In compliance with the recommendation for yearly alcohol screening for adults in primary care, a family medicine residency director wants to develop a curriculum to teach her residents how to use a validated alcohol-screening tool and provide brief alcohol counseling. Given competing educational demands, she wants this curriculum to be both efficient and effective. She plans to evaluate her residents and the curriculum. .
Medical training programs are increasingly focused on assessing clinical competencies that demonstrate a learner’s readiness for (or progression toward) independent practice. Training programs must track a multitude of competencies or “entrustable professional activities” (EPA’s) that often include both concrete observable procedures and more nuanced but essential doctoring skills, such as empathy and cultural sensitivity. Although the general principles of learner and curricular assessment hold equally true for the behavioral and social sciences (BSS), these content areas can be more difficult to operationalize and evaluate. Moreover, high-quality BSS teaching and assessment tools often require explicit, robust institutional support that relies on careful programmatic evaluations that compare institutional goals with curricular performance. Although evaluations assess a learner and/or program, the results should also iteratively drive curricular and institutional evolution.
This chapter provides guidance on designing evaluation strategies for assessing both medical learners and curricular programs with an eye toward continuous improvement. In the section “Assessment and Evaluation Planning,” we outline how to plan assessments including evaluation processes, methods, and tools for evaluation program design. In the section “Learner Assessment and Evaluation,” we describe assessment methods and instrumentation that can ensure learners have the skills needed to address behavioral and social issues that influence health. In the section “Program Evaluation,” we address how measurements can be used to assess curricular and program performance. Lastly, in the section “Educational Research and Scholarship,” we underscore the importance of educational scholarship and research as a means to move the science of educational evaluation forward.
Fundamental principles have influenced the content of each section. First, evaluation is as important as the training curricula delivered. Evaluations should not be an afterthought after the curriculum has already been delivered. Second, just as we urge our learners to practice evidence-based medicine, we urge educators to practice evidence-guided teaching. Although educational science is young, there is a growing body of research to guide selection of teaching interventions, curricular timing and “dose,” and the choice of valid and reliable assessment tools. Educational tradition and convenience are simply not sufficient to guide efficient and effective uses of precious training hours. Finally, we assert that rigorously developed, delivered, and evaluated curricula should be published and shared as scholarly peer-reviewed works to advance educators’ skills and the field.
ASSESSMENT AND EVALUATION PLANNING
Evaluation designs are critical for determining the impact of curriculum or teaching approaches on learners’ knowledge, attitudes/values, and skills. Evaluation design selection might also consider cost effectiveness, systems change, or impact ...