Principle of Assessment:PBA&WBA

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The Learning DomainBenjamin Bloom (1956), identified three domains of educational activities:

•Cognitive: mental skills (Knowledge)

•Affective: growth in feelings or emotional areas (Attitude)

•Psychomotor: manual or physical skills (Skills)

K A S

“ ต้�องการทราบอะไร ให้�วั�ด์สิ่��งน��น”

Conventional

OSCE, observe

Observe

เรามุ�กประเมุ�น สิ่��งท"�ประเมุ�นง�าย

Types of assessment

•Formative- provides feedback about progress and offers guidance for

improvement

Summative- measures achievement and determines levels of competence

for progression

Miller’s Pyramid

Authentic Assessment

Workplace Based Assessment

AUTHENTICITY OF CLINICAL ASSESSMENT – MILLER’S PYRAMID

Miller (1990)

Knows

Shows how

Knows how

Does

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Cognition

Actual performance assessment (WPBA)

MILLER’S PYRAMID – 1990

Knows

Shows how

Knows how

Does

Procedural competence assessment (OSCE), simulation

(Clinical) context-based tests, MCQ, essays

Factual tests, MCQ, essays

WBA

WHAT&HOW DO WE ASSESS?

Clinical knowledge and skills

Practical skills

Interpersonal skills and judgement

Professional behaviours

Case-based discussion

(CBD)

Direct observation of

procedures (DOPs)

Direct observations of non-clinical

skills (DONCS)

360º appraisal

(360)

Workplace assessment – judgement based on….

• Single encounter• Actually observed performance • Case specific • Routine performance• Observation over a period on different

occasions on different problems • Reduces problems with case specificity

Workplace assessment – nature of judgement

• Did it happen? มุ"ห้ร#อไมุ�มุ"• Checklist approach • Objective• Structured• Consistent• But not very discriminatory

Workplace assessment – nature of judgement

• Was the trainee any good? ด์"ห้ร#อไมุ�ด์"• Global rating• More valid

Workplace assessment – MiniCEX

• Faculty member observes a trainee interacting with a patient in a clinical setting

• 15 minutes (+5 minutes for feedback) • Interviewing skills, physical exam,

professionalism, communication skills• Formative feedback

Workplace assessment – CbD

• Case based discussion • Trainee selects case studies, assessor

chooses one of these • Assessor should ask why this selection• Assesses quality of … diagnosis, assessment,

management, record-keeping• 15 minutes (5 minutes for feedback)

Workplace assessment – DOPS

• Direct observation of procedural skills• Real patients• 15 minutes (+ 5 minutes feedback) • Trainees select from an approved list of

procedures• Indications, communication, technique,

analgesia, asepsis

Workplace assessment – DOPS

• 6 times in the year • Valid • Global rating scales

Workplace assessment – portfolios

• Different types of information• Summary of educational experiences• Reviewed by an assessor • Reflection• Action plan• Purpose must be clear (e.g. for summative

use)• Need be specific about what portfolio should

contain

Workplace assessment – checklists vs global ratings?

• Scores are broadly correlated

• Checklists – objective, reliable, lower level of expertise

• Global ratings – subjective, more valid

• Only experts can use global ratings• Anyone can be trained to use a checklist

Validity and Reliability•Validity: “Has the test effectively measured what it

was intended to measure?”

•Reliability: “reproducibility of assessment data or scores, over time or occasions”

From novice to expert

Take Home Messages- วั�ด์สิ่��งท"�ต้�องการวั�ด์- อย�าลื#มุใช้�การวั�ด์ห้ลืายๆ อย�าง- Formative as well as Summative assessment

Thank You