ASSESSMENT OF ATTITUDES & PSYCHOMOTOR SKILLS

Raja C. Bandaranayake

DOMAINS OF LEARNING
Cognitive (Knowledge)

Psychomotor (Motor skills) Affective (Attitudes)

THE AFFECTIVE DOMAIN

Awareness [knowledge base]

e.g. Reads about importance of rural health care e.g. Acknowledges rural health care is important

Receiving [willing to receive or attend]

Responding [actively attending]

e.g. Seeks additional information about rural health needs & problems

THE AFFECTIVE DOMAIN contd.

Valuing [worth to learner]

e.g. Spends free time working in rural areas

Organizing [takes steps to incorporate into ones life]

e.g. Undergoes training to deal with rural health problems

Characterisation by value or value complex [becomes part of ones life]

e.g. Enters a career of rural health care

PROBLEMS IN ASSESSING ATTITUDES

One must rely on inference An attitude has many facets e.g. feelings,
beliefs, values

An attitude has many manifestations e.g.

behaviours, verbal responses
always match

Behaviours, beliefs and feelings will not

An attitude can fluctuate There is often lack of agreement on the

nature or desirability of certain attitudes

ORIENTATIONS TO ATTITUDE ASSESSMENT

Behavioural
Observation of behaviours

Psychometric
Standardized pen-and-paper tests

Counselling
One-to-one discussion

BEHAVIOURAL ORIENTATION

Behaviours can be observed

Rely on observation tools

Expectations explicit Assessment consistent Inference necessary

checklist, rating scale, anecdotal record

many variables affect behaviour

BEHAVIOURAL ORIENTATION (contd.)

Change can be monitored

Spied on feeling Coercive atmosphere

Individual event may be trivial

need to observe many behaviours

BEHAVIOURAL ORIENTATION

Who are the observers?

Trained observers Administrators Teachers Peers Other professionals Patients Parents Self

PSYCHOMETRIC ORIENTATION

Pen-and-paper instruments Validated, standardized tests Self reports possible

Inexpensive and objective

Socially desirable responses possible

Situation-specific
Conclusions indefinite

QUESTIONNAIRES
Open-ended
[Respond in own words]

Closed
[select, rank, rate]

e.g. Essay

e.g. Likert scale Semantic differential Tests of judgement Forced-choice

LIKERT SCALE
SA A medical history is incomplete without a social history The logical leader for a health team is the doctor The team approach to health care is a waste of time A U D SD

SEMANTIC DIFFERENTIAL
Surgeons are: Theoretical _ _ _ _ _ _ _ Practical

Personal
Active Diseaseoriented

_ _ _ _ _ _ _ Impersonal
_ _ _ _ _ _ _ Passive _ _ _ _ _ _ _ Patientoriented

COUNSELLING ORIENTATION

Discussion between teacher and student to reveal feelings underlying behaviours Student may be more motivated to change if understand him/her-self

Low risk environment

Counselling role not compatible with authority role

Student may manipulate or avoid giving responses

Teachers are not trained counsellors

PSYCHOMOTOR DOMAIN
1.

Perception Using senses for cues to motor activity Set Readiness to take a particular type of action

2.

3. Guided response Imitating a skill; trial and error 4. Mechanism Response habitual and confident

PSYCHOMOTOR DOMAIN contd.

5. Complex overt response Skillful & complex performance
6. Adaptation Able to modify movement pattern to suit particular situation

7. Origination Creating new movement pattern for a specific purpose

OBSERVATIONS: Relatively Unstructured

Complete description of event

Participant observation (e.g. simulated

patient)

Time and motion or time-sampling study Anecdotal record Disadvantages

Sampling less Reliability low Observer influence Memory distortion

OBSERVATIONS: Structured

Specific plan made for making and recording observation

Investigator knows what aspects of behaviour are relevant for the purpose

Observational Instruments

1. CHECKLIST Where the response is Yes or No

2. RATING SCALE Where quality of performance is important

CHECKLIST: When to use?

Performance skills that can be divided into a series of clearly defined steps, each of which is either done or not done

e.g. steps in cardio-pulmonary resuscitation

Performance products that can be evaluated by noting presence (or absence) of observable characteristics

e.g. patients medical record

CHECKLIST: STEPS IN CONSTRUCTION

Analyse task or performance into specific sequential steps required

List common errors (of omission and commission) made by students List actions and errors in logical order of occurrence

Provide a system for observer to record sequence of actions

CHECKLIST: Mouth-to-mouth resuscitation

Done Order Not # done Shakes & shouts to check if unconscious NA

Applies chin lift to open airway *Applies neck lift to open airway Uses look, listen, lift method for apnoea Closes nose by pinching
Effects tight mouth-tomouth seal

CHECKLIST: contd.

Gives 4 quick ventilations Checks carotid pulse *Checks pupils for dilatation *Bares victims chest Checks anatomical landmarks

TYPES OF RATING SCALES Graphic

Poor rapport Excellent rapport

Graphic with anchors

Poor Fair Good

Very Good

Excellent

Frequency scales
Never Seldom

Often

Always

Behaviourally-anchored

BEHAVIOURALLY-AHCHORED RATING SCALE: ATTITUDES Relationship with patients A. Rapport

0: Unable to establish rapport 1: Fair rapport, but occasional lack of communication 2: Good rapport, communicates concern 3: Listens, communicates well, instills confidence 4: Convinces patient of expertise and puts patient at ease 5. Not observed

RATING SCALE: COMMUNICATION

Participation in group discussion C. Nature of contributions
0: Does not contribute at all 1: Comments usually distract from the topic

2:
3: Comments usually pertinent, occasionally wanders from topic 4: 5: Comments always related to the topic

RATING SCALE: SKILLS

Mouth-to-mouth resuscitation A. Effects tight seal
Cannot determine
Inadequate: Does not attempt to create a tight seal or seal is grossly inadequate

Satisfactory: Has leak, but adequate ventilation Excellent: Fully covers mouth from corner to corner, creating an airtight seal

RATING SCALE: STEPS IN CONSTRUCTION

Define unambiguously dimension or behaviour being rated Decide on number of rating steps
Usually 3 to 10 Uneven number better Intervals not necessarily equidistant

Define / describe extremes and then each step in between

Try to avoid relative terms (e.g. frequently), which could be interpreted differently

ERRORS IN RATING

Error of leniency Error of central tendency Halo effect Logical error Error of contrast