UNIT 6: ASSESSMENT/EVALUATION

METHODS/STRATEGIES

PURPOSES, SCOPE AND PRINCIPLES IN SELECTION OF

ASSESSMENT METHODS AND TYPES

PURPOSES OF EVALUATION

The overall purpose of the evaluation will be to provide information to enable

each student to develop according to his potential within the framework of
educational objectives.

Bloom stated the following main purposes of evaluation:

o To discover the extent of competence which the students

o have developed in initiating, organizing and improving his day-to-day work

and to diagnose his strengths and weakneses with a view to further guidance

o To predict the educational practices which a particular student-teacher can

best participate in or organize

o At the end of the career to certify student's degree, proficiency in a

particular educational practice.

 Thus the overall purposes of evaluation are as follows:

o To appraise the status of and changes in student's behavior

o To make provision for guiding the growth of the individual student

o To diagnose the individual students' educational weakness and strength

 o To assess the student's progress from time to time and disclose student's
needs and possibilities
SCOPE OF EVALUATION

It can be enlisted as follows:

• Ascertaining the extent to which the educational objectives have been attained.

• Effectiveness of appraisal or methods, of instruction. Identifies pupil's strengths

and weakness difficulties and problems, needs and demands.

Provides base line for guidance and counseling.

• Placement and promotion in jobs.

• Development of attitudes, interest, capabilities, creativity, originality, knowledge

and skills.

• Development of tools and techniques for evaluation.

• Development of curriculum and for its revision.

• Interpretation of results.

• Helpful for curriculum planners and administrators to improve the curriculum

program.

PRINCIPLES OF EVALUATION

 Establishing inter-relationships between objectives, instructions or learning

experiences and evaluation.
 Determining and deciding what is to be evaluated.
 Selecting appropriate evaluation techniques for the achievement of objectives.
 Combining a variety of evaluation techniques for comprehensive evaluation.
 Knowing the merits and limitations of various evaluation techniques.
  Defining objectives in behavioral terms clearly and specifically.

TYPES OF ASSESSMENT METHODS

The major purpose of assessment in schools should be to provide interpretative

information to teachers and school leaders about their impact on students, so that
these educators have the best information possible about what steps to take with
instruction and how they need to change and adapt. So often we use assessment in
schools to inform students of their progress and attainment. Of course this is
important, but it is more critical to use this information to inform teachers about
their impact on students. Using assessments as feedback for teachers is
powerful. And this power is truly maximized when the assessments are
timely, informative, and related to what teachers are actually teaching.

Six types of assessments are:

 Diagnostic assessments
 Formative assessments
 Summative assessments
 Ipsative assessments
 Norm-referenced assessments
 Criterion-referenced assessments

1. Diagnostic assessment

When you structure diagnostic assessments around your lesson, you’ll get the
information you need to understand student knowledge and engage your whole
classroom.
Some examples to try include:
 Short quizzes
 Journal entries
 Student interviews
 Student reflections
 Classroom discussions
 Graphic organizers (e.g., mind maps, flow charts, KWL charts)
Diagnostic assessments can also help benchmark student progress. Consider giving the
same assessment at the end of the unit so students can see how far they’ve come!
 2. Formative assessment
Just because students made it to the end-of-unit test, doesn’t mean
they’ve mastered the topics in the unit. Formative assessments help teachers
understand student learning while they teach, and provide them with information
to adjust their teaching strategies accordingly.
Formative assessments help you track how student knowledge is growing and
changing in your classroom in real-time. While it requires a bit of a time
investment — especially at first — the gains are more than worth it.
Some examples of formative assessments include:
 Portfolios
 Group projects
 Progress reports
 Class discussions
 Entry and exit tickets
 Short, regular quizzes
 Virtual classroom tools like Socrative or Kahoot!
When running formative assessments in your classroom, it’s best to keep
them short, easy to grade and consistent.

3. Summative assessment
Summative assessments measure student progress as an assessment of learning.
Standardized tests are a type of summative assessment and provide data for you,
school leaders, and district leaders.
They can assist with communicating student progress, but they don’t always give
clear feedback on the learning process and can foster a “teach to the test” mindset
if you’re not careful.
No matter what type of summative assessment you give your students, keep some
best practices in mind:
 Keep it real-world relevant where you can
 Make questions clear and instructions easy to follow
 Give a rubric so students know what’s expected of them
 Create your final test after, not before, teaching the lesson
 Try blind grading: don’t look at the name on the assignment before you mark it

4. Ipsative assessments
 Ipsative assessments are one of the types of assessment as learning
that compares previous results with a second try, motivating students to set
goals and improve their skills.
When a student hands in a piece of creative writing, it’s just the first draft. They
practice athletic skills and musical talents to improve, but don’t always get the
same chance when it comes to other subjects like math.
A two-stage assessment framework helps students learn from their mistakes and
motivates them to do better. Plus, it removes the instant gratification of goals and
teaches students learning is a process.
You can incorporate ipsative assessments into your classroom with:
 Portfolios
 A two-stage testing process
 Project-based learning activities

5. Norm-referenced assessments
Norm-referenced assessments are tests designed to compare an individual to a
group of their peers, usually based on national standards and occasionally adjusted
for age, ethnicity or other demographics.
Unlike ipsative assessments, where the student is only competing against
themselves, norm-referenced assessments draw from a wide range of data
points to make conclusions about student achievement.
Types of norm-referenced assessments include:
 IQ tests
 Physical assessments
 Standardized college admissions tests like the SAT and GRE
Proponents of norm-referenced assessments point out that they accentuate
differences among test-takers and make it easy to analyze large-scale trends.
Critics argue they don’t encourage complex thinking and can inadvertently
discriminate against low-income students and minorities.
Norm-referenced assessments are most useful when measuring student
achievement to determine:
 Language ability
 Grade readiness
 Physical development
 College admission decisions
 Need for additional learning support
6. Criterion-referenced assessments

Criterion-referenced assessments compare the score of an individual student

to a learning standard and performance level, independent of other students
around them.
In the classroom, this means measuring student performance against grade-level
standards and can include end-of-unit or final tests to assess student
understanding.
Outside of the classroom, criterion-referenced assessments appear in professional
licensing exams, high school exit exams and citizenship tests, where the student
must answer a certain percentage of questions correctly to pass.
Criterion-referenced assessments are most often compared with norm-referenced
assessments. While they’re both considered types of assessments of learning,
criterion-referenced assessments don’t measure students against their peers.
Instead, each student is graded to provide insight into their strengths and areas for
improvement.

BARRIERS TO EVALUATION

Lack of Time

Nursing faculty often makes complaints/excuses of lack of time for not evaluating
the students regularly. Lack of time may be a result of poor time management
skills hence, faculty must try to overcome this barrier. If it is not manageable then
they can hire external evaluators from outside to manage the affairs so that, this
core activity of the education will not be jeopardized. They must consider that
evaluation is as important as delivering lectures or demonstrating skills to the
nursing students.

Lack of the Skills to Carry Out Evaluation

Some teachers may not be competent enough to plan and execute the evaluation
schedule. These teachers must be identified by the principal of the college and
remedial actions, e.g. in-service education, refresher courses, etc., can be planned
for those who are in need.
Continuous Evaluation is not Cost-effective

Sometimes continuous comprehensive evaluation may not be cost effective. But it

should not be a reason to hamper the process of evaluation; remedies to manage
the budgets should be explored and employed.

Problem of Workload of the Teachers

Nursing faculty may be excessively burdened with teaching and non-teaching

works; for instance, they have to go to the clinical area for 4 hours daily thereafter
they have to take 10-12 hours classes per week, which means 2 classes per day;
beside that they have to perform a lot of clerical works (maintain class and clinical
attendance registers, getting the students' leave signed by the principal, planning
time table, clinical rotations, etc.) so it becomes very difficult to plan and
implement this rigorous evaluation strategy which includes setting of question
papers, checking answer sheets and maintaining records of internal assessment.
That is a reason why the faculty avoids taking responsibility of internal
assessments. Education experts are required to give a thought on this issue to
solve the problem.

Problem-Related to Lack of Knowledge Regarding Available Curriculum

Guidelines for Internal Assessment

INC has specified internal assessment criteria in the revised BSc(N) syllabus. But,
most of the teachers are ignorant about the items that should be covered in internal
evaluation. This hampers the planning and implementation of internal assessment.

Lack of Uniform Standards of Evaluation

Lack of uniform standards will cause inconsistency in the evaluation process that
may lead to frustration among students. Given below are some examples of
inconsistency in evaluation. Some teachers will allow retakes of tests and quizzes,
others do not. Different policies exist for work turned in late. The validity and
reliability of student assessments vary. There are major philosophical differences
regarding evaluation. Some teachers view learning as primarily a student
responsibility, while some place the responsibility for teaching mainly on
 themselves. There is little agreement on how many assessments and what kinds
are needed for evaluation. Even within the same school different teachers teach
differently and test differently for the same course.

