Department of Learning in Engineering Sciences, KTH Royal Institute of Technology, Stockholm, Sweden.
Department of Education, Stockholm University, Stockholm, Sweden.
Med Educ. 2022 Jun;56(6):651-659. doi: 10.1111/medu.14789. Epub 2022 Mar 14.
In light of reforms demanding increased transparency of student performance assessments, this study offers an in-depth perspective of how teachers develop their assessment practice. Much is known about factors that influence assessments, and different solutions claim to improve the validity and reliability of assessments of students' clinical competency. However, little is known about how teachers go about improving their assessment practices. This study aims to contribute empirical findings about how teachers' assessment practice may change when shared criteria for assessing students' clinical competency are developed and implemented.
Using a narrative-in-action research approach grounded in narrative theory about human sense-making, one group including nine health professions teachers was studied over a period of 1 year. Drawing upon data from observations, interviews, formal documents and written reflections from these teachers, we performed a narrative analysis to reveal how these teachers made sense of experiences associated with the development and implementation of joint grading criteria for assessing students' clinical performances.
The findings present a narrative showing how a shared assessment practice took years to develop and was based on the teachers changed approach to scrutiny. The teachers became highly motivated to use grading criteria to ensure fairness in assessments, but more importantly, to fulfil their moral obligation towards patients. The narrative also demonstrates how these teachers reasoned about dilemmas that arose when they applied standardised assessment criteria.
The narrative analysis shows clearly how teachers' development and application of assessment standards are embedded in local practices. Our findings highlight the importance of teachers' joint discussions on how to interpret criteria applied in formative and summative assessments of students' performances. In particular, teachers' different approaches to assessing 'pieces of skills' versus making holistic judgements on students' performances, regardless of whether the grading criteria are clear and well-articulated on paper, should be acknowledged. Understanding the journey that these teachers made gives new perspectives as to how faculty can be supported when assessments of professionalism and clinical competency are developed.
鉴于改革要求提高学生表现评估的透明度，本研究深入探讨了教师如何发展其评估实践。人们已经了解了影响评估的因素，并且有不同的解决方案声称可以提高对学生临床能力评估的有效性和可靠性。但是，对于教师如何改善其评估实践却知之甚少。本研究旨在提供有关经验发现，即当制定和实施评估学生临床能力的共同标准时，教师的评估实践可能会发生怎样的变化。
本研究采用基于叙事理论的行动中的叙事研究方法，对包括九名健康专业教师在内的一个小组进行了为期一年的研究。我们利用来自这些教师的观察，访谈，正式文件和书面反思的数据，进行了叙事分析，以揭示这些教师如何理解与制定和实施共同的评估学生临床表现的评分标准相关的经验。
研究结果提出了一个叙述，展示了共同的评估实践是如何花费数年时间发展起来的，并且基于教师对审查的方法的改变。教师们非常有动力使用评分标准来确保评估的公平性，但更重要的是，履行他们对患者的道德义务。叙述还表明了这些教师如何在应用标准化评估标准时出现困境时进行推理。
叙事分析清楚地表明了教师对评估标准的发展和应用是如何嵌入到当地实践中的。我们的研究结果强调了教师共同讨论如何解释在形成性和总结性评估中应用于学生表现的标准的重要性。特别是，应该承认教师对评估“技能片段”与对学生表现进行整体判断的不同方法，而不论评分标准在纸面上是否清晰和明确。了解这些教师所走过的道路，为教师在制定专业和临床能力评估时如何获得支持提供了新的视角。
