Assessment in higher education

Assessment drives learning and influences the quality of learning by directing the approach students take towards learning and by aligning the outcomes of the educational program with teaching methodologies and the educational environment. Assessment needs to be recognized as a multidimensional entity and not a singular activity or concept that transcends across three domains cognitive, affective and psychomotor. Any assessment requires activation of and access to different cognitive, affective andpsy-chomotor skills at multiple levels and their applications through a fusion in a multidimensional collusion of stored memories, learned knowledge and behaviour and acquired skills. Another dimension that requires consideration here is the context in which assessment takes place. Context of assessment can be defined in terms of the environment in which assessjnent takes place, its background, stakes as well as the stakeholders involved. New formats and mediums are being used in all areas of education both as a learning / teaching strategy as well as for assessment. Computerized, computer - aided or online teaching and learning have paved the way for computer - assisted - assessment techniques. Whether assessment is formative or summative, influences its design, approach and outcomes. To the adjninistrator, the results of the assessment, either formative or summative, provide data that will help establish current policies or bring changes to them. To the program developers, the same results establish the worth of the program or otherwise. To the trainees, the scores or feedback help in understanding their deficiencies in relation to the clearly predefined goals and objectives of the educational program. The public places great emphasis on the native of assessment and the outcomes related to it since it is the public that is going to use the product of the medical education programs and confidence in the product will be related to their acceptability of the assessjnent and its outcomes. This paper identifies different formats of assessment and their contextual relevance

Medical colleges admission test in Punjab, Pakistan

Nearly 18,000 candidates securing 60% and above marks in Higher Secondary School Certificate [HSSC] examination contest for admission in Medical Colleges, in Punjab, Pakistan by sitting in the Medical College Admission Test [MCAT] each summer. This cross-sectional study was conducted to identify patterns related to demographic, economic and educational backgrounds, over a two-year-period, in this population, and how HSSC and MCAT marks predict future performance of the selected candidates. Marks obtained by candidates in HSSC, MCAT, and 1st Professional MBBS [Part-I] Examinations over two years 2008-2009, were analysed using parametric tests in SPSS. Total 18,090 candidates in 2008 and 18,486 in 2009 sat in the MCAT. National HSSC candidates scored higher marks in HSSC and MCAT but lower marks than their foreign qualified HSSC counterparts [e.g., Advanced-Levels from Cambridge University, UK] in Part-I overall and in all its subcomponents individually [p<0.05]. Female students scored higher marks than males in HSSC [p>0.05], MCAT [p>0.05] and Part-I theory, practical, viva voce, continuous assessment and Objective-Structured Performance Evaluation [OSPE] components [p<0.05]. In both years, students from the Dera Ghazi Khan District scored the highest marks in the HSSC Examinations [p<0.05] but least marks in MCAT in 2008 [p<0.05] and in Part-I in 2008 and 2009 [p<0.05]. Students from 'tougher' Boards like Rawalpindi in 2008 and the Federal Board in 2009 who scored least marks in HSSC scored highest marks in MCAT, and in Part-I Examinations [p<0.05]. Linear regression on Part-I by taking HSSC and MCAT marks as independent variables showed that the MCAT marks exerted the greatest positive influence consistently at 0.104 [2008] and 0.106 [2009]. In 2009 HSSC marks were shown to exert a negative influence [-0.08] on Part-I. There is need to standardise HSSC education and examination across all Intermediate Boards. MCAT is a better predictor of Medical Students' future performance

effect on student performance of scrambling questions and their stems in medical colleges admission tests

Assessment is an indispensable part of an educational program. Multiple Choice Questions [MCQs] is an objective tool of assessment provided cheating is controlled. A method employed to reduce the chance of cheating is to scramble the sequence of the MCQs and responses in multiple papers having the same content. It is assumed that the performance of students is mainly dependent on the difficulty of the items and not the order in which they are placed within the instrument. The marks obtained by 1,02,211 candidates sitting in Medical Colleges Admission Test [MCAT] from 2008 to 2011 and given similar-content but scrambled-sequence question paper codes were analyzed using parametric tests. A significant difference amongst the mean marks of candidates in the different codes of MCAT 2008 [F = 22.15, p < 0.001] and MCAT 2011 [F = 3.85, p = 0.009] was identified. No significant difference was found in the mean marks of the candidates' each year for different codes in each centre.

