meaning for the recipient, its application in the clinical workplace, its tutor development implications, and its integration with high stakes assessments (Campbell et al., 2009; Archer, 2010; Norcini, 2010).
One way in which the learning function of assessment can be formalised is through progress tests. These follow stages of the course on a longitudinal basis, whereby different sets of questions in samples that take account of all the core learning are used to test how students perform diachronically (Friedman Ben-David, 2009). For ethico-legal content, outcomes from an inventory of core patient case presentations (discussed in the previous chapter) could readily be included in a progress test. Without necessitating an additional burden of student preparation beyond the ongoing routine of studying, these tests can reinforce previous learning (of the depth variety rather than by rote) while allowing students to gauge their own progress across a range of criteria, such as comparison with a standard according to course level, or with their performance in previous progress tests, or with the performance of the rest of the class.
Another way of gauging progress in student learning is through validated instruments to identify levels of ethico-legal awareness, or reasoning, or decision-making (Clarkeburn et al., 2002; Tsai et al., 2009). These tests classify responses from students to items presented in vignette form, and among the resources of this type used in medical curricula that feature in the literature are the Defining Issues Test, a generic tool developed by Rest and based on Kohlberg’s cognitive moral development theory (Self et al., 1998b), and the clinically-oriented Ethics and Health Care Survey Instrument developed by Kipnis & Gerhard (Goldie et al., 2001, 2002, 2003). In addition to what the performances of students in regular assessment tell us about the effectiveness of the course, this type of testing provides complementary evidence on the impact of the ethics and law curriculum.
The range of programme evaluation levels differentiated by Kirkpatrick probably exceed the scope of what is appropriate to the formal ethics and law curriculum – how students react to what they experience, what learning is evident from changes in attitudes or knowledge or skills, what behaviour change is demonstrated by the learner in the workplace setting, and what results are observed in the workplace for the functioning of the organisation, for the performance of the learner, or for the benefits to patients (Steinert, 2009). Hafferty & Franks (1994) comment that, “course material or even an entire curriculum can in no way decisively influence a student’s personality or ensure ethical conduct”. However, neither can ethico-legal education in medicine be exempted from the relevant layers of evaluation. Leinster (2009) comments that, “There is likely to be a close relationship between the assessment process and the evaluation of outcomes. It is important that this linkage is prospective and incorporated in the overall design of the curriculum rather than being an afterthought”.
Content and form of assessment
In order to realise this coupling between assessment and learning, the tasks set for students need to be fit for purpose. The two main dimensions to this are utility and fairness: the methods of assessment should be compatible with the
In order to realise this coupling between assessment and learning, the tasks set for students need to be fit for purpose.
Another way of gauging progress in student learning is through validated instruments to identify levels of ethico-legal awareness, or reasoning, or decision- making.
Guide 53: Ethics and Law in the Medical Curriculum
33
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52