دکتر محمد کمالی

1. دکتر محمد کمالی -1386

2. دکتر محمد کمالی www.mkamali.com kamali@mkamali.com استاديار دانشکده علوم توانبخشی دانشگاه علوم پزشکی ايران تهران - صندوق پستی 183-17445 دکتر محمد کمالی -1386

3. دکتر محمد کمالی -1386

4. ارزیابی در توانبخشی دوره بازآموزی اصول توانبخشی سازمان بهزیستی کشور آذر ماه 1386 دکتر محمد کمالی -1386

5. تعاریف دکتر محمد کمالی -1386

6. Assessment The act of assessing; appraisal. An amount assessed, as for taxation. The qualified opinion of a healthcare provider, informed by patient feedback and examination results, with regard to a specific health issue, whether critical, pending, or routine. Dental Dictionary دکتر محمد کمالی -1386

7. Assessment Assessment is the process of documenting, usually in measurable terms, knowledge, skills, attitudes and beliefs. Children's Health Encyclopedia The act or result of judging the worth or value of something or someone:(Thesaurus ) دکتر محمد کمالی -1386

8. Description • Assessment is used in both an educational and psychological setting by teachers, psychologists, and counselors to accomplish a range of objectives. These include the following: • to learn more about the competencies and deficiencies of the individual being tested • to identify specific problem areas and/or needs • to evaluate the individual's performance in relation to others • to evaluate the individual's performance in relation to a set of standards or goals • to provide teachers with feedback on effectiveness of instruction • to evaluate the impact of psychological or neurological abnormalities on learning and behavior • to predict an individual's aptitudes or future capabilities دکتر محمد کمالی -1386

9. تعریف ارزیابی ارزیابی ، عمل یافتن ارزش و بهای هر چیز ، بخش و بررسی حدود هر چیز و برآورد کردن ارزش آن کلمه ارزیابی حاصل مصدر است. فعالیتی است که ماهیت آن آموزشی ، اقتصادی ، اجتماعی و فرهنگی می‌باشد. از این رو به کمک ارزیابی باید مقایسه ای میان اهداف ضمنی و اهداف بیان شده از یک سو و نتایج مورد انتظار و نتایج پیش بینی نشده از سوی دیگر به عمل آورد و سپس باید به سنجش تاثیر این نتایج بر محیط اقتصادی ، اجتماعی و فرهنگی پرداخت . دکتر محمد کمالی -1386

10. تعریف ارزیابی هدف ارزیابی گردآوری اطلاعات جهت بهبود بخشیدن به فرآیند برنامه ریزی Process of the planning و در نتیجه بهبود در سطح ملی، منطقه ای و جوامع محلی است. باید توجه داشـت کـه ارزیـابـی فقـط یـک بـار پـس از اجـرای برنامـه Implementation or Execution انجام نمی پذیرد بلکه در طول اجرای برنامه به طور مستمر ارزیابی باید انجام گیرد تا تطبیق عملکرد را با هدف برنامه میسر سازد.(کتاب فرآیند برنامه‌ریزی آموزشی تالیف گروه مشاوران یونسکو) دکتر محمد کمالی -1386

11. تعریف ارزیابی در کتاب اصلاح نظام‌های مدیریتی جلد سوم از 7 برنامه تحول در نظام اداری آمده است: ارزیابی : فرآیند سنجش ، ارزش گذاری و قضاوت (مصوب هیات وزیران در تاریخ 28/10/81 طی شماره 44642/ت 27701 ه- ارزیابی فرآیندی است که سنجش و اندازه گیری ، ارزش گذاری و قضاوت در خصوص عملکرد طی دوره ای معین می پردازد. (کتابچه راهنمای ارزیابی عملکرد دستگاههای اجرایی از انتشارات سازمان مدیریت و برنامه ریزی کشور) ارزیابی امری است پیچیده و به منظور مقایسه بین نتایج حاصل و هدف های تعیین شده برنامه انجام می پذیرد. نتایج حاصل از برنامه میتواند کاملاٌ با آنچه انتظار می رفته است مغایر باشد. (کتاب فرآیند برنامه ریزی آموزشی) دکتر محمد کمالی -1386

12. Types • Assessments can be classified in many different ways. • The most important distinctions are: • (1) formative and summative; • (2) objective and subjective; • (3) referencing (criterion-referenced, norm-referenced ); • (4) informal and formal. دکتر محمد کمالی -1386

13. Formative and summative There are two main types of assessment: Summative assessment - Summative assessment is generally carried out at the end of a course or project. In an educational setting, summative assessments are typically used to assign students a course grade. Formative assessment - Formative assessment is generally carried out throughout a course or project. Formative assessment, also referred to as educative assessment, is used to aid learning. In an educational setting, formative assessment might be a teacher (or peer) or the learner, providing feedback on a student's work, and would not necessarily be used for grading purposes. دکتر محمد کمالی -1386