case study of multidimensionality of organizational culture

The right kind of institutional culture enhances its effectiveness that ultimately leads towards achieving its missions, objectives and goals. This case-study was conducted in the University of Health Sciences, Lahore to identify the Institutional Culture in the University. Academic Culture Inventory [ACI] and Values Survey Module [VSM] 08 were used as survey questionnaires. Fifty ACI questioners were distributed among grade 16 - 20 officials, 10 in each grade. Hundred VSM 08 Questionnaires were distributed among the garde 1-15 employees. Ten questionnaires from each category and fifty six VSM 08 questionnaires were retuned and institutional culture was identified. Responses and behaviors of the people on different social and job situations were determined on the findings of VSM 08 through Chi-Square Test. Microsoft Excel and Statistical Package for Social Sciences [SPSS] were used to generate the results. A p-value of = 0.05 was considered as statistically significant. Developmental Culture' and 'Virtual Culture' were identified as the strongest institutional cultures by the higher and lower grade officials respectively. 'Tangible Culture' was identified as the weakest institutional culture in both cases. In the VSM 08 questionnaires, the response rate was 56%. Various demographic variations within the culture were identified based on the VSM 08 questionnaire survey. Communication gap between the Higher-grade officials and lower-grade employees should be bridged by holding various meetings, conferences and seminars where the lower-grade staff gets the opportunity to interact with their officers and share their own ideas about the policies and strategies of their institutes

Concept mapping; Rational of learning theories

The explanations of different concepts of learning are called theories and approaches towards the learning process. The difference of concepts is based on interpretations of learning rather than the definition of learning. Five major learning theories: behaviorists, humanists, cognitivists, social cognitivists and constructivists exist, which explore the process of learning. In this paper, the concept maps of all these theories will be discussed separately. The overarching linkages between the theories shown in the concept maps will also be explained

English language proficiency; an important socio-economic factor and its impact on student's performance

Each year, more than 30,000 students sit in the Government sponsored Entrance Test conducted by University of Health Sciences, Lahore for admission in Public and Private Medical and Dental Institutes of Punjab, Pakistan. In this study, we have embarked to seek the relationship of the performance of students in the English component of the test and their sciences components scores and how this English-Science relationship varies amongst the developed and underdeveloped districts of Punjab, Pakistan. Three years from 2008 to 2010. The sciences components scores of the candidates in MCAT, their scores in English portion in the test and their demographic variables were entered into Statistical Package for Social Sciences [SPSS] v.16. Parametric tests were applied. Nearly 14% of the question paper tests proficiency of the candidates in the English Grammar. The students from the socioeconomically challenged districts scored less marks in English component as well as in the sciences component of Entrance Test when compared with the scores of the students of more developed districts [p<0.05]. The difference in the mean marks of English and Sciences components of the test when adjusted for weightage was higher in the socioeconomically developed districts [p<0.05]. A steady improvement from 2008 to 2010 in the scores obtained by candidates in English component of the Entrance Test was observed [p<0.05]. For admission in Medical and Dental Colleges in Punjab, candidates scoring more than 60% marks in their Higher Secondary School Certificate Board Examination, have to sit in a uniform Entrance Test in which from the year 2008-2009, candidates from socioeconomically low districts have performed poorly in both English component and sciences components of test in comparison to the candidates from more developed districts. The comparatively lower score is more significant in sciences components of test. The lower scores of the less developed districts, candidates can not therefore be attributed to their low proficiency in the English language but rather to a lower general educational performance

