EVALUATION AND ASSESSMENT IN NURSING.pptx

Evaluation in educational context implies broad programme that examines achievements, attitude, interests, personality, traits and skills factors which are taken into consideration. Thus cognitive, affective and psychomotor learning outcome is measured in the evaluation process. The evaluation is a two part process. The first part of evaluation is the determination of what is to evaluate (Goal) and the second part is the judgment of whether the goals are being achieved. The overall purpose will be to provide information to enable each student to develop according to his potential with in the frame work of educational objectives

1. EVALUATION AND ASSESSMENT IN NURSING Prof. B.KAVITHA M.SC(N) Vice Principal Aswini College of Nursing Thrissur

2. Introduction • Evaluation is part of life, in our life we need to make evaluation frequently – like which dress you want to wear in marriage – What you want to give in gift to your friend. • In educational scenario evaluation have important role in judging student progress to know up to what extent student have achieved the desired set goal. The word ‘assess’ comes from the Latin verb ‘ assidere ’ meaning ‘to sit with’. Assessment can focus on the individual learner, the learning community (class, workshop, or other organized group of learners), the institution, or the educational system.

3. Evaluation is such an essential part of teaching and learning. Evaluation in education is the process of judging the effectiveness of educational experience through careful appraisal or involves measurement but is different from it. Measurement is appraisal in terms of a fixed standards whereas an evaluation implies the use of relative and flexible standards. Educational evaluation is made in relation to the objectives that have been determined previously by faculty, individual teacher and student.

4. DEFINITIONS EVALUATION: “ It is a process of making judgment that to be used as a basis for planning. It consists of establishing goals, collecting evidence concerning growth or lack of growth towards goals, making judgments about the evidence and revising procedures and goals in the light of the judgments.” ___ Wiles “ It is the process of determining to what extent the educational objective are being realized.” ___ Ralph Tylor “ It is a systematic examination of educational and social programs.” ____ Conbach

5. DEFINITIONS ASSESSMENT: “Assessment is the process of documenting, usually in measurable terms, knowledge, skill, attitudes, and beliefs.” “Assessment in education is the process of gathering, interpreting, recording, and using information about pupils’ responses to an educational task.” ___ Harlen, Gipps, Broadfoot , Nuttal,1992

6. Nature of evaluation Evaluation in educational context implies broad programme that examines achievements, attitude, interests, personality, traits and skills factors which are taken into consideration. Thus cognitive, affective and psychomotor learning outcome is measured in the evaluation process. The evaluation is a two part process. The first part of evaluation is the determination of what is to evaluate (Goal) and the second part is the judgment of whether the goals are being achieved.

7. Purposes of evaluation The overall purpose will be to provide information to enable each student to develop according to his potential with in the frame work of educational objectives. Bloom stated the following purposes:- 1) To discover the extent of competence through which the student have developed in initiating, organizing and improving his/her day to day work and to diagnose his/her strength and weakness with a view to further guidance. 2) To appraise the status of and changes in student’s behaviour. 3) To assess the student’s progress from time to time and disclose student’s needs and possibility.

8. Purposes of evaluation 4) To predict the student’s future in academic success. 5) To provide basis for modification of the curriculum and course. 6) To motivate students for better attainment and growth. 7) To improve instructional and measuring devices. 8) To locate areas where remedial measures are needed.

9. Purposes of evaluation in nursing EDUCATION To determine the level of knowledge and understanding of the students at various times. To determine the level of student’s clinical performance at various stage. To diagram each student’s strength and weakness and to suggest remedial measures. To encourage student’s learning by measuring their achievement and inform them their success.

10. To help students to acquire the attitude of and skills in self evaluation and self directing in their study. To provide motivation in practicing critical thinking, the application of principle, the making of judgment, etc. To estimate the effectiveness of teaching and learning technique, of subject content and instructional media in reaching the goals. To gather information for administrative purpose such as selecting students for higher courses, placement of students for advanced training, etc.

11. scope of evaluation

12. characteristics of evaluation 1. Continuous process. 2. Includes academic and non academic subjects. 3. Procedure for improving the product. 4. Discovers the needs of an individual student and to design learning experience that will solve their needs. 5. Correlation between the educational system and the system of evaluation. 6. Complex process which need scientific techniques and tools.

