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EducationalAssessment

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

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EducationalAssessment

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  1. EducationalAssessment Classroom MCQs Clinical OSCE

  2. 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

  3. 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

  4. 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)

  5. 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

  6. Overview of Assessment what why Whom Of What Assessment where How when

  7. Assessment • What? process of gathering… • Why? • Measure academic achievement • Identify areas for improvement • Predict future performance

  8. Domains Cognitive (Knowledge) Affective (Attitude) Psychomotor (Skills) Content Facts and principles Processes Signs and symptoms Clinical methods Techniques Management Etc…. Of what?

  9. How? • Written tests • Essay • True false • MCQs • MCIs • Viva/oral • Practical • Long case/short case • Osce • Projects

  10. How? Performance assessment in vivo Undercover SPs, Video, Logs only in real world of practice Does Performance assessment in vitro OSCE, Standardized-patient based test Shows how (Clinical) Context based tests MCQ, essay, oral Knows how Factual test: MCQs, Essay, Oral Knows Both areas tested by traditional written exams…. (Miller 1990)

  11. When?

  12. Where? • Testing in situations similar to those in training and practice, enable to make justifiable decisions

  13. Assessment Types

  14. Attributes of Assessment Curricular attributesinclude • 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)

  15. 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.

  16. Consists of two parts Stem Can be a question or an incomplete statement, scenario, problem Several options/ distracters But to choose the best response Multiple Choice Questions. MCQs

  17. Steps in Designing MCQs Stem • 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)

  18. Steps in Designing MCQs Options • 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

  19. Examples of MCQs • Knowledge 1. A patient’s father died of Huntington’s chorea. What are the chances that pt will have the disease? • 25% • 50% • 75% • 100%

  20. 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? • Assault • Battery • Negligence • Tort

  21. 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? • Administer a narcotic bolus as ordered • Assess the neurovascular status of leg • Lower the leg to increase arterial flow • Raise the leg to decrease venous return

  22. 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? • Hypertonic • Hypotonic • isotonic

  23. 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

  24. 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 MCQs

  25. Inspect Palpate Percuss Auscultate OSCE CPR being performed on a mannequin used for training

  26. 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,

  27. 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)

  28. 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

  29. 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/

  30. Approaches/Models to OSCE Multi station OSCE AKU Med students 1st & 2nd year OSPE Scenario based OSCE (sometimes called obj structured clinical assessment (OSCA) OSCE 3rd & 4th year Top to Toe Assessment OSCE /simulated Assessment with random allocation Some centers also use viva, or Q/A with these models (Rushforth 2007)

  31. 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)

  32. 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)

  33. 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

  34. 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

  35. 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 Views of students and faculty

  36. 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

  37. Cont… http://www.oucom.ohiou.edu/AcademicAffairs/predoc/osce/index.htm Norman, G. (2002) The long case versus objective structured clinical examinations. BMJ324: 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

  38. 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

  39. Questions

  40. THANK YOU

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