Perspectives from the Faculty of Medicine and Dentistry

The Faculty of Medicine and Dentistry teaches undergraduate and postgraduate students, as well as delivers health care. In clinical years, students are on rotation from one discipline to another. Therefore assessment of student learning in the Faculty is a dynamic process and generally revolves around a competence framework (Fig. 1).

Fig. 1. Competence framework adapted from Miller (1990)

A number of challenges are faced by the Faculty, which are constantly under discussion and review. The challenges include:

• achieving balance between different assessment tools
• avoiding over assessment
• allocating resources, both physical and human, especially the hours required for developing and using assessment tools
• accommodating increased student numbers
• ensuring educational effectiveness of assessment

Some initiatives that have been undertaken to meet these challenges are outlined below.

1. Defined learning outcomes

   The framework for medical curriculum is structured around four themes. Each theme is made up of several strands which help all units to define explicit learning outcomes. Students are expected to demonstrate satisfactory performance in each strand through multiple opportunities ranging from multiple choice questions to portfolios. Some of the methods used are introduced early in the course, and are repeated each year at increasing levels of complexity and engage in higher cognitive learning attributes such as critical thinking, problem solving, and research skills in addition to clinical skills.

   A similar approach is adopted by the other disciplines offering courses in the Faculty.

2. Integrated Assessment

   The Faculty critically examines how much evidence is really required of students to demonstrate that the said outcome has been achieved. This helps to integrate assessment horizontally and vertically during the course of six years and at the same time reduces the assessment overload on faculty and students.

3. Review Curriculum Structure

   With increasing student enrolment, a working party is reviewing current teaching and assessment practices to determine their feasibility.

4. Formative Assessment

   The criteria that establishes a good assessment includes reliability, validity, standardisation, practicality and above all its educational effectiveness for the students. This requires use of formative assessment which provides feedback to students. The feedback may be formal or informal, and it can be provided daily or periodically. Students are also offered opportunities for self assessment, for example, through case scenarios and online tests during rotation.

In short, maximum efforts are made to integrate and align learning, teaching and assessment. There are critical reviews conducted by individual schools, committees at each year level of course, and by the Medical Curriculum Committee. The ultimate aim for ongoing discussion is to ensure a shared understanding of relevant aspects between staff and students in the faculty.

• Miller, G.E. (1990). The assessment of clinical skills/ competence/performance. Academic Medicine (Supplement), 65(9), S63-S67.

Contribution from Dr Zarrin S Siddiqui, Lecturer in Medical Education (Assessment & Evaluation) in the Faculty of Medicine and Dentistry.