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Watling, C. J. and S. Ginsburg (2019). "Assessment, feedback and the…
Watling, C. J. and S. Ginsburg (2019). "Assessment, feedback and the alchemy of learning." Med Educ 53(1): 76-85.
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The history - assessment
- In the 1960s the dichotomy of formative and summative emerged
Sadler:
- Learner need to understand standard
- Needs information about gap
- Needs strategies to close gap
EJ - "freeing learners from dependence on the teacher by empowering them to grasp standards, make reflective comparisons with their own performance and take action."
- In 1950s recognition that exams influence student learning
- Research up until the mid-1990s was focussed on psychometric properties.
Assessment's value was seen in predicting future professional performance.
Research aimed at improving robustness.
- 1996 van der Vleuten - utility model with trade-offs between reliability, validity, educational impact, acceptability and cost. Also shifted view of assessment's purpose from simply judgement to facilitation of learning and subsequent role of feedback post-assessment.
5.Competency based medical education movement and
move towards assessment programs with frequent low-stakes assessments.
Conversation re:feedback
- Modest benefit
- Effect is variable
- Should be timely, specific, actionable and task-oriented
- Not person oriented
- More likely to use if credible (direct observation and from trusted source) and constructive (has action plan
- Challenging if it threatens "self-esteem or self-image or triggers strong negative emotions".
Social, cultural and organisational influences and importance of trust and safety. Introduction of coaching
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Learner perception - how does it influence the experience? Programmatic assessment means formative experiences may be seen as summative. Therefore learners may seek out more lenient assessors and easier cases
Learners and direct observation - recognise the value, but also feel discomfort. Hawthorne effects
Elements of vulnerability and risk for the trainee. Stakes for the trainee and supervisor come with different perspectives
?Weight for age stakes??
Culture - learning is not entirely an individual pursuit
"Professions maintain distinct and sometime singular approaches to educating their own - "signature pedagogies""
WBA "is a complex social interaction"
Concept of positive and negative face.
Sociocultural niceties may impede honest feedback. Thus tension arises.
Is observation and coaching just assessment and feedback in disguise?
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Resolving the tension
- Looks like one medical school bit the bullet and the students did as well or better than other schools on USMLE exams
- Coaching and mentoring - faculty must be developed too
- Formative intent v summative threat
- Performance culture over improvement culture