ASSESSMENT OF ATTITUDES & PSYCHOMOTOR SKILLS

1. ASSESSMENT OF ATTITUDES & PSYCHOMOTOR SKILLS Raja C. Bandaranayake

2. DOMAINS OF LEARNING • Cognitive(Knowledge) • Psychomotor(Motor skills) • Affective(Attitudes)

3. THE AFFECTIVE DOMAIN • Awareness[knowledge base] e.g. Reads about importance of rural health care • Receiving[willing to receive or attend] e.g. Acknowledges rural health care is important • Responding [actively attending] e.g. Seeks additional information about rural health needs & problems

4. THE AFFECTIVE DOMAIN – contd. • Valuing[‘worth’ to learner] e.g. Spends free time working in rural areas • Organizing[takes steps to incorporate into one’s life] e.g. Undergoes training to deal with rural health problems • Characterisation by value or value complex[becomes part of one’s life] e.g. Enters a career of rural health care

5. 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 not always match • An attitude can fluctuate • There is often lack of agreement on the nature or desirability of certain attitudes

6. ORIENTATIONS TO ATTITUDE ASSESSMENT • Behavioural • Observation of behaviours • Psychometric • Standardized pen-and-paper tests • Counselling • One-to-one discussion

7. 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

8. BEHAVIOURAL ORIENTATION (contd.) • Change can be monitored • “Spied on” feeling • Coercive atmosphere • Individualevent may be trivial • need to observe many behaviours

9. BEHAVIOURAL ORIENTATIONWho are the observers? • Trained observers • Administrators • Teachers • Peers • Other professionals • Patients • Parents • Self

10. PSYCHOMETRIC ORIENTATION • Pen-and-paper instruments • Validated, standardized tests • Self reports possible • Inexpensive and objective • Socially desirable responses possible • Situation-specific • Conclusions indefinite

11. 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

12. LIKERT SCALE SA A U D SD A medical history is incomplete without a social history The logical leader for a health team is the doctor The team approach to health care is a waste of time

13. SEMANTIC DIFFERENTIAL Surgeons are: Theoretical _ _ _ _ _ _ _ Practical Personal _ _ _ _ _ _ _ Impersonal Active _ _ _ _ _ _ _ Passive Disease- _ _ _ _ _ _ _ Patient- oriented oriented

14. COUNSELLING ORIENTATION • Discussion between teacher and student to reveal feelings underlying behaviours • Student may be more motivated to change if understand him/her-self • Low risk environment • Counselling role not compatible with authority role • Student may manipulate or avoid giving responses • Teachers are not trained counsellors

15. PSYCHOMOTOR DOMAIN 1. Perception Using senses for cues to motor activity 2. Set Readiness to take a particular type of action 3. Guided response Imitating a skill; trial and error 4. Mechanism Response habitual and confident

16. PSYCHOMOTOR DOMAIN – contd. • Complex overt response Skillful & complex performance 6. Adaptation Able to modify movement pattern to suit particular situation 7. Origination Creating new movement pattern for a specific purpose

17. 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

18. OBSERVATIONS: Structured • Specific plan made for making and recording observation • Investigator knows what aspects of behaviour are relevant for the purpose

19. Observational Instruments • CHECKLIST Where the response is “Yes” or “No” 2.RATING SCALE Where quality of performance is important

20. CHECKLIST: When to use? • Performance skillsthat can be divided into a series of clearly defined steps, each of which 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. patient’s medical record

21. CHECKLIST: STEPS IN CONSTRUCTION • Analyse task or performance into specific sequential steps required • List common errors (of omission and commission) made by students • List actions and errors in logical order of occurrence • Provide a system for observer to record sequence of actions

22. CHECKLIST: Mouth-to-mouth resuscitation

23. CHECKLIST: contd. • Gives 4 quick ventilations • Checks carotid pulse • *Checks pupils for dilatation • *Bares victim’s chest • Checks anatomical landmarks

24. TYPES OF RATING SCALES • Graphic Poor rapport Excellent rapport • Graphic with anchors Poor Fair Good Very Good Excellent • Frequency scales Never Seldom Often Always • Behaviourally-anchored

25. BEHAVIOURALLY-AHCHORED RATING SCALE: ATTITUDES Relationship with patients • 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

26. 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

27. RATING SCALE: SKILLS Mouth-to-mouth resuscitation • Effects tight seal Cannot determine Inadequate: Does not attempt to create a tight seal or seal is grossly inadequate Satisfactory: Has leak, but adequate ventilation Excellent: Fully covers mouth from corner to corner, creating an airtight seal

28. RATING SCALE:STEPS IN CONSTRUCTION • Define unambiguously dimension or behaviour being rated • Decide on number of rating steps • Usually 3 to 10 • Uneven number better • Intervals not necessarily equidistant • Define / describe extremes and then each step in between • Try to avoid relative terms (e.g. frequently), which could be interpreted differently

29. ERRORS IN RATING • Error of leniency • Error of central tendency • Halo effect • Logical error • Error of contrast