13. principles of evaluation : Evaluation is most effective when based on sound operational principles. The following principles stated by Gronlund provide a framework within which the process of evaluation may be viewed. Determining and clarifying what is to be evaluated always has priority in the evaluation process: The objectives must be clearly stated before evaluation is made. Techniques should be selected in term of the purposes to be served. Evaluation is a means to an end and not as end itself.

14. Comprehensive evaluation requires a variety of evaluation techniques. No single evaluation technique is adequate to evaluate various outcome. Proper use of evaluation techniques require an awareness of their limitations as well as their strength. Evaluation procedures must contribute to improved decisions of instruction, guidance and administrative nature. Adequacy of experience should be made in terms of excellence of performance and quality of experience. Record for practice should reflect the objectives of practice and give evidence to the extent of achievement of these objectives.

15. OBJECTIVE BASED EVALUATION

16. OBJECTIVE BASED EVALUATION OBE is a widely accepted concept among teachers It depicts the relationship between Instructional objectives, Evaluation & Learning experience or instruction provided

17. FUNCTIONS OF EVALUATION

18. Formative evaluation It is used to monitor the learning process of students during the period of instruction. It provides continuous feedback to both teacher and student concerning learning successes and failure while instruction is in process. Feedback to students provides reinforcement of successful learning and identifies the specific learning errors that need correction. Feedback to teacher provides information for modifying instruction and for prescribing individual and group remedial work.

19. Formative evaluation It aims at improvement of instruction. It is concerned with the process of development of learning Cornback is the first educationist who said that the greatest service evaluation can perform is to identify aspects of the course where education is desirable. It is a positive evaluation because it attempts to create desirable learning goals and tools for achieving such goals.

20. Types of formative evaluation   Diagnosing- It is concerned with determining the most appropriate method or instructional materials conducive to learning. Placement- It is concerned with finding out the position of an individual in the curriculum from which he has to start learning. Monitoring- It is concerned with keeping track of the day today progress of the learners and to point out changes necessary in the methods of teaching instructional strategies etc.

21. Characteristics of Formative evaluation   It is an integral part of learning process. It occurs frequently during the course of instruction. Its results are made immediately known to the learners. It may sometimes take teacher’s observation only. It reinforces learning of the students. It pinpoints difficulties being faced by weak learners. Its result can not be used for grading or placement purposes.

22. E xamples Of Formative Evaluation Monthly Test Class Test Periodical Assessment Teacher’s Observation Etc. It helps in modification of instructional strategies including method of teaching immediately. It motivates learners; as it provides them with knowledge of progress made by them. It sees the role of evaluation as a process. It is generally teacher made test It does not take much time to construct

23. Summative Evaluation It is done at the end of the course of instruction to know to what extent the objectives previously fixed have been accomplished. Its main objective is to assign grades to the pupils. It indicates the degree to which the students have mastered the course content. It helps to judge the appropriateness of instructional objectives. It has danger of making negative effects. This evaluation may brand a student as a failed candidate, and thus causes frustration and setback in the learning process of the candidate. The tests for summative evaluation are given at the end of a course .

24. The functions of summative evaluation Crediting - It is concerned with collecting evidence that a learner has achieved some instructional goals in respect to a defined curriculum. Certifying - It is concerned with giving evidence that the learner is able to perform a job according to the previously determined standards. Promoting - It is concerned with promoting pupils to next higher class. Selecting - Selecting the pupil for different courses after completion of a particular course structure.

25. Characteristics of summative evaluation It is judgemental in character in the sense that it judges the achievement of pupils. It views evaluation ‘as a product’, because its chief concern is to point out the levels of attainment. It may or may not motivate the learners. Sometimes it may have negative effects. It is terminal in nature as it comes at the end of the course of instruction. It reinforces learning of the students who has learnt an area. Its result can be used for placement and grading purposes It does not pin point difficulties faced by the learner. It can not based on teacher’s observation only. Examples of summative evaluation Traditional school and university examinations. - Standardised tests. Teacher made tests. Practical and oral tests.

