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5. Assessment of Psychomotor_ Perceptual and Attitudinal Skills_ including Checklists and Rating Scales

VIEWS: 38 PAGES: 29

									ASSESSMENT OF ATTITUDES
  & PSYCHOMOTOR SKILLS

     Raja C. Bandaranayake
   DOMAINS OF LEARNING
• Cognitive   (Knowledge)

• Psychomotor (Motor skills)

• Affective   (Attitudes)
    THE AFFECTIVE DOMAIN

• Awareness [knowledge base]
  e.g. Reads about importance of rural health
  care

• Receiving [willing to receive or attend]
  e.g. Acknowledges rural health care is
  important

• Responding [actively attending]
  e.g. Seeks additional information about
  rural health needs & problems
 THE AFFECTIVE DOMAIN – contd.

• Valuing [‘worth’ to learner]
  e.g. Spends free time working in rural
  areas

• Organizing [takes steps to incorporate into
  one’s life]
  e.g. Undergoes training to deal with rural
  health problems

• Characterisation by value or value complex
  [becomes part of one’s life]
  e.g. Enters a career of rural health care
 PROBLEMS IN ASSESSING ATTITUDES
 One must rely on inference
 An attitude has many facets e.g. feelings,
  beliefs, values
 An attitude has many manifestations e.g.
  behaviours, verbal responses
 Behaviours, beliefs and feelings will not
  always match
 An attitude can fluctuate
 There is often lack of agreement on the
  nature or desirability of certain attitudes
  ORIENTATIONS TO ATTITUDE
         ASSESSMENT
 Behavioural
  – Observation of behaviours

 Psychometric
  – Standardized pen-and-paper tests

 Counselling
  – One-to-one discussion
     BEHAVIOURAL ORIENTATION

   Behaviours can be observed

   Rely on observation tools
    – checklist, rating scale, anecdotal record

   Expectations explicit

   Assessment consistent

   Inference necessary
    – many variables affect behaviour
    BEHAVIOURAL ORIENTATION (contd.)

   Change can be monitored

   “Spied on” feeling

   Coercive atmosphere

   Individual event may be trivial
    – need to observe many behaviours
       BEHAVIOURAL ORIENTATION
          Who are the observers?

   Trained observers
   Administrators
   Teachers
   Peers
   Other professionals
   Patients
   Parents
   Self
    PSYCHOMETRIC ORIENTATION

   Pen-and-paper instruments
   Validated, standardized tests
   Self reports possible
   Inexpensive and objective
   Socially desirable responses possible
   Situation-specific
   Conclusions indefinite
             QUESTIONNAIRES


Open-ended               Closed
[Respond in own words]   [select, rank, rate]

e.g. Essay               e.g. Likert scale
                         Semantic differential
                         Tests of judgement
                         Forced-choice
                LIKERT SCALE
                         SA   A   U   D SD

A medical history is
incomplete without a
social history
The logical leader for
a health team is the
doctor
The team approach to
health care is a waste
of time
     SEMANTIC DIFFERENTIAL

Surgeons are:

Theoretical _ _ _ _ _ _ _ Practical

Personal   _ _ _ _ _ _ _ Impersonal

Active     _ _ _ _ _ _ _ Passive

Disease-   _ _ _ _ _ _ _ Patient-
oriented                  oriented
     COUNSELLING ORIENTATION
   Discussion between teacher and student to
    reveal feelings underlying behaviours
   Student may be more motivated to change
    if understand him/her-self
   Low risk environment
   Counselling role not compatible with
    authority role
   Student may manipulate or avoid giving
    responses
   Teachers are not trained counsellors
          PSYCHOMOTOR DOMAIN
1.   Perception
      Using senses for cues to motor activity

2.    Set
     Readiness to take a particular type of
     action

3. Guided response
   Imitating a skill; trial and error

4. Mechanism
   Response habitual and confident
 PSYCHOMOTOR DOMAIN – contd.

5. Complex overt response
   Skillful & complex performance

6. Adaptation
   Able to modify movement pattern to suit
   particular situation

7. Origination
   Creating new movement pattern for a
   specific purpose
OBSERVATIONS: Relatively Unstructured
Complete description of event
   Participant observation (e.g. simulated
    patient)
   Time and motion or time-sampling study
   Anecdotal record

    Disadvantages
        Sampling less
        Reliability low
        Observer influence
        Memory distortion
   OBSERVATIONS: Structured


 Specific plan made for making
  and recording observation

 Investigator knows what aspects
  of behaviour are relevant for the
  purpose
   Observational Instruments

1. CHECKLIST
   Where the response is “Yes” or
   “No”

2. RATING SCALE
   Where quality of performance is
   important
        CHECKLIST: When to use?

   Performance skills that can be divided into
    a series of clearly defined steps, each of
    which is either “done” or “not done”
    e.g. steps in cardio-pulmonary resuscitation

   Performance products that can be
    evaluated by noting presence (or absence)
    of observable characteristics
    e.g. patient’s medical record
               CHECKLIST:
         STEPS IN CONSTRUCTION

   Analyse task or performance into specific
    sequential steps required
   List common errors (of omission and
    commission) made by students
   List actions and errors in logical order of
    occurrence
   Provide a system for observer to record
    sequence of actions
 CHECKLIST: Mouth-to-mouth resuscitation

                             Done Order Not    NA
                                  #     done
Shakes & shouts to check
if unconscious
Applies chin lift to open
airway
*Applies neck lift to open
airway
Uses ‘look, listen, lift’
method for apnoea
Closes nose by pinching
Effects tight mouth-to-
mouth seal
              CHECKLIST: contd.

•   Gives 4 quick ventilations
•   Checks carotid pulse
•   *Checks pupils for dilatation
•   *Bares victim’s chest
•   Checks anatomical landmarks
           TYPES OF RATING SCALES

 Graphic
 Poor rapport                         Excellent rapport



 Graphic with anchors
 Poor    Fair   Good      Very Good   Excellent




 Frequency scales
 Never    Seldom       Often   Always



 Behaviourally-anchored
    BEHAVIOURALLY-AHCHORED RATING SCALE:
                      ATTITUDES
Relationship with patients
A. Rapport

   0: Unable to establish rapport

   1: Fair rapport, but occasional lack of communication

   2: Good rapport, communicates concern

   3: Listens, communicates well, instills confidence

   4: Convinces patient of expertise and puts patient at ease

   5. Not observed
   RATING SCALE: COMMUNICATION
Participation in group discussion
C. Nature of contributions

    0: Does not contribute at all

    1: Comments usually distract from the topic

    2:

    3: Comments usually pertinent, occasionally wanders from topic

    4:

    5: Comments always related to the topic
              RATING SCALE: SKILLS

Mouth-to-mouth resuscitation
A. Effects tight seal

Cannot determine

Inadequate:   Does not attempt to create a tight seal or seal
              is grossly inadequate

Satisfactory: Has leak, but adequate ventilation

Excellent:    Fully covers mouth from corner to corner,
              creating an airtight seal
           RATING SCALE:
       STEPS IN CONSTRUCTION
   Define unambiguously dimension or
    behaviour being rated
   Decide on number of rating steps
    – Usually 3 to 10
    – Uneven number better
    – Intervals not necessarily equidistant

   Define / describe extremes and then each
    step in between
    – Try to avoid relative terms (e.g. frequently),
      which could be interpreted differently
           ERRORS IN RATING


   Error of leniency
   Error of central tendency
   Halo effect
   Logical error
   Error of contrast

								
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