GUIDELINES TO DEVELOP ASSESSMENT TEST

General guidelines
As you create assessments in your course, we encourage you to consider implementing the
following six evidence-based guidelines:
1. Align assessments with learning aims
2. Use multiple low stakes assessments
3. Create authentic assessments
4. Use both formative and summative assessments
5. Use varied forms of assessments
6. Use cumulative assessments

TIPS FOR CREATING EFFECTIVE ASSESSMENTS

1. Use Multiple Methods

A single method is not enough to provide a complete picture of the knowledge and skills
acquired by the students. Thus, a teacher must use multiple methods to assess the students for
their capabilities in different fields.
Various activities such as projects, questionnaires, surveys, and others help in the assessment of
different skills. These activities are conducted in the form of either formative or summative
assessment.
2. Specify the Objectives
Learning aims to inculcate a certain type of skill. Any form of learning has some necessary
objectives for acquiring the required skills and knowledge. Moreover, these objectives determine
the efforts of the learners and their contribution to the learning process as they participate in
various activities. Therefore, specifying the objectives at the beginning of an assessment test
helps students identify the skills they must demonstrate. Also, it motivates them to perform better
as they are aware of what they are doing.
3. Stick to the Goals
An assessment is nothing without a goal. Effective assessment activities are completely goal-
oriented. Thus, teacher as well as students should be aware of the goals and objectives of
learning and should stick to them.
Additionally, teachers must ensure that the activities that do not fulfill the goal requirements are
avoided to avoid the sheer waste of time.
4. Eschew Biases
Biases create hindrances in the process of development. They develop a sense of insecurity
among the learners that often affects their performance. Therefore, teachers should work on
creating a free and healthy environment where the students can display their abilities without the
fear of judgment.
As a result, the students develop a sense of self-awareness and become progressive as they
express themselves better. Moreover, unbiased assessments contribute to the development of
their overall personality.
Additionally, the assessments that are not related to the skills/knowledge of the target group of
students must be avoided.
5. Engage Learners
Learner engagement is a fundamental requirement for learning. The assessment of learning
produces more accurate results when the learners actively participate in the classroom. Also,
participation inculcates self-confidence in students as they learn to take initiative.
Moreover, the students learn many social skills as they collaborate with peers in group activities.
Therefore, assessment activities involving more learner interaction and participation must be
prioritized.
6. Record the Results
Keeping a record of the assessment results is important. It helps to assess the levels of
improvement in the learners and also gives a clear picture of their potential.
Also, it helps the teachers identify areas where the learner requires assistance and practice.
Accordingly, teachers can then design lessons and choose a teaching methodology that serves the
purpose.
Moreover, students get to know where they stand, and a sense of healthy competition develops
among them. This motivates the students to compete for better results.
7. Give Feedback
Feedback is what helps students to move further in learning. It gives them insights into their
current performance and the areas they need to improve upon. Also, it helps teachers identify
potential threats to learning and encourage the students to overcome their fears.
Moreover, feedback initiates an interaction between students and teachers. This creates a healthy
classroom environment that leads to the development of communication skills. Also, the overall
development of the students’ personality takes place within the classroom.
8. Modify Instructional Strategies
Choosing the right instructional strategy determines the effectiveness of the assessment and the
overall course. Thus, the teacher must give clear instructions and should not refrain from
modifying the instructional strategy.
Incorporating Gamification in assessments is a strategy that works to engage students while they
have fun developing their skills. Apart from this, Blended Learning and Flipped Classroom are
two other effective instructional strategies to use.
Furthermore, experimenting with instructional strategies helps to cater to the individual learning
needs of the students and renders better performance results in assessments.
Creating effective assessments can be challenging sometimes. The above-mentioned tips for
creating effective assessments can help the teachers to fulfill the requirements of learning and
assessment to give the students an enriching learning experience.

MULTIPLE-CHOICE QUESTIONS

Multiple-choice questions (MCQs) are a form of assessment where respondents

are asked to select the best possible answer (or answers) out of choices from a list.
Although E.L. Thorndike developed an early multiple-choice test, Frederick J.
Kelly was the first to use such items as part of a large-scale assessment. MCQs are
a special type of questions that are widely used in various entrance exams where
thousands of students attempt the exams. These are standardized tests with high
reliability and validity. A typical MCQ begins with a stem which may be an
incomplete statement, picture or graph, which is followed by 4-5 alternatives or
choices. All the wrong answers or alternatives are known as distractors. The
correct answer/answers are known as the key.Clear instructions are provided at the
beginning of the questionnaire about the selection of the answer (e.g. choose one
response that is correct; choose all responses that are correct) or instructions are
provided within the questionnaire whenever necessary. Scoring in MCQs is easier
as compared to essay-type and short answer-type questions but the other side of
the coin is that it is equally difficult to construct good quality MCQs and there is a
high chance of cheating and guesswork practices.
The basic structure of multiple-choice questions.

The stem is followed by 4-5 options. The options are possible answers that the
examiner can choose from with the correct answer called the key and the incorrect
answers called destructors . Generally, only one answer can be keyed as correct.
However, when more than one answer is keyed as correct, then these questions are
named as multiple-response questions (Box 9.3).

Usually, a correct answer earns a set number of points towards the total marks and
an incorrect answer earns nothing. However, tests may also award partial credit
 for unanswered questions or penalize students for incorrect answers to discourage
guessing.

Markings of the answers made by the teacher are objective as there is no scope of
subjectivity. Answers can be checked by computers or by any other person
supplied with the answer key.

GUIDELINES TO CONSTRUCT GOOD MCQS

The following basic rules must be observed for writing good multiple-choice
questions:

A. General tips

 Design each item to measure an important learning objective or learning

outcome.

 Before writing a question, think about what it is that you want to test.
Lecture notes, textbook readings, assigned problems and other course
materials can be an inspiration to write items.
1. STRUCTURE AND CHARACTERISTICS OF MCQS

 Multiple-choice questions consist of a stem and a set of options. The stem

is the beginning part of the item that presents the item as a problem to be
solved, a question asked to the respondent or an incomplete statement to
be completed and any other relevant information.
 Control the difficulty of the item either by varying the problem in the stem
or by changing the alternatives.

 Make certain that each item is independent of the other items in the test.
Make sure that each item is grammatically accurate to avoid ambiguity in
understanding

 Keep the question stem and alternatives as short as possible. Use few
words. Avoid repeating words from the question stem in the alternatives.
  Make sure to have a sufficient number of easy and more challenging
questions so that the poor, fair. good and excellent students are effectively
judged and separated.

 Try to make the first few MCQs relatively quick and easy, to help calm
students down so they can

 focus on the more challenging questions to come. Avoid the temptation to

test many things in one question. If possible, try to write more than one
MCQ rather than test multiple concepts in one question.

 Ask more than one questions when a fair amount of information must be
provided as it takes time for students to carefully read and understand the
information you provide in a test. For example. you could give them a
table of results, a graph, or a scenario and then ask two or three different
MCQs about it.

 Do not try to write the entire test in one day; it takes time, creativity and
thought to write good MCQs.

 After constructing the MCQ test, a try-out may be planned on nearly

similar subjects and an item analysis must be carried out before
preparation of a final draft of the test.

B. Construction of the stem

 Present a single, clearly formulated problem in the stem of the

item/question.

 Phrase the question stem as clearly and concisely as possible, avoiding

complex language.

 State the stem of the item in a positive form, wherever possible.

  Emphasize negative wording whenever it is used in the stem of an item;
for example, which of the following is NOT an appropriate method of
back massage?

 Avoid verbal clues, which might enable students to select the correct
answer or to eliminate an incor rect alternative. Similarity of wording in
both the stem and the correct answer is one of the more obvious clues.

C. Construction of alternatives

 Make certain that the intended answer is correct or clearly the best.

 Make all alternatives grammatically consistent with the stem of the item
and parallel in form.

 Avoid the use of the alternative 'all of the above' and use 'none of the
above' with great caution.

 Do not include alternatives such as 'both (A) and (D)' or 'all but (C)', as
these complicate the struc ture of the question and tend to confuse students
and/or slow them down.

 Vary the position of the correct answer in a random manner.

 Vary the relative length of the correct answer to eliminate length as a clue.

 There is no set rule about the number of options you should include in
MCQs. The greater the number of options, the smaller the mathematical
chance of correct guesswork. Therefore, generally 4-5 alternatives are
used.

 Make the distracters plausible and attractive to the uninformed, by: • Using
common misconceptions or common errors of students as distracters.
  Using good sounding words (e.g. accurate, important, etc.) in the
distracters, as well as in the correct answers.
 Making the distracters similar to the correct answer in both length and
complexity of wording.

 Stating the alternatives in the language of the student.

 Construct the destructors as close as possible to the correct answer to make

most effective destructors.

D. Advantages of MCQs

 Easy to use and administer.

 Can cover a large content area of syllabus.

 Easy to check answers.

 High reliability and validity.

 No scope of subjective biasness.

 Allow more adequate sampling of content.

 Tend to more effectively structure the problem to be addressed.

 Questions can be used more efficiently and reliably than just supplying
items.

 Different response alternatives can provide diagnostic feedback about the

planned questions (item analysis is possible).

 Questions can be constructed to address various levels of cognitive

complexities.
Disadvantages of MCQs

 Not useful to test the highest level of cognitive domain.

 Difficult to construct good MCQs.

 Provide an opportunity to guess the answer if the question is not

properly constructed.

 More suitable format for cheating in students if the invigilator is not

highly keen in observing students.

 A time-consuming process to construct good questions.

 Can lead the instructor to favour simple recall of facts.

 High degree of dependence on student's readings and instructor's

writing ability. .

 Measuring synthesis and evaluation can be difficult.

 Inappropriate for measuring the outcomes that require skilled

performance.

SHORT ANSWER QUESTIONS

 Short answer questions (SAQs) are very similar to objective items as a

clearly-defined answer is re-

 quired in both. However, in short answer questions the answer has to be

generated and supplied by the

 learner rather than chosen from a number of options provided. SAQs are
sometimes called objective
  questions, because they can be marked with a very high degree of
reliability, if suitably designed.

 Strictly speaking, however, they are not truly objective as the marker may
sometimes have to exercise a

 certain amount of subjective judgement in deciding whether an answer is

satisfactory. The evaluator

 may, for example, have to decide whether a wrongly-spelt word, a partly

correct answer or a perfectly

 good answer that the question setter did not anticipate is acceptable, and
may also have to decide whether an explanation or description is
satisfactory. Obviously, the subjective judgement involved tends to
increase with the length and complexity of the required answer, while the
degree of 'objectivity' shows a corresponding fall.

PURPOSES OF SAQS

 Useful to assess the recall ability of students (lower cognitive domain).

Used to assess students in a classroom while a lecture is in progress.

 Useful in formative assessment.

 May be used in summative evaluation to supplement other forms of

questions.

PRINCIPLES FOR CONSTRUCTION OF SAQS

 The following guidelines must be followed for the construction of essay-

type questions:

 The learning objective which is supposed to be evaluated by the short

answer type question should be clearly defined in simple words.
 The overall purpose and content of the item should be determined.

 Short answer questions should be written using the following guidelines:

 The item should be expressed in such a way that only a single, brief
answer is possible.

