Written Assessment Dr Shamima Parvin Professor Head of

Written Assessment

Dr. Shamima Parvin Professor & Head of Biochemistry Mugda Medical College

• “To change curriculum or instructional methods without changing assessments would achieve nothing” • “Changing the assessment system without changing the curriculum had a much more profound impact upon the nature of learning” — G. E. Miller

The curriculum instructs teachers what to teach; The exam instructs students what to learn. Donald Melnick, 1991

Or Exam

Objectives of the session • At the end the of the session fellow be able to— • identify the principle of written assessment • classify instruments/tools for written assessment • differentiate between types of instrument used • state the merits & demerits of different instrument • construct ideal written assessment instrument

Assessment ? • Why ? • What? What ? • How? How ? • When ? • ? When? By Whom • Where? Where

Why should we assess? • To pass or fail

Why should we assess? • To pass or fail

Why should we assess? • To certify

Why should we assess? • To rank

Why should we assess? • To provide feedback (Both teachers and students)

What do we assess? The curriculum outcomes & Instruction

How do you elicit a knee jerk? Flex the knee joint…………

does Workplace based assessment shows how OSCE/OSPE knows how knows Written

Principle of written assessment • Cognitive domain (Knowledge) • intellectual skills, information & fact • Psychomotor domain (Skills) • practical skills • Affective domain (Attitude) • communication skills & behavior • Educators called it KSA

Level of cognitive domain

Elements in written assessment 1. The stimulus: • Short statement or question eg …. . • Statement or question with diagram eg……? • Patient presenting with some clinical scenario followed by question …. ? • More extended patient management problem

Elements in written assessment 2. The learner’s response : • Selected response/close ended e. g. MCQs, PMPs • Constructed response/open ended —Essay Question/Traditional essay —Structured Essay Question (SEQ) —Modified Essay Question (MEQ) —Short Answer Question (SAQ) Special type of essay questions

Question setter Ex am in er Essay Question Examinee e Exa ne i m

Comparison between Traditional Essay & SEQ Traditional Essay SEQ 1. Discuss the biochemical basis 1. Answer the following and clinical features of G-6 -P-D questions: deficiency (10). a. Depict the HMP shunt pathway in RBC by using a flow chart (2. 5). b. Explain how G 6 PD deficiency will produce haemolysis in the presence of oxidant drug (2. 5). c. State two condition other than drug exposure which may trigger same state(1. 0)

Modified Essay Question (MEQ) • Problem solving type of question, consist of— • Case history • Followed by number of sequential questions • Candidates have to construct the response • Interdependency of the sequential questions • If answer of the 1 st question is incorrect, all subsequent answer will also be incorrect.

Advantages of newer format • SEQ, MEQ and PMP— ─ presents a typical problem faced in daily practice ─ encourage more complex thinking skills among students ─ help to develop problem solving & decision-making skills ─ suitable for emergency/high risk problems where a student cannot be allowed to handle real situation

The eyes cannot see what the mind does not know

What is SAQ? • SAQs are open-ended questions that require students to create an answer • Educationists have various opinion — • what actually constitute a SAQ? • SAQ typically require responses of one word/ one phrase to few sentences.

What is SAQ? • Answer should be short • A patient of pulmonary TB undergoing 4 -drug treatment regime develops peripheral neuritis. Name the drug responsible for neuritis in this patient. • Answer-Isoniazid

What is SAQ? • It may simply ask the student to write a missing word or phrase: • Anaerobic glycolysis produce— ( 0. 5) • It may call for brief listings: • List the names of ketone bodies (1. 5) • A one-sentence answer: • What is the basic principle of colorimetry? (1)

Differences between SAQ & MCQ • SAQ is similar to a well-stated MCQ without the alternatives/options • The examinee is required to generate the specific answer rather than just select from the options provided

Example • Hormone maintaining calcium homeostasis is/area. calcitonin b. calcitriol c. thyroxine d. parathyroid hormone e. Aldosterone • Name 3 hormones that maintain calcium homeostasis (1. 5)

Differences between SAQ & MCQ • These open-ended questions are more flexible than MCQ • We can test the issues that require creativity and spontaneity • By well-constructed SAQs we can even assess higher cognitive level

Differences between SAQ & MCQ • Life saving hormones are/ isa. thyroid hormones b. aldosterone c. parathyroid hormone d. insulin e. cortisol • Why PTH is considered as life saving hormone? (2)

Guideline for writing written questions

Test matrix (Blueprint) Contents Cognitive domain Knowledge 50% Application 20% Total 100% Biophysic & Biomolecule 30% 1 Comprehension 30% 1 Digestion & absorption 20% 1 1 Metabolism 30% 1 1 Food & nutrition 10% Vitamins & minerals 10% 1 1 Total=100% 5 3 1 3 2 1 2 3 10 items

Guideline for writing written questions • The statement should be worded carefully to get very specific answer • Intended answer should be write 1 st , then we have to write question • Question should be concise, clear & understandable • Statement should not be lifted as it is from text book • Unintentional correct answer cues should be avoided

Types of SAQ • Completion items (fill in the blanks) • Definition • Label/draw diagram • Unique answer type • Numerical problems • Open SAQs • Problem solving items

Example of different types of SAQs • Completion items (fill in the blanks) • Consists of incomplete sentence & examinee have to supply missing word, term, symbol etc • Type II alveolar cells of lung secrete…… • Name of the causative agent….

Example (Contd…) • Unique answer type— • Name essential fatty acid • Numerical problem SAQ— • A patient with H+ conc. 40 nmol/L. Calculate p. H of that patient • Draw /label — • Draw & label the structure of lipoprotein

Example (Contd…) • Open SAQs — • List merits & demerits of…. • Mention 4 important functions of…. • List indications of…. .

Problem solving items • A 46 years old female patient comes to you with a history of generalized weakness, palpitation, excessive sweating, and heat intolerance for the last one year. In spite of a good appetite, she has lost 10 kg of weight during this period. • What will be the possible cause of above mentioned symptom? Justify (3) • What biochemical investigations will you advise to the patient for diagnosis? (2)

Take home message

Take home message d n la u f g n i n a g e n i nts m n , r g a e n i e d l u rd le t a s b r w Re taina ce fo s n u e i s r e p x e

References • Assessment in medical education: Evolving perspectives and contemporary trends by Rita Sood & Tejinder Singh. • Essentials of medical education by Adhikari & Jayawickramarajah • Essential skills for a medical teacher by Harden and Laidlaw, • Concepts of medical education by Tahmina Begum • online resource materials

“Students work to pass, not to know. . . They do pass and they do not know” Thomas Huxley