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.

1. SUMMATIVE
EVALUATION
Prof. K.T. Moly
Principal
Amrita College of Nursing

2. CONTENTS
 Introduction
 Significance
 Definition
 Existing Pattern
 Steps for improvement
 Criticisms
 Conclusion

3. INTRODUCTION
 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
learning needs.

4. SIGNIFICANCE
“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
personnel evaluation.”
Scriven (1991)

5. SIGNIFICANCE (Cont…..)
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
practice and
 For teachers concerned with potential charges of
unfair evaluation practices and the legal
repercussions of decisions where students are
wrongly failed (or passed)

6. DEFINITION
Summative evaluation
 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
work.

7. Summative Evaluation
Purposes.
 To evaluate learner success in retaining
content knowledge through types of
assessment such as traditional paper and
pencil tests.
 A tool used to evaluate the curriculum and
training process.

8. Formative Assessment
 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

9. 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.
 "Good summative assessments must be
demonstrably reliable, valid, and free of
bias" (Angelo and Cross, 1993).

10. Formative Summative
‘… 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 …’
(Harlen, 1998)
‘ … includes both feedback and
self-monitoring.’ (Sadler, 1989)
‘… is used essentially to feed
back into the teaching and
learning process.’ (Tunstall and
Gipps, 1996)
‘…assessment (that) has
increasingly been used to sum
up learning…’(Black and Wiliam,
1999)
‘… 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)

11. 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
plants.
Formative assessment is the equivalent of feeding
and watering the plants appropriate to their needs -
directly affecting their growth.

12. Existing Pattern in Nursing
 Written Examination
 Practical Examination
 Oral Examination

13. Written Examination
 Educational objectives centered?
 Content coverage?
 Types of questions?
 Time (duration) ?

14. 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
1977)
 These words are equally relevant today and
perhaps more so as educators struggle with
issues of clinical evaluation.

15. 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
clinical competency.
 Combining multiple methods adds breadth and
depth to an investigation.
 Performance check list
 Written exams, etc.

16. Practical Examination - Issues
 Patients
 Number of students per day
 Examiners (Internal / External)
 Environmental factors
 Subjectivity and inconsistency of clinical
evaluation practices

17. Practical Examination
Standardized methods
 Objective structured clinical examination (OSCE)
Designed to objectively assess clinical skills
performance in simulations of actual clinical
situations
 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.

18. Oral Examination - Issues
 Whole syllabus / case or both ?
 Questions - more theory / applications ?
 Procedure book / Log book / Subject file ?
 Same questions or different ?

19. 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.

20. 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
conduct

21. Six Practice Areas
1. Professional responsibility and
accountability
2. Nursing practice
3. Communication and interpersonal
relationship
4. Valuing human being
5. Management
6. Professional Advancement

22. Area no. 2 Nursing Practice -
Standards
2.1 Nursing care reflects adherence to
practice standards
2.2 Delivery of Nursing care reflects nursing
process approach
2.3 Nursing care is provided in a safe
environment

23. 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.

24. 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

25. Standard of Nursing Practice – 2.3
Nursing care is provided in a safe environment
Performance Criteria
2.3.1 Ensure safe and therapeutic environment in
care settings
2.3.2 Adheres to standard safety measures
2.3.3 Follows guidelines for biomedical waste
management
2.3.4 Sensitizes co-workers, individuals and groups
about the importance of safe environment

26. CRITICISMS
 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,
Arthur 1995)
 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)

27. CRITICISMS (Cont…)
 Evaluation is a continuous and ongoing
process.
 Formative and Summative evaluation are
similarly seamless; there is a formative
element in any summative evaluation
(Schoenhofer and Coffman 1994)

28. CRITICISMS (Cont…)
 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.

29. CRITICISMS (Cont…)
 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
summative decisions.

30. Conclusion
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
evaluative process.

31. Thank youThank you

34. 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.

35.  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.
Scriven (1991)

36. 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

37.  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
performance.

38. 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
measurement.
 The second generation – expanded to include
description
 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