Student assessment (IFMSA Policy Paper)
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- To outline the skills a medical student should acquire during his or her medical studies in order to become a good physician.
- To outline the problems in assessment of medical students that hinder the acquisition of such abilities.
- To define the pedagogical role of assessment in medical education.
- To find alternative methods or improve the ones already existing in order to overcome problems of objective 2) above.
- To support any other proposals that would help to achieve improvements in students’ assessment.
- IFMSA considers it necessary for a medical student to acquire the following skills during his or her medical education:
- To be able to assimilate , integrate and apply medical information in the manner most profitable for the patient and society.
- To be able to bear in mind the humanitarian and ethical aspects of any of his or her decisions.
- To be able to perform a meticulous clinical examination.
- To be able to attach the due importance to the doctor-patient-relationship.
- To be able to undertake efficient interaction with other members of the medical professions.
- The traditional methods of assessment in medical education confront us with the following problems:
- They do not allow enough space for the development of the full individual in each medical student.
- Instead of promoting the students’ ability to learn actively and solve problems, some assessment methods rather induce a passive attitude in the student. Reproduction or, even worse, recognition of information is given more importance then analysis and problem solving (MCQ).
- On the other hand assessment methods with direct teacher-student-contact can never guarantee full objectiveness. Furthermore we find that the lack of standardization between medical faculties in different countries limits the mobility of students.
- IFMSA believes that student assessment should transcend its present dimension of solely passing or failing students to one that is more pedagogically oriented. This should mean that the assessment would be a platform for motivation without undue competition: The student have the possibility to see that what will be required from him or her in any kind of exam is of relevance to his or her future work as a ohysician. Moreover there should be a feedback for both student and medical teacher providing both with information on the level the student has reached in his or her medical education. Assessment should allow the student to view the patient in his or her entirety (i.e. without labels of medicine, surgery, etc.).
- IFMSA considers the following as possible solutions to the above problems:
- IMPROVING EXISTING METHODS OF ASSESSMENT
- Oral exams should be performed as comprehensive exams, viewing the patient in his or her entirety. Objectivity should be increased by using exam commissions instead of single examiners and keeping minutes of each exam.
- Essays should be corrected according to a standardized answer sheet. They should be patient-centred.
- Practical exams should comprise basic clinical skills.
- MCQs should never be used as sole method of assessment. They should only be used provided there is continuous evaluation and feedback.
- Assessment should always be based on a variety of methods. All these methods should follow a standardized protocol in an effort to maximize the objectivity of the method. Anonymity should be safeguard as far as possible. Students should receive feedback about their performance in all exams undertaken.
- INTRODUCING ALTERNATIVE METHODS OF ASSESSMENT
- IFMSA is of the opinion that alternative ways of assessment in medical education should play a much larger role than they have so far had. Among the methods to be taken in to consideration should be:
- Objective Structured Clinical Examination (OSCE), involving the testing of various practical skills via a number of stations, each having a checklist to assess the performance of the student.
- Continuous assessment and feedback on wards, contributed by all members of the team (360°)
- Continuous assessment using the same set of questions throughout the whole curriculum (students from different semesters would expected reach different levels).
- Paper cases with several steps (each subsequent page would give further information on the "paper patient").
- Assessment of communication skills using video cameras.
- Utilization of the group process in tutorial groups as a means of assessment in order to strengthen collaboration and reduce competition among students.
- Introducing quality assessment of curricula and medical teaching staff by the medical students themselves that has official and substantial bearing on the rewarding of teaching posts.
- Rotation of examiners in a regional group of medical schools or presence of external examiners, so as to improve objectivity.
Students should be provided with guidelines and a framework of studying. The methods of assessment and the minimum requirements for passing should be made available to the students at the beginning of the course of studies. Flexibility concerning the sitting for exam sessions should be guaranteed. Assessment should lead to one universal degree for medical doctors. The better the assessment of medical students is, the better is the quality of future medical care to be provided for the whole society.