion
Exam
Ward
Completion
SUMMATIVE
CONTINUOUS INTERNAL ASSESSMENT
Item
clearance
FORMATIVE

36. Designing a system of assessment
• All domains of learning should be taken into account &
weightage to be given to all three domains for assessment.
• Miller’s pyramid provides a simple way to select appropriate
tool for assessment.
• Efforts should be made to climb higher in the pyramid.
• Some aspects from competencies of other phases/ other
subjects can be included – help to assess integration of
concepts.

37. Group Activity –
Plan formative & internal assessment (on the given competency)
• Answer the following questions:-
1. Whom to assess?
2. Identify learning domains to be addressed during assessment.
3. Which level of Miller’s pyramid to be assessed?
4. How to assess (Which tools to be used)?
6. When to provide feedback?
7. Specific subject/learning areas to be addressed during feedback.

38. Thank You