 The item should be expressed in a clear, simple language, making it as

concise as possible while avoiding looseness or ambiguity.

 The item should be expressed in a positive form wherever possible as it

has been found that posi- tively phrased test items tend to measure more
important learning outcomes than negatively phrased items.

 One should try to avoid providing clues to the required answer

unwittingly.

 Where a numerical answer has to be supplied, the degree of precision

expected and (if appropri- ate) the units to express it should be indicated.
For example, how many milligrams of Lasix a nurse will administer to a
patient with renal failure in a day?

 Precise, simple and unambiguous language should be used.

 Action-oriented verbs should be used.

 Each question should deal with important content area of a unit.

 Long complex sentences should be avoided and the questions should be

kept as simple as possible.

 Phrases like 'write briefly on, short notes on' should be avoided.

 Space should be provided for answers below each question per the
requirement of the question being asked.
  Specific problems for questions that will have distinct specific answers
should be chosen.

 Fill in the blank type questions should use statements that omit only one or
two key words (answer) at the end of sentence.

 While finalizing the layout of questions, it must be ensured that:

 The item is presented in such a way that the learners are in no doubt as to
what they are expected

 to do and how they are required to indicate their response. The wattage for
each question and criteria for marking is mentioned clearly.
 . Items to be evaluated by the subject experts panel: An expert must ensure
the availability of the following information before finalizing the
evaluation of each short answer item: Is the item relevant to the
course/module/syllabus to which it relates?

 Is the item style appropriate to the topic being covered and the specific
educational skills or outcomes being assessed?

 Does the item present the learners with a clearly-defined task?

 Is the item logically and structurally sound?

 Is the item stated in a simple and clear language?

 Is the item free from extraneous clues?

 Is the stated difficulty of the item likely to prove accurate?

 Is this stated difficulty appropriate?

TYPES OF SAQS
Fill in the blank type

Example: 0.1 / A patient is diagnosed with brain tumour. The nurse's assessment
reveals that the patient has difficulty in interpreting visual stimuli. Based on these
findings, the nurse suspects injury in the..... ..lobe of the brain.

Answer: Occipital

Statement completion

Example: Q.1: A 45-year-old patient is admitted with excruciating paroxysmal

facial pain. He reports that the episodes occur most often after feeling cold draft
and drinking cold beverages. Based on these findings, the nurse determines that
the patient is most likely suffering from...

Answer: Trigeminal neuralgia

Labelling a diagram

Example: Q.1: An elderly patient fell and fractured the neck of his femur. Identify
the area where the fracture occurred.
Short answer in 5-10 words

Example: Q.1: Mention the five commonly occurring signs and symptoms of
hypothyroidism.

1.

3.

2.

5.

4.
Advantages of SAQS

 Provide the opportunity to cover a much wider content of the syllabus to

evaluate the students.

 Can be administered to a large group of students for a short formative

assessment.

 Useful to assess the recall of information without any assistance or cues or

alternatives.

 Provide less scope for guesswork. Require less stationary as compared to

 essay type questions. Less scope of subjectivity as compared to essay type

questions when judging answers.

 Easy to administer and mark the tests; ensure more objective scoring.

Disadvantages of SAQs

 They are not particularly well suited for testing some types of higher
cognitive and noncognitive outcomes, especially if these are of a
multifaceted or complex nature, or involve the assessment of 'life skills'.

 They can lead to cheating within a group of students if the examination

hall is not spacious enough.

 They can lead to difficulties in scoring if not worded carefully.

 They provide no scope to assess the writing ability, expression,

organization of answer, etc.

ESSAY TYPE QUESTIONS

Educators choose essay questions over other forms of assessment because essay
items challenge students to create a response rather than to simply select a
response. Some educators use them because essays have the potential to reveal
students' abilities to reason, create, analyze, synthesize, and evaluate In short,
essay items are used for the advantages they offer. Despite the advantages
associated with essay questions, there are numerous disadvantages also. However,
essay-type questions are the most frequently used method of evaluation in most
Indian universities, colleges and schools.

Essay questions are defined as a test item that requires a response composed by
the examinee, usually in the form of one or more sentences, of a nature that no
single response or pattern of responses can be listed as correct, and the accuracy
and quality of which can be judged subjectively only by one skilled or informed in
the subject.
-John M. Stalnaker

An essay type test presents one or more questions or other tasks that require
extended written responses from the persons being tested. -Robert L.E.
and David A.F.

Essay type questions are a test containing questions requiring the students to
respond in writing. It emphasizes recall rather than recognition of the correct
alternative.-Gilert Sax

Based on Stalnaker's definition, an essay question should meet the following

criteria:

They should require examinees to compose rather than select their response.

They should elicit student responses that must consist of many interlined
sentences. They should allow different or original responses or a pattern of
responses.

They should require subjective judgement by a competent specialist to judge the

accuracy and quality of responses.
They should provide students with an indication of the types of thinking and
content to use in responding to the essay question.

Essay questions are different from these other constructed response items because
they require more systematic and in-depth thinking. An effective essay question
will align with each of the four criteria given in Stalnaker's definition and provide
students with an indication of the types of thinking and con- tent to use in
responding to the essay type question.

FEATURES OF ESSAY TYPE QUESTIONS

 Questions are used both as formative and summative assessments.

 They require a great deal of thought and planning.

 Students prepare their own answers.

 They evaluate knowledge areas alone.

 Student's handwriting, spelling, neatness, organization and way of

expressing ideas may be considered while scoring the items.

 No single answer can be considered thorough or correct.

 The examinee is permitted freedom of response.

 Answers vary in their degree of equality or corrections.

PURPOSES OF ESSAY TYPE QUESTIONS

 Essay type questions are subjected to criticism by educationists but are still
used in university exams across the globe. One might wonder if there are
so many loopholes, why they are consistently being used for evaluation in
nursing. This is because essay type questions serve distinct purposes which
 cannot be accomplished by any other type of questions. These purposes are
discussed below:

 Students get a chance to express own views: It provides students with an

opportunity to express their views on particular phenomena.

 To assess factual recall of knowledge: Sometimes teachers might be

interested in knowing how well students can recall the facts they have
learned. This purpose can be fulfilled by having essay type questions in the
test paper.

 Analysis and explanation of relationships: When the teacher is interested

in knowing how well the students can explain the relationship between two
or more concepts, essay type questions are used because no other form of
question can serve this purpose.

 Assessment of non-content-related attributes of students: Creativity,

writing style, organization, neatness and cleanliness are some other
attributes that can be more appropriately assessed through essay type of
questions.

PRINCIPLES FOR CONSTRUCTION OF ESSAY-TYPE QUESTIONS

 The following guidelines must be followed for the construction of essay-

type questions:

 The learning objective supposed to be evaluated by an essay type question

should be clearly defined in simple words.

 If a learning objective can be evaluated by any other type of question, the

use of essay type question should be avoided.

 It is always better to use several short essay type questions instead of a

long one.
 The question and the task in a problem situation should be clearly defined
by ensuring the

 following: Clearly define the question so that students understand what to

write.

 Delimit the scope of the question so that students do not feel that they need
to write infinite num-

 ber of pages. Clearly develop the problem or problem situation so that

students can be focused

 The approximate time and word limit for each essay type question should
be specified.

 The distribution of marks for different segments of a particular question

and organization, neatness, and expressive language should be explained.

 The use of complex and ambiguous words should be avoided.

 Questions that are too broad in scope and allow for blunders should be
avoided.

 Words like differentiate and compare should be used at the beginning of

the question to restrict the

 scope of the question. Simple unambiguous language well understood by

all students should be used.

 A reasonable question should be presented to students, so that they do not

feel that it is outside their ability and scope to answer.

 Questions can be written in declarative as well as interrogative statements.

  The relative point value and the approximate time limit should be specified
in clear directions.

 The criteria for grading should be stated so that students know what to
include in the answer.

 The use of optional questions which may confuse the students and make
evaluation difficult should be avoided.

 The essay question should be improved through preview and review.

 Preview: Before administration, the evaluator must

 Predict student responses.

 Write a model answer.

 Ask a knowledgeable colleague to critically review the essay question, the

model answer and the intended learning outcome for alignment.

 Review: After the administration of essay-type questions, the evaluator

must

 Review student responses to the essay question.

Advantages of essay-type questions

 Assess higher-order or critical-thinking skills in learners.

 Evaluate student thinking and reasoning.

 Provide an opportunity to assess the problem-solving and decision-making

abilities in learners.
  Help evaluate thinking, recall, analysis and synthesis of facts. Provide an
opportunity for creative expression and organization of facts.

 Are relatively easy to construct but require a good knowledge of essay

type question contraction among evaluators.

 Provide very limited scope of guessing answers.

 Disadvantages of essay type questions

 These questions lead to vague answers if wording of questions is

ambiguous and difficult to understand.

 They assess a limited sample of the range of content from the entire
curriculum.

 It is difficult and time consuming to grade the answers.

 Evaluation is subjective; different teachers may mark the same answer

differently.

 There is a scope of a lot of subjective biases.

 These questions provide practice in poor or unpolished writing.

 They have a limited range of applications. .

ASSESSMENT OF SKILLS: CLINICAL EVALUATION-

Observation (checklist, rating scales, videotapes)

OBSERVATION CHECKLIST

An observation checklist is the most commonly used instrument for performance

evaluation. A checklist enables the observer to note only whether a trait is present
or not. It consists of a listing of steps, activities or behaviors the observer records
when an incident occurs. The observer has to judge whether a certain behavior has
taken place.

An observation checklist is simply a list of the performer's behaviors associated

with particular nursing interventions within a space for the assessor to check or
tick off whether or not that particular behavior occurred.

DEFINITIONS OF CHECKLIST

A checklist is a simple instrument consisting prepared list of expected items of

performance or attributes, which are checked by an evaluator for their presence or
absence.

Checklists are constructed by breaking a performance and the quality of a product,

which specifies the presence or absence of an attribute or trait which is then
'checked' by the rater/observer.

CHARACTERISTICS OF A CHECKLIST

 Observe one respondent at a time.

