1. ASSESSMENT OF ATTITUDES & PSYCHOMOTOR SKILLS
Raja C. Bandaranayake

2. DOMAINS OF LEARNING Cognitive (Knowledge) Psychomotor (Motor skills)
Affective (Attitudes)

3. 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

4. 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

5. 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

6. ORIENTATIONS TO ATTITUDE ASSESSMENT
Behavioural
Observation of behaviours
Psychometric
Standardized pen-and-paper tests
Counselling
One-to-one discussion

7. 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

8. BEHAVIOURAL ORIENTATION (contd.)
Change can be monitored
“Spied on” feeling
Coercive atmosphere
Individual event may be trivial
need to observe many behaviours

9. BEHAVIOURAL ORIENTATION Who are the observers?
Trained observers
Administrators
Teachers
Peers
Other professionals
Patients
Parents
Self

10. PSYCHOMETRIC ORIENTATION
Pen-and-paper instruments
Validated, standardized tests
Self reports possible
Inexpensive and objective
Socially desirable responses possible
Situation-specific
Conclusions indefinite

11. 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

12. 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

13. SEMANTIC DIFFERENTIAL
Surgeons are:
Theoretical _ _ _ _ _ _ _ Practical
Personal _ _ _ _ _ _ _ Impersonal
Active _ _ _ _ _ _ _ Passive
Disease _ _ _ _ _ _ _ Patient-
oriented oriented

14. 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

15. 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

16. 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

17. 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

18. OBSERVATIONS: Structured
Specific plan made for making and recording observation
Investigator knows what aspects of behaviour are relevant for the purpose

19. Observational Instruments
CHECKLIST
Where the response is “Yes” or “No”
2. RATING SCALE
Where quality of performance is important

20. 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

21. 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

22. 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

23. CHECKLIST: contd.
Gives 4 quick ventilations
Checks carotid pulse
*Checks pupils for dilatation
*Bares victim’s chest
Checks anatomical landmarks

24. 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

25. 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

26. 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

27. 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

28. 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

29. ERRORS IN RATING Error of leniency Error of central tendency
Halo effect
Logical error
Error of contrast