14. Objective and subjective • Assessment (either summative or formative) can be objective or subjective. • Objective assessment is a form of questioning which has a single correct answer. • Subjective assessment is a form of questioning which may have more than one correct answer (or more than one way of expressing the correct answer). دکتر محمد کمالی -1386

15. Formal and Informal Formal assessment usually implicates a written document, such as a test, quiz, or paper. Formal assessment is given a numerical score or grade based on student performance. Whereas, informal assessment does not contribute to a student's final grade. It usually occurs in a more casual manner, including observation, inventories, checklists, rating scales, rubrics, performance and portfolio assessments, participation, peer and self evaluation, and discussion. دکتر محمد کمالی -1386

16. Psychological Assessments Psychological assessment of children is used for a variety of purposes, including diagnosing learning disabilities and behavioral and attention problems. Psychologists can obtain information about a child in three general ways: observation, verbal questioning or written questionnaires, and assignment of tasks. دکتر محمد کمالی -1386

17. تفاوت ارزیابی و ارزشیابی دکتر محمد کمالی -1386

18. نمونه تفاوت قائل نشدن بین ارزیابی و ارزشیابی بررسی و ارزشیابی سطح رشدی فرد مددجو از نظر رشد هوشی، حركتی، اجتماعی، شناختی و توجه به توانایی‌ها و محدودیت‌ها توسط سنجش رسمی با استفاده از تست‌ها و سایر چك لیست‌های استاندارد و سنجش غیررسمی با استفاده از مصاحبه با مربیان آموزشی و والدین و مشاهدة مددجویان.در سطح سنجش رسمی- برای ارزیابی توان هوشی از آزمونهای ریون ، گودیناف ، وبندر گشتالت استفاده می‌شود- برای ارزیابی رشد اجتماعی از آزمون واینلند و مقیاس رفتار سازشی AAMR استفاده می‌شوددر سطح سنجش غیر رسمی- چك لیست رشد شناختی، تهیه شده در مؤسسه كه میزان اطلاعات مدد جو را در موضوعاتی مانند میوه ها/ رنگها / حیوانات / مشاغل / اشكال هندسی / اعضاء بدن / و 11 مفهوم اساسی و اولیه می‌سنجد- چك لیست مربوط به پیش نیازهای چهار حرفه فعلی موجود در مؤسسه شامل ساخت پالت چوبی- پاك كردن و بسته بندی حبوبات- ساخت تایل ترکیبی از قطعات سنگ – ساخت پاكت - چك لیست ارزیابی مهارتهای حركتی- چك لیست ارزیابی ظرفیت فیزیكی دکتر محمد کمالی -1386

19. What is the Difference between Assessment and Evaluation? • Assessment is an on-going process aimed at improving student learning, programs, and services that involves a process of • 1) publicly sharing expectations, • 2) defining criteria and standards for quality, • 3) gathering, analyzing, and interpreting evidence about how well performance matches the criteria, and • 4) using the results to documents, explain, and improve performance. • Evaluation appraises the strengths and weaknesses of programs, policies, personnel, products, and organizations to improve their effectiveness. • Evaluation is to determine significance or worth or judge the effectiveness of educational programs. Assessment is to determine a rate or amount and is used as an activity to measure student learning and other human characteristics. دکتر محمد کمالی -1386

20. Measurement Measurement refers to the process by which the attributes or dimensions of some physical object are determined. However, when we measure, we generally use some standard instrument to determine how big, tall, heavy, voluminous, hot, cold, fast, or straight something actually is. Standard instruments refer to instruments such as rulers, scales, thermometers, pressure gauges, etc. We measure to obtain information about what is. Such information may or may not be useful, depending on the accuracy of the instruments we use, and our skill at using them. There are few such instruments in the social sciences that approach the validity and reliability of say a 12" ruler. We measure how big a classroom is in terms of square feet, we measure the temperature of the room by using a thermometer, and we use Ohm meters to determine the voltage, amperage, and resistance in a circuit. In all of these examples, we are not assessing anything; we are simply collecting information relative to some established rule or standard . Assessment is therefore quite different from measurement, and has uses that suggest very different purposes. دکتر محمد کمالی -1386