 Clearly specifies the characteristics of the behavior to be observed.

 Use only carefully prepared checklists to avoid more complex traits.

 The observer should be trained on how to observe, what to observe and

how to record the observed behavior.

 Use checklists only when you are interested in calculating a particular

characteristic.

CONSTRUCTION OF A CHECKLIST

 While constructing or preparing checklists, the following points should be

kept in mind:
  Express each item in clear, simple language.

 An intensive survey of the literature should be made to determine the type

of checklist to be used in a particular assessment/evaluation.

 The list of items in the checklist may be continuous or divided into groups
of related items.

 These lists of the items are formulated on the basis of the judgment of
experts and each item is evaluated concerning the number of favorable and
unfavorable responses.

 Avoid negative statements whenever possible.

 Avoid lifting statements verbatim from the text.

 Ensure that each item has a clear response: yes or no, or true or false.

 Review the items independently.

 Checklists must have the quality of completeness and comprehensiveness.

Advantages of checklists

 Checklists allow inter-individual comparisons.

 They provide a simple method to record observations.

 They are adaptable to subject matter areas.

 Checklists are useful in evaluating learning activities expected to be

performed.

 They are helpful in evaluating procedure work.

  Properly prepared checklists allow the observer to constrain the direct
attention.

 Checklists have objectivity to evaluate characteristics.

 Useful for evaluating the processes that can be subdivided into a series of
actions.

 . Decreases the chances of errors in observation.

Disadvantages of checklists

 Checklists do not indicate quality of performance so the usefulness of

checklists is limited.

 Only a limited component of overall clinical performance can be

evaluated.

 Only the presence or absence of an attribute, behavior or performance

parameter may be assessed.

 However, the degree of accuracy of performance can be assessed.

 It has limited use in qualitative observations.

 Checklists are not easy to prepare.

RATING SCALE

Rating is the term used to express opinion or judgement regarding some

performance of a person, object, situation and character. The rating scale involves
qualitative description of a limited number of aspects of a thing or traits of a
person. When we use rating scales, we judge an object in absolute terms against
 some specified criteria, i.e. we judge properties of objects without reference to
other similar objects.

Definition
Rating scale refers to a scale with a set of opinion, which describes varying degree
of the dimen- sions of an attitude or a phenomenon being observed.

-Suresh K. Sharma

Rating scale is a device by which judgements may be qualified or a opinion

concerning a trait can be systematized.

A rating scale is a tool in which one person simply checks off another person's
level of performance. It could be a 3-point or 7-point rating scale. Rating scales
measure how much or how well something happened, where generally
quantitative and qualitative terms are used to judge the performance. A wide
variety of attributes may be assessed by using rating scales; details may be
perused from Box 9.6.

Q. How frequently do you discuss with your clinical instructor the difficulties
encountered during clinical posting?

Q. The overall performance of the student in a mouth care procedure.

TYPES OF RATING SCALES

(a) Graphic rating scale: In this scale, the performance is printed horizontally at
various points from lowest to highest. It includes the numerical points on the
scale. It is anchored by two extremes presented to the respondents for the
evaluation of a concept or object. For example: How satisfied are you with the
lecture delivered by Professor X?
Excellent Very Good Good Average Poor

Fig.6.1 Five-Point Rating Scale

Always Sometime Never

Fig.6.2 Three-Point Rating Scale

Least Most

Fig 6.3 Graphic Rating scale

 (b) Descriptive rating scale: This type of rating scale does not use numbers but
divides the assessment into a series of verbal phrases to indicate the level of
performance.

For example: Q. Judge the level of performance of the nursing personnel in a

medical ICU.

LEVEL OF CLINICAL PERFORMANCE

NURSI VERY A MOD P
NG ACTI C ERAT A
PERSO VE T ELY S
NNEL I ACTI SI
IN A V VE V
WARD E E
1. SANG
EETA
2. MEEN
A
3. KALPE
SH
4. PRIYA
NKA

(c) Numerical rating scale: It divides the evaluation criteria into a fixed number of
points and defines only numbers except at the extremes. In these scales, each
statement is generally assigned a nu- merical score ranging from 1 to 10 or even
more. For example: Pain assessment numerical scale. (d) Comparative rating
scale: In this type of rating scale, the rater makes a judgement about a person's

attributes by comparing with an other similar person(s). For example, Mr Ram's

decision abilities closely resemble that of Mr Shyam and Mr Gopal. In this type of
rating scale, making the rater must have prior knowledge about the selected
attributes of the people with whom the subjects are supposed to be compared.
 Worst
No Pain 2 3 4 5 6 7 8 9
Pain

Fig-6.4 Numerical rating scale

CHARACTERISTICS OF A RATING SCALE

Rating scales are value judgements of the attributes of one person by another
person. These scales are most commonly used tools to carry out structured
observations.

They are generally developed to make quantitative judgements about qualitative

attributes. They provide more flexibility to judge the level of performance or
presence of attributes among

subjects. Guiford (1954) identified that a rating scale must have the following
basic characteristics that must be taken care of while constructing a rating scale.

Clarity: The rating scale must be constructed using short, concise statements in
simple and unam- biguous language.
Relevance: The statement designed the intended be relevant to the phenomenon
and should be exactly in accordance with the variables under study. Variety: While
developing the rating scale, variety in different statements must be ensured.
monotony of the statements must be avoided and

Objectivity: The statement formed in a rating scale must be objective in nature so

that it is conve nient for the rater to judge the attributes or performances of the
subjects under study.

Uniqueness: Each statement constructed in a rating scale must be unique in itself

so that the attributes can be judged appropriately.
Advantages of a rating scale

 Rating scales are easy to administer and score the measured attributes.
 They have a wide range of application in nursing educational evaluation.
 Graphic rating scale is more easy to make and less time-consuming.
Rating scales can be easily used for a large group.
 They are also used for quantitative methods.
 They may also be used for the assessment of interests, attitudes and
personal characteristics.
 They are used to evaluate performance, skills and product outcomes.
 Rating scales are adaptable and flexible assessment instruments.

Disadvantages of rating scales

 It is difficult or dangerous to fix up ratings about many aspects of an

individual. Misuse can result in a decrease in objectivity.

 There are chances of subjective evaluation thus the scales may become
unscientific and unreliable.

VIDEO CASSETTE RECORDER (VCR)/ VCD PLAYER/

The video cassette recorder is an electromechanical educational medium that

constitutes an electronic machine, prerecorded video cassettes and a television
screen for display (Fig. 8.30). This educational medium is considered as a useful
teaching aid because preplanned tailor-made teaching programs may be prepared
and used as and when required for multiple times with audio as well video
stimulation for the learners. Gradually with the development of science and
technology, the conventional VCR has been replaced by more sophisticated
electronic advanced VCD players because of their handiness and cost factors.

A. Educational uses of VCR / VCD player

The VCR and the VCD player are considered as potential educational media for
learning a wide range of motor, intel- lectual, cognitive, and interpersonal and
affective skills. These audiovisual educational media have certain specific
qualities to bring visual and auditory stimulus, which finally leads to a permanent
memory impact and learning. They are used for a wide range of educational
purposes ranging from simple classroom content delivery to facilitating dis- tance
education.

Advantages of VCR / VCD player

 Easy to access and use for educational purposes.

 Multiple use and repetition of the same content several times is possible.

 They can be used in daylight in the classroom without any special

preparation.

 Recording and playing content does not require any special skills and
techniques.

 Combines the advantages of both the motion pictures and a tape recorder.

Limitations of VCR / VCD player

 Older playback equipment is bulky and large to transport to different

situations.

 A power supply is mandatory to run these equipment; without power

supply they do not have any use.

 Recorded content cannot be edited in basic equipment.

 Good quality video recording is a time-consuming and cumbersome task.

  Written communication-, nursing care plans, process recording, written
assignments

PROGRESS NOTES

Definition

Part of a medical record where healthcare professionals record details to document

a patient's clinical status or achievements during the course of a hospitalization or
over the course of outpatient care serve as a record of events during a patient's
care, allow clinicians to compare past status to current status, serve to
communicate findings, opinions and plans between physicians and other members
of the medical care team, and allow retrospective review of case details for a
variety of interested parties intended to be a concise vehicle of communication
about a patient’s condition to those who access the health record Physicians are
generally required to generate at least one progress note for each patient encounter
Nurses are required to generate progress notes on a more frequent bases,
depending on the level of critical care notes may be required anywhere from
several times an hour to several times a day

Daily progess note serves as a written medical-legal document to • Serve as a

record of a patient’s hospitalization • be completed on a daily basis and includes
all “events” that occur during the hospitalization • Record “events” in terms of
subjective and objective findings included new and active patient health/social
issues (“problems”) • to evaluate/assess each problem and to formulate an
appropriate • be legible and well written so to avoid any misunderstanding by the
reader • have a time and date and be signed on each page by the author in legible
fashion

Purpose
 To inform research
 To act as a working document for day-today recording of patient care
 To store a chronological account of the patient’s life, illnesses, its context and who
did what and to what effect
 To enable the clinician to communicate with him- or herself
 To allow continuity of approach in a continuing illness
 To record any special factors that appear to affect the patient or the patient’s
response to treatment
 To record any factors that might render the patient more vulnerable to an adverse
reaction to management or treatment
 To record risk assessments to protect the patient and others
 To record the advice given to general practitioners, other clinicians and other
agencies
 To record conversations with other clinicians for collaboration, consultation or to
help facilitate referrals
 To record the information received from others, including carers
 To store a record to which the patient may have access
 To inform medico-legal investigations
 To inform clinical audit, governance and accreditation
 To allow contributions to national data-sets, morbidity registers in a
multidisciplinary treatment setting, notes offer different clinicians a way to stay
informed based on the observations and interventions of other clinicians

Problem Oriented record keeping is cornerstone of problem-oriented medical

practice and consists of
• Establishment and use of data base
• Formulation and maintenance of problem list
• A plan for management of problem
• Education of the patient
• Establishment and maintenance of some form of audit

Date Based
The result of registration in the medical record of a defined store of information
pertinent to the patient and his/her problems

