How Are Students Assessed at Medical Schools Across the UK?

How are students assessed at medical schools across the UK? Contents Introduction 2 What is an assessment strategy? 4 How do schools validate the scoring of assessments and exams? 8 How do schools measure students’ progression? 11 How is the professionalism of students assessed? 11 How do schools ensure the quality management of their assessment strategies? 11 How do schools ensure equal opportunities for students? 11 What happens next? 18 Glossary of terms 19 General Medical Council | 01 Introduction In 2013–14, we reviewed the assessment systems used in 31 medical schools across the UK. The review has helped us understand how robust undergraduate assessment is and to compare the way that medical schools assess students. This report summarises the key themes and highlights case studies that appear to be working well locally, which medical schools may find of interest. We also identify where assessment systems are not meeting our standards as set out in Tomorrow’s Doctors (2009) and we have taken steps to investigate these further. What did we do? We analysed data from the annual reports that strategy, delivery standards, quality management and medical schools submitted to us between 2009 and governance processes, and assessment outcomes. 2013. These reports tell us about substantial changes to curricula and assessment systems, highlight This was a paper-based audit and therefore has a concerns, and update us on a school’s progress if number of limitations. Notably, the evidence obtained we’ve required or recommended changes on previous has not been compared against other sources as quality visits. would happen with other quality assurance evidence. However, acknowledging those limitations, we were We asked schools for further information to give us a able to identify the structure of each system and areas comprehensive overview of each school’s assessment working well to share with all schools. 02 | General Medical Council What did we find? We found many examples of areas working well that as it should encourage the sharing of ideas and could benefit other schools. In some schools, we did innovation between schools. However, all systems not find any aspects of their assessment systems that should continue to meet our standards as set out in appeared to need further review or improvement. Tomorrow’s Doctors (2009). But, while some schools manage aspects of assessment very well, they perform less well in As each school has developed over time, so have others or fail to use modern assessment practices. their assessment programmes and practices. Whether a school is part of a university that In the following sections, we look at: uses a tutorial-based system also affects how its assessment system evolves. n the assessment strategies schools have n how schools validate the scoring of assessments Not all components of an assessment system are and exams of equal importance, but together they reflect how a school considers its assessment strategy and the n how schools measure students’ progression impact on students. n how the professionalism of students is assessed n how schools ensure the quality management of Aspects of assessment that are central to meeting their assessment strategies our standards – such as how schools map their n how schools ensure equal opportunities curricula to make sure students meet required for students. competences across the programme, and how schools teach professionalism – vary widely across We found variation across assessment systems, schools. There are also significant differences in from when assessments happen, to the guidance how individual schools work with students who students are given, and the number and nature of have behaved poorly or are failing to progress. This hurdle assessments, final exams and workplace includes arrangements for students to resit exams, assessments. The level of variation was expected, repeat study years and exit with grace arrangements particularly because the structure of curricula (where students leave on good terms, but without across schools varies widely. The variation of completing the programme). assessment systems can be considered valuable General Medical Council | 03 What is an assessment strategy? An assessment strategy is a school’s overarching approach to assessment and how assessment fits within the wider curriculum. We looked at choices of assessment tools, the We expect an assessment strategy to be clear and timing and distribution of assessments, and the comprehensive, setting out a school’s philosophy range of approaches to hurdle exams and high stakes about the value of assessment and how it selects assessments. assessment tools. Hurdle exams are those that need to be passed in A school’s assessment strategy can be influenced order for students to progress to the next stage of a by that of its parent university. Case studies have course of study. shown us that the assessment strategy is often adapted to suit the medical school. At University High stakes assessments are exams that carry a College London Medical School, for example, the large number of marks, usually held at the end of a parent university’s approaches to assessment are period of study. reflected in the school’s assessment strategy. But the school’s assessment strategy has been adapted We also looked at the formats for final exams used to also include expected outcomes by level and year by each school. Some schools failed to give enough of study, and to demonstrate how its methods of evidence for us to properly audit their strategies. assessment are linked to this. 04 | General Medical Council The new strategy includes a sound philosophy and clear selection and use of assessment tools, improved quality management and better feedback to students.” From our review of Cardiff University School of Medicine What makes a successful assessment Most schools extensively help students strategy? prepare for exams Overall, many schools demonstrate commendable We found good examples of schools using practice in this area, with assessment strategies that year-by-year guides to outline the key information are linked to the domains in Tomorrow’s Doctors that students need to know, alongside a clear (2009) and achieve a sensible balance between timetable for high stakes exams. assessment for learning and for professionalism. Several schools give students a clear timetable of In particular, Keele University School of Medicine and all assessments they’ll complete throughout their Cardiff University School of Medicine have clear and programme, including a countdown mechanism comprehensive assessment blueprints and a good to plan for exam preparation. The University of approach to final-year assessment that provides Birmingham Medical School also uses tools, such a good balance between what is required from a as an in-course skills passport, to help record which student’s skills logbook, their marks from high stakes skills students are acquiring. exams and their overall performance. Most schools have an effective assessment strategy, and continually review how well the strategy is working and show how it meets the standards in Tomorrow’s Doctors (2009). General Medical Council | 05 In-course assessment is comprehensive. The final year is comprehensively assessed, across knowledge, professionalism, prescribing and clinical domains.” From our review of St George’s, University of London Timing of assessment is crucial Format of exams is sometimes We found extensive variety in the timing of final year poorly planned assessments. Schools should time knowledge and Hurdle exams should be mapped across knowledge, performance tests sensibly. It is important to avoid skills and ability domains as outlined in Tomorrow’s overburdening students and for students to know Doctors (2009). Not all assessments can be high what needs to be prepared for and when. stakes. But, in some schools, a greater proportion of exams are high stakes or hurdle exams, or both, At St George’s, University of London, for example, without a clear reason why. some assessments have been moved to better balance student workload, with the final year Some schools seem especially reliant on very balanced to provide comprehensive assessment long exams, or on essay questions. of knowledge, professionalism, prescribing and clinical skills. We believe that greater use of statistics at individual question level (known as item level) and a more planned approach should help schools achieve acceptable reliability and content validity in shorter assessments rather than longer exams. Most UK schools achieve this. 06 | General Medical Council Key information about assessment tools, standards, decision making and progression to final award has been communicated well to students.” From our review of Newcastle University Medical School Approaches to assessment We found significant variation in how schools blueprinting vary approach this area. Some schools appear to have no specific blueprint at all. Other schools’ blueprints How schools map the components of curriculum were basic and lacking in detail, too list based, and not and assessment across programme modules effectively mapped to Tomorrow’s Doctors (2009) or and programme years to meet the competence conversely, tried to include too much detail. A blueprint domains in Tomorrow’s Doctors (2009) is known should be a comprehensive guide, but not seek to as blueprinting. Blueprinting should also be used replicate every aspect of an assessment strategy. to show how the intended learning outcomes of individual

Load more