Medical student’s perception towards the modification of the existing internal assessment pattern

 

Anitha O R

Abstract              Background: The traditional way of assessment is very effective in assessing the knowledge and psychomotor skills in the medical students but the affective domain has not been tested effectively. MCI proposed vision 2015 ¹, where in, there is a scope to test even the affective domain in a medical student. As this was done in order to improve the students’ overall performance, we felt a need to know their perception towards modification of the Internal Assessment (I.A.) pattern. Thus, this study was taken up. Specific objectives: To find out the medical students’ perception towards: I)Modification of the present internal assessment pattern. ii) Including assessment of affective domain in a medical student as a part of I.A. Methodology: Taking the quarter model proposed by Tejinder singh² as a base, we conducted a study to know the reactions of students about making modifications in the internal assessment. 130 students were given the present I.A. pattern and also the proposed I.A. pattern. They were asked to give their feedback by answering to the questionnaire using the likert scale. Results: Majority of the students felt that the present assessment pattern needs modification. 98% of the students strongly agreed that testing the element of empathy should be a part of I.A. Almost all agreed that regularity, MCQs, sincerity and communication skills/ bedside manners should be a part of I.A. There was a 50% agreement to include seminar as a part of I.A. Conclusion: The students in the study were aware of the importance of testing the affective domain and were agreeing for modification of the present internal assessment pattern. Thus by doing the proposed changes, we will be able to test medical students as a whole person. This will also encourage the students to become more proficient and humane doctor.

Key Words: Internal assessment, new curriculum, Vision 2015, affective domain.

 

INTRODUCTION

Goal of any medical college is to produce doctors who are highly proficient in both the scientific and humanistic aspects of medical practice, so they remain focused on treating the patient as a whole (holistic approach). In this aspect it’s very essential to inculcate knowledge, psychomotor skills and attitude in the medical students while they are in the medical college. Most of this has been inculcated in our curriculum. Any skill taught should be assessed for its effective acquisition. The traditional way of assessing medical students has been followed from past many decades. In this method, internal assessment has been done only in the form of 3 written theory examinations and 3 practical / clinical examinations. This type of assessment is very effective in assessing the knowledge and psychomotor skills in the medical students but the affective domain has not been tested effectively. In this context MCI proposed vision 2015 ¹, where in, there is a scope to test all the three domains in a medical student. This study was done in 2016, when there was lot of discussions was going on about the big change in MBBS curriculum. As the change in curriculum was done in order to improve the students performance and to some extent inculcate empathy in them, we felt a need to know about students’ perspective towards this modified Internal assessment pattern as students are important stake holders in an education system . Thus, this study was taken up to know the same.

MATERIALS AND METHODS

The quarter model proposed by Tejinder Singh² attempts to modify the existing internal assessment (I.A.) pattern to include testing of affective domain. This includes testing of skills like communication skills, bedside manners, regularity, sincerity etc. Taking this as a base we designed a modified assessment pattern (table 1 and 2). This plan was given to the students and they were told to compare this pattern to that of their existing pattern of assessment. Along with this pattern a questionnaire was given to the subjects to know the reactions of students about making such modification in their existing I.A pattern. The questionnaire was semi structured with likert scale. Cronbach’s alpha of the questionnaire was found to be 0.708 which showed a better validity and reliability. This questionnaire was distributed among 150 students in their 5^th term. These students were particularly selected as these students had already faced traditional pattern of exams both in pre clinical and clinical subjects. Out of 150 students only 130 gave the written consent and returned the filled questionnaire forms. The students were given the present I.A. pattern and also the proposed I.A pattern. They were asked to give their feedback by answering to the questionnaire with likert scale.

 

OBSERVATIONS AND RESULTS

Table 1: PROPOSED INTERNAL ASSESSMENT PATTERN: Theory – 50 Marks

 

Figure 1: Medical students’ perception towards different changes in Internal Assessment

 

Table 2: PROPOSED INTERNAL ASSESSMENT PATTERN: Practical/ Clinical– 50 Marks

There was a mixed opinion about inclusion of seminar in I.A. while 50% of the students agreed to include this as a part of I.A., another 50% disagreed. 80 % of Students strongly agreed to include MCQs as a part of I.A.