Components
 Presenting problems Patient profile
 Present illness(es)
 Past history
 Previous illness
 Systems review Family history
 Physical examination
 Growth charts
 Developmental flow sheet or screening tests
 Defined baseline lab data

o Once the initial data has been recorded, further data are recorded in relation to
specific ,named and numbered problems
o The number of the problem is entered in left hand margin and the name of the
problem is the first part of the entry

Problem list derived from information obtained from the data base
It includes:
 Medical – Social – Developmental – Psychologic – Economic – Environmental –
Nutritional
 An essential feature of the problem list is that it remains intellectually honest i.e.,
each problem should be expressed only at the level of understanding or
confidence which can be substantiated by objective evidence
 It helps to avoid jumping to potentially erroneous diagnostic conclusions

PAIP
To be PAIP used at the end of opening notes
Shorter than opening or narrative notes
P - Problem
A - Assessment
I - Intervention
P – Plan

SOAP
 SOAP a method of documentation employed by health care providers to write out
notes in a patient‘s chart, along with other formats
 Most commonly used progress note
 More focussed than complete history and physical documentation
 Limited to what is pertinent to current problem(s)
 Components:
o Subjective Objective
o Assessment Plan

 Subjectives
 Recoed of subjective findings that occurred during the evening , overnight, and in
the morning that patient is being examined
 Essentially how the patient felt during the evening, night time and morning hours
and what happened during those hours
 Usually recorded in two paragraphs
 First paragraph addresses chief concerns or complaints. If this is the first time a
physician is seeing a patient, the physician will take a History of Present Illness.
Second paragraph includes pertinent portions of past medical history

Objective
 Physical Exam : Vital signs, focused physical exam but almost always should
include:
• RESPIRATORY
• CARDIAC
• ABDOMINAL
• CNS
 pertinent normal findings and abnormalities
 Laboratory data
 Diagnostic Imaging
 Microbiology
 a Medication List which includes a listing of all scheduled and PRN (as needed)
medications relevant to active problems is recommended but is not required.

Assessment
 The most important part of SOAP note
 begin with a one-sentence summary of the problem
 should be organized by problems with the newest or most acute problem first
 For each problem, include,
o Statement of the problem
o Differentials (acute problem) and present status(chronic problem)
o Clinical reasoning for and against each differential

Plan: A plan must be formulated to address each problem

Includes the following components
 Diagnostic tests
 Treatment plan
 Patient education
 Planned follow-up

NURSING CARE PLANS

NURSING PROCESS = SCIENTIFIC METHOD + CRITICAL THINKING

 Provide a direction for individualized patient care.

 Provide continuity of care for the patient with all hospital departments.
 Provide needs. documentation on patient and family
 Provides acuity for staffing needs.
 Provides reimbursement for insurance which was started by Medicare and
Medicaid and now used by all insurance companies. This is how hospitals and
patients receive payment.

Types of Nursing Care Plans

 Actual-What is actually wrong with the patient.
 Psychosocial- Nursing Process and

Purpose of Nursing Care Planning

 Nursing care plans are an important part of providing quality patient care.

 They help to define the nurses' role in the patient's treatment,

  provide consistency of care and allow the nursing to customize its interventions
for each patient.

 Additionally, it promotes holistic treatment of the patient and helps define specific
goals for the patient.
 Defining Patient Goals

STEPS IN NURSING PROCESS

1. Assessment
2. Nursing Diagnosis
3. Planning
4. Intervention
5. Evaluation

• ASSESSMENT • Systematic and continuous collection of data

• NURSING DIAGNOSIS • The statement of the clients actual or potential
problem

Assessment Nursing Goal Planning Intervention Evaluation

Diagnosis
Subjective Short team
Data: Goal:

Objective
Data: Long Term
Goal:

• PLANNING • The development of goals for care and possible activities to meet
them
• INTERVENTION • The giving of the actual nursing care
• EVALUATION • The measurement of the effectiveness of nursing care

PROCESS RECORDING
 Introduction:
It’s a written reports of verbal interactions with clients. They are verbatim (to the
extent that is possible) accounts, written by the nurse or student as a tool for
improving interpretation communication techniques.

Definition:
is a written account recording of all that transpired, during and immediately
following the nurse patient interaction.  It is a recording of the conversation
during the interaction or the interview between nurse and the patient in the
psychiatric setup with the nurse inference.

Purpose:
 To Critically analyze communication and its effect on behavior of the individual.
 To gain the patients confidence and get this cooperation.
 To establish rapport with the patient.
 To study the patients psychological social and emotional behavior.
 It helps to increase the ability to identify problems and develop skills in solving
them.
 It allows students to gain the ease and function in written expression that are
important for professional development.

Goals & Objective:

 Establish a therapeutic nurse patient relationship.
 To give necessary health education to the patient.
 To obtain the identification data of the patient.
 To assess the insight of the patient.

Guidelines:
General guidelines:
 Process recording is one method by which we can record the content of an
interview.
 Record the conversation verbal time.
 Use a recording device and obtain patients permission for using it this will in
reviewing the session if needed.
 Each process recording should be concluded with a summary.
 Pre-Requisite:

 Getting consent of the patient for the possibility of cassette recording.

 Confidentiality should be maintain.
 Physical setting , calm and quite environment.

Steps of Process recording

 Preparation  Record nurse patient interaction .
 Written process recording may begin with taken during the interview.
 Identification data
 Present Complaint

WRITTEN ASSIGNMENTS

Written work provides teachers with an excellent opportunity to assess the

student's ability relative to the thinking process, the communication of ideas, and
the values and beliefs apparant (Some of the written work is more relevant to
clinical practice and will be discussed in the following chapter). Critical analysis
of readings, phenomena or situa-tions, essays, defense of positions, on issues, and
reports of studies can follow the patterns previously illustrated. Many of the
suggestions for questions stated in the essay section are particularly pertinent.
Further, illustrative examples will not be given but some general principles are
offered.

General Principles
1. The behavioral objectives for the assignment be stated clearly.
2. Instructions must be stated clearly and understood by the learner.
3. Provision should be made for individual guidance, as the need is indicated so that
the student can aspire to mastery.
 4. Learners should be notified of standards for evaluation and the basis for
grading.
5. Faculty should support creative approaches to meeting objectives.
6. Written work deviating from the prescribed format should be assessed. In terms
of its response to the objectives, not to its adherence to an expected form.

VERBAL COMMUNICATION (ORAL EXAMINATION)

Oral Examination

The oral examination or test is frequently used by the teachers which date back to
the beginning of human language. In Vedic period, oral examination seems to
have been in vogue. That time, Rote learning was the chief method of acquiring
knowledge and oral examination was the method of examinations.
Oral examination is a face to face question-answer activity between the examiner
and the examinee. The examiner asks questions and the examinee attempts to
answer them. The examiner probes into with further questions or accepts the
answer. Finally, the examiner judges the quality of the answers and grades the
examinee accordingly. Sometimes more than one examiner participates in the
panel.

Types of Oral Examination

There are various forms of oral examination, some important ones are as follows:
• Interview
• Viva voce
• Quiz contest
• Panel discussions.

Each of these can be used as a teaching-learning technique and as an evaluation

technique.

Objectives of Oral Examination

1. To probe into student's insight that directs and focuses on student's skill in
appreciating and critically analysing a topic.

2. To identify and analyse students presence of mind exposed through oral

questioning.

3. To evaluate students cognitive, affective and psychomotor abilities

4. To evaluate student's spontaneity and mannerism.

5. To evaluate the soundness of the knowledge acquired by the student through

various forms of questions.

6. To upgrade the teaching learning process by shifting the emphasis from mere
transmission of information to the development of abilities that would help the
student in his/her later life.

7. To boost students analytical and divergent approach to problems that need

critical enquiry.

8. To supplement the information obtained through other evaluation techniques

9. To diagnose students limitations and weaknesses and to take remedial action.

Advantages of Oral Examination

1. It helps a teacher to know whether a student knows.

2. It helps a teacher to make evaluation continuous.

3. Some objectives like oral expressions, pronounciation, recitation, etc. are

evaluated by this type of test only.
 4. It permits the examiner to determine how well a student can synthesize
integrate and organize his/ her ideas and express himself /herself.

5. It permits free response by students.

6. It is best for young children who have not mastered the skills of reading and
writing.
7. It permits a detailed probing by an examiner and hence may be very useful in
diagnostic sense. A very well qualified examiner can actually elicit responses that
may be indicative of student's thinking process.
8. The relative informality of the oral test is far less frightening to a timid
student/child.

9. The student can ask for clarification; he/she can ask to have the question
rephrased.

10. The examiner is able to claim a student by either rephrasing a question or by

reassuring them.

11. It is valuable for testing physically handicapped students who are unable to
written test.

12. It is valuable in those situations where the objective is to see how student will
conduct himself/herself before a group of people.

13. It saves a lot of the expense involved in written tests or examinations.

Disadvantages of Oral Exams

1. Oral exams provide for a very limited sampling of the

content of a course.

2. It has low reliability because of inadequate sampling.

 The teacher is forced to evaluate each student on the basis of a very limited
sample of responses.

3. They tend to be very subjective, because

• It is affected by minor changes in the psychological and physical status of the

teacher or the students

• It is influenced by what the examiner knows about the examinee and so may not
be equally fair to all students, and

• It permits favoritism by the teacher.

4. They are usually unplanned, and they may not be uniformity in the maintaining
of standards by the examiner to examiners. It often encourages lack of planning.

5. It cannot have a permanent objective record of students responses for future

reference (unless the use; and item analysis is difficult to obtain).

5. The results cannot be accumulated for reference to any other person than
examiner himself (unless the use of a tape recorder).
7. It is very costly or expensive and time-consuming, for only one student can be
tested at a time.

8. The question put to different students may have a different difficult value,
comparability, of question is difficult to obtain.

9. It does not provide a complete picture of the ability of a student.

10. It does not test a student extensively or efficiently.

11. Students who are shy in nature are likely to be adversely affected by the
presence of an examiner.

12. Lot of pressure may be put on the examiner to award more marks.
 13. Several influences may work to lower the validity of the oral examination.

