Conceptualising Surgical Education Assessment

  • Lambert W. T. Schuwirth
  • Cees P. M. van der Vleuten
Chapter
Part of the Advances in Medical Education book series (AMEDUC, volume 2)

Abstract

The principles of surgical assessment do not differ much from assessment of medical competence in general. Purposes of surgical assessment include not only decision making about the level of the trainee surgeons, but also, in a training setting, steering learning behaviour. Reproducibility or reliability of the assessment results, validity of the methods, their educational impact, cost efficiency and acceptability/feasibility are all important concepts to be considered when designing or changing an assessment programme. The robust research findings that the content of the assignments (and not their format) is important for validity and that good sampling across contents and possible sources of error is more important for reliability than trying to make the assessment objective have given rise to a whole new set of observation-based assessment formats for the assessment of performance in practice. Some of the most important are described here. These must be seen as an addition rather than as a replacement of more theory-orientated forms. It is important to understand that where in theory-based assessment reliability and validity are built into the test paper, in practice-based assessment these qualities depend on the user. For practice-based assessment, good teacher training is, therefore, indispensible.

References

  1. Bodle, J. F., Kaufmann, S. J., Bisson, D., Nathanson, B., & Binney, D. M. (2008). Value and face validity of objective structured assessment of technical skills (osats) for work based assessment of surgical skills in obstetrics and gynaecology. Medical Teacher, 30, 212–216.CrossRefGoogle Scholar
  2. Carr, S. (2006). The foundation programme assessment tools: An opportunity to enhance feedback to trainees? Postgraduate Medical Journal, 82, 576–579.CrossRefGoogle Scholar
  3. Case, S. M., & Swanson, D. B. (1993). Extended-matching items: A practical alternative to free response questions. Teaching and Learning in Medicine, 5, 107–115.CrossRefGoogle Scholar
  4. Chi, M. T. H., Glaser, R., & Rees, E. (1982). Expertise in problem solving. In R. J. Sternberg (Ed.), Advances in the psychology of human intelligence (pp. 7–76). Hillsdale: Lawrence Erlbaum Associates.Google Scholar
  5. Cronbach, L. J. (1983). What price simplicity? Educational Measurement: Issues and Practice, 2, 11–12.CrossRefGoogle Scholar
  6. Cusimano, M. D. (1996). Standard setting in medical education. Academic Medicine, 71, 112–120.CrossRefGoogle Scholar
  7. Davies, H., Archer, J., Heard, S., & Wouthgate, L. (2005). Assessment tools for foundation programmes – A practical guide. British Medical Journal, 330, 195–196.Google Scholar
  8. Driessen, E., Van Tartwijk, J., Van der Vleuten, C., & Wass, V. (2007). Portfolios in medical education: Why do they meet with mixed success? A systematic review. Medical Education, 41(12), 1224–1233.CrossRefGoogle Scholar
  9. Ebel, R. L. (1983). The practical validation of tests of ability. Educational Measurement: Issues and Practice, 2, 7–10.CrossRefGoogle Scholar
  10. Frederiksen, N. (1984). The real test bias: Influences of testing on teaching and learning. The American Psychologist, 39, 193–202.CrossRefGoogle Scholar
  11. Harden, R. M., & Gleeson, F. A. (1979). Assessment of clinical competence using an objective structured clinical examination (OSCE). Medical Education, 13, 41–54.Google Scholar
  12. Newble, D. I., & Jaeger, K. (1983). The effect of assessments and examinations on the learning of medical students. Medical Education, 17, 165–171.CrossRefGoogle Scholar
  13. Norcini, J., Blank, L. L., Arnold, G. K., & Kimball, H. R. (1995). The mini-CEX (clinical evaluate on exercise); A preliminary investigation. Annals of Internal Medicine, 123, 795–799.Google Scholar
  14. Page, G., Bordage, G., & Allen, T. (1995). Developing key-feature problems and examinations to assess clinical decision-making skills. Academic Medicine, 70, 194–201.CrossRefGoogle Scholar
  15. Pangaro, L. N., & Holmboe, E. S. (2008). Evaluation forms and global rating scales. In E. S. H. R. E. Hawkins (Ed.), Practical guide to the evaluation of clinical competence. Philadelphia: Mosby Elsevier.Google Scholar
  16. Pendleton, D., Schofield, T., & Tate, D. (1984). A method for giving feedback. In The consultation: An approach to learning and teaching. Oxford: Oxford University Press.Google Scholar
  17. Petrusa, E. R. (2002). Clinical performance assessments. In G. R. Norman, C. P. M. van der Vleuten, & D. I. Newble (Eds.), International handbook of research in medical education. Dordrecht: Kluwer Academic Publishers.Google Scholar
  18. Posner, M. I. (1988). What is it to be an expert? In M. T. Chi, R. Glaser, & M. J. Farr (Eds.), The nature of expertise (pp. xxix–xxxvi). Hillsdale: Lawrence Erlbaum Associates, inc.Google Scholar
  19. Ramsey, P. G., Wenrich, M. D., Carline, J. D., Inui, T. S., Larson, E. B., & Logerfo, J. P. (1993). Use of peer ratings to evaluate physician performance. Journal of the American Medical Association, 269, 1655–1660.CrossRefGoogle Scholar
  20. Regehr, G., Macrae, H., Reznick, R., & Szalay, D. (1998). Comparing the psychometric properties of checklists and global rating scales for assessing performance on an osce-format examination. Academic Medicine, 73, 993–997.CrossRefGoogle Scholar
  21. Van der Vleuten, C. P. M. (1996). The assessment of professional competence: Developments, research and practical implications. Advances in Health Sciences Education, 1, 41–67.CrossRefGoogle Scholar
  22. Van der Vleuten, C. P. M., & Swanson, D. (1990). Assessment of clinical skills with standardized patients: State of the art. Teaching and Learning in Medicine, 2, 58–76.CrossRefGoogle Scholar
  23. Van der Vleuten, C. P. M., Norman, G. R., & De Graaf, E. (1991). Pitfalls in the pursuit of objectivity: Issues of reliability. Medical Education, 25, 110–118.CrossRefGoogle Scholar
  24. Ward, P. (1997). 360-degree feedback. London: CIPD.Google Scholar
  25. Wilkinson, J. R., Crossley, J. G., Wragg, A., Mills, P., Cowan, G., & Wade, W. (2008). Implementing workplace-based assessment across the medical specialties in the united kingdom. Medical Education, 42, 364–373.CrossRefGoogle Scholar
  26. Williams, M., Klamen, D., & McGaghie, W. (2003). Cognitive, social and environmental sources of bias in clinical performance ratings. Teaching and Learning in Medicine, 15, 270–292.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Lambert W. T. Schuwirth
    • 1
  • Cees P. M. van der Vleuten
    • 1
  1. 1.Department of Educational Development and ResearchMaastricht UniversityMaastrichtThe Netherlands

Personalised recommendations