Assessment and process of medical education

Assessment plays an important role in the process of medical education as it is an effective tool which detect quality in students training to motivate and direct them to what they must learn(1). “Assessment drives learning” this statement focus on the essential role of assessment as well planned and implemented assessment has an important steering effect on learning because it transfers what is important to learn and motivate students for learning(2). Many people argued that as the curriculum should be the key which motivate learning while assessment should be designed to be sure that learning outcomes have occurred, So assessment tool must has clarity of the learning purpose and must be designed to drive educational intent and maximize learning(3).

Constructive alignment is an important influential idea in which the students construct meaning from related learning activities and teachers apply learning environment which support planned learning activities to achieve the intended learning outcomes(4). So constructive alignment makes the teaching systems consistent when curriculum, learning activities and assessment methods are aligned with intended learning outcomes(5) . Moreover, assessment may reveal learning outcome which isn’t expected but it is recognized as important outcome, so it must be integrated into the intended learning outcome as emergent outcome(6).

Formative assessment promotes deeper learning as it provides students with feedback to encourage them to know their strength and weakness which reinforce students internal motivation to learn and improve their knowledge and skills(7). Summative assessment is a final assessment which determine the rank-order students and decide grades(1). Wass et al(7) argued superficial learning which aim mainly on passing the examination and they emphasized on the importance of feedback on students assessment which encourage student reflection and deep learning. However, Epstein(8) showed that summative assessment influence learning even in the absence of feedback as students study what they expect to be tested on. Although formative and summative assessment are stark in contrast, they are both necessary and distinction between them should be made to detect which assessment is suitable only for formative use or have sufficient rigorous for summative use(7). Van der Vleuten and Schuwirth(9) emphasized that formative and summative assessment can be used with little difference with focusing on the development of comprehensive assessment programme in which both encourage learning and right decision about learners.

I will focus my writing on written assessment as I am involved in assessing written examination of MSc of Radiology scince 5 years. According to Miller pyramid we use written assessment to assess the domain of cognition, either factual recall of knowledge “knows” or application of knowledge and problem solving “knows how”. We use written assessment in the form of essays and multiple choice questions in formative assessment of the residents and in summative assessment of final exam. Our final written exam formed of two papers of essays, each one formed of four essay questions with three hours duration for each, and third paper of 20 multiple choice questions with one hour duration. When we prepare a written exam we identify the level of residents training to apply test which assess knowledge appropriate to students experience.

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