26. Maximum Performance evaluation & TYPICAL PERFORMANCE EVALUATION Maximum Performance Evaluation: Determines what individual can do when performing at their best. Evaluating the person’s abilities and individual performance during motivation Aptitude and achievement tests are useful in measuring maximum performance Typical Performance Evaluation : Individuals performance under natural conditions i.e their typical behavior Individuals performance during routine and normal situation Attitude tests, personality inventories and observational techniques will help measure typical behavior

27. Criterion- referenced evaluation A criterion-referenced test is used to ascertain an individual’s status with respect to a defined achievement domain. I t is concerned with the performance of an individual in terms of what he can do or the behaviour he can demonstrate. In this evaluation there is a reference to a criterion but there is no reference to the performance of other individuals in the group. In it we refer an individual’s performance to a predetermined criterion which is well defined. It is objective based test. It includes the entire terminal behaviour that is supposed to be shaped through the programme . It is not the test of grading the students rather it is a test designed to measure the extent to which students have mastered their learning outcomes

28. Norm- referenced evaluation A norm referenced evaluation test is used to ascertain an individual’s status with respect to the performance of other individual on that test. Here measurement act relates to some norm, group or a typical performance. It is an attempt to interpret the result in terms of the performance of certain group It is used by teachers to differentiate and classify among students of some defined group like age or grade. In it comparison of students is relative rather than absolute.

29. Features It is used for discriminating students who have different backgrounds Classifying the students for the purpose of selection in some course As a guideline for students Promoting the students in higher class The selection of employees by the employers Counsellors and guidance workers Teachers to rank the students

30. CONTINOUS COMPREHENSIVE EVALUATION

31. CONTINOUS COMPREHENSIVE EVALUATION It is an approach that aims at assessing those attributes which cannot be assessed through one- attempt written examination The National Policy of Education 1986 also looks at student assessment as a device for bringing about qualitative improvement in education suggested the introduction of CCE

32. Characteristics of CCE • To improve learning and diagnosis of weakness so that remedial measures can be provided • Both scholastic and non scholastic aspects of pupils growth are evaluated • It carry out the formal evaluation of the teachers in school • Provides the multiple techniques of evaluation • It evaluates the total teaching –learning programmers • It gives evidence on three different ways – self reference, criterion – referenced, Norm-referenced

33. STEPS IN EVALUATION

34. CRITERIA FOR SELECTION OF ASSESSMENT TECHNIQUE/METHOD

35. TECHNIQUES AND TOOLS OF EVALUATION

36. ASSESSMENT OF KNOWLEDGE Essay type questions Short answer Objective type

37. ESSAY TYPE QUESTIONS It is a test containing questions requiring the student to respond in writing. It emphasizes recall rather than recognition of correct alternatives. The student prepares his/her own answers. Handwriting, spellings, neatness, organization are also considered in scoring. An essay test presents one or more questions or either tasks that require extended written responses from the person being tested. -Robert Lebel & David Wiedmann (1933) observed that an essay type question may use the following eleven words signifying the simple to higher mental processes and classified as eleven major categories: What, Who, When, Which and Where, List, Describe, Contrast, Compare, Explain, Discuss, Develop, Summarize and Evaluate.

38. FEATURES:- No answer can be considered throughout and correct. The examinee is permitted freedom of response. The answers vary in their degree of equality or corrections.

39. TYPES:- EXTENDED RESPONSE- no restriction is placed on the student on the point he/she discusses. E.g : Explain the role nurse in health care team RESTRICTED RESPONSE -Student will have less scope, limited nature in the form, because he is told specifically the context in which his answer is to be made. E.g : State the main difference between kwashiorkor and marasmus How good nutrition prevents the pressure sore? (Specific questions are given)

40. Suggestion for constructing Essay questions Restrict the use of essay question to those learning outcomes that cannot be satisfactorily measured by objective items Formulate the question that will call forth the behaviour specified in the learning outcomes Maximum subject matter content is covered Avoid the use of optional questions Do not give too many lengthy questions. Avoid phrases e.g. ‘Discuss briefly’. Words should be clear and simple, unambiguous and carefully selected. Do not allow too many choices. According to level of students’ difficulty and complexity items has to be selected. The limits of areas and the behaviour which you want should be clearly mentioned.