 

DISCUSSION

MCI ‘s Vision 2015 defines the role of a doctor as a Clinician, who understands and provides preventive, promotive, curative, palliative and holistic care with compassion¹. Empathy is a quality which is important for improved patient- doctor relationship and also this is associated with more accurate diagnosis and better adherence to therapy.³ Empathy should form the learning objective in a medical college. In the present study most of the students agreed on including the testing of empathy as part of I.A. and also to include assessing communication skills/ bedside manners as a part of I.A. In our study majority of the students strongly agreed to include MCQs as part of I.A. Medical students need to develop the skills to think analytically about complex clinical problems. Well framed MCQs can be a reliable tool to test the different levels of knowledge in students. Multiple-choice questions (MCQs) are widely used in medical education and can promote surface learning strategies.⁴ Almost all agreed that regularity and sincerity should be a part of assessment. At present, RGUHS gives importance for the attendance, by taking 75% attendance as one of the eligibility criteria to appear for the university examination. But students do not get any benefit in the form of marks by attending classes more than the required 75%. Sincerity in a student's life ensures the betterment in the life of any student. More important for medical students as sincerity helps to build trust among patients.⁵ Awarding marks for the attendance and regularity will not only encourage students to inculcate sincerity in them, but also help them to gain more knowledge. This system is already been followed in some of the universities in our country.⁶ This could also be inculcated in our Internal assessment. There is a great deal of evidence indicating that the quality of communication between physician and patient influences the patient’s health outcome. Doctors’ levels of work stress, quality of diagnosis, and even malpractice claims are associated with their communication skills. Miscommunication or lack of communication between the doctor and patients has led to many mishaps and also is the main reason for allegations against doctors.⁷ A recent study on whether patients with chronic bronchial asthma adhered to treatment also showed that adherence was significantly related to the quality of the information given to the patient.⁸ Effective communication training methods are therefore need of the hour for the doctors- to -be. It should be inculcated in the curriculum. As is known by all educationists that, Students learn what is asked in the exams and not what is taught in the classroom, it is indeed very much necessary that communication skills should be assessed as it is one of the competencies to be achieved by the Indian medical graduate.

CONCLUSION

In the present study, we found that the students wanted some modification; though they were happy with the present internal assessment pattern. The students in the study were aware of the importance of testing the affective domain. This was shown by majority of students agreeing to include the testing of skills like empathy, regularity, sincerity, bedside manners and communication skills as a part of Internal assessment. Thus by doing the proposed changes in the existing pattern of I.A. we will be able to test medical students as a whole person rather than testing merely knowledge in them. This will also encourage the students to become more proficient and humane doctor. As this study was done in a small group of students, we would like to extend it further by including more students from our college and also from other colleges.

ACKNOWLEDGEMENTS:

I thankfully acknowledge subjects for volunteering to participate in the study and also our dean and Principal Dr. Jayanthi V., for her continuous encouragement and support.

SOURCES OF FUNDS: NIL.

ETHICAL CLEARANCE: Institutional Ethical Committee, SIMSandRC, Bangalore.

 

REFERENCES

1. Vision 2015 MCI, published in March 2011.
2. Tejinder Singh, Anshu And Jyoti Nath Modi. The Quarter Model: A Proposed Approach For In-Training Assessment Of Undergraduate Students In Indian Medical Schools Indian Pediatrics 2012, 49.
3. Nunes P, Williams S, Bidyadhar Sa, Stevenson K. A study of empathy decline in students from five health disciplines during their first year of training. IJME, 2011; 2:12-17.
4. Grainger, R., Dai, W., Osborne, E. et al.. Medical students create multiple-choice questions for learning in pathology education: a pilot study. BMC Med Educ 2018; 18, 201- 208.
5. Thomas B. Moral and human values in medical education. J Indian Soc Periodontol. 2015;19(5):486-89
6. Ordinance VIII- E – Internal assessment, Hindu college, University Enclave, Delhi -07.
7. Gomez G, Aillach E. Ways to improve the patient-physician relationship. Curr Opin Psychiatry. 2013; 26(5):453–457.
8. Maguire P, Pitceathly C. Key Communication Skills and how to Acquire Them. BMJ. 2002. pp. 697–700.

 

Policy for Articles with Open Access
Authors who publish with MedPulse International Journal of Physiology (Print ISSN:2550-7613) (Online ISSN: 2636-4565)agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.