5. assessment of psychomotor, perceptual and attitudinal skills, including checklists and rating...

7/29/2019 5. Assessment of Psychomotor, Perceptual and Attitudinal Skills, Including Checklists and Rating Scales

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ASSESSMENT OF ATTITUDES

& PSYCHOMOTOR SKILLS

Raja C. Bandaranayake


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DOMAINS OF LEARNING

Cognitive (Knowledge)

Psychomotor(Motor skills)

Affective (Attitudes)


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THE AFFECTIVE DOMAIN

Awareness[knowledge base]e.g. Reads about importance of rural healthcare

Receiving[willing to receive or attend]e.g. Acknowledges rural health care isimportant

Responding [actively attending]e.g. Seeks additional information aboutrural health needs & problems


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THE AFFECTIVE DOMAIN contd. Valuing[worth to learner]

e.g. Spends free time working in ruralareas

Organizing[takes steps to incorporate intoones life]e.g. Undergoes training to deal with rural

health problems

Characterisation by value or value complex[becomes part of ones life]

e.g. Enters a career of rural health care


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PROBLEMS IN ASSESSING ATTITUDES

One must rely on inference

An attitude has many facets e.g. feelings,beliefs, values

An attitude has many manifestations e.g.behaviours, verbal responses

Behaviours, beliefs and feelings will notalways match

An attitude can fluctuate

There is often lack of agreement on thenature or desirability of certain attitudes


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ORIENTATIONS TO ATTITUDEASSESSMENT

Behavioural Observation of behaviours

Psychometric Standardized pen-and-paper tests

Counselling One-to-one discussion


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BEHAVIOURAL ORIENTATION

Behaviours can be observed

Rely on observation tools

checklist, rating scale, anecdotal record

Expectations explicit

Assessment consistent

Inference necessary many variables affect behaviour


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BEHAVIOURAL ORIENTATION (contd.) Change can be monitored

Spied on feeling

Coercive atmosphere

Individual event may be trivial need to observe many behaviours


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BEHAVIOURAL ORIENTATIONWho are the observers?

Trained observers Administrators

Teachers Peers Other professionals

Patients Parents Self


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PSYCHOMETRIC ORIENTATION

Pen-and-paper instruments

Validated, standardized tests

Self reports possible

Inexpensive and objective

Socially desirable responses possible

Situation-specific

Conclusions indefinite


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QUESTIONNAIRES

Open-ended Closed[Respond in own words] [select, rank, rate]

e.g. Essay e.g. Likert scale

Semantic differential

Tests of judgement

Forced-choice


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LIKERT SCALE

SA A U D SD

A medical history isincomplete without a

social historyThe logical leader fora health team is thedoctor

The team approach tohealth care is a wasteof time


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SEMANTIC DIFFERENTIAL

Surgeons are:

Theoretical _ _ _ _ _ _ _ Practical

Personal _ _ _ _ _ _ _ Impersonal

Active _ _ _ _ _ _ _ Passive

Disease- _ _ _ _ _ _ _ Patient-

oriented oriented


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COUNSELLING ORIENTATION

Discussion between teacher and student toreveal feelings underlying behaviours

Student may be more motivated to changeif understand him/her-self

Low risk environment

Counselling role not compatible withauthority role

Student may manipulate or avoid givingresponses

Teachers are not trained counsellors


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PSYCHOMOTOR DOMAIN

1.

PerceptionUsing senses for cues to motor activity

2. Set

Readiness to take a particular type ofaction

3. Guided response

Imitating a skill; trial and error

4. MechanismResponse habitual and confident


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PSYCHOMOTOR DOMAIN contd.5. Complex overt response

Skillful & complex performance

6. AdaptationAble to modify movement pattern to suitparticular situation

7. OriginationCreating new movement pattern for aspecific purpose


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OBSERVATIONS: Relatively Unstructured

Complete description of event Participant observation (e.g. simulated

patient)

Time and motion or time-sampling study Anecdotal record

Disadvantages

Sampling less Reliability low Observer influence Memory distortion


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OBSERVATIONS: Structured

Specific plan made for making

and recording observation

Investigator knows what aspects

of behaviour are relevant for thepurpose


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Observational Instruments

1. CHECKLISTWhere the response is Yes or

No

2.RATING SCALEWhere quality of performance isimportant


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CHECKLIST: When to use?

Performance skillsthat can be divided intoa series of clearly defined steps, each ofwhich is either done or not done

e.g. steps in cardio-pulmonary resuscitation

Performance productsthat can be

evaluated by noting presence (or absence)of observable characteristics

e.g. patients medical record


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CHECKLIST:STEPS IN CONSTRUCTION

Analyse task or performance into specificsequential steps required

List common errors (of omission andcommission) made by students

List actions and errors in logical order ofoccurrence

Provide a system for observer to recordsequence of actions


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CHECKLIST: Mouth-to-mouth resuscitation

Done Order#

Notdone

NA

Shakes & shouts to checkif unconscious

Applies chin lift to openairway

*Applies neck lift to openairway

Uses look, listen, liftmethod for apnoea

Closes nose by pinching

Effects tight mouth-to-

mouth seal


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CHECKLIST: contd. Gives 4 quick ventilations

Checks carotid pulse

*Checks pupils for dilatation *Bares victims chest

Checks anatomical landmarks


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TYPES OF RATING SCALES

GraphicPoor rapport Excellent rapport

Graphic with anchorsPoor Fair Good Very Good Excellent

Frequency scalesNever Seldom Often Always

Behaviourally-anchored


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BEHAVIOURALLY-AHCHORED RATING SCALE:ATTITUDES

Relationship with patientsA. Rapport

0: Unable to establish rapport

1: Fair rapport, but occasional lack of communication

2: Good rapport, communicates concern

3: Listens, communicates well, instills confidence

4: Convinces patient of expertise and puts patient at ease

5. Not observed


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RATING SCALE: COMMUNICATION

Participation in group discussion

C. Nature of contributions

0: Does not contribute at all

1: Comments usually distract from the topic

2:

3: Comments usually pertinent, occasionally wanders from topic

4:

5: Comments always related to the topic


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RATING SCALE: SKILLS

Mouth-to-mouth resuscitationA. Effects tight seal

Cannot determine

Inadequate: Does not attempt to create a tight seal or sealis grossly inadequate

Satisfactory: Has leak, but adequate ventilation

Excellent: Fully covers mouth from corner to corner,creating an airtight seal


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RATING SCALE:STEPS IN CONSTRUCTION

Define unambiguously dimension orbehaviour being rated

Decide on number of rating steps Usually 3 to 10 Uneven number better Intervals not necessarily equidistant

Define / describe extremes and then eachstep in between Try to avoid relative terms (e.g. frequently),

which could be interpreted differently


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Error of leniency

Error of central tendency Halo effect

Logical error

Error of contrast

ERRORS IN RATING

5. assessment of psychomotor, perceptual and attitudinal skills, including checklists and rating...

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