Prepare and Use Skills Assessments

Introduction

• Why do we assess
student clinical
skills?

• What is challenging
about preparing and
using skills
assessments?
 Steps in Skill Development

• Introduce and demonstrate a skill.

• Observe students as they practice the skill and

give feedback to help them improve their
performance.

• Assess students for competency in the skill.

 Objectives

• Select methods for assessing the skills of

students
• Prepare skills assessments
• Develop structured practical examinations
• Administer and score skills assessments
• Use results to improve performance
 Skill Assessment Methods

• Direct observation
of students as they
perform skills

• Structured feedback
reports on students’
performance

• Logbooks, learning
journals, and care
plans
 Direct Observation #1

• Most valid way to assess students’ skills.

• Can be used for both formative and summative

assessments.

• Need to be creative developing approaches

when you have large numbers of students.
Direct Observation #2

• Oral questioning
can be used with
direct observation.

• Can be done with

simulations
(formative) and with
patients
(summative).
Structured Feedback Reports #1

• Assessing sustained performance rather than

just taking “a snapshot” as you would with an
examination.

• Can cover overall performance, demonstrated

attitudes, and essential healthcare delivery
skills.

• Useful for assessing characteristics such as

personal attributes, attitudes, and professional
values.
Structured Feedback Reports #2

• Are easy, efficient, and consistent

• Provide a formal structure for assessment,
particularly formative assessment
• Reinforce essential skills
• Ensure that each student receives feedback

• See Sample 11-1 and 11-2

 Logbook

• The logbook (also called a casebook) contains

a list of skills or tasks that students should be
able to perform.

• The students are responsible for learning how

to do each of the tasks, and when they believe
they are ready, they can ask a teacher, tutor,
or clinical instructor to assess their
performance.
Learning Journal
A learning journal is
used to record
learning
experiences,
especially those in
which the student
has minimal or no
supervision, such as
home visits,
community-based
experiences, or
rotations to distant
clinic sites.
 Care Plan

• A care plan is used to document the patient’s

problems, care required, and expected
outcomes.

• Students are often required to create care

plans to demonstrate their understanding of
and ability to explain management required for
a specific problem.
 Checklists

• A list of steps needed to perform a skill

correctly, listed in the correct sequence.

• Assessor observes each step.

• Well-constructed checklists should contain

only sufficient detail to help the assessor
evaluate and record the student’s
performance.
 Designing a Checklist #1

• Identify the steps or tasks:

• Adapt an existing tool, or
• Conduct a task analysis

• Place the steps in the correct sequence.

• Identify the standards or minimum level of

performance (Yes/No or Multi-level rating
systems).
 Designing a Checklist #2

• Include the key elements of a checklist (title,

space for names, course information,
instructions, space for signature).

• Field-test the checklist.

• See Samples 11-3, 11-4 and 11-5.

Structured Practical Examinations #1

• Typically students rotate through a series of

stations where they answer questions (orally or
in writing), or perform tasks while being
observed.

• Students may demonstrate a skill, interpret

diagnostic materials, or respond to short
questions or case studies.
Structured Practical Examinations #2

• This type of examination is also known as a

multiple station assessment test (MSAT).

• The Objective Structured Clinical Examination

(OSCE) is one of the most well known forms of
the structured practical examination.
 Components of a Structured
Practical Examination

• All students rotate through multiple stations

and are tested on the same KSAs.

• There is a time limit for each station.

• An assessor at each station that requires

observation.

• All students are assessed according to the

same standards.
 Steps to Prepare for a Structured
Practical Examination #1

• Choose which learning objectives will be

tested.

• Decide on a problem, issue, or activity that

addresses each learning objective.

• Map out a plan for the stations (see Sample

11-1).
 Steps to Prepare for a Structured
Practical Examination #2

• Plan the details for each station:

• Write the task/scenario to be completed.

• Develop instructions.

• Develop assessment tools.

• List the resources needed.

 Before the Skills Assessment

• Discuss previous practice sessions with the

student.

• Ask if the student has any questions about the

skill and is ready to be assessed.

• Review the assessment tool.

 During the Skills Assessment

• Observe and assess the student’s

performance:
• Stand where you can see without intruding and
let the student perform the skill.
• Do not interfere unless the student is about to
make a mistake that may endanger the patient.
• Provide only essential feedback while the
student is performing the skill.
 After the Skills Assessment

• Review the skill with the student (student

shares what she or he did well and what could
be improved).

• Provide positive feedback and offer

suggestions for improvement.

• Determine if the student is competent or needs

additional practice.
Use Results to Improve Performance
#1

• Give students an opportunity to ask you

questions about steps they did not understand
or they performed incorrectly.

• Instruct students to practice the steps that they

performed incorrectly.
Use Results to Improve Performance
#2

If many students
had trouble with the
same tasks, either
the teaching
methods or
materials did not
adequately cover
that learning
objective, or the
task needs to be
redefined.
 Summary #1

• Direct observation is the most valid method for

assessing skills, but can be influenced by the
judgment of the observer.

• You can improve this method by using

standardized tools such as checklists to guide
assessment.
 Summary #2

• Structured practical examinations require time

for planning and preparing valid stations, but
provide a highly structured and reliable method
for assessing knowledge, skills, and attitudes
that can be used from year to year.

• Assessing students’ skills is one of the keys to

improving students’ performance.
 Discussion

• In the large group or in small groups:

• What is the role of the EDC, PIC and QCC in

assisting with student knowledge and skills
assessment?

• What challenges do we face in strengthening

student knowledge and skills assessments?