41. Suggestion for scoring Essay questions Prepare a outline of the expected answer in advance by point scoring system Use the scoring method that is most appropriate Describe how to handle factors that are irrelevant to the learning outcomes being measured Evaluate all answers to one questions before going to the next one Evaluating all answers to one question at a time helps counteract another type of error that creeps in the scoring of essay questions

42. Evaluate the answers without looking at the students name If especially important decisions are to be based on the results, obtain two or more independent rating When 2 or more teacher’s correct the same test, they should agree on the scoring procedure before the test and correct the answer scripts. The time allowed and the marks allotted will act as a guide to the students to answer the questions.

43. BLUFFING-A SPECIAL SCORING PROBLEM Wrting something for every questions Stressing the importance of the topic covered by the questions Agreeing with the teachers view whenever it seems appropriate Being the name dropper Writing on the related topic and fitting in to the questions Writing in general terms that can fit many answers

44. ADVANTAGES & DISADVANTAGES

45. Objective TYPE Test It is generally call for single words, phrases, numbers, letter and other symbols as response to items. Is defined as one for which the scoring rules are so specific that they do not allow scorers to make subjective inferences or judgments. Objective test items are items that can be objectively scored on which persons select a response from a list of options. - Weirsma & G . Jurs - 1990

46. True or False Test Type An objective type test presented in a form simple declarative statement, to which the pupils respond indicating whether the statement is true or false. It is applicable to all learning areas. Uses: Measuring the ability to identify the correctness of statements of facts, definitions of terms, statements of principles, differenciating facts from opinion and the like

47. Types of True or False Test • Simple True or False • Modified True or False • True or False with correction • Cluster True or False • True or False with options. • Fact or Opinion Eg : Tetany occurs with increased secretion of parathyroid hormones.

48. GUIDELINES to construct the true or false type test Avoid broad general statements if they are to be judged true or false Avoid trivial statement and Express statement in a simple language as possible Avoid the use of negative statements especially double negative Avoid the including two ideas in one statement, unless cause and effect relationships are being measured True and false statements should be in eq ual strength Avoid long and complex sentences and reasonably short or restrict them to have one central area. Be very careful about the grammatical structure of the sentences.

49. MULTIPLE-CHOICE TEST • Is a test used to measure knowledge outcomes and other types of learning outcomes such as comprehension and applications. • Most commonly used format in measuring student achievements in different levels of learning. • Consist of three Stem – represents the problem question. Keyed option – correct answer Distracters – incorrect options or alternative Eg : you are caring for an elderly patient who was told recently that he has cataracts. Which one of the following is a cause for cataract; A. Aging.* B. Arteriosclerosis. C. Hemorrhage. D. Iritis.

50. VARIATIONS IN MULTIPLE CHOICE FORMAT A. ONE CORRECT ANSWER- simplest type. One correct option and other incorrect options. B. BEST ANSWER -the student is told to select the best answer. C. ANALOGY -the student is required to deduce relationship that exists between the two first parts. e.g. Lack of iron content: anemia::lack of iodine content: …………… a)cretinism b) myxoedema c) goitre D. RESERVE TYPE -all but one answer is correct. Selection of the incorrect answer.

51. GENERAL GUIDELINES in Constructing the Multiple-choice Test Make a practical test. Use diagram or drawing when asking questions about application, analysis or evaluation. Use tables, figures, or charts when asking question to interpret. Use pictures when students are required to apply concepts and principles. When ask to interpret or evaluate quotations, present actual quotations List of choices vertically not horizontally. Avoid trivial questions. Use one correct answer only. Use to three to five options. Be sure to use effective distracters. Increase similarity of the options. Do not use “none of the above” when asking for best for a best answer. Avoid using “all of the above” options.

52. Guidelines in Constructing the Stem 1. The stem should be written in question form or completion form. 2. Do not leave blank at the beginning or at the middle of the stem in completion form. 3. Clear and concise. 4. In a positive form. Avoid using negative words, if you do underline or capitalize. Ex: Which of the following does not belong to the group? Or which of the following does NOT belong to the group? 5. Stem is grammatically correct.