21. Assessment Assessment is a process by which information is obtained relative to some known objective or goal. Assessment is a broad term that includes  testing. A test is a special form of assessment. Tests are assessments made under contrived circumstances especially so that they may be administered.  In other words, all tests are assessments, but not all assessments are tests. We test at the end of a lesson or unit. We assess progress at the end of a school year through testing, and we assess verbal and quantitative skills through such instruments as the SAT and GRE. Whether implicit or explicit, assessment is most usefully connected to some goal or objective for which the assessment is designed. A test or assessment yields information relative to an objective or goal. In that sense, we test or assess to determine whether or not an objective or goal has been obtained. Assessment of skill attainment is rather straightforward. Either the skill exists at some acceptable level or it doesn’t. Skills are readily demonstrable. Assessment of understanding is much more difficult and complex. Skills can be practiced; understandings cannot. We can assess a person’s knowledge in a variety of ways, but there is always a leap, an inference that we make about what a person does in relation to what it signifies about what he knows. دکتر محمد کمالی -1386

22. Evaluation Evaluation is perhaps the most complex and least understood of the terms. Inherent in the idea of evaluation is "value." When we evaluate, what we are doing is engaging in some process that is designed to provide information that will help us make a judgment about a given situation. Generally, any evaluation process requires information about the situation in question. A situation is an umbrella term that takes into account such ideas as objectives, goals, standards, procedures, and so on. When we evaluate, we are saying that the process will yield information regarding the worthiness, appropriateness, goodness, validity, legality, etc., of something for which a reliable measurement or assessment has been made. For example, I often ask my students if they wanted to determine the temperature of the classroom they would need to get a thermometer and take several readings at different spots, and perhaps average the readings. That is simple measuring. The average temperature tells us nothing about whether or not it is appropriate for learning. In order to do that, students would have to be polled in some reliable and valid way. That polling process is what evaluation is all about. A classroom average temperature of 75 degrees is simply information. It is the context of the temperature for a particular purpose that provides the criteria for evaluation. A temperature of 75 degrees may not be very good for some students, while for others, it is ideal for learning. We evaluate every day. Teachers, in particular, are constantly evaluating students, and such evaluations are usually done in the context of comparisons between what was intended (learning, progress, behavior) and what was obtained دکتر محمد کمالی -1386

23. Assessment, Measurement, Evaluation To sum up, we measure distance, we assess learning, and we evaluate results in terms of some set of criteria. These three terms are certainly connected, but it is useful to think of them as separate but connected ideas and processes. Collecting data (assessment), quantifying that data (measurement), making judgments (evaluation), and developing understanding about the data (research) always raise issues of reliability and validity دکتر محمد کمالی -1386

24. Summary of Differences دکتر محمد کمالی -1386

25. Process Evaluation and Adjustment Assess Prioritize Analyze problem and propose model to address Develop Intervention goals, objectives, implementation plan Evaluate outcomes دکتر محمد کمالی -1386

26. چرا ارزیابی می کنیم دکتر محمد کمالی -1386

27. (AAC) Augmentative and Alternative Communication (AAC) strategies assist people with severe communication disabilities to participate more fully in their social roles including interpersonal interaction, learning, education, community activities, employment, volunteerism, care management, and so on. دکتر محمد کمالی -1386

28. Current Assessment Theory • Moved from candidacy criteria to focusing on an individual’s need for improved communication • Communication Needs Model (Beukelman, Yorkston, & Dowden, 1985) • Examines individual’s natural environment, and recommends implementation of AAC intervention when unmet communicative needs are present دکتر محمد کمالی -1386

29. Purpose of Assessment • Purpose of assessment • Determine the skills that an individual has or needs to develop in order to communicate effectively • Identify communication system individual currently uses • Determine effectiveness • Refine current methods & identify new methods • Determine optimal way to configure system • Goal of AAC assessment & intervention • Independent, functional interactive communication • Achieved through assessment, system trials, instruction دکتر محمد کمالی -1386

30. Main Function of AAC Assessment to determine whether an individual with communication impairment requires augmentative communication intervention During an assessment, an individual's communication needs, as well as his or her capabilities, are evaluated in order to implement the assistive technology as soon as possible to enable the individual to begin immediate communication interaction. The appropriate augmentative communication system is selected to meet the needs of the individual, and an intervention plan is developed دکتر محمد کمالی -1386

31. Identification of Present Ways of Communicating -> limitations and needs • Oral Speech - actual production of words. • Linguistic Knowledge - language reception and expression. • Reading & Writing Ability - The interpretation and generation of written symbols. • Cognition - ability to recall information, reason, problem solve, and follow directions. • Non-Oral Communication - use of gestures, signs, facial expressions, body language, and current augmentative communication usage. • Communication Effectiveness - types of messages successfully communicated. • Communication Partners - ways to communicate with familiar and unfamiliar partners. • Communication Settings - contexts in which communication devices will be used (i.e. school, work, home). • Message Needs - Ways to initiate, comment, request, convey, or reply to conversation. • Developmental & Educational/Vocational Needs - Literacy development. دکتر محمد کمالی -1386

