Learning Outcomes for The Role of the Doctor within the Health Service
This is a rapidly changing area of medical education and practice, which is subject to many external influences including political, legal and economic. However, there are a number of key outcomes applicable to the new graduate, awareness of which should provide a firm basis for dealing with future developments and changes within the health service.
Modes of assessment for this outcome common to several schools already include:
Two fairly new assessment methods have been recommended for this outcome:
Research into the validity and reliability of the tools listed above is required. Although there is information for some of the more established tools e.g. MCQ, MEQ and OSCEs this may not be applicable in the context of this outcome. Further work is required to evaluate them.
Assessment of many of the Level 4 outcomes will be applied in an integrated fashion i.e. professional conduct and motivation can only be assessed within the context of observed clinical or project work and not alone. Many of the outcomes will be assessed together e.g. lateness at clinics may be a marker for poor motivation and/or poor organisational skills.
Compensation should no longer be permitted between academic content and personal/professional development to prevent information on studentsí suitability for medical practice being Ďlostí within assessment of academic ability. Separate tracking of personal and professional development is suggested to allow concerns about a studentís professional qualities to be identified and acted upon quickly to benefit students, patients and the profession.
Assessment methods and tools must be selected which will motivate medical students to adopt attitudes, skills and knowledge for professional practice and not merely for examinations. In particular we need to encourage specific strategies in medical students e.g. reflective practice, deep learning and skills in teamworking. Research on the effect of assessment on studentsí personal and professional development will be very important in the new medical curricula.
These recommendations on continuous assessment, portfolios and educational mentoring are all tempered by the recognition that each requires significant resources. Staff development is necessary to ensure that teachers understand the purpose of these systems and how to make objective and fair assessments and give feedback.
These modes of assessment also require tutors to find more time to gather information about students on attachment and offer feedback on their performance; mark several pieces of written work for the portfolio, often including reflective writing where the tutor needs to be familiar with the whole portfolio; and to offer appraisal and mentoring to a few students perhaps twice in the academic year. These concerns about tutorsí time emphasise the need to introduce these modes of assessment cautiously and enquiringly and to review the acceptability by both staff and students as part of the evaluation.
Different methods of assessment are essential in a balanced assessment portfolio. This is to match assessment to outcomes, to provide a range of types of assessment so that students finding particular difficulty, for example with written assessment have an opportunity for compensation through excellence in other media, and to give students a wider experience. Direct and indirect methods should be used to give as complete and authentic a picture of the student as possible. It should be remembered that assessment is an integral part of the educational cycle and contributes not just to the studentís progress but also to course evaluation and revision.
The recommended assessment methods test attitudes and behaviour and depend on reflection and synthesis rather than reproduction of factual information, although this is not totally excluded. Tutorsí reports on attitudes, commitment, and motivation may be the most appropriate tool to use, if there is an opportunity for the tutor to get to know the student. Validated tools are available and there is the possibility of adopting the RITA scale which would provide a link with the postgraduate years. Many of these outcomes should be assessed in an integral way with other outcomes. For example, attitudes and professional behaviour can be specifically part of marking schedules for OSCE stations, and assessment topics within health care systems would be a specific part of guidance for, and marking schedules for, oral patient case studies, or written reports.
Recommended methods of assessment include:
Potential new methods of assessment are:
|Published by the Scottish Deans' Medical Curriculum Group © 2011|