MEDICAL EDUCATION

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Notes for Primary Care Teachers

ASSESSMENTS – THE BASICS

SC Chan, MD, FRACGP, FAFPM, FAMM, PG Cert Med Edu
Principal Lecturer in Primary Care, Universiti Kuala Lumpur – Royal College of Medicine Perak

Address for correspondence: Professor Chan Sook Ching, Royal College of Medicine Perak, 3 Jalan Greentown, 30450 Ipoh, Perak Darul Ridzuan, Malaysia. Tel: 605-2432635, Fax: 605-2432636, Email: csching@rcmp.unikl.edu.my

Chan SC. Assessments – the basics. Malaysian Family Physician. 2007;2(2):81-83

As a primary care teacher, you will be involved in student assessment. This article will touch briefly on the purpose of assessment, definitions of some terms commonly used, what should be assessed and the assessment instruments.

Assessment is defined as a measure of student learning. This is different from evaluation which is the appraising of teaching.  The purposes of assessments are:

1. To pass or fail a student
2. To grade or rank students
3. To provide feedback to both students and teachers
4. To motivate students

Formative assessment is a means of monitoring a student’s progress through a course, and providing feedback to help the student improve. It does not count towards the final grades obtained by the student for the course. Continuous assessment means a student is assessed throughout the course by various means including assignments, tests and case presentations.  Continuous assessment can be formative or the marks/grades obtained may be added to the end-of-course assessments to become a part of the summative assessment. Summative assessment is designed to find out if a student has achieved the course’s objectives. It is usually at the end of the course, and a mark/grade is given to the student.

Examinations can be norm-referenced or criteria-referenced. Norm-referencing describes a student’s performance in relation to the rest of the group. By ranking, students can be compared with each other. The passing mark may be set to cut off a pre-determined percentage of students at the bottom. The disadvantage is that it cannot provide a clear picture as to what students can or cannot do. In criterion-referencing, students must meet a minimum standard of competence set, in order to pass. It gives a clearer picture of what students can or cannot do. However the percentage of passes for each particular year of the course can vary widely depending on that particular cohort of students, whether they are largely good or weak students.

Validity: A test is considered valid if it measures what it is supposed to measure. For example, multiple choice questions tests factual recall but, by itself, it cannot test how well a student can utilise the factual information in managing a patient.
Reliability: A test is considered reliable if it consistently measures whatever it measures.

What should be assessed? 
This usually follows the educational objectives of the course and includes:

1. knowledge (what the student knows)
2. skills (what the student can do)
3. attitude (what the student feels)

Core knowledge should be tested, not trivial knowledge (nice to know).

What assessment instruments to use?

This depends on what you are trying to examine. Table 1 gives a summary of commonly used written assessments.^1,2,3 In addition, open book examination tests reference techniques and projects tests the ability to seek relevant information.