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ASSESSING HIGHER SKILLS

ASSESSING HIGHER SKILLS. “ Examinations are formidable even to the best prepared, for the greatest fool may ask more than the wisest man can answer.” Charles Caleb Colton (1780 - 1832). What are we assessing ?. COMPETENCY IN THE THREE DOMAINS OF LEARNING: Cognitive (Knowledge)

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ASSESSING HIGHER SKILLS

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  1. ASSESSING HIGHER SKILLS • “ Examinations are formidable even to the best prepared, • for the greatest fool may ask more • than the wisest man can answer.” • Charles Caleb Colton(1780 - 1832)

  2. What are we assessing ? • COMPETENCY IN THE THREE DOMAINS OF LEARNING: • Cognitive (Knowledge) • Psychomotor (Motor skills) • Affective (Attitudes)

  3. EACH DOMAIN HAS ITS OWN HIERACHY OF LEARNING : • COGNITIVE DOMAIN • Knowledge • Comprehension • Application • Analysis • Synthesis & transfer • Evaluation

  4. EACH DOMAIN HAS ITS OWN HIERACHY OF LEARNING : • PSYCHOMOTOR DOMAIN • Imitation • Manipulation • Precision • Actualisation • Naturalisation

  5. EACH DOMAIN HAS ITS OWN HIERACHY OF LEARNING : • AFFECTIVE DOMAIN • Recognition • Responding • Valuing • Organising • Conceptualising

  6. “Effective assessment is based upon knowing what the students need to know, what they have been taught and expected to learn, and at which hierarchical level in the domains of learning they are expected to be at”.

  7. “How do we ask the questions for assessment ? • Multiple choice questions (MCQ)  • Short answer questions (SAQ) • Modified essay questions (MEQ)  • Long essay questions • OSPE / OSCE Stations • Clinical Examinations (Long cases / Short cases) • Orals

  8. MULTIPLE CHOICE QUESTIONS ( MCQ) • Type A Single or one best response ( Multiple Completion Type) • Type E Relationship analysis • Type R Extended matching items • Theme • Options • Lead in • Item stems

  9. MCQ – Type R Theme: Cardiovascular drugs Options:A. Alpha agonists B. Alpha blockers C. ACE inhibitors D. Beta agonists……. K. Vasoconstrictors Lead-in:For each patient, select the most appropriate drug class Item stems: 1. A 40-year-old man with sudden onset of severe headache, dizziness and vomiting, BP 260/130 mmHg; encephalopathy and grade IV retinopathy 2. A 55-year-old man with mild, chronic hypertension, tachycardia and other symptoms of mild congestive cardiac failure. Previous history of asthma and gout. 3. ………

  10. THE MODIFIED ESSAY QUESTION (MEQ) An ability to assess a student in each of the three domains of learning, inclusive of a broad curriculum content

  11. MEQ flowchart: Myocardial infarction TRIGGERSSEQUENCEQUESTIONS Male 55 yr Central chest pain Embryology Medical Histology, Anatomy Pain radiates to arm & neck Neurology Cold periphery Sweating, cyanosis Myocardial infarction Pathology ECG Diagnosis Biochemistry Physiology Thrombolytics Management Pharmacology Post –infarction ComplicationsImmunology syndrome Intervention Management Pharmacology Disease prevention Health promotion Preventative health Life style change Psychology Behavioural sciences

  12. You are the admitting officer on call in a busy District General Hospital: Early one morning, you admit a 55 years old gentleman who has a history of crushing chest pain, radiating into his neck and left elbow. This is accompanied with generalised coldness, vomiting and peripheral cyanosis. You make a tentative diagnosis of myocardial infarction.

  13. Q1a Explain in patho-physiological terms the cause of the patients central chest pain. Q1b Explain why the patient feels pain in his neck and left armQ1c Describe the physiological processes that are causing the coldness and the peripheral cyanosis Q1d Name the process that is occurring in the patients myocardium and the histological changes that are happening.

  14. Q2a Below is the 12 lead ECG of the patient. Write a report on its findings Q2b Give two biochemical tests that would support a diagnosis of myocardial infarction Seven days after his admission the patient develops further chest pain and is diagnosed with Dresslers Syndrome Q3 Describe what maybe found on the patients ECG and chest X-ray at this time Q4 What causative factors are known to have a direct link to myocardial infarction

  15. MEQ Content / subject gridQN. ANA PHY PAT MIC BIO PHA CLIN H/prom X X X X X X X X X X X X X X X X X X X X X X X X X X X

  16. TRADITIONAL ESSAY QUESTION ( TEQ) • Describe the embryological • development of the human heart • List and describe four common congenital abnormalities of the heart and briefly describe how they arise embryologically

  17. MCQ – Type E The ductus arteriosus closes at birth by muscular contraction because Oxygen tension in the blood perfusing the ductus arteriosus rises when the pulmonary circulation opens up

  18. SHORT ANSWER QUESTION (SAQ) Biochemistry of Calculi • Name two sites in the human body where stone formation can occur • Describe the types of stones that can occur in the human body in relation to their chemical composition • Briefly describe two common patho-physiological processes involved with stone formation

  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

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