14. Oral examination may open doors of prejudice, partiality and discrimination.

15. Oral examination may work to the advantage of the highly articulate students.

To overcome limitation of the oral examination the following suggestions will

help improving oral tests.
• Decide first the objectives and the content area
• Only those objectives which cannot be evaluated by a written test should be
evaluated by an oral test
• Plan for the questions to be used and also for acceptable answers
• Decide on the method of grading beforehand
• Questions of almost equal difficulty value should be asked.

SIMULATION
Simulation is as old as human beings on earth.It is technique to train young one to
adjust in their physical environment.

Definition
Simulation has been defined ” as n attempt to give appearance and or to give the
effect of something else” . {Barton 1970}

Purposes :
 It helps students practice decision making and problem solving skills. By means of
active involvement in a simulation exercise , a game , or a role – playing
situation , the student achieves cognitive , affective and psychomotor outcomes.
 Students have a chance to apply principles and theories they have learned and to
see how and when these principles work

Characteristics :
 A good simulation will be: Mirror real situation.
 Provide a safe environment in which learning has priority over patient care or
system demands.
 Provide immediate feed back on performance.
 Uses :
 Simulation technique can be used to achieve many learning objectives.
Simulations can help nursing student gain skill in applying the nursing process .
Learn to solve problems efficiently with minimal wasting of time and resources.

Steps:
 Ned Flanders has recommended the following procedural steps in simulated
teaching:-
 First of all the teacher must assign letter (A, B, C) designation to all the members of
the group and develop a system of rotating the role assignment by letters so that
each individual has the opportunity to participate and as a chance to be actor and
observer.
 It includes planning , preparation and deciding the topic of the skill to be practiced
through simulated technique .
 The teacher should carefully and intelligently select and appropriate topic
according to his knowledge and interest in the subject.
 The teacher should decide in advance as regards the name of the member of the
group who will start conversation.
 A detailed schedule for actors who will start
 The teacher should decide the procedure of evaluation and decide on what kind of
data the observes are record .
 Conduct the first practice session on topic or skills you decide . Provide the actor
with feed back on his performance and be prepared.
 As soon as the practice sessions are working smoothly and each person has
opportunity to be actor , increase the difficulty of the task.
 This is the last step in simulation . Now the teacher should be prepared to alert the
procedure , change topic and move on the next skill so as to prevent a significant
challenge to each actor and to keep interest as high as possible . The task should
be neither high nor too easy for the participants.

Role of Teacher:
 Planning
 Facilitating
 Debriefing

Merits:
 it actively engages learners in the application of knowledge and skills in realistic
situations.
 It is useful in promoting the transfer of learning from the classroom to the clinical
setting.
 Students can learn without harming the patient.
 By controlling some of the variables, the situation is still close to reality.
 Students can receive feedback on the appropriateness of their actions during
simulation.
 It encourages creative and divergent thinking.

Demerits:
 Simulation is costly in terms of both time and money.
 Simulation techniques also consume a lot of classroom time.
 It is possible that emotions may be aroused to an undesirable degree.
 The process and outcomes of simulation methods are not always predictable.
 Models are often easily damaged.
 Never the same as performing technique on a patient.

Key Ponits:

 Thoroughness in preparation for the student.

 Choice of time in the course or unit.
 It should be appropriate for the student's experience.
 Teachers should be always flexible in case it is necessary.
 Simulation what we choose should be nearer to real life.
 Motivation of students.
 Students should get a feedback.

Objective Structured Clinical Examination (OSCE)

OBJECTIVE STRUCTURED CLINICAL EXAMINATION (OSCE)

Objective structured clinical examination (OSCE) is a modern type of

examination often used in health sciences (e.g. medicine, dentistry nursing,
pharmacy and physiotherapy) to assess clinical skill performance and competence
in skills such as communication, clinical examination, medical and nursing
procedures/ prescription, exercise prescription, joint mobilization/manipulation
techniques and interpretation of results.

1. DEFINITIONS OF OSCE

Objective Structured Clinical Examination (OSCE) is a form of performance-

based testing used to measure candidates clinical competence. During an OSCE,
candidates are observed and evaluated as they go through a series of stations in
which they interview, examine and treat standardized po tients who present with
some type of medical problem.

The OSCE is an approach to the assessment of clinical competence in which the

components of competence are assessed in a planned or structured way with
attention being paid to the objectivity of the examination.

-Harden

OSCE is an assessment tool in which the components of clinical competence such

as history taking, physical examination, simple procedures, interpretation of lab
results, patient management prob lems, communication, attitude etc. are tested
using agreed check lists and rotating the student mund a number of stations some
of which have observers with checklists.

-N. Ananthakrishnan

II. USES OF OSCE

OSCE can be used for undergraduate as well as postgraduate nursing students to

assess their clinical competencies. Generally, ranges of basic and advanced
clinical practice skills are assessed by using a 10-station OSCE session which
comprises practice stations such as physical examination stations, history-taking
stations, stations that cover communication skills and stations to perform nursing
proce dures followed by response stations to ask related multiple choice or short
answer questions. Generally. the following range of practical skills are typically
assessed in nursing using OSCE:
Interpersonal and communication skills

History-taking skills

Physical examination of specific body systems

Mental health assessment

Clinical decision making, including the formation of differential diagnosis

Clinical problem-solving skills

Interpretation of clinical findings and investigations

Management of a clinical situation, including treatment and referral

Patient education

Health promotion

Acting safely and appropriately in an urgent clinical situation

Basic and advanced nursing care procedure practices.

III. ORGANIZING THE OSCE

The OSCE examination consists of about 10-15 stations, each of which requires
about 4-5 minutes. The number of stations and time spent on each station may
vary based on needs of evaluation.

• All stations should be capable of being completed in the same time.

The students are rotated through all stations and have to move to the next station
at the signal.
As the stations are generally independent, students can start at any procedure
stations and complete the cycle.

Thus, using 15 stations of 4 minutes each, 15 students can complete the

examination within 1 hour. Each station is designed to test a component of clinical
competence.

At some stations, called the procedure stations, students are given tasks to perform
on patients or simulators (some of the essential examples of procedure stations
that may be used for first

year B.Sc. Nursing students are given i. At all such stations there are observers
with agreed upon checklists or rating scales to score the student's performance.

At other stations called response stations students respond to questions of the

objective type or interpret data or record their findings of the previous procedure
stations.

Self-evaluation

Self-evaluation is often considered as the best mode of evaluation. Teachers

monitor their own behavior in relation to goals, expectations and outcomes. They
are also more likely to act in self-gained data than on information from other
sources. It is important for teachers to model self- assessment. Teachers need to
show their students that it is important for everybody to self-evaluate by doing
their own self-evaluations. One thing teachers can do is to ask their students for
feedback on how the class is going and what the teacher is doing well and not so
well. In this way the teacher is showing that they want to make improvements
where needed. The various sources of self-evaluation are as follows:

Teachers can write a descriptive account, evaluating various aspects of their

performance indicating their strengths and weaknesses.

Checklist or rating scale can also be used. The checklist or the rating scale can
concentrate on the main tasks and responsibilities of the teacher. In this process an
extensive, detailed set of questions is prepared to evaluate all aspects of a teacher's
contribution, together with suggesting maximizing potential in the areas of
training, further experience and additional responsibilities. This process also offers
much needed opportunities for recognition of valuable contributions and how to
help the teacher develop. Often, rating techniques are applied for this purpose
which mainly focuses upon the following areas:

■ General: Classroom management and discipline.

■ Subject: Presentation and teaching skills, working habits.

■ Competence: Dependability and record keeping.

■ Personal characteristics: Punctuality, tact, voice, coop- eration, sense of humor,

initiative and personal fitness.

■ Human relations: Human relations with students, other faculty members, the
principal, and the community.

■ Professional growth: Professional conduct, research and publication.

• Each faculty member completes a Performa about his expected performance at

the beginning of the academic session and then at the close of the session, he fills
up another Performa showing actual performance.

• Another procedure instrument that is being completed by his peers or students

discrepancies can thus be noted on the one hand, between his/her own rating and
the ratings he desires for himself/herself, and on the other hand between his own
rating and ratings of others. This procedure is useful for personal growth as well
as for instructional development.

• Filling out self-evaluation forms, journalizing, taking tests, writing revisions of

work, asking questions, and through discussions.
 • Teachers could put up a suggestion box, and they can hand out evaluation forms
at different times of the year.

In self-evaluation, the teacher gets an opportunity to think, reflect and write down
the problems and constraints, which come in the way of his/her effective
functioning. The different remedial measures which could be taken and the
changes which can be brought about in school organiza- tion for improving on-
the-job performance of teachers can be emphasized. Teachers get a chance to
predict their main targets for the coming year and think about their career ad-
vancement.

Disadvantages of self-evaluation

• There is a general tendency for weak teachers to over assess their capabilities
while teachers tend to be more conservative while estimating their potential and
capacity.

• Results seem to vary depending on the personality of a teacher. It is seen that

confident teachers do not wish to appear over confident and boastful, while the
over confident ones have no such reservations. Empirical studies have generally
demonstrated that there is a tendency amongteachers to give themselves better
ratings than the ratings given by students, colleagues and administrators. Most
teachers overstate the quality of their own performance relative to others.

CLINICAL PORTFOLIO

 The portfolio is advocated as an assessment tool, capable of demonstrating high

quality care and profes- sional competence by offering evidence from a variety of
sources: practice, the literature, study and research (Klenowski, 2002; Pearce,
2003).
 An effective portfolio is a visual representation of the individual, their experience,
strengths, abilities and skills.
 An effective portfolio is a visual representation of the individual, their experience,
strengths, abilities and skills.

The portfolio can provide a practitioner with evidence of: reflection on academic
and clinical experiences, continuing profes- sional development and lifelong
learning, decisions about the quality of work, effective critical thinking skills,
reflection on professional and personal growth, responsibility for learning and
development of the skills necessary of a critical reflective practitioner (Klenowski,
2002; Pearce, 2003).

