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Formative Assessment Case Studies (FACS)

Formative Assessment Case Studies (FACS). Shekhar Kumta, Jack Cheng, James Ware Chinese University of Hong Kong. (Refer to CD for FACS engine and sample workshop case study). Hong Kong International Consortium. What Are FACS?.

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Formative Assessment Case Studies (FACS)

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  1. Formative Assessment Case Studies (FACS) Shekhar Kumta, Jack Cheng, James Ware Chinese University of Hong Kong (Refer to CD for FACS engine and sample workshop case study) Hong Kong International Consortium

  2. What Are FACS? • We have designed a user friendly engine for generating and delivering web-based, interactive, clinical scenarios • These case studies allow accommodation for multimedia features & require formative feedback to facilitate student learning. • RCTs have established the effectiveness of FACS • and students prefer using this learning and assessment model. • FACS engine provides a value added option for administering items from IDEAL’s non restricted (formative) bank.

  3. FACS Strength: enhanced authenticity to the assessment Clinicians feelFACS provide a convenient means to generate & present a meaningful clinical context for one’s formative items. FACS enables not only incorporation of, but enhanced use for formative items that are • Vignette-based A type • Vignette-based R- type • Key features based

  4. Option of using Key Features Evidence: one can assess student learning by testing only some elements that are essential to the resolution of that problem (i.e. the clinical problem’s key features). • Using key features is also an effective way of facilitating student learning (not just the assessment of their learning). • key features based assessments correlate better with problems solving ability and clinical reasoning than patient management problems

  5. How to Select Case Studies for FACS • Identify areas where students frequently encounter difficulties understanding clinical concepts. • the clinical scenario needs to set a context so that application of knowledge becomes the focus for the virtual problem . • ensure steps within the problem enable strategic formative feedback in order to develop & facilitate understanding.

  6. Workshop Objectives for FACS • Short Term • Create a FACS • Write or incorporate existing formative items • Incorporate formative feedback • Intermediate • Install the FACS templates provided on your own or your institution’s computers / servers • Long Term • Develop a bank of educationally relevant and validated FACS for sharing among consortium members

  7. The Problem and Objectives Generic Problem Apply to several cases + + Objectives • Graduating Level • What do interns do? • Objectives = assessment • Practical issues • Consider theoretical issues

  8. The Problem and Objectives Generic problem Scenario Cases Feedback 1 Action List 1 Clinical detail Explanation 1 Action List 2 Feedback 2 etc

  9. The Problem and Objectives Chest pain Generic Problem + + Objectives • Clinical features • Prioritise management • Interpret investigations • Include discharge etc.. • Anatomy of thorax Suggest some notes

  10. Writing the Scenario Generic problem Scenario

  11. Writing the Scenario • INCLUDE: • Age and gender • Site of care • Summary of presentation • Keep generic at this stage • Onset, duration, severity • ~2 – 6 lines • Other (e.g., family history) • The Scenario: • shall always include common info • realism important • summary form

  12. Writing the Scenario The Scenario: Important, the same stem shall apply to several cases, e.g., pneumothorax and MI etc. 38 year old Chinese male with a twenty year history of heavy smoking is admitted to the A&E Department with sudden onset of chest pain one hour before and is apparently having difficulty in breathing.

  13. Choices of Cases Generic problem Scenario Cases

  14. Choices of Cases Create several related cases: Case 1 + • common scenario • common cases • common objectives Case 2 + Case 3 + Case 4 . . .

  15. Choices of Cases The Cases Pneumothorax, tension + Pneumothorax, simple + Myocardial infarction + Acute oesophagitis

  16. Writing Clinical Detail Scenario Cases Clinical detail

  17. Writing Clinical Detail Case 1: Pneumothorax Clinical detail + Clinical images • Consider site • Usually vital signs • Important info: • Specific clinical findings • + special tests

  18. Writing Clinical Detail HR: 120bpm BP: 80/60 mm Hg RR: 30 / min T: 37.5o C Hyper-resonant Rt., absent BS and reduced respiratory movement Rt., Clinical detail With Added value

  19. Writing an Action List Scenario Cases Clinical detail Action List 1

  20. Writing an Action List Include Lead-in + Up to “n” possible actions • Brief • Likely choices • Pick one best response • Ensure four or more

  21. Writing an Action List What is your next action? Lead-in + Incorrect Correct choice Incorrect 1.Order chest radiograph + 2. Insert a chest drain + 3. Order a chest CT

  22. Writing Feedback Scenario Cases Clinical detail Feedback 1 for incorrect choices Action List 1

  23. Writing Feedback Feedback For all incorrect choices + Included • Why inappropriate • or • Trigger further thought • Linkages to resources • Another image?

  24. Writing Feedback 1. Life threatening situation . . . For each feedback that is incorrect give a summarised form of info. Will offer re-entry assessment after incorrect choices + 2. Quite incorrect . . . + 3. No place for definitive . . . + 4. Tests unnecessary . . .

  25. Explanation for Correct Choice Scenario Cases Clinical detail Feedback 1 for incorrect choices Explanation 1 for correct choice Action List 1 REPEATED SEQUENCE

  26. Explanation for Correct Choice Explanation Summarised + Added value • Video of procedure • Text for action • or • Result (s) of investigation

  27. Writing an Action List Scenario Cases Clinical detail Feedback 1 for incorrect choices Explanation 1 for correct choice Action List 1 Action List 2

  28. Writing an Action List Action List Lead-in + Up to “n” possible actions • Brief • Likely choices • Pick one best response • Ensure four or more

  29. Writing an Action List What is your next action? Lead-in + Partially incorrect Correct choice Incorrect 1.Order chest radiograph + 2. Admit for observation + 3. Discharge after . . .

  30. Writing Feedback Scenario Cases Clinical detail Feedback 1 for incorrect choices Explanation 1 for correct choice Action List 1 Feedback 2 for incorrect choices Action List 2

  31. Writing Feedback Feedback For all incorrect choices + Included • Why inappropriate • or • Trigger further thought • Linkages to resources • Another image?

  32. Writing Feedback 1. Not an immediate priority . . Don’t forget the further assessment to re-enter at the last action point + 2. Pt. needs monitoring . . . + 3. Too early for discharge . . . + 4. Review later for need . . .

  33. Explanation for Correct Choice Scenario Cases Clinical detail Feedback 1 for incorrect choices Explanation 1 for correct choice Action List 1 Feedback 2 for incorrect choices Explanation 2 for correct choice (s) Action List 2

  34. Explanation for Correct Choice Conclusion Summarised + Added value • Video of procedure • Text for action • or • Result (s) of investigation

  35. Re-entry Assessment Stem Use relevant clinical info + + • MCQ format • + vignette • R type • Key features etc . . . Options

  36. Explanation for Correct Choice Scenario Cases Clinical detail Explanation 1 for correct choice correct choice Action List 1 incorrect choices Assessment # failed tries decides if exit Feedback 2 for incorrect choices Action List 2

  37. CREATING A FACS DEMONSTRATION

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