53. Guidelines in Constructing Options One correct or best answer only. List of options are vertical. Avoid creating a pattern. Options must be homogenous in content. As much as possible options must be in the same length. Avoid the phrase “all of the above”, “none of the above” or “I don’t know.” GUIDELINES IN CONSTRUCTING DISTRACTERS 1. The distracters should be plausible. 2. Should be equally popular with the rest of the options. Which of the following philosophical schools was most identified with the Greek Philosopher Aristotle? A. Stoicism B. Agnosticism C. Platonism D. Empiricism Which of the following philosophical schools was most identified with the Greek Philosopher Aristotle? Stoicism Platonism Agnosticism Empiricism

54. Uses OF MULTIPLE-CHOICE TEST

55. Advantages & Disadvantages

56. Multiple response items Multiple response or completion item More than one of the given alternatives is correct , but there is one correct answer to the precise questions stated in the first sentence of the item Versatile type lending to testing of recall, reasoning and exercise of judgement Which of the following group could be included among Pottassium sparing diuretics? a.Diamox b.Burnet c.Chlotorothiazide d.Triamterine e. Spirinolactone A&c Only, D&e Only, C&e Only

57. MATCH THE FOLLOWING The matching exercise consist of two parallel columns with each words, number of symbol in one column being matched to the word, sentence or phrase in the other column The item in the column for which a match is sought are called premises and the item in the column from which the selection is made is called as response The basis for matching the response to premises is sometimes Self Evident

58. SHORT ANSWER QUESTIONS The short answer item and completion item are supply test items that can be answered by a word, phrase, number or symbol The short item use number uses direct questions & i deally, only one answer is acceptable. The students response by selection of one or more of several given alternatives by giving words or phrases. It does not call for an extensive written response and the answer is expected as short and can be expressed in different forms.

59. PRINCIPLES FOR PREPARATION:- Use precise, simple and accurate language in relation to the subject matter area. Provide the necessary space for answers below each question asked Question can be as long as possible, but answer should be short. Each item should deal with important content area. Use action oriented precise verbs.

60. Completion type Test An objective type of test that includes series of sentences which certain important words of phrase has been omitted for the pupils to fill in a sentence may contain one or more blanks and the sentences may be disconnected or organized into a paragraph. Each blanks counts one point. Example: Fill up the blanks with the correct answer. 1. The Father of educational testing is ________. Answer: Edward L. Thorndike 2. Alfred Binet a French psychologist and also known as the _________.

61. How construct completion type of test Omit only words that are essential to the meaning of the statement or sentence. Do not omit any words in a statement. The statement may lose its meaning. Make the blanks equal in length to avoid clues. Long blanks suggest long answers, short blanks suggest short answers.

62. Simple Recall Test Objective type of test that sometimes require the student to supply an answer to direct question and sometimes require him to complete a statement where a word or phrase has been omitted. Example Direction: Follow the directions in each of the problem below. Write the answer to each problem in the blank provided at the left. You may use the side of this sheet for computation. The following are the scores of Mathematics student 18, 12, 16, 10, 10, 22, 15, 13, 17, & 18 . 14.90 What is the mean? 2. Who is the father of mental/modern testing? A. Benit

63. How to construct Simple Recall Test • Do not lift statement from the book verbatim • Frame the questions so that one correct answer is possible. • Avoid extraneous hints that give the students clues to the answer. • Design the test items so that the blank comes at the end of the statement. • If the item requires the pupils to compute figures in order to arrive at an answer, always indicate the units to express the answer, whether it is feet, inches or in seconds, minutes or hours and minutes.

64. Labeling Type Test An objective test in which the names of parts of diagrams, map, drawing or picture are to be indicated. How to construct the labeling type of test • Make the diagram, map, drawing or picture to be labels very clear and recognizable especially the parts to be labeled. • The parts to be labeled should indicate by the arrows so that labels can be written in a vertical column in a definite place and not on the face the diagram, map, drawing or picture. • Labeling can be matching type of test if the labels with some extras are given.

65. ASSESSMENT OF SKILL Observation, checklist, Rating Scale & Anecdotal Record Cumulative Records, writing clinical examinations, critical Incident record& Viva Voce Oral Examination Objective Structured Clinical Examination (OSCE) & Objective Structured Practical Examination (OSPE)

66. Observation It is a old method Observare – to keep open ( Latin word) Measurement without using any instrument or device

67. Understanding the environment by sense organs E xternal behaviour of persons in appropriate situations Tools such as check list and score-card, tape- recorder, thermometers, audiometer, stop- watch, binoculars etc. Devices used: Anecdotal records, checklist and rating scale Student attitude Personal qualities and abilities Motivation and commitments Learning speed and style Attainment and progress

