educationalassessment
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EducationalAssessment. Classroom MCQs Clinical OSCE. Objectives. By the end of seminar learners will be able to: Define assessment Overview of assessment and educational assessment Explain attributes of assessment - PowerPoint PPT PresentationTRANSCRIPT
EducationalAssessment
Classroom MCQs
Clinical OSCE
Objectives By the end of seminar learners will be able to: Define assessment Overview of assessment and educational assessment Explain attributes of assessment Describe multiple choice questions (MCQs) Discuss the steps of designing MCQs. Identify advantages and disadvantages of MCQs Define OSCE Discuss the process of OSCE Converse approaches/models of OSCE Debate on OSCE Discuss Ethical issues in OSCE Know the views of students and faculty for OSCE
Definition of Assessment Assessment comes from the old French
word assessor, meaning to sit by as an assistant judge or guide.
The process of collecting information on student achievement and performance. Provides information for basis of sound decision making regarding teaching and learning.
http://www.aac.ab.ca/final
Cont… “The process of assessment is to
gather, summarize, interpret, and use data to decide a direction of action”
(Bastable 2003)
“Begins with educational values, works best when program has clear purposes…is ongoing and meets the responsibilities to students and public”
(Billings 2003)
Educational Assessment “Is the process of documenting, usually
in measureable term, knowledge, skills, attitudes, and beliefs”
“It focus on the individual learner, the learning community, the institution, or the educational system as a whole”
http://en.wikipedia.org/wiki/Assessment
Overview of Assessment
Assessment
why
where How
what
Whom
when
Of What
Assessment
What? process of gathering… Why?
Measure academic achievement Identify areas for improvement Predict future performance
Of what? Domains Cognitive (Knowledge)
Affective (Attitude)
Psychomotor (Skills)
Content Facts and principles Processes Signs and symptoms Clinical methods Techniques Management Etc….
How? Written tests
Essay True false MCQs MCIs Viva/oral Practical Long case/short case Osce Projects
How?
Shows how
Does
Knows how
Knows Factual test: MCQs, Essay, Oral
(Clinical) Context based testsMCQ, essay, oral
Performance assessment in vitroOSCE, Standardized-patient based test
Performance assessment in vivoUndercover SPs, Video, Logs only in real world of practice
(Miller 1990)Both areas tested by traditional written exams….
When?
Continuous assessment
End of yearassessment
Strength Multiple points of observation can lead to greater confidence in judgment
Easier to define specific objectives and structured test content
Limitations
Assessor bias Busy facultyMay not observe
More artificial
Where? Testing in situations similar to those in training and practice, enable to make justifiable decisions
Assessment TypesFormative Summative
Strength Can identify weaknesses and further guide student learning
Can provide a clear diagnostic statement about a student competence
Limitations
May not be taken seriously by non self-directed learners
Usually occur too late to have any meaningful impact on learning
Curricular attributes include Program and course objectives Critical learning experiences Learning outcomes
Faculty attributes comprise Level of content knowledge attitude about teaching Instructional skills Appropriate knowledge of teaching learning theories
Students’ attributes consist of Knowledge and skills Cognitive abilities Learning styles Motivation to achievement (Billings 2005)
Attributes of Assessment
How to develop effective Assessments?
Should be RELIABLE and VALID
Reliability: A reliable assessment is one that provides consistent “scores”.
Validity: An assessment is valid when it accurately measures what is to measure.
Multiple Choice Questions. MCQs Consists of twoparts Stem
Can be a question or an incomplete statement, scenario, problem
Several options/ distracters But to choose the
best response
Steps in Designing MCQsStem
Clear single problem Content should be common Independent of all others in the test Information in one stem should not give clue to
another item Scenarios incorporated carefully Use of action verbs of Bloom taxonomy (1956)
according to cognitive level of students Knowledge, comprehension, application, analysis
(Billings, 2005)
Steps in Designing MCQsOptions
Grammatically consistent with stem to avoid giving clues to right one
Arrangement order, alphabetical, numerical
Having same length Give only one best option, to which
all faculty agree Should not use all of above, none of
above
Examples of MCQs Knowledge1. A patient’s father died of Huntington’s
chorea. What are the chances that pt will have the disease?
a) 25%b) 50%c) 75%d) 100%
Comprehension
2. A pt resists the nurse's attempts to get him out of bed. If this attempt is without pt’s approval, what legal charge could nurse face?
a) Assaultb) Batteryc) Negligenced) Tort
Application 3. On the 1st post-op day after an open reduction
and internal fixation (ORIF) of the tibia with application of long leg cast, the pt begins complaining of severe pain uncontrolled by his scheduled pain med. What would be the priority nursing intervention?
a) Administer a narcotic bolus as orderedb) Assess the neurovascular status of legc) Lower the leg to increase arterial flowd) Raise the leg to decrease venous return
Analysis 4. A 70 yrs old woman is admitted to the
hospital with a diagnosis of dehydration. Vital signs are stable. Serum sodium level is 165 mmol/L. Which of the fluid replacement is most likely to be administered?
a) Hypertonicb) Hypotonicc) isotonic
What makes MCQs “Good”? Alignment: to content, learning outcomes/goals, Importance: testing details is a waste of
resources; concentrate on fundamental concepts Clarity: the intent of the task and the meaning of
the options must speak for themselves and be interpreted in the same way by all examinees
Item construction: well-constructed items can be answered successfully by examinees who have the knowledge or skill you are testing, and NOT by examinees who are lacking the skill or knowledge
MCQs Advantages Large content in single
test
Scored easily and objectively
Measure understanding at numerous cognitive levels in taxonomy category
Disadvantages Time consuming in
designing for faculty More time needed by
students to read and understand
Differentiate against creative, verbal student
Writing style affects scores
Difficult to write MCQs at synthesis and evaluation level
CPR being performed on a mannequin used for training
Inspect Palpate Percuss
Auscultate
OSCE
Objective Structured Clinical Examination
OSCE is a competency-based evaluation aimed at testing the psychomotor and affective domains with an inbuilt system for systematic feedback.
