From Inside a Unique Exam Opportunity
At the Teaching in Focus conference in December I attended a session about eliminating final exams from courses. From my perspective, the presenter was not talking about eliminating cumulative assessments, simply rethinking the format of these assessments. The final exam I wish to speak about in this post is one I would argue models what an effective cumulative assessment can be.
I am excited to share my experience as a simulated person (SP) for a final exam in the Athletic Therapy Program. My role was to be a patient simulating a particular injury for the Athletic Therapy student to diagnose and rehabilitate. I was not responsible for assessing the students and how well they met the learning outcomes for this exam. There were two external examiners for that. Instead, I was there to allow the students to have this interaction, which was as close to reality as it could be. I had the opportunity to provide written feedback to the students based on my interaction with them, specifically how they made me feel and my comfort level with them. This brought in a human element, which is arguably the most important part of an Athletic Therapist’s job. Through this interaction, the students could learn, demonstrate and be assessed on how well they interacted with a patient.
In preparation for this role I felt like I was preparing for an exam myself. I had a booklet full of notes to learn and was supported by the course instructors, and members of the Simulated Person Methodology Lab. We had two meetings to rehearse the role. These meetings not only supported me to ensure I would enact the role correctly and be consistent with each student I interacted with, but also to ensure that all SPs were standardized, that is, that each student would have the same experience no matter who they interacted with. There were 5 SPs in total and each of us would interact with 4 students to ensure this final exam could be completed as efficiently and effectively as possible.
After these meetings and my own preparation, I felt fully prepared for this role. I knew what injury I was simulating and what I should report during the exam. However, the way the students asked questions influenced how I responded and this affected their ability to accurately diagnose my injury. At first I was worried that I wasn’t being consistent, but upon further reflection I realized I was simply reacting to the way the students asked the questions. One student asked very general questions and I answered their questions, but I never had the opportunity to fully share my symptoms. As an SP it is important to respond to the student you are interacting with and ensure you aren’t giving away the answers. An important outcome for this exam was that the student asks all appropriate questions and perform all necessary measures in order to determine the injury. If the student did not ask a particular question I could not offer that information. This type of exam, as with any assessment, is a learning opportunity for the student. If I had performed my role as if I was regurgitating everything I learned about my role, as I might do on a traditional exam, the student I was interacting with wouldn’t have learned and demonstrated how they would diagnose an injury. Instead they would simply receive information and identify what injury these symptoms would signal. I can imagine this would be the type of outcome possible on a traditional written exam in athletic therapy. With the SP interaction, if performed correctly, as rehearsed, the outcomes assessed for each student encompass much more.
The students have an opportunity to interact with a patient, introduce themselves and develop trust. They learn how to speak with a patient in an accessible way, for example, to describe the tests they will perform and to ensure their patient is comfortable. Moreover, they are all assessed on how they perform various tests to ensure they perform them correctly and safely. A written exam that describes what steps to take does not assess whether the student will perform them correctly. This type of assessment is vital prior to the students practicing on real patients. I was treated very well by each student I interacted with and feel confident that every student graduating from the Athletic Therapy Program will be prepared when performing in the field.
If you are interested in learning more about the Simulated Person Methodology (SPM) Lab and discovering ways that you can enhance your assessments, or even incorporating a learning activity into your class, please visit the Simulated Person Methodology (SPM) Lab website or email spmyu@yorku.ca.