68. Uses of Observation In descriptive research Significant aspects of personality which express themselves in behaviour Physical aspects of school buildings or students and teachers – through physical examination, measurement, assessment and comparison with fixed standards In classroom – learning behaviour Cumulative record – anecdotal evidence – research studies

69. MERITS OF DIRECT OBSERVATION Record of actual behavior, so more reliable and objective Study of individual in natural situation Employed to all section of students Need training and experience and all teachers can use it Used in every situation

70. MERITS OF DIRECT OBSERVATION Adaptable to individual and group Frequent observation can provide continuous check on his progress Provide teachers with valuable supplementary information Problems can be identified immediately and remedial measures can be taken accordingly

71. DEMERITS OF OBSERVATION Scope for personal prejudices and bias of the observer May not be 100% accuracy Difficult to observe every behaviour of the student Reveal the overt behaviour only i.e behavior that is expressed

72. PRINCIPLES OF OBSERVATION Observe the whole situation Select one student to observe at a time Observe in all regular activities such as in classroom and in clinical areas Made over a period of time Observations from several teachers should be combined

73. REQUISITES OF A GOOD OBSERVATION

74. Anecdotal records An anecdotal record (or anecdote) is like a short story that educators use to record a significant incident that they have observed. Anecdotal notes are used to record specific observations of individual student behaviors, skills and attitudes as they relate to the outcomes in the program of studies. Such notes provide cumulative information on student learning and direction for further instruction.

75. Anecdotal notes are often written as the result of ongoing observations during the lessons but may also be written in response to a product or performance the student has completed. Every behavior can’t be recorded, only which reflect some significance can be recorded. Notes taken during or immediately following an activity are generally the most accurate. Anecdotal notes for a particular student can be periodically shared with that student or be shared at the student’s request. They can also be shared with students and parents at parent–teacher–student conferences.

76. Characteristics A factual description of an event in which:- i . How it occurred, ii. When it occurred, iii. Under what circumstances it occurred, iv. The treatment Each anecdotal should be of one incident Being positive and objective Use descriptive language

77. PURPOSES: 1) To stimulate teachers to look for information i.e. to help student in self-adjustment. 2) The teacher is able to understand her pupil in realistic manner. 3) It provides healthy pupil-teacher relationship. 4) Helps the student to improve in their behavior, as it is a direct feedback of an entire observed incident. 5) Can be used by students for self appraisal and peer assessment.

78. Tips for Establishing and Maintaining Anecdotal Notes Keep a binder with a separate page for each student. Record observations using a clipboard and sticky notes. Write the date and the student’s name on each sticky note. Following the note taking, place individual sticky notes on the page reserved for that student in the binder. Keep a binder with dividers for each student and blank pages to note down notes. The pages may be divided into three columns: Date, Observation and Action Plan.

79. Keep a class list in the front of the binder and check off each student's name as anecdotal notes are added to their section of the binder. This provides a quick reference of the students you have observed and how frequently you have observed them. Keep notes brief and focused (usually no more than a few sentences or phrases). Note the context and any comments or questions for follow-up. Keep comments objective. Make specific comments about student strengths, especially after several observations have been recorded and a pattern has been observed.

80. • Record as the observations are being made, or as soon after as possible, so recollections will be accurate. • Record comments regularly, if possible. • Record at different times and during different activities to develop a balanced profile of student mathematics learning. • Review records frequently to ensure that notes are being made on each student regularly and summarize information related to trends in students' learning. • Share anecdotal notes with students and parents at conferences.

81. ADVANTAGES:- Provision of insight into total behavioral incidents. Use of formative feedback. Economical and easy to develop. Needs no special training. DISADVANTAGES:- If careless recorded, the purpose will not be fulfilled. Subjectivity. Lack of standardization. Difficulty in scoring. Time consuming

82. Cumulative records Comparing to the progress records and personal records of the students, cumulative records are much comprehensive. Other than the academic progress of the student they also give information regarding intelligence, personality, aptitude, interests, attitude, values, emotional maturity and conflicts, or self – adjustment, etc. The interpretation of this record is subjective and difficult to an extent

83. Observed checklists It is an approach to monitor performance of specific skills, behaviors, or dispositions of individual student. Checklist is