Assessing Your Learner
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Transcript of Assessing Your Learner
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Assessing Your Learner
Lawrence R. Schiller, MD, FACGDigestive Health Associates of Texas
Baylor University Medical Center, Dallas
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Why do we assess trainees?
• It is an essential part of the learning process– Teacher needs to know what needs to be taught– Learner needs to know strengths to build on,
weaknesses to be corrected• It provides “quality control” for education– Effectiveness of teaching– Appropriateness of content
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Education Science• Cognitive psychology and neuroscience
provide insights into learning process– Principles for learning– “Experience is the best teacher” (if guided)– Learning with understanding • More than memorizing facts• Based on pre-existing knowledge
– Active learning• Learner is invested in process• Learner takes control of own education
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Education Science• Cognitive psychology and neuroscience
provide insights into learning process– Principles for learning– “Experience is the best teacher” (if guided)– Learning with understanding • More than memorizing facts• Based on pre-existing knowledge
– Active learning• Learner is invested in process• Learner takes control of own education
EVIDENCE-BASED TEACHING
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Skills-attainment Continuum
NoviceAdvanced beginner
CompetentProficient
Expert
After Dreyfus
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How experts differ from novices
• Experts notice features and meaningful patterns of information that are not noticed by novices
• Experts have acquired content knowledge that is organized with deep understanding of field
• Experts’ knowledge reflects contexts of applicability (conditioned by circumstances)
• Experts can retrieve knowledge with little attentional effort
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Adaptive Expertise
• “Metacognition”: thinking about how you are thinking about a given problem
• “Internal conversation” focusing on what additional information is needed for effective decision-making
• Self-assessment of how one is doing in dealing with a clinical issue
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Skills-attainment Continuum
NoviceAdvanced beginner
CompetentProficient
Expert
After Dreyfus
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Elements of Competence
• Deep foundation of factual knowledge• Conceptual framework for applying
knowledge• Organization of knowledge to facilitate
retrieval and application• (Adequate technical/motor skills)
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Types of Assessment
• Formative (feedback)– Measure of knowledge and/or skills
• Summative (appraisal/global assessment)– Integrated review of all aspects of work– May incorporate targets for future performance
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Purposes of Assessments
• Evaluating pre-existing knowledge
• Monitoring learning• Determining level of
achievement• Profiling strengths and
weaknesses
• Assuring that predetermined minimal qualifications are met
• Deciding about promotion or repetition of course
• Selection of best candidates for program
FORMATIVE SUMMATIVE
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Educational Objectives
• Expected results of learning, not methods of instruction– Should be observable, measurable, feasible
• Standards for assessment should be set ahead of time and discussed with learner– Norm-referenced (comparison to peers)– Criterion-referenced (absolute standard)– Limen-referenced (minimal threshold set)
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Miller, 1990
Assessment Tools
“No single assessment method can provide all the data required for judgment of anything so complex as the delivery of professional services by a successful physician.”
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Assessment Tools
• Validity– The extent to which an assessment measures
what it is supposed to measure• Domains of validity– Content validity– Concurrent validity– Predictive validity– Construct validity– Face validity
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Assessment Tools• Written tests– Progress testing – Mastery testing
• Oral examinations• In-training assessment• Objective structured clinical exam (OSCE)• Global rating scales– Behaviorally anchored scales– Likert scales
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Workplace-based Assessments
• Checklists• Milestones/Logs• Mini-clinical evaluation
exercise (mini-CEX)• Multisource feedback
(360o evaluations)• Directly observed
procedural skills (DOPS)• Procedure-based
assessments (PBA)
• Case-based discussions• Significant event
analysis• Chart audits• Patient satisfaction
surveys• Review of recorded
patient visits• Portfolio reviews
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ACGME General Competencies
• Patient Care• Medical Knowledge• Practice-based Learning and Improvement• Interpersonal and Communication Skills• Professionalism• Systems-based Practice
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Review with Learners
• Plan for the session– Collect data– Organize thoughts– Review standards against which trainee is to be judged
• Decide whether assessment is formative or summative
• Consider emotional intelligence aspects– The capacity for recognizing our own emotions and those
of others for motivating ourselves and others, and for managing emotions well in ourselves and others to enhance work performance
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Emotional Intelligence
• EI Competencies are learned capabilities• Self-Awareness– Emotional self-awareness, accurate self-
assessment, self-confidence• Self Management– Self-control, transparency, optimism, adaptability,
orientation to achievement, initiative• Social Awareness– Empathy, organizational awareness, altruism
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Emotional Intelligence
• Relationship Management– Developing others– Inspirational leadership– Influence decisions of others– Catalyze change– Manage conflict– Promote teamwork and collaboration
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Emotional Intelligence
• Relationship Management– Developing others– Inspirational leadership– Influence decisions of others– Catalyze change– Manage conflict– Promote teamwork and collaboration
YOU NEED TO KNOW YOUR LEARNER
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Review with Learners• Maintain a relaxed, positive atmosphere• Private and confidential; timely• Descriptive rather than judgmental• Focus on observed behaviors, not intentions or
interpretations; be specific rather than general• Involve learner in dialogue, listen to what
learner says (it provides the basis for action).• Help the learner understand any problems and
make plans to address issues in the future
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Questions?
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Summary
• Assessment is the process of measuring an individual’s performance during education
• Assessments can be – Formative: designed to improve performance– Summative: designed to assess competence
• Timely and appropriate assessment shared honestly with the learner is the best way to improve future performance