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ASSESSMENT OF ATTITUDES & PSYCHOMOTOR SKILLS
Raja C. Bandaranayake
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DOMAINS OF LEARNING Cognitive (Knowledge) Psychomotor (Motor skills)
Affective (Attitudes)
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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
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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
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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
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ORIENTATIONS TO ATTITUDE ASSESSMENT
Behavioural Observation of behaviours Psychometric Standardized pen-and-paper tests Counselling One-to-one discussion
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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
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BEHAVIOURAL ORIENTATION (contd.)
Change can be monitored “Spied on” feeling Coercive atmosphere Individual event may be trivial need to observe many behaviours
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BEHAVIOURAL ORIENTATION Who are the observers?
Trained observers Administrators Teachers Peers Other professionals Patients Parents Self
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PSYCHOMETRIC ORIENTATION
Pen-and-paper instruments Validated, standardized tests Self reports possible Inexpensive and objective Socially desirable responses possible Situation-specific Conclusions indefinite
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QUESTIONNAIRES Open-ended Closed Semantic differential
[Respond in own words] [select, rank, rate] e.g. Essay e.g. Likert scale Semantic differential Tests of judgement Forced-choice
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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
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SEMANTIC DIFFERENTIAL
Surgeons are: Theoretical _ _ _ _ _ _ _ Practical Personal _ _ _ _ _ _ _ Impersonal Active _ _ _ _ _ _ _ Passive Disease _ _ _ _ _ _ _ Patient- oriented oriented
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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
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PSYCHOMOTOR DOMAIN Using senses for cues to motor activity 2. Set
Perception Using senses for cues to motor activity Set Readiness to take a particular type of action 3. Guided response Imitating a skill; trial and error 4. Mechanism Response habitual and confident
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PSYCHOMOTOR DOMAIN – contd.
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
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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
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OBSERVATIONS: Structured
Specific plan made for making and recording observation Investigator knows what aspects of behaviour are relevant for the purpose
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Observational Instruments
CHECKLIST Where the response is “Yes” or “No” 2. RATING SCALE Where quality of performance is important
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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
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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
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CHECKLIST: Mouth-to-mouth resuscitation
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
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CHECKLIST: contd. Gives 4 quick ventilations Checks carotid pulse *Checks pupils for dilatation *Bares victim’s chest Checks anatomical landmarks
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Behaviourally-anchored
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
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BEHAVIOURALLY-AHCHORED RATING SCALE: ATTITUDES
Relationship with patients 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
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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
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Mouth-to-mouth resuscitation Effects tight seal
RATING SCALE: SKILLS Mouth-to-mouth resuscitation 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
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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
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ERRORS IN RATING Error of leniency Error of central tendency
Halo effect Logical error Error of contrast
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