Chapter 7 ppt eval & testing 4e formatted 01.10 mo edits

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Chapter 7Assessment of Higher Level LearningOermann & GabersonEvaluation and Testing in Nursing Education4th edition


Higher Level Thinking

♦ Application, analysis, synthesis, and evaluation levels of cognitive taxonomy– Apply concepts, theories, and other types of

knowledge to new situations– Process knowledge, compare approaches– Use knowledge to interpret patient needs– Make decisions about actions to take

♦ Use clinical reasoning, clinical judgment

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Assessing Higher Level Learning

♦ Main principle– Develop assessment methods that require

students to apply knowledge and skills in new contexts

♦ Clinical practice requires higher-level thinking – Patient needs rarely match textbook picture– Rapidly changing conditions

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Problem Solving

♦ Ability to solve patient- and setting-related problems is essential in clinical practice

♦ Involves:– Recognizing and defining the problem– Gathering additional data to clarify it further– Developing solutions and evaluating their

effectiveness

♦ Requires understanding of the problem and possible solutions

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Problem Solving

♦ Ability influenced by:– Past experience with similar problems

(real or hypothetical)• Experienced nurse can anticipate typical problems in

clinical situations

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Types of Problems♦ Well structured– Provide the information to solve the problem– Typically have one correct solution – Do not require extensive thinking skills

♦ Ill structured– Real-life problems and clinical situations – Problem may be unclear or there may be

insufficient data to determine the problem– Different problems and solutions may be possible

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Decision Making

♦ Learner makes decision after considering alternatives and their consequences

♦ Decision reflects a choice after considering different possibilities

♦ Critical thinking helps students compare alternatives and decide what actions to take

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Critical Thinking

♦ Reflective thinking♦ Logical reasoning– Thinking through and analyzing situations– Reflecting on ideas, actions, and decisions

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Learners Who Think Critically

♦ Ask questions♦ Are inquisitive and willing to search for answers♦ Consider alternate ways of viewing information

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Learners Who Think Critically (cont’d)♦ Offer different perspectives♦ Extend their thinking beyond class, readings,

clinical activities, and other requirements♦ Are open-minded

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Context-Dependent Items

♦ Learner analyzes or interprets introductory material and answers questions or completes other tasks related to it

♦ Also known as interpretive exercises

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Context-Dependent Items (cont’d)

♦ Can be included on NCLEX® as alternate-format items– Hot-spot– Chart/exhibit

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Example—Hot-Spot Item

In this fetal monitoring strip, identify the beginning of the contraction.

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Context-Dependent Items

♦ Advantages– Assess student understanding of situations

simulating clinical practice– Provide same context for analysis for all students– Evaluate understanding, not memorization

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♦ Disadvantages– Difficult to construct to focus on high-level

learning– Responses may depend on reading and

writing skills

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♦ Introductory material – Description of clinical situation– Patient data– Research findings– Issues associated with clinical practice– Excerpts from reading materials– Diagram– Images– Table– Figure

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Example—Clinical Situation as ContextYou call the pharmacy about a medication and learn that the amount ordered is twice the usual dose. You contact the physician who tells you, “Give it anyway. The patient needs it.”

1.What are your options at this time? Describeadvantages and disadvantages of each.2. How would you solve this dilemma?

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Example—Diagram as Context

Identify the corresponding structures of the nephron and state one function for each.

30.___________________________31.___________________________

32.___________________________33.___________________________34. ___________________________

For items 30-34, use the diagram below. Each response is worth two points.

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Writing Context-Dependent Items

♦ Specify in advance:– How responses are to be scored– If restricted essay, limit of response length– Criteria for evaluation

♦ Can be developed with varied types of test items

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Layout

♦ Heading– Indicates which items pertain to the

introductory material ♦ Context– Needs to be obvious to students—center, extra

space before and after♦ Test items– On same page as heading and context if possible

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Other Assessment Methods

♦ Ask students about alternate perspectives and options

♦ Include higher level questions♦ Assess clinical judgment, ability to think

through situations

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Case Method

♦ Short cases♦ Combined with higher-level questions for

assessment♦ Any item format ♦ Appropriate for small-group analysis and

discussion

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Example

A patient is admitted with headache, nausea, and vomiting. Two hours after admission, she complains that her headache is getting worse, and she is “having trouble seeing.”

1.Analyze this case in terms of content presented today in class.2.What data are most important and why?3.How does this compare with Chapter 7 in your book?

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Example

You are discharging a 7-year-old child who had been admitted following an asthma attack. In talking with the mother, you learn that the child has been seen in the ED at your hospital and elsewhere nearly monthly for the last year.

1.What are two different actions you could take at this time?2.Which of these would you do and why?

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Example

You have your first clinical experience in a long-term care setting and see the nursing assistant tie patients to their chairs prior to dinner.

1.What would you do? Why?

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Example

A 12-year-old comes to the pediatrician for his allergy injection. The mother says that her child had a fever yesterday but is fine now. The RN gives the injection.

1.Was this the correct decision? Why or why not?

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Case Study

♦ Hypothetical or real-life situation for student analysis

♦ Longer and more comprehensive than case method

♦ Students include rationale underlying analysis and decisions made

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Unfolding Cases

♦ Simulates a patient situation that changes over time

♦ Context is presented sequentially as time passes– Similar to actual clinical practice

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Unfolding Cases (cont’d)

♦ Minimum of 3 brief paragraphs– Paragraph 1 introduces case, background information • Follow with questions to answer

– May be discussed in small groups, reported to entire group

– Paragraphs 2 and 3 change scenario• e.g., change in patient status, new data, new time frame, etc.• Follow with questions

•

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Example

You are making a home visit to see a 71-year-old woman who has a leg ulcer that began after she fell. The patient is coughing and wheezing; she tells you she feels “terrible.”

1.What additional data would you collect in the initial assessment? Why?2.What actions would you take during this home visit? Provide a rationale.

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Case continues…

In 3 days you visit this patient again. She has increased shortness of breath, more fatigue, and a pale color.

1.Does this new information change your impression of her problems? Why or why not? 2.List priority problems for this patient with a brief rationale.

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Case continues…

The patient recovers from that episode, and you are able to visit her one more time. At this last visit, she is still short of breath but otherwise seems improved.

1.Write your final report on this patient using the form of the home care agency.

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Discussion

♦ Focus on higher-level questions– Begin with lower level (factual questions) and

progress to higher level questions♦ Phrase questions carefully to encourage

students to think through answer♦ Individual or small group

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Debate

♦ Use for assessing ability to – analyze problems – consider alternative points of view– develop position

♦ Use for assessing critical thinking♦ Evaluate based on strength of argument

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Media Clips

♦ Short media clips for analysis♦ Timing of use– Intersperse within class or online presentation– Use at end for synthesis

♦ Case method presented visually

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Short Written Assignments

♦ Assess students’ thinking and reasoning♦ Avoid summarizing literature and reporting

on ideas of others♦ Conserve faculty time♦ Give prompt feedback

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Chapter 7 ppt eval & testing 4e formatted 01.10 mo edits