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WHO?
WHAT?
Analysis
Application
Comprehension
Recall
Evaluation
Synthesis
Bloom’s categorization Associated thinking skills
Knowledge acquisition Memorization
Comprehension Question, discuss, explanation,
Abstraction and transfer
Application Doing a task
Analysis Categorizing, characterization,
comparison, contrast
Synthesis Collating, creating
Evaluation Relevancy, ordering, prioritizing,
judgment
Knows
Shows how
Knows how
Does
Knows Factual tests:MCQ, essay type, oral…..
Knows how(Clinical) Context based tests:
MCQ, essay type, oral…..
Shows howPerformance assessment in vitro:
OSCE, SP-based test…..
DoesPerformance assessment in vivo:Undercover SPs, Video, Logs…..
Knowledgeassessment
Problem-solvingassessment
Clinical skillsassessment
Practiceassessment
Professional or clinical
Authenticity
1960 2000
(adapted from van der Vleuten 2000)
What is a key features problem?
What are the conceptual and measurementissues underlying the design of key featureproblems?
What is the process for writing a key featuresproblem?
A clinical problem, with age & clinical situation specified (e.g., Severe, life-threatening respiratory distress in an infant)
A case scenario typically followed by 2 or 3 questions
Questions assess clinical decisions and actions (not underlying knowledge or reasoning)
Questions are asked only in relation to the most important steps/challenges in the resolution of the problem – i.e., the problem‟s “key features”
Case Specificity
(Arthritis , Anemia, Diabetes) =Key Features (KFs)
Problem solving for
each problem not a general skill
The critical or essential steps in the
resolution of the problem.
Steps, actions most likely to lead to error.
Most difficult aspects of problem
identification and management in practice.
Assess only the key steps/decisions (2- 4), in the resolution of a clinical problem (not reasoning)
…best discriminators
Assess effectiveness, not thoroughness
Permit wide sampling of problems to address “case specificity”
Reliability – “Focused" problems -- better sampling, more accurate assessment
Content Validity – assessing the most important clinical decisions within (a representative sample of) problems
“Bottom-up” thinking – assessing knowledge application and what clinicians do in real life!
What about “fidelity/authenticity”?
Higher “Fidelity” increased discriminating power More effective identification of weaker candidates
1.Select a Clinical Problem
2.Select a Clinical Situation
3.Define the problem's Key Features
4.Select a Case to represent the Problem
5. Develop Questions to test only the key features
6.Select the Format for the questions
7.Prepare Scoring Keys
Only score responses that relate to the Key Features
Each key feature should be scored out of „1‟. Partial scores can be assigned to multiple correct answers (e.g., .5 and .5). Key feature scores within a problem should be averaged to produce a problem score
A key feature score of „0‟ can be assigned if a student chooses too many options or harmful actions (e.g., doing a catheterization when uncalled for)
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