The portfolio as an assessment tool, as suggested by some authors, is valuable as

a means of assessment, enabling students to provide evidence of achievement of
competencies (Pearce, 2003; Brown et al., 1996).

Portfolio assessment key elements

 Student having autonomy over the items to be included
 Self-directed learning
 Evidence
 Reflection

CLINICAL LOGS
Definition: Clinical logs are structured records or documents that healthcare
professionals maintain to systematically document patient interactions,
procedures, treatments, and observations during clinical practice. These logs are
typically organized chronologically and serve as a comprehensive repository of a
clinician's experiences and activities within a healthcare setting.
Purpose:
1. Documentation and Record Keeping: Clinical logs serve as a legal and
professional record of patient care, providing a detailed account of clinical
encounters, interventions, and outcomes. They facilitate continuity of care by
enabling healthcare providers to track patient progress over time.

2. Reflective Practice: Clinical logs encourage reflective practice by prompting

healthcare professionals to critically evaluate their performance, decisions, and
clinical reasoning. Reviewing past experiences documented in the logs helps
clinicians identify areas for improvement and refine their clinical skills.

3. Education and Training: Clinical logs are valuable educational tools for
students, interns, and residents in healthcare training programs. They offer hands-
on learning experiences, allowing trainees to document their clinical activities,
receive feedback from supervisors, and demonstrate competency in various
aspects of patient care.

4. Research and Quality Improvement: Aggregated data from clinical logs can be
used for research purposes to analyze trends, outcomes, and healthcare practices.
Additionally, these logs contribute to quality improvement initiatives by
identifying patterns, errors, or areas of inefficiency in clinical workflows.

Characteristics:
1. Comprehensive: Clinical logs capture a wide range of clinical activities,
including patient assessments, diagnoses, treatments, consultations, and follow-up
care. They provide a holistic view of a clinician's professional activities and
responsibilities.

2. Objective and Accurate: Clinical logs prioritize accuracy and objectivity in

documenting clinical information. Entries should be factual, precise, and free from
subjective interpretations or biases to ensure the integrity and reliability of the
recorded data.

3. Confidential: Clinical logs contain sensitive patient information and must be

handled and stored securely to maintain patient confidentiality and comply with
healthcare privacy regulations such as HIPAA (Health Insurance Portability and
Accountability Act) in the United States.

4. Structured Format: Clinical logs often follow a standardized format or template,

incorporating fields for essential details such as patient demographics, chief
complaints, medical history, physical examinations, diagnostic tests, treatment
plans, and follow-up notes. This structured approach facilitates efficient
documentation and information retrieval.
5. Continuous Updating: Clinical logs are regularly updated to reflect ongoing
patient care activities. Healthcare professionals add entries in real-time or shortly
after each clinical encounter to ensure the accuracy and timeliness of the recorded
information.

ASSESSMENT OF ATTITUDE:

ATTITUDE SCALES

An attitude is a dispositional readiness to respond to certain situations, persons or

objects in a consistent manner, which has been learned and has become one's
typical mode of response. An attitude has a well defined object of reference. For
example, one's views regarding a class of food or drink, sports and maths are
attitudes.

A scale is a device designed to assign a numeric score to people to place them on a

continuum with respect to attributes being measured, like a scale for measuring
attitudes or weight. These rating scales are used to assess the attitudes and feelings
of self-concept. The expressions in view of any point are accounted as
measurements towards any item, object or concept. It shows a person's positive or
negative attitude towards any concept. Measuring the score between two opposite
words tells us the attitude, feeling and perception of a person or study subject
towards the directions of positive or negative attitude in a scale. Visual scales
illustrate visual depiction of any culture; photographs are given to get feelings.
belief, opinions about contrast, texture, colour and elements.

TYPES OF ATTITUDE SCALES

There are two attitude scales commonly used to assess the attitude of individuals:
Likert scale and semantic differential scale.

LIKERT SCALE

Likert scale was named after a psychologist Rensis Likert, who developed it in
1932 as a psychological concept measurement scale. Likert scale is the most
commonly used scaling technique. It was developed to measure the attitudes,
values and feelings of people. Primarily, the original version of this scale was
developed with a five-point scale (strongly agree, agree, uncertain, disagree and
strongly disagree) containing a mixture of positive and negative declarative
statements regarding measuring variables (Box 9.10). However, one can even
observe the Likert scale now with four point (strongly agree, moderately agree,
disagree and uncertain) to seven point (very strongly agree, strongly agree, agree,
uncertain, disagree, strongly disagree and very strongly disagree) scaling
categories.

DEFINITIONS OF A LIKERT SCALE

Likert scale is a composite measurement scale used to measure attitude, values

and feelings of the people that involve summation of scores on the set of positive
and negative declarative statements regarding measuring variables to which
respondents are asked to indicate their degree of agreement or disagreement.

Likert scale is a composite measure of attitudes that involve summation of scores

on set of items (statements) to which respondents are asked to indicate their
degree of agreement or disagreement

Please tick ( ) in appropriate column for each statement

St s A U D s
at t g n i t
e r r c s r
m o e er a o
e n e ta g n
nt g in r g
l e l
y e y

a d
g i
r s
e a
e g
 r
e
e
1. P
er
s
o
n
w
it
h
m
ul
ti
pl
e
se
x
p
ar
tn
er
s
ar
e
at
hi
g
h
ri
s
k
of
A
I
D
 S
2. Y
o
u
c
a
n
g
et
A
I
D
S
B
y
s
h
ar
in
g
ut
e
n
si
ls
3. Y
o
u
m
a
y
h
a
v
e
H
 I
V
b
y
s
h
ar
in
g
n
e
e
dl
es
w
it
h
ot
h
er
s
4. O
nl
y
g
a
y
m
e
n
c
a
n
g
et
A
 I
D
S

II. USES OF A LIKERT SCALE

It is basically used to measure the attitudes, values and feelings of the people
about a specific concept such as a situation, people, place, object, programme,
practice and policy.

This scale is used to have quantified measurement of the qualitative attributes of

people such as feelings. values and attitude.

It may also be used to assess the opinion of people about a particular abstract
concept.

It spreads out people with various attitudes, emotions and feelings towards a
particular concept.

CHARACTERISTICS OF A LIKERT SCALE

The main characteristics of a Likert scale are are as follows:

Psychological measurement tool: Likert scale is basically a psychological

measurement tool to assess the attitudes, values and feelings of the people about a
specific concept.

. Illustrative in nature: This scale is generally illustrative in nature, where each

statement in the scale is stated in an explicitly graphical way so that a person can
make a clear judgement about the degree of agreement or disagreement with the
particular item of scale.

Neutral statements: The scale must contain neutral statements without

incorporation of any bias of the evaluator.
 Bipolar scaling method: This is composed with an alternative mixture of positive
and negative de clarative statements, so that the respondent's casual response bias
can be eliminated. Positive statements get a high score with agreement and
negative statements get a high score with disagreement with the statement.

Measurement of the specific number of scaling categories: This scale is originally

developed with five scaling categories and later the scales even developed with
four, six and seven scaling categories.

IV. SCORING OF THE LIKERT SCALE

Scoring of the Likert scale is done on the basis of the type of statement and the
level of the respondents agreement with the statement.

For a positive statement, respondents get a higher score if there is agreement with
a statement. How- ever, in case of negative statements, respondents get a higher
score, if there is disagreement with a statement or vice versa as depicted in Box
9.11.

GUIDELINES FOR THE CONSTRUCTION OF LIKERT SCALE

 A five-point or seven-point Likert scale may be designed with appropriate degrees

of agreement-4 disagreement phrases.

 The statements should be brief, concise and precise.

 Each statement should convey only one complete thought. More than one idea
should not de bucuin a single statement; it is better to construct more statements.

 The statement should belong to the attitude variable that is to be measured.

 Care should be taken about language:

o use simple sentences
o avoid double negatives
o avoid: all, always, none or never
o use with care: only, just, merely

 Avoid words with more than one meaning.

 The statements should cover the entire range of the affective scale of interest.

 Statements should be such that they can be endorsed or rejected

(agreed/disagreed)

 Acceptance and rejection should indicate something about the attitude measured.

Advantages of a Likert scale

 It is relatively easy to construct this scale.

 Likert scale is considered more reliable and valid tool to measure psychosocial
variables.

 It is easy to administer as the respondents only have to place a tick in the provided
spaces against each statement.

 It is less time-consuming during construction and administration.

Please tick ( ) in the appropriate column for each statement

Statement strongl Agree Uncertain
y agree
(Positive 5 4 3
Statement)
1. Person
wuth
multiple
sex
partners
are at high
risk of
 AIDS
(Nagative 1 2 3
Statement)
2. You can
get AIDS
By
sharing
utensils

B. Disadvantages of a Likert scale

 In a Likert scale, the respondents may feel forced to answer the question against
each preplanned item and its categories.

 Feelings of the respondents may not be fully assessed due to researcher's

preplanned statements and

 categories. Difficulty in justifying the selection of the number of categories and

numerical assignment to these categories.

 Casual approach of respondents in these scales may provide misleading data.

SEMANTIC DIFFERENTIAL SCALE

Semantic differential scale is the most effective and most widely used technique
these days. In 1967, Osgood, Suci and Tannenbaum introduced this method for the
first time in their book, The Measurement of Meaning. Although the original
purpose of the scale was not necessarily to measure the assessment of attitude, the
procedure was well adopted for attitude assessment.

Semantic differential questions measure people's attitude towards stimulus, words,

objects and con- cepts. This question type consists of a series of contrasting
adjective pairs (e.g. good-bad, beneficial- harmful) listed on opposite ends of a
bipolar scale. Many studies have shown that semantic differential questions can
work effectively with different age groups, cultures and languages. This scale is
 popular because it is extremely easy to construct and administer, and provides
reasonably valid and reliable quantitative data. An example of a semantic
differential scale to assess the attitude of student nurses towards patients is
illustrated in Fig. 9.9.

1. DEFINITION OF A SEMANTIC DIFFERENTIAL SCALE

Semantic differential scale is a type of rating scale designed to measure the

connotative meaning of objects, events and concepts. These connotations are used
to derive the attitude of the objects, events and concepts.

