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ASSESSMENT OF ATTITUDES ASSESSMENT OF ATTITUDES & PSYCHOMOTOR SKILLS& PSYCHOMOTOR SKILLS
Raja C. BandaranayakeRaja C. Bandaranayake
DOMAINS OF LEARNINGDOMAINS OF LEARNING
• Cognitive (Knowledge)
• Psychomotor (Motor skills)
• Affective (Attitudes)
THE AFFECTIVE DOMAINTHE AFFECTIVE DOMAIN
• AwarenessAwareness [knowledge base]e.g. Reads about importance of rural health care
• ReceivingReceiving [willing to receive or attend]e.g. Acknowledges rural health care is important
• Responding Responding [actively attending]e.g. Seeks additional information about rural health needs & problems
THE AFFECTIVE DOMAIN – contd.THE AFFECTIVE DOMAIN – contd.
• ValuingValuing [‘worth’ to learner]e.g. Spends free time working in rural areas
• OrganizingOrganizing [takes steps to incorporate into one’s life]e.g. Undergoes training to deal with rural health problems
• Characterisation by value or value Characterisation by value or value complexcomplex [becomes part of one’s life]e.g. Enters a career of rural health care
PROBLEMS IN ASSESSING ATTITUDESPROBLEMS 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 ORIENTATIONS TO ATTITUDE ASSESSMENTASSESSMENT
Behavioural– Observation of behaviours
Psychometric– Standardized pen-and-paper tests
Counselling– One-to-one discussion
BEHAVIOURAL ORIENTATIONBEHAVIOURAL ORIENTATION
Behaviours Behaviours can be observed
Rely on observation toolsRely on observation tools– checklist, rating scale, anecdotal record
Expectations explicitExpectations explicit
Assessment consistentAssessment consistent
Inference necessaryInference necessary– many variables affect behaviour
BEHAVIOURAL ORIENTATION (contd.)BEHAVIOURAL ORIENTATION (contd.)
Change can be monitoredChange can be monitored
““Spied on” feelingSpied on” feeling
Coercive atmosphereCoercive atmosphere
IndividualIndividual event may be trivialevent may be trivial– need to observe many behaviours
BEHAVIOURAL ORIENTATIONBEHAVIOURAL ORIENTATIONWho are the observers?Who are the observers?
Trained observersTrained observers AdministratorsAdministrators TeachersTeachers PeersPeers Other professionalsOther professionals PatientsPatients ParentsParents SelfSelf
PSYCHOMETRIC ORIENTATIONPSYCHOMETRIC ORIENTATION
Pen-and-paper instrumentsPen-and-paper instruments
Validated, standardized testsValidated, standardized tests
Self reports possibleSelf reports possible
Inexpensive and objectiveInexpensive and objective
Socially desirable responses possibleSocially desirable responses possible
Situation-specificSituation-specific
Conclusions indefiniteConclusions indefinite
QUESTIONNAIRESQUESTIONNAIRES
Open-endedOpen-ended ClosedClosed[Respond in own words] [select, rank, rate]
e.g. Essay e.g. Likert scale Semantic
differentialTests of judgement
Forced-choice
LIKERT SCALELIKERT SCALE
SA A U D SDSA A U D SD
A medical history isincomplete without asocial historyThe logical leader fora health team is the doctorThe team approach tohealth care is a waste of time
SEMANTIC DIFFERENTIALSEMANTIC DIFFERENTIAL
Surgeons are:
Theoretical _ _ _ _ _ _ _ Practical
Personal _ _ _ _ _ _ _ Impersonal
Active _ _ _ _ _ _ _ Passive
Disease- _ _ _ _ _ _ _ Patient-oriented oriented
COUNSELLING ORIENTATIONCOUNSELLING 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 DOMAINPSYCHOMOTOR DOMAIN
1. Perception Using senses for cues to motor activity
2. SetReadiness to take a particular type of action
3. Guided responseImitating a skill; trial and error
4. MechanismResponse habitual and confident
PSYCHOMOTOR DOMAIN – contd.PSYCHOMOTOR DOMAIN – contd.
5. Complex overt responseSkillful & complex performance
6. AdaptationAble to modify movement pattern to suit particular situation
7. Origination Creating new movement pattern for a
specific purpose
OBSERVATIONS: OBSERVATIONS: Relatively Relatively UnstructuredUnstructuredComplete 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: StructuredOBSERVATIONS: Structured
Specific plan made for making and recording observation
Investigator knows what aspects of behaviour are relevant for the purpose
Observational InstrumentsObservational Instruments
1.1. CHECKLISTCHECKLISTWhere the response is “Yes” or “No”
2. RATING SCALERATING SCALEWhere quality of performance is important
CHECKLIST: When to use?CHECKLIST: When to use?
Performance skillsPerformance 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 productsPerformance products that can be evaluated by noting presence (or absence) of observable characteristicse.g. patient’s medical record
CHECKLIST: CHECKLIST: STEPS IN CONSTRUCTIONSTEPS 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: CHECKLIST: Mouth-to-mouth Mouth-to-mouth resuscitationresuscitation
Done
Order #
Not done
NA
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.CHECKLIST: contd.
• Gives 4 quick ventilations• Checks carotid pulse• *Checks pupils for dilatation• *Bares victim’s chest• Checks anatomical landmarks
TYPES OF RATING SCALESTYPES OF RATING SCALES
GraphicPoor rapport Excellent rapport
Graphic with anchorsPoor Fair Good Very Good Excellent
Frequency scalesNever Seldom Often Always
Behaviourally-anchored
BEHAVIOURALLY-AHCHORED RATING SCALE: BEHAVIOURALLY-AHCHORED RATING SCALE: ATTITUDESATTITUDES
Relationship with patientsRelationship with patientsA. 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: COMMUNICATIONRATING SCALE: COMMUNICATION
Participation in group discussionC. 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: SKILLSRATING SCALE: SKILLS
Mouth-to-mouth resuscitationMouth-to-mouth resuscitation
A.A. Effects tight sealEffects tight seal
Cannot determineCannot determine
InadequateInadequate: Does not attempt to create a tight seal or seal is grossly inadequate
SatisfactorySatisfactory: Has leak, but adequate ventilation
ExcellentExcellent: Fully covers mouth from corner to corner, creating an airtight seal
RATING SCALE:RATING SCALE:STEPS IN CONSTRUCTIONSTEPS 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