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Integrated Assessment
in Medical Education
Objectives for this brief session
• Consider integration as a continuum
– from Isolation to Trans-disciplinary holism
• Sh...
Intro…
– “Learning is by connecting things. If you can not
connect, you can not learn.”
– Lord Chesterton (paraphrased)
• ...
From Isolation
to Authentic T-L
- in 11 steps
(Harden et al)
Fragmentation | Anarchy
Connection | Consultation
infusion
co...
Integrated Curriculum needs
Integrated Assessment
I Year Integrated MBBS
MCBM = Molecular and
Cellular Basis of Medicine
H...
Year 1 – Concurrent “Slice of Pie”
Model of Assessment
• Molecular & Cellular Basis of Medicine
– Paper-1 – Structure & Fu...
Year 2 – Multi-Disciplinary Model
• Systems based Theory papers (n=6)
– LAQ – SAQ – MCQ
• With “Slice-of-Pie” division amo...
Years 3 & 4 – Purposive Outcomes
Oriented Integrated OSCE
• Theory Papers (isolated & Subject based )
– LAQ/SAQ/MCQ
• Outc...
Final Exams in Year-5
• Theory – multi-disciplinary papers (n=2)
– Medical specialties | Surgical specialties
• Clinical E...
Assessment during PG Residency
In-training formative assessment by
• Clinical Skills Exam (CHEX)
• DOPS (direct observatio...
Rubric – more explicit than
Rating Scale
• Rubrics have 4 parts:
– 1- description of the task = Check-list
– 2- the scale ...
Many
requirements of
task are missing
All requirements of
task done; partial
understanding
All requirements o
task done wi...
Rubrics for Outcomes
1. Measure outcomes based on real-life criteria
2. Specify graded performance indicators
3. Permit as...
Be a Trail-blazer
• One more trail to blaze:
• Making rubrics for effective assessment of
specialty training to suit your ...
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Integrated assessment in medical education

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To be effective, an Integrated curriculum needs integrated assessment. This brief talk captures the essence of integrated evaluation carried out in Malaysia using a hybrid curriculum modelled after the British curricula. Harden's 11-step ladder of integration forms the basis of the talk.

Published in: Health & Medicine
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Integrated assessment in medical education

  1. 1. Integrated Assessment in Medical Education
  2. 2. Objectives for this brief session • Consider integration as a continuum – from Isolation to Trans-disciplinary holism • Share personal experience in Integrated assessment in a hybrid UG curriculum • Consider various tools for integrated assessment of competencies especially for postgraduate residencies
  3. 3. Intro… – “Learning is by connecting things. If you can not connect, you can not learn.” – Lord Chesterton (paraphrased) • Integration as an educational strategy • Medical Teachers are polarized (For/Against) • Ronald Harden described a 11-step ladder between the two extremes.
  4. 4. From Isolation to Authentic T-L - in 11 steps (Harden et al) Fragmentation | Anarchy Connection | Consultation infusion concurrent teaching Integrate ! joint teaching concomitant program mixed program contributory monolithic Immersion | authentic
  5. 5. Integrated Curriculum needs Integrated Assessment I Year Integrated MBBS MCBM = Molecular and Cellular Basis of Medicine HBM = Human Basis of Medicine II Year Integrated MBBS Systems-based approach
  6. 6. Year 1 – Concurrent “Slice of Pie” Model of Assessment • Molecular & Cellular Basis of Medicine – Paper-1 – Structure & Function (Anat-Physiol) – Paper-2 – Biochemical & Gen Pharma – Paper-3 – Gen-Path, Immunology, Microbiology • Human Basis of Medicine – Paper-4 – Epidemiology, Basic statistics etc – Paper-5 – Ethics, Bio-psycho-social approach etc • Integrated 24 station OSPE
  7. 7. Year 2 – Multi-Disciplinary Model • Systems based Theory papers (n=6) – LAQ – SAQ – MCQ • With “Slice-of-Pie” division among departments • Integrated OSCE in 2 sessions – 18 to 24 station performance (5-10-min stations) + – 40 to 50 items for response (3 min per item) – This avoids duplication of skills across subjects
  8. 8. Years 3 & 4 – Purposive Outcomes Oriented Integrated OSCE • Theory Papers (isolated & Subject based ) – LAQ/SAQ/MCQ • Outcomes based integrated OSCE – Clinical skills: Paeds OG & Forensic in Year-3 – Clinical skills: Med – Surgery – Com-Med (year-4) – 15 to 20 station performance (5-10-min stations) + – 40 to 50 items for response (3 min per item) – This avoids duplication of skills across subjects
  9. 9. Final Exams in Year-5 • Theory – multi-disciplinary papers (n=2) – Medical specialties | Surgical specialties • Clinical Exam – Integrated – Long case: 1 of 4 (Med/Sur-Ortho/Paed/OG) – Short case: other 3 of 4 (joint vs. concurrent) – OSCE: 24 station Integrated OSCE • 12 each for Medical & Surgical specialties • History – physical exam – Dx tests – Rx advice – counseling on diet/life-style etc
  10. 10. Assessment during PG Residency In-training formative assessment by • Clinical Skills Exam (CHEX) • DOPS (direct observation of procedural skills) • Self evaluation using e-Portfolio • Peer assessment • Multi-source / 360o evaluation • Tools: Check list / Rating scale / Rubric Haldane T. “Portfolios” as a method of assessment in medical education” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017561/ (accessed on 9-9-2015)
  11. 11. Rubric – more explicit than Rating Scale • Rubrics have 4 parts: – 1- description of the task = Check-list – 2- the scale to be used = Rating scale – 3- the dimensions of the task – 4- the description of each dimension on the scale. • The Development of a Competency Based Assessment Rubric to Measure Resident Milestones - DOI: 10.4300/01.01.0008
  12. 12. Many requirements of task are missing All requirements of task done; partial understanding All requirements o task done with full understanding Most requirements of task are done; some understanding
  13. 13. Rubrics for Outcomes 1. Measure outcomes based on real-life criteria 2. Specify graded performance indicators 3. Permit assessment of outcome level achieved in a specific competency 4. Ensure coherent and consistent assessment 5. Improve the quality of assessment 6. A collage of rubrics may permit integrated assessment of professional behaviour
  14. 14. Be a Trail-blazer • One more trail to blaze: • Making rubrics for effective assessment of specialty training to suit your training objectives • Will you do it soon to enhance the quality of assessment ? • Strive for Success – Best wishes…

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