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Tools of clinical assessment

Tools of clinical assessment. Presentation outline. Introduction Our daily practice Types of assessment tools Pros and cons Emphasis Summary Q&A. Introduction. It is part of our daily practices Undergraduate as well as postgraduate Most of them are difficult to organize

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Tools of clinical assessment

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  1. Tools of clinical assessment

  2. Presentation outline • Introduction • Our daily practice • Types of assessment tools • Pros and cons • Emphasis • Summary • Q&A

  3. Introduction • It is part of our daily practices • Undergraduate as well as postgraduate • Most of them are difficult to organize • Lack of information • The students • Formative Vs summative • Wedded to tradition

  4. Our daily practice • Done at the corridor • Most the times it is ORAL • Observe while doing it • We chose the easy one/s to conduct • Rigidity • Restricted with venues!!! • Feedback is almost always ZERO

  5. OSCE The candidates rotate through a series of stations at which they are asked to carry out a (usually clinical) task

  6. Advantages of the OSCE • Valid examination • Controlled complexities • Summative as well formative • Larger number of students • Reproducible • Less biased • Fun activity

  7. Disadvantages of the OSCE • Knowledge and skills are tested in compartments • The OSCE may be demanding for both examiners and patients • More time in setting it up • Shortage of examiners • Might be quite distressing to the student

  8. Long case exam • Candidates spend 45-60 min with patient • No examiner (s) is present • Students are then examined by examiner for 20-30 min • Time is fixed by the institute where the examination is run • Usually ran over 4-5 days

  9. Advantages of long case exam • Holistic approach to patients’ problem (s) • Realistic • Interactive • Time • More related to daily practice of student • Student is used to such encounters

  10. Disadvant.of long case exam • Time consuming • Not observed • Physical signs • Different emphasis by examiners • Biased • Fixed • Not structured • Not standardized

  11. OSLER (1/2) The following are the key features of OSLER: • Ten item structured record. • Objective approach – there is prior agreement on what is to be examined. • Examiner reliable – all candidates are assessed on identical items. • Construct validity is recognized and assessed

  12. OSLER (2/2) • History process and product are assessed. • Communication skill assessment is emphasised. • Case difficulty is identified by the examiner. • Can be used for both criterion and norm referenced assessment. • A descriptive mark profile is available where marks are used. • No extra assessment time is required.

  13. Oral examination • Face to face discussion • No. of examiners vary, usually 2-3 • Mainly related to emergencies or important topics but in reality………. Once the question is asked:

  14. Advantages of oral exam • Allows assessment of personal characteristics • Assess language related issues • Discussion Vs argument • Flexible • Easy to conduct

  15. Disadvantages of oral exam • Prejudice • Threatening • Not standardized • Personal preference • Factual knowledge and recall • No. of students • No criteria

  16. Short cases exam • Each student will be assessed using 3-4 cases of different clinical findings • Usually observed by 2 examiners • Cases should be prepared before hand • Examiners must have a look at the cases before taking the student to them

  17. Advantages of short exam • Identify real clinical signs • Assess clinical examination skills • Time • Reproducible • Setting up • No of examiners

  18. Disadvantages of short case exam • Compartmental • Not objective • Not standardized • Hectic to both patients and students • Not valid • Low reliability • biased

  19. WORKPLACE –BASED ASSESSMENT Contextualisation, real life, formative and summative, objective

  20. Case-based Discussion (CbD) • Consultation Observation Tool • Clinical encounter cards • Clinical work sampling • Blinded patient encounters • Multi-Source Feedback ( 360 degree assessment) • Patient Satisfaction Questionnaire (PSQ) • Direct Observation of Procedural Skills (DOPS) • Clinical Evaluation Exercise ( Mini CEX) • Clinical Supervisors Report

  21. PORTFOLIOS • Clinical log-books • Procedural log-books • Clinical diaries • Reflective portfolios • Portfolios of learning • Formative • Summative

  22. Finally…… • There is no clinical assessment tool that is better than the other • Tools should correlate with objectives and learning process • Faculty need to be aware • Students need to know how are they going to be assessed • Use the tool properly Then inshalla…………….

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