Assessment in medical education in Pakistan: evaluating evaluation

Over the past decade, Pakistan has seen phenomenal growth in Health Profession Education. As the products of these newer medical colleges join the industry, we have received anecdotal accounts of considerable variations in competency, knowledge and attitudes towards the profession, peers, patients and the industry. The question addressed in this article is whether the assessment techniques used in medical education in Pakistan evaluate higher order critical thinking. A review of published literature in four international medical education journals, Medical Teacher, Medical Education, Journal of Pakistan Medical Association and Journal of Phy-sicians and Surgeons Pakistan was conducted through systematically searching their databases using keywords. This review covers only the methods used for assessment in medical education in Pakistan at present and their contextual relationship to measurement of critical thinking. Multiple tools used to assess each of the three domains, cognitive, psychomotor and affe-ctive were identified. Each one of these tools in relation to the context can effectively evaluate cri-tical thinking but requires careful planning and proper application. Tools used elsewhere [outside Pakistan] were holistic in their measurement with high contextual relevance. Critical thinking sets higher education apart. Currently the tools of assessment emplo-yed to evaluate knowledge, skills and attitudes in medical education in Pakistan are sound but re-quire a critical analysis and review in their construct and applicability in relation to the context. Better tools are also available that can be used to 'teach' as well as 'assess' critical thinking

Perceived variations in dental graduate competency outcomes based on demographic variables

The 30 final competencies required to be possessed by a dental graduate to be identified as a 'safe' health professional practicing dentistry in the community have already been validated and grouped into five overarching integrative themes i] Clinical competence, confidence and a multidisciplinary approach; ii] Role of dental house officer in the health services; iii] Treatment Planning; iv] Attitude, ethical stance and legal responsibilities and v] Communication Skills, information handling and teaching. These themes encompass all three domains of cognition, affect and skills. The purpose of this study was to identify variations in the acceptability of the 30 competencies amongst the three stakeholders, the students, the public and the faculty based on gender and demographic socioeconomic variables. 1876 students in the three public and seven private dental colleges were administered a questionnaire eliciting responses in the 30-item dental graduate competency document. 103 Faculty of the affiliated dental colleges and 173 general public were included in the survey. The response rate was 95% in students, 85% in public and 92% in faculty. Variations in the perceived value in each item and overall were identified within each group based on gender, socioeconomic status, educational background, urban/rural setting and public/private work place settings. These differences are real and will be encountered by the junior dental practitioner in his/her practice and should therefore be factored in to the educational outcomes

Evaluation techniques in Punjab, Pakistan: eight years of reforms in health professional education

Pakistan, the most populated country in the WHO Eastern Mediterranean region has a population of over 170 million, spread over five provinces and four federally administered areas. It has a growth rate of 1.9%. Punjab is the most populous and developed province with an estimated population in 2010 of 81 million. In 2008, Punjab's development index of 0.60 and a literacy rate of 80% were the highest in the country. In Pakistan, the number of doctors and nurses has risen from 48 to 71 per 100,000 and from 16 to 30 per 100,000, respectively between 1990 and 2003. The major challenge, still, is the imbalance of the population to health-care workers ratio. At the time of creation of Pakistan, King Edward Medical College was the only fully functioning medical college. Over the years, as a result of health reform initiatives, a number of government medical colleges were established in the country. University of Health Sciences, Lahore was established in 2002, having sole jurisdiction over all medical, dental and allied health institutes in the province with the aim of moving medical education towards an outcome-based patient and community oriented competency-driven system. This paper attempts to clarify how initiatives and reforms in the evaluation process have helped the UHS realise its aims. Evaluation in all branches of higher education has long been taken as a means to an end. The focus of UHS on teacher-training, introduction of behavioural sciences as a compulsory subject and setting up an outcome-based evaluation process, has established a knowledge-acquisition medical education atmosphere. The challenges in the future relate to sustainability through capacity-building and staying abreast with the Best Evidence Medical Education practices worldwide, implementing them to fit our local needs and resources

Assessment driven integrated learning [ADIL]: assessment directed medical education [ADME] curriculum

