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ASSESSMENT IN GP/FM

ASSESSMENT IN GP/FM. Mladenka Vrcic-Keglevic, MD, PhD Head of Family Medicine Department, Medical School, Univerity of Zagreb mvrcic@snz.hr. Content of the session. Definition of the terms How to use assessment (summative, formative) Assessment methods (AM)

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ASSESSMENT IN GP/FM

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  1. ASSESSMENT IN GP/FM Mladenka Vrcic-Keglevic, MD, PhD Head of Family Medicine Department, Medical School, Univerity of Zagreb mvrcic@snz.hr

  2. Content of the session • Definition of the terms • How to use assessment (summative, formative) • Assessment methods (AM) • What can be assessed by different AM • Metric’s characteristics of AM • ….. • Interactive session

  3. Definition of the terms • Evaluation: A process that attempts to systematically determine the relevance, effectiveness, and impact of activities in light of their objectives. Can be related to structure, process or outcome of (programme, person). • Assessment: A system of evaluation of professional accomplishments in light of educational objectives, using defined criteria and usually including an attempt at measurement either by grading on a rough scale or by assigning numerical values. AMEE – Glosary of Medical Education Terms

  4. Well defined educational objectives - prerequsite for assessment Example for this session: At the end of this session participants will be able: • To named at list three differences between summative and formative assessment • To make a list of at least three written AM • To name the most effective AM to assess clinical skills • To describe the most effective AM to assess attitudes

  5. How to use assessment? • Summative: This is usually undertaken at the end of a training programme or teaching course and determines whether the educational objectives have been successfully achieved. With summative assessment the students usually receives a grade or a mark. Exam • Formative: This is testing that is part of developmental or ongoing teaching / learning process. It should emanate from a wish to foster learning and understanding. It should include delivery of feedback to the student.

  6. Summative - Examination What the exams are? • For students – A difficult and unpleasent steeplechase to run on a way for diploma • For teachers – A less desirable teaching activity • For public – An important protection from un-competent doctors

  7. Summative assessment The reasons: • A statement of achievement - university degree (diploma) • An entrance requirement to an educational institution • A guide as to the wisdom of continuing with further study • A certification of competence – public responsibility (licence) • A determinant of programme effectiveness

  8. Written: MCQ - Multiple Choice Questions Un-Q – An-cued Questions Essay MEQ – Modified Essay Questions EMI - extended matching items PMP – Patient Management Problem Oral, viva Traditional practical OSCE – Objective Structured Clinical Examination SP - Standardised Patient Portfolio ACC – Assessment of Clinical Competence Assessment methods (AM)

  9. What can be assessed by different AM • Factual knowledge • Interpretations • Problem-solving skills • Ethical • Clinical skills • Emotional reactions • Communication

  10. What can be assessed?

  11. Metric characteristics of AM • Validity - the degree to which a measurement instrument truly measures what it is intended to measure • Reliability – it is an expression of the precision, consistency and reproducibility. Ideally, measurements should be the same when repeated by the same student or made by the different assessors. • Relevance – it is a degree to which the assessment questions and educational objectives are in concordance • Objectivity – it is a level of agreement among independent assessors (experts) about the right answer to certain question

  12. Metric’s characteristics?

  13. Practicality? • Preparation – resources (time, human…) • Easy to perform, aplay • NC – number of candidates • NC/teacher – number of candidates per one teacher

  14. Practicality

  15. MCQ – Multiple Choice Questions • Difficulty index • Discrimination index • Minimum pass level

  16. Indeks of difficulty QD = (G + P)/N • QD – question’s difficulty • G – number of right answers in good group • P – number of right answers in poor group • N – number of students in both groups

  17. Difficulty Index 0,3 0,5 0,6 0,7 ------/---------------(------------)----------/--------- recommended -------------------------------------------------------------- acceptable too difficult too difficult

  18. Discrimination Index • DI = 2 (G-P)/N • DI – discrimination Index • G – number of right answer in “good” group • P – number of right answer in “poor” group • N – number of students in both group

  19. Diskrimination Index 0.15 0.25 0.35 ----------/----------/----------/---------- throw off to check good excelent

  20. What AM to use in reality? • There is no perfect AM • A choice depends of what is to be measured – educational objectives (knowledge, skills, competences, attitudes) • Careful preparation, trained assessors • Multiple methods – better then one

  21. Specialistic exam in GP in Croatia Should be submeted in advance: • Portfolio • 8 essays • Questionary of professional competence – signed by trainer • Trainer’s report about trainee’s achievements • Trainee’s report – How to organise my practice, what to invent? • Medical records (videos) of 3 patients / family

  22. Specialistic exam in GP in Croatia • MCQ test – 150 questions • OSCE – 20-25 stations • Oral – jury (3 members): 1 academic GP + 1 well recognised GP (publication) + 1 trainer

  23. Formative assessment The reasons: • Information for the student about his/her achievement of educational objectives • Repetitive – progress measurement • Discover “week points”–teacher’s support • Help to a teacher to correct programme • The results should not be used in summative assessment

  24. Formative assesssment -which AM? • The same as for summative – progress test • Protocols for observing clinical work (consultation, communication, p-s abilities, professional competences) • Checklists • Diaries – what has been done • Appraising projects, audit… • Portfolio • Self and peer assessment

  25. Formative assesssment • Feedback • Feedback • Feedback • Feedback • Feedback

  26. Educational objectives in this session – achieved? At the end of this session participants will be able to: • name at least three differences between summative and formative assessment • make a list of at least three written AM • name the most effective AM to assess clinical skills • describe the most effective AM to assess attitudes

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