Learner Assessment

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Learner Assessment

• Win May

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What is Assessment?

• Process of gathering and discussing information
  from multiple sources
• to gain
• deep understanding of what learners
• know, understand and can do

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Purpose of Assessment

• Subsequent learning
• improve
• Assessment Results

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Learner-Centered Assessment

• What is it that my learners need to know and be
  able to do during their professional lives?
• What skills and knowledge will stand the test of
  time, given the rapidly evolving nature of
  knowledge?

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Characteristics of Learner-Centered Assessment

• Promotes high expectations
• Respects diverse talents and learning styles
• Promotes coherence in learning
• Integrates education experience
• Actively involves learners
• Provides prompt feedback
• Fosters collaboration
• Huba Freed, 2000

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Competence in Medical Education

• Habitual and judicious use of
• Communication
• Knowledge
• Technical skills
• Clinical reasoning
• Emotions
• Values
• Reflection
• in daily practice for the benefit of individuals
  communities being served.
• Epstein Hundert, 2002

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Assessment of Competence

• Insight into actual performance
• Capacity to
• adapt to change
• find and generate new knowledge
• improve overall performance
• Fraser Greenhalgh, 2001

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Pyramid of Competence
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Goals of Assessment

• Optimize capacities through self-directed
  learning
• Identify incompetent physicians
• Provide basis for selecting applicants for
  advanced training

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Types of Assessment

• Formative
• Guide future learning
• Promote reflection
• Motivate
• Shape values
• Summative
• Certify
• Promote

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Which is the best method?

• Valid
• Reliable
• Appropriate to the objective
• Feasible
• Acceptable to faculty and learners
• Cost-effective
• Impacts future learning and practice

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Types of Learner Assessment

• Written exercises
• Case-based module
• Multiple choice questions
• Short-answer questions
• Structured essays
• Key feature and script-concordance questions
• Paper/Thesis/Project
• Assessments by supervisors
• Chart-stimulated recall
• Product review
• Standardized oral examination
• Global ratings
• Structured direct observation

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Types of Learner Assessment

• Clinical simulations
• Standardized patients
• Multi-station examinations
• Unannounced standardized patients
• High-tech simulators
• Multi-source assessments
• Portfolio
• Peer assessment
• Patient assessment
• Self-assessment

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Some methods to assess cognitive skills
Assessment Method Domain Domain Strengths Limitations
Assessment Method Domain Domain
MCQ Knowledge, Problem-solving Knowledge, Problem-solving Many content areas High reliability Computer grading Difficult to write Cueing
SCT Knowledge, Problem-solving Clinical problem-solving Computer grading Transfer not yet proven
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Table of Specifications
No. Content Area Recall of facts Application/ Interpretation Synthesis/ Problem-solving Total
1. Oro-pharyngeal cancer 1 2 2 5
2. Myocardial infarction 1 1 3 5
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Multi-method Assessment

• Each method has limitations
• Essential to use multiple methods
• Allows inclusion of wider content areas
• Multiple points of view

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Outcomes - Based Education

• 3 circles of outcomes
• Inner circle
• What the doctor is able to do
• Middle circle
• How the doctors approach their practice
• Outer circle
• Doctor as a professional

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What the doctor is able to do

• Apply skills of history and PE
• Communication skills
• Health promotion disease prevention
• Procedural skills
• Investigative skills
• Management skills

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How doctors approach their practice

• Apply basic sciences to clinical practice
• Use critical thinking, problem solving, clinical
  reasoning
• Incorporate appropriate attitudes, ethics and
  understanding legal issues
• Information retrieval and handling skills

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Doctor as professional

• Role of doctor within health care system
• Aptitude for professional development and
  transferable skills

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Summary

• Assess competence in an integrated, coherent, and
  longitudinal fashion
• Know limitations of each method
• Use multiple methods
• Implement longitudinally
• Provide frequent and constructive feedback