Clinical Assessment: at the heart of healthcare education
“ The rules of clinical assessment are the same for whatever Doctor you are producing…. .
…… clinical assessment has to be: real, relevant & objective . valid and reliable
…… the world has moved on !! .. society has changed …… society expects more from its Doctors …….. we should respond to that need .
…… and since the unexpected can always happen we must make provision for it
What do we want students to achieve in the clinical assessment of our students ? • Show they have achieved a previously overall defined level of competence • Understand very well the fundamentals of clinical practice and apply their previous learning • Show they can perform to a required and accepted level of competence in real or simulated real practice in specified areas • Adapt their practice to real life situations and normal / expected variations .
Performance assessment in vivo: Masked SPs, Video, Audits….. Does Performance assessment in vitro: OSCE, SP-based test….. Knows how (Clinical) Context based tests: MCQ, EMI, essay type, oral….. Knows Factual tests: MCQ, essay type, oral….. Shows how …. we want to see students climbing the pyramid Does Shows how Knows how . Knows
Most schools have moved away from : Long cases Short cases Oral / viva voce Why: Often irrelevant to real life Specialty specific, not integrated Non-standardised / comparable Highly subjective One opportunity to become a star .
To: OSCE – OSVE, OSPE, ISCE etc Written formative – portfolios, reflective diaries, log books etc Web-based Case-based Workplace-based 360 degree, multi-professional Competency- based .
But, if we use these methods, we must address the issues of: • Standardisation • Objectivity • Validity • Reliability • Real-life situations with complexity • Safety • Multiple biopsy technique .
Clinical Assessment What is the best way ?