32. Comprehensive Assessment Based on the screening, which areas require more indepth information/testing? Where do I need to target my interventions? دکتر محمد کمالی -1386

33. Self Care Assessment Personal care (feeding, bathing, grooming, dressing, toileting) Community management (shopping, finances, transportation/driving) Functional mobility (transfers, current aids used - home and community, seating and positioning needs) Functional communication (writing or computer use, telephone use) دکتر محمد کمالی -1386

34. Productivity Assessment Paid or unpaid work (job, volunteer work, school, etc) Household management (cleaning, laundry, cooking, etc) Child Care/Parenting دکتر محمد کمالی -1386

35. Leisure Assessment • Activities enjoyed previously and currently • Socialization (visiting, phone calls, correspondence, etc) • Quiet recreation (hobbies, reading, crafts, etc) • Active recreation (sports, outings, travel, etc) دکتر محمد کمالی -1386

36. Assessment of Environment Physical environment; possible barriers Consideration of social support systems available Consideration of cultural factors دکتر محمد کمالی -1386

37. Fatigue Assessment MS fatigue Other factors contributing to fatigue Impact of fatigue Expectations for self دکتر محمد کمالی -1386

38. Cognitive Screening • Primarily assess functional cognition • Attention • Ability to follow directions • Memory difficulties • Executive function • If more indepth assessment needed then refer on to Neuropsychology دکتر محمد کمالی -1386

39. Assessment of Physical Status • U/E tone • U/E ROM • U/E strength • U/E sensation • U/E coordination • Functional balance (more of a screen) • Pain (more of a screen) * Often work together with PT on this area دکتر محمد کمالی -1386

40. How do I use the assessment data? To decide on approach to treatment (restoration/remediation, adaptation, compensation) To determine at which level I intervene (impairments, occupational tasks/abilities, participation/roles) To make recommendations (eg, referrals, workplace accommodations, followup care) دکتر محمد کمالی -1386

41. ابزار های ارزیابی دکتر محمد کمالی -1386

42. Assessing Severity of Illness • A brief method of identifying the severity of the mentally ill • suitable for everyday use (‘feasible’) دکتر محمد کمالی -1386

43. Global Assessment of Function (GAF) 1. Moos RH. Psychiatry Serv 2002;53, 730-7. Clinician’s judgment of overall level of functioning Guide treatment need and planning (DSM-IV) Rating - clinical dx and sx stronger predictor of than social or occupational functioning1 Minimally associated with treatment outcome1 No robust association btwn GAF and clinician interview or patient self report1 دکتر محمد کمالی -1386

44. Threshold Assessment Grid • Assesses severity of person’s mental health problems • Referrals to “routine” community mental health service • One page assessment - 7 domains - 4 to 5 point scale for each domain • Second page provides evidence-based criteria for each domain دکتر محمد کمالی -1386

45. Diagnostic assessment Self-administered tool that: • help identify and diagnose patients with mental illnesses commonly encountered in a primary care practice • allow for reporting of associated stressors • practical • reasonable performance characteristics • easy to average literacy level • useful in both initial management decisions and monitoring treatment outcome دکتر محمد کمالی -1386

46. General Health Questionnaire (12 and 26)1 1. Goldberg D P et al Psycho Med 197;27,191-7. Self completed (3 to 4 minutes) Validated\reliable, “current state”, predictive validity Identifies common underlying elements Focuses: inability to carry out normal functions; appearance of new distressing phenomena “Casernes” varies according to threshold FP (physically ill) and FN (“compared to normal”) دکتر محمد کمالی -1386

47. Patient Health Questionnaire (PHQ) Instrument based on psychiatric disorder criteria (reference symptom count) Not dependent on threshold of symptom severity Offset potential for symptom count not reliable indicator of impairment by having scale mode دکتر محمد کمالی -1386

48. توانائی فردی برای انجام در 5 بعد تحرک درد و رنج خود مراقبتی اضطراب و افسردگی فعالیتهای معمول شاخص های ارزیابی کیفیت زندگی معیارهای EQ-5D دکتر محمد کمالی -1386

49. Functional assessment tools That I use: • Canadian Occupational Performance Measure (COPM) • Functional Independence Measure (FIM) • Multiple Sclerosis Self Efficacy Scale (MSSE) • Doron Simulator • Interview/observation That others use: • Functional Assessment Measure (FAM) • Kohlman Evaluation of Living Skills (KELS) • Self Reported Functional Measure (SRFM) • Worker Role Inventory Checklist دکتر محمد کمالی -1386

50. Environmental/Community assessment tools That I use: • Home assessment form developed by our Home Service OT That others use: • Reintegration to Normal Living Index • SAFER دکتر محمد کمالی -1386