Assessment in Systembased Curriculum Dr Usman Mahboob Assistant

Assessment in System-based Curriculum Dr Usman Mahboob Assistant Professor in Medical Education

1. Foundation Module First Year Modules 2. Blood & Immunology 3. Musculo-skeletal and Locomotion 4. Cardiovascular 5. Respiratory

System-based Curriculum: How?

Activity (Exams, holidays, vacations) End of Module Exam 5 th Feb Public Holiday Block-I Exam 23 rd March Public Holiday Spring Break 1 st May Public Holiday Block-II Exam Eid Holidays End of Module Exam Block-III Exam 4 -weeks Preperatory Leaves for Professional Exam Year 1 Professional Exam Start of Year 2 Academic Session Date Week No. Year 1 Modules Dec 31 - Jan 5 Jan 07 - Jan 12 Jan 14 - Jan 19 Jan 21 - Jan 26 Jan 28 - Feb 02 1 2 3 4 5 Foundation-I Feb 04 - Feb 09 6 End of Module Exam Feb 11 - Feb 16 Feb 18 - Feb 23 Feb 25 - Mar 02 Mar 04 - Mar 09 Mar 11 - Mar 16 Mar 18 - Mar 23 Mar 25 - Mar 30 April 01 - April 06 April 08 - April 13 April 15 - April 20 April 22 - April 27 April 29 - May 04 May 06 - May 11 May 13 - May 18 May 20 - May 25 May 27 - June 01 June 03 - June 08 June 10 - June 15 June 17 - June 22 June 24 - June 29 July 01 - July 06 July 08 - July 13 July 15 - July 20 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 Blood & Immunology July 22 - Aug 22 30 -33 Aug 23 - Sept 14 34 -36 30 -Sep Block-I Exam MSK Block-II Exam CVS-I End of Module Exam Respiratory-I Block-III Exam 4=weeks Preperatory Leaves for Professional Exam Tentative dates for Exam Tentative Start of Year 2 Academic Session Year-1 Academic Colander Academic Calendar Year 1, (Session 2018 -2019)

01 - Foundation Module (6 -weeks) SNO Theme Duration 1 Orientation 1 week 2 Cell 1 week 3 Growth & Development of Human Body 2 weeks 4 Human Body tissues, bones & joints 2 weeks

02 – Blood & Immunology (5 -weeks) S No Theme Duration 1 Pallor and swelling 2 weeks 2 Fever (Infection and Immunity) 2 weeks 3 Excessive bleeding & Transfusion Reaction 1 week

03 – MSK & Locomotion (8 -weeks) S No Theme Duration 1 Orientation and shoulder pain 2 weeks 2 Weak grip and painful hand 1 week 3 Pain lower limb/limping 2 weeks 4 Bony arches and fracture of foot 1 week 5 Backache 1 week

04 – CVS (5 -weeks) SNO Theme Duration 1 Chest pain 1 week 2 Breathlessness and ankle swelling 2 weeks 3 Blood Pressure 1 weeks 4 Palpitations 1 week

05 – Respiratory (4 -weeks) S No Theme Duration 1 Chest wall injury 1 week 2 Cough and Hemoptysis 1 week 3 Breathlessness 2 weeks

Integrating Teaching of Behavious in Curriculum

Outcomes required by the PMDC Outcomes Year 5 Year 4 Year 3 Year 2 Year 1 Medical Knowledge Clinical Practice & patient care Community Health Promoter Communication Skills Doctor as Leader and Manager Doctor as Scholar/ Researcher Doctor as Professional/ Professionalism

How to learn these skills? P – Professionalism, Patient safety & Communication Skills R – Research I – Identity formation M – Management & Leadership E – Ethics & Legal issues

n i t n e m s s e Ass d e s a b m e t sys m u l u curric

• FM End of Module Exam • Block 1 exam (FM+ Blood) Assessment in • Block 2 exam (MSK) System-based • CVS End of Module Exam Curriculum • Block 3 exam (CVS+ Resp. ) • Pre-prof exam (Paper I, III) • Prof exam (University)

How to assess in System-based curriculum? • Assessment is based on blueprints • Students would pass the module/block • University theory paper – MCQ only • University Skills assessment – OSPE/OSCE only

Year 1 Professional Exam in System-based Curriculum Theory paper Paper A Paper B Paper C TOTAL MARKS Modules FM Blood MSK CVS Respiratory OSPE/ OSCE Internal Assessment OSPE/ OSCE (10%) TOTAL MARKS 14 90 10 234 120 13 90 10 233 360 40 270 30 700 Theory Marks Internal Assessment Theory (10%) 120