Assessment has been shown to drive learning. For assessment to drive learning in the right direction, it needs to fulfil certain criteria including reliability, validity, educational impact, feasibility, acceptability to stakeholders, cost-effectiveness etc. Assessment has the greatest effect as a driving force in learning if it is authentic, context relevant and samples widely. In this paper, we present a new curriculum design and a model for experiential learning through assessment. We call it Assessment Directed Medical Education [ADME] Curriculum using Assessment Driven Integrated Learning [ADIL]. In this model, we propose a cent percent rightest shift in the curriculum design and learning strategy by using assessment as the sole tool to a self-directed learning process through supervised simulated and real-patient encounters testing competencies in cognitive, psychomotor and affective domains in an integrated approach utilising key resources for active learning. It is presumed that, this will, in the long term improve health care delivery by producing competent healthcare professionals that have learned through direct student-'patient' encounters from day one of their medical education and are competent in making professional judgments, exhibit appropriate skills and behaviours

Determination of medical education environment in Punjab private and public medical colleges affiliated with university of health sciences, Lahore-Pakistan

The main purpose of this study was to identify differences, if any, in the Medical Education Climate between the Private and Public Medical Colleges in the Province of Punjab affiliated with the University of Health Sciences, Lahore and to gather recommendations from students on measures that need to be taken to improve the environment. This Mixed Quantitative and Qualitative Prospective Study was conducted in 2008. The population of the study consisted of 1612 MBBS Final Year Medical Students of both Private and Public Medical Colleges. Stratified Random Sampling was done to ensure representation of both Sectors. Dundee Ready Education Environment Measure [DREEM] was used to assimilate Quantitative Data and a Questionnaire consisting of 10 items was used to accumulate Qualitative Data. To analyse Quantitative Data, t-test and Chisquare tests were used. Common themes were identified in the Qualitative Data. All the SIX Research Hypotheses were rejected and Null Hypotheses were upheld. Analysis of Qualitative Data indicated a number of Examination, Curriculum, Teaching Methodology, Teacher and Peer related Stressors without discrimination in students of both Private and Public Sectors. Solutions by students focused on improving co-ordination between Institutions and University of Health Sciences as well as developing and delivering Clinically-Centred, Community-Oriented and Problem-Based Education through development of appropriate Teaching Methodologies. Even though there is no difference in the Medical Education Climate between the Private and Public Medical Education Sectors, the Environment is less than Ideal. However, this can be improved through shifting the onus of Education from Teacher-Centred Didactic Approach to a more Student-Centred Self-Learning Strategy. In this paradigm shift the UHS, Lahore needs to play a pivotal role in order to effectively train the Trainers and standardise this change throughout Punjab

Evaluation of the educational environment of postgraduate surgical teaching

Medical Education is becoming increasingly community-oriented, student-centred, self learning and self and peer-assessing process especially in the undergraduate years. This is happening because of increasing patient awareness of their rights in our new healthcare world of increased consultant responsibility; and implementation in the UK health institutions of the 'European Working Time Directive' and 'Modernization of Medical Careers'. The study was conducted to determine the change if any in the education environment of postgraduate surgical teaching in a leading teaching hospital in London when a teacher-centred, old-fashioned postgraduate teaching approach was replaced with a student-centred, self-assessment, portfolio-based approach. Postgraduate Hospital Educational Environment Measure [PHEEM]. Twenty postgraduate trainees filled in the questionnaire before and after the change in their learning/ teaching pattern. The response rate was 100%. No statistically significant difference in the overall score for the two teaching environments [p=0.8024, 95% CI= -5.549273 to 4.349273] was found, because the loss of on-call rooms, trainee's mess and catering services statistically significantly deteriorated the social support subscale of the PHEEM scale [P < 0.0001, 95% CI=6.66752 to 13.03248] to counteract any statistically significant improvement in the teaching role perception subscale of the instrument [p=0.001, 95% CI= -12.443896 to -4.856104]. There was no statistically significant difference in the role autonomy perception subscale in the two methods [p=0.3663, 95% CI= -5.870437 to 2.270437]. A student-centred approach to postgraduate teaching is better than a teacher-centred approach. However, further studies will be needed to evaluate both postgraduate teaching and training environment