E Denessen | PubMed Health

PubMed2004

The structure of medical competence and results of an OSCE.

BACKGROUND: Medical competence is a central concept in medical education. Educational efforts in medical training are directed at the achievement of a maximal medical competence. The concept of the structure of medical competence (multidimensional or one-dimensional with strongly interrelated competences) therefore affects the educational developments and assessment procedures. PURPOSE: To examine the applicability of a one or more dimensional character of medical competence in student assessments, by analysing the results of 356 students in the history taking station of an objective structured clinical examination (OSCE), in relation to other assessment procedures. METHODS: The performances of 356 students in a history taking station of an OSCE were analysed. Analyses of the checklist scores were aimed at the dimensionality of history taking skills. External criteria were used to test the validity of the scores on the checklist. RESULTS: The analyses of the scores on the history taking checklist indicated at least five dimensions of history taking skills: the frequency of patient-centred skills, the quality of performance of patient-centred skills, complaint-oriented skills, general social skills, and the provision of procedural information. CONCLUSION: Medical competence, as a subject of assessment, can be seen as a multifaceted construct. This study shows that history taking alone might be composed of five different dimensions, suggesting that medical competence in respect of assessment might be viewed as a multifaceted construct which in that sense has implications for the assessment of medical competence.

Competency-Based Education↗

PubMed2002

Assessing orientations to learning to teach.

BACKGROUND: An important purpose of teacher education is that student teachers develop and change their existing knowledge on learning and teaching. Research on how student teachers variously engage in this process is scarce. In a previous study of 30 student teachers, we identified five different orientations to learning to teach. AIMS: Our aim was to extend the results of the previous study by developing an instrument to assess orientations to learning to teach at a larger scale. The development and psychometric properties of the instrument are discussed. The results with respect to how student teachers learn are compared to the results of the qualitative study. SAMPLE: Participants in this study were 169 secondary student teachers from three institutes which had all adopted an initial in-service model of learning to teach. METHODS: On the basis of extensive qualitative study, a questionnaire was developed to assess individual differences in learning to teach. Factor-, reliability-, and nonparametric scalability analyses were performed to identify reliable scales. Cluster analysis was used to identify groups of students with similar orientations to learning to teach. RESULTS: Eight scales covering cognitive, regulative and affective aspects of student teachers' learning were identified. Cluster analysis indicates that the instrument discriminates well between student teachers. Four of the five previously found patterns were found again. CONCLUSIONS: The four orientations found in relatively uniform learning environments indicate that student teachers need differential support in their learning. Although the instrument measures individual differences in a reliable way, it is somewhat one-sided in the sense that items representing constructive ways of learning dominate. New items forming a broader range of scales should be created.

Adult↗