Clinical Assessment:at the heart of healthcare education

.

“ The rules of clinical assessment are the

same for

whatever

Doctor you

are

producing….

.

real, relevant & objective

valid and reliable

…… clinical assessment has to be:

.

…… the world has moved on !!

.. society has changed

…… society expects more from its Doctors

…….. we should respond to that need

…… and since the unexpected can always happen we must make provision for it

.

…… new advances are just around the corner

… new

problems are

constantly

emerging

.

What do we want students to achieve in the clinical assessment of our students ?

• Show they have achieved a previously overall defined level of competence

• Understand very well the fundamentals of clinical practice and apply their previous learning

• Show they can perform to a required and accepted level of competence in real or simulated real practice in specified areas

• Adapt their practice to real life situations and normal / expected variations

.

Knows

Shows how

Knows how

Does

Knows Factual tests: MCQ, essay type, oral…..

Shows howPerformance assessment in vitro:OSCE, SP-based test…..

DoesPerformance assessment in vivo: Masked SPs, Video, Audits…..

Knows how(Clinical) Context based tests:MCQ, EMI, essay type, oral…..

…. we want to see students climbing the pyramid

.

Most schools have moved away from :

Long cases

Short cases

Oral / viva voce

Why:

Often irrelevant to real life

Specialty specific, not integrated

Non-standardised / comparable

Highly subjective

One opportunity to become a star

.

To:

OSCE – OSVE, OSPE, ISCE etc

Written formative – portfolios, reflective

diaries, log books etc

Web-based

Case-based

Workplace-based

360 degree, multi-professional

Competency- based

.

But, if we use these methods, we must address the issues of:

• Standardisation

• Objectivity

• Validity

• Reliability

• Real-life situations with complexity

• Safety

• Multiple biopsy technique

Clinical Assessment

What is the best way ?