OSCE is a modern type of examination often used in health sciences (e.g. medicine, physical therapy, nursing, pharmacy) to test clinical skill performance and competence such as communication, clinical examination,
Cont…
medical procedures / prescription, exercise prescription, joint mobilization / manipulation techniques, and interpretation of results.
http://www.osceskills.com/
Also known as “Standardized Patient Exams SPEs, described as an acceptable and powerful instrument in clinical performance evaluation… pretended patients in an artificial environment designed to simulate actual clinical condition”
(Borbasi & Koop 1994 as cited in Billing 2005)
Process of OSCE
It normally consists of several short (5-10 minute) stations, in which each is examined on a one-to-one basis with an impartial examiner and either real or simulated patients (actors).
Considered to be an improvement over traditional examination methods because the stations can be standardized enabling fairer peer comparison and complex procedures can be assessed without endangering patients health
Cont…
The other ways an OSCE is made objective is by having a detailed mark scheme and standard set of questions.
For example, a station concerning the demonstration to a simulated patient on how to use a Metered dose inhaler would award points for specific actions which are performed safely and accurately (e.g. candidate explains to patient the need for a seal around the mouthpiece, etc.)
http://www.osceskills.com/
Approaches/Models to OSCE
Multi station OSCE
Scenario based OSCE(sometimes called objstructured clinical assessment (OSCA)
Top to ToeAssessment
OSCE /simulated Assessment with randomallocation
(Rushforth 2007)
Some centers also use viva, or Q/A with these models
OSPE
AKU Med students1st & 2nd year
OSCE
3rd & 4th year
Is OSCE debatable? OSCE stations can never be truly standardized and
objective in the same way as a written exam.
It has been known for different patients / actors to afford more assistance, and for different marking criteria to be applied (literature shows marking criteria as pass/fail, checklist, likert scale, percentages, done/not done)
It provides a formative evaluation for both students and the educational institution.
(Rentschler et al, 2007)
Cont… It is a fast and well-organized evaluation method, allows rapid
feedback to students about their clinical deficits (Billings 2005)
OSCE has been tested and found to be reliable, valid in various settings, provides a controlled clinical situation that is realistic and nonthreatening
# of stations 16 minimum, 37 max (as cited in Rushforth 2007)
Easy in controlled setting but difficult in real world
Literature says that it should be mandatory for nursing students as well
(Rentschler et al, 2007)
Ethical Issues in OSCE
Perceived inequity between students
Lack of honesty and professionalism of peers
http://jme.bmj.com/cgi/content/abstract/32/12/734
Cont… Discuss the OSCE cases with other
students after the OSCE?violation of the honor code.
Why not children as simulated patients?
http://www.oucom.ohiou.edu/AcademicAffairs/predoc/osce/index.htm
Views of students and faculty
Students Overall satisfied Stressful Improve
performance Can practice on
peers as well Encouragement and
motivation
Faculty Overall satisfied Students practice
actively Provide
evaluation to students soon after exam
References Billings,D.M,Halstead,J.A. (2003).Teaching in
nursing: A guide for faculty. 2nd ed.
Bastable,S.B.(2003).Nurse as educator:principles of
teaching and learning for nursing practice. 2nd ed.New York: Jones and Bartlett Publishers.
Hammond,L,D & Bransford, J.(eds) (2005). Preparing
teachers for a changing world:what teachers should learn and be able to do. USA. Jossey Bass. pp 275-326
Cont…http://www.oucom.ohiou.edu/AcademicAffairs/predoc/osce/index.htm
Norman, G. (2002) The long case versus objective structured clinical examinations. BMJ 324: 748-749
Objective Structured Clinical Examination. Retrieved Jan 29, 2009 from http://www.osceskills.com/
Parks,R.,Warren,P.M.,Boyd,K.M., Cameron,H.,Cumming, A., & Jones, J.L. (2006). The Objective Structured Clinical Examination and student collusion: marks do not tell the whole truth. Journal of Medical Ethics,32. 734-738
Cont…
Rentschler,D.D; Eaton,J; Cappiello,J; McNally,S.F; & McWilliam,P.(2007). Evaluation of undergraduate students using objective structured clinical examination. Journal of Nursing Education, 46 (3) 135-139
Rushforth, H.E. (2007). Objective structured clinical examination (OSCE): Review of literature and implications for nursing education. Nurse Education Today ,27, 481-490
Stiggins,R. J.(1999). Assessment, Student Confidence, and School Success. Phi Delta Kappan, 81, (3) Retrieved Jan 23, 2009 from http://www.aac.ab.ca/final 2002.doc
Questions
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