Sample Blueprint: Paper A (FM+ Blood) No. of MCQs in Foundation (total 158 hours) No. of MCQs in Blood (total Total * 93 hours) Gross Anatomy 12 1 13 Histology 10 4 14 Embryology 15 0 15 Physiology 10 22 32 Biochemistry 14 12 26 Pathology 2 4 6 Pharmacology 1 1 2 Community medicine 1 2 3 Forensic medicine 0 1 1 PRIME 5 3 8 Total 70 50 120 Subject * Distribution of MCQs are based on a ratio of 1. 7: 1 (158: 93) between 2 modules

Sample Blueprint: Paper B (MSK) No. of hours allocated in TT Subject Gross Anatomy 121 Percent distribution (No. of hours allocated in TT for specific subject/total hours x 100) Percentage distribution of hours (subjectwise) 59 Histology Embryology Physiology Biochemistry Pathology 14 7 26 26 3 7 3 13 13 2 Pharmacology 1 Community medicine PRIME Total subject-wise MCQs out of 120 71 69 13 13 2 8 4 16 16 2 1 1 1 1 207 1 100 1 120

Sample Blueprint: Paper C (CVS+ Resp. ) Subject CVS module MCQs Respiratory module MCQs Total MCQs* Gross Anatomy 9 12 21 Histology 4 4 8 Embryology 5 3 8 Physiology 34 20 54 Biochemistry 14 8 22 Pathology 1 1 2 Pharmacology 1 0 1 Forensic medicine 1 1 2 Community medicine 1 1 2 Total 70 50 120 CVS module (total 109 hours) Respiratory module total 65 hours) *total MCQs are distributed with a ratio of 1. 7: 1 (109: 65) ! example=(30/120) x 50 (where 30 is the total no. of MCQ for gross anatomy in individual Respiratory module out of 120 MCQs and 50 is the total MCQs required for block assessment according to the ratio of 1. 7: 1)

OSPE • Minimum 18 stations (excluding pilot and rest stations) for each batch. • Mix of static and interactive stations. • Time: Minimum 3 -6 minutes, including 1 minute for movement between the stations and reading the instructions. • Faculty up to demonstrator/ SR level to be involved. • For every block exam, there should be at least three external examiners for the major subjects • One of the external examiner - Nominated as coordinator

Phy Internal Viva Static Action potential Exit Bio External Viva Ana Internal Viva Static Walking mechanism Phy External Viva Static G 6 PD deficiency Static Histology slide Ana External Viva Static ATP production Bio Internal Viva Example: OSPE Circuit MSK & Locomotion Enter Static Shoulder Joint model

OSPE Circuit Dr Usman Mahboob This Photo by Unknown Author is licensed under CC BY-SA

Example of Paper A

Operating The Microscope Anatomical terms 7 5 3 1 Histology of Simple Epithelia Rest 1 Ana Viva 1 Histology of Glands/ Lymph nodes Rest 2 9 Ana Viva 2 Sterilization Lab Equipment’s 25 Bio Viva 2 OSPE Circuit Paper A (FM+ Blood & Immunology) Rest 7 23 Rest 3 11 Phy Viva 1 Detection of Monosaccharide’s Oral temperature Bio Viva 1 Rest 6 21 PH and buffer solutions Blood count 19 Rest 5 Hb determination 17 Phy Viva 2 Rest 4 15 Blood grouping 13

Plan 1 (Single Circuit – 25 students) Total Circuit Time: 25 * 5 = 125 minutes (2 hours and 5 minutes) • Circuit 1 (9 – 11: 05 AM) • Break 1 (11: 05 – 11: 30 AM) • Circuit 2 (11: 30 AM – 1: 35 PM) • Break 2 (1: 35 – 2: 00 PM) • Circuit 3 (2: 00 – 4: 05 PM) • Break 3 (4: 05 – 4: 30 PM) • Circuit 4 (4: 30 – 6: 35 PM)

Plan 2 (Parallel Circuits – 50 students) Boys Common Room • Circuit 1 (9 – 11: 05 AM) Group A & B • Break 1 (11: 05 – 12: 00 PM) • Circuit 2 (12: 00 – 2: 05 PM) Group C & B Girls Common Room Circuit 1 (Group A) Circuit 1 (Group B) Circuit 2 (Group c) Circuit 2 (Group D)

Works cited

Thank you Dr Usman Mahboob MBBS, MPH, FHEA (UK), Ph. D (UK), Fellow FAIMER (USA) Director Medical Education Khyber Medical University usman. mahboob@kmu. edu. pk