CONSTRUCTING A SEMANTIC DIFFERENTIAL SCALE

 The bipolar adjective pairs can be used for a wide variety of subjects. . The
adjective pairs are selected according to the objectives of the survey.

 The adjective pairs can be grouped into three large categories and each survey
question usually includes a few points from each category. These categories are
evaluation, potency and activity.

 Often, the attitude scale needs to be constructed for a particular aspect that one
wishes to measure and the following steps are used in construction of an attitude
scale.
o Specify the attitude variable that is to be measured.
o Collect a wide variety of statements.
o Edit the statements.
o Sort out the statements into (an imaginary) scale.
o Calculate the scale value.

Advantages of a semantic differential scale

 A convenient method to assess beliefs, attitudes and values in quantitative form.

 Easy to administer.
 Provides reasonable, valid and reliable quantitative data.

Disadvantages of a semantic differential scale

 It is difficult to select the relevant concepts that are appropriate for any given
investigations.

 It is time consuming, if anyone is not able to find the appropriate adjective pairs.

ASSESSMENT TEST FOR HIGHER LEARNING:

INTERPRETIVE QUESTIONS
When exploring any type of text (fiction, non-fiction, poetry) it is important to ask
interpretive questions that build upon one another. Interpretive questions are
effective both with well planned discussions and in spontaneous situations.
Interpretive questions stimulate comprehension, oral language, and written
language.
Types of Questions
 Factual - A factual question has only one correct answer.
 Interpretive - An interpretive question has more than one answer that can be
supported with evidence from the text. Interpretive questions keep
discussions going and require the reader to refer back to the text.
 Evaluative - An evaluative question asks the reader to decide if s/he agree
with the writer’s ideas or point of view. The answer to an evaluative
question depends on the reader’s prior knowledge, experience, and opinions.

Writing Interpretive Questions:

 Character motivation (why a character does something).
 Develop an interpretive question to discover the reasons behind a
character’s statements, actions, &/or thoughts. Interesting use of language.
 An interpretive question used to develop discussion on how the author
expresses an idea or creates a description.
 Some details in the story can function as important elements in an
interpretation.
 The answer cannot be simply resolved from a dictionary
  Plot: Well written stories have plots that are interconnected with the various
parts supporting one another. An interpretive question can help discover the
meaning and relationships between its parts.
 Key words: To start a question include how, what, where, why, and when.
 Testing the Questions:
 There should be genuine doubt about the answer(s) to the question.
 If a question is open to different possible answers students will be
more willing to share their thoughts.
 You should have genuine interest in the question.
 Students will ‘read’ your interest (or lack of) in the question and
story.
 The question should stimulate discussion.
 The question should create an interest in revisiting the story for
evidence.
 The question should be clear.
 The participants should easily understand the question.
 The question should be specific.
 The question should fit the story and not generic to any story

Leading a Discussion:
Here are the basic ground rules for leading a discussion:
1 - Participants must have read or heard (read aloud) the story.
2 - Discussion is focused on the selection everyone has read or heard.
3 - Opinions should be supported with evidence from the story.
4 - Leaders only ask questions – they do not answer them. For a discussion based
on interpretive questions to be successful, student interest needs to be encouraged
and valued.

Prepared and Spontaneous Questions:

 To create effective questions and questioning techniques it is very important
to develop and test the questions prior to discussing the story with the class.
 To facilitate quality questions it is beneficial to take notes when initially
reading the story.
 Writing Interpretive Questions provides a template of the types of notes to
help develop quality questions.
  After writing questions from your notes have another person read the story
and try the questions out on them.
 This will provide an opportunity to test the Testing the Question criteria.
 Spontaneous interpretive questions are an important part of all discussions.
Experience with preparing questions and using interpretive questioning
techniques support spontaneous questioning.

The Question Game

 To start the question game the two participants must initially decide on a
topic to question.
 One person starts with an open ended question, then the other person
responds with a related open ended question.
 This continues back and forth with the two participants.
 An example is: Topic: (e.g. object in the room) light bulb
 Questioner A: How does a light bulb work?
 Questioner B: Who designed the current light bulb?
 Questioner A: Who invented the light bulb?
 Questioner B: Why would someone invent the light bulb?
 Questioner A: How can we improve the light bulb?
HOT SPOT QUESTIONS
o Hotspot questions (also known as hotspot on image questions) are a

dynamic element in e-learning that turn parts of an image into clickable

areas, revealing additional information, hints, or questions when interacted
with. They serve a dual purpose: enhancing learner engagement through
interaction and providing a deeper dive into content without clear imagery.
o With Hot Spot questions, students are presented with an image and select a
particular area as the answer. Examples of Hot Spot questions include these:

 Anatomy: Locate parts of the body.

 Geography: Locate areas on a map.
 Foreign Language: Select articles of clothing.
Hot Spot questions are graded automatically.
 Benefits of hotspot questions
Incorporating hotspot questions in e-learning courses offers numerous
benefits:
o Increases engagement: The interactive nature of hotspot questions keeps
learners active and involved in their learning process.
o Enhances retention: By actively engaging with content, learners are more
likely to remember and understand complex information.
o Supports exploratory learning: Hotspots encourage learners to explore
images and concepts at their own pace, leading to deeper learning
experiences.
o Adapts to various learning styles: Visual learners, in particular, will benefit
from this interactive approach to image-based content.

Create a Hot Spot question

1. Start by selecting the “Hotspot Question” from the left-hand menu and add it to
your section.
2. Enter a question title and provide instructions for your learners.
3. Upload a background image. A width of 880px is recommended for optimal
display, and the image should be less than 5MB to ensure smooth loading.
4. To create a hotspot, click on the image and drag to select the area of interest. You
can set the question for a single correct answer or allow multiple selections.
5. Finally, input feedback for both correct and incorrect responses to guide your
learners’ understanding.

Tips for creating effective hotspot questions

Creating compelling hotspot questions involves more than just selecting areas on
an image. Here are some tips for crafting questions that not only engage but also
educate:
Choose the right images
Select clear, high-quality images that directly relate to your learning objectives.
Overly complex or irrelevant images can confuse learners.
Define clear hotspots
Make sure each hotspot serves a clear purpose, whether it’s to reveal additional
information, ask a question, or provide context.
Limit to five hotspots
Add a maximum of five hotspots per image. Any more than that may confuse or
overwhelm learners.
Provide instant feedback
This tip applies to all quizzes or assessments: offer immediate feedback to help
learners understand their mistakes and learn from them.
Test for usability
Ensure that hotspots are easily clickable, especially on mobile devices, and that
the information they reveal is displayed clearly and concisely.

DRAG AND DROP

Drag and Drop Questions:

o Students have to drag correct response options (text, images, labels) and drop
them into respective drop zones or reorder them.

o Example: Drag the stages of the water cycle in the correct order into the boxes.
 ORDERED RESPONSE QUESTIONS:

 Students have to arrange a set of options or steps in the proper sequence or

hierarchy.
 Example: Number the following steps for making a peanut butter and jelly
sandwich in the right order:
 ___________Get a plate
 ___________Apply peanut butter to one slice

REVIEW QUESTIONS

Short Notes:

Write short notes on the following:

1. Short answer questions (SAQ),

2. Multiple choice questions (MCQ)

3. Process Recording
Long Answers Questions

1. Briefly explain the Objective Structured Clinical Examination (OSCE)

2. Define attitude scales and discuss types, advantages disadvantages of attitude
scales.
3. Discuss the purpose, scope and principles of Evaluation and barriers to evaluation

Multiple-Choice Questions (MCQs)

1. What is one of the main purposes of evaluation as stated by Bloom?

a) To provide a baseline for curriculum development

b) To certify a student's proficiency in a particular educational practice
c) To determine the cost-effectiveness of educational programs
d) To compare students' performances against national standards

2. What is a common barrier to effective evaluation mentioned in the context?

a) Excessive focus on standardized testing

b) Lack of teacher training in evaluation techniques
c) Over-reliance on digital assessment tools
d) Insufficient classroom resources

3.What is the primary purpose of a rating scale in performance evaluation?

A. To list a performer's behaviors for assessment

B. To determine the presence or absence of attributes
C. To judge the quality of performance on a continuum
D. To provide a checklist of criteria for evaluation

4. What is one recommended practice for creating effective assessments?

a) Use a single method for all assessments

b) Specify the objectives clearly at the beginning
 c) Avoid recording the results to save time
d) Focus on assessing only cognitive skills

5. What is a key characteristic of a Likert scale?

A. It measures behavioral observations

B. It uses binary response options
C. It includes both positive and negative statements
D. It assesses attitudes with multiple scaling categories

Answer of the Multiple-Choice Questions

1.(B), 2. (B),3.(C),4.(B),5.(D)

Bibliography
1 Mary.C. Townsend, psychiatric mental health nursing, jaypee publication page-
158-159.
2.Neerja Ahuja , a short textbook of psychiatric Ist edition, Jaypee brothers medical
publishers
3. R. Sreevani, A guide to mental health and psychiatric nursing 3rd edition ,
Jaypee brothers. Medical publishers
References:
1.DeWitt, S. (9th ed), Medical- Surgical Nursing Concepts and Practice, St. Louis,
Mo., Saunders PowerPoint's. http://emievil.hubpages.com/hub/7-Bad-Study-
Habits-A-College-Student-Must-Not-Have Microsoft clip art and microsoft office
Case studies from previous classes and patient files.
2. Comprehensive text book of nursing education,Jaspreet kaur sodhi, second
edition,jaypee publication,page no.367-368
3. Nursing Education, B.T Basavanthappa,2nd edition, Jaypee publication, Page
no. 488,368
4.https://www.evelynlearning.com/tips-for-creating-effective-assessments/
5. https://cei.umn.edu/teaching-resources/assessments/general-guidelines-creating-
assessments
6. https://www.prodigygame.com/main-en/blog/types-of-assessment/
7.https://blog.thinkingschoolsethiopia.com/wp-content/uploads/2012/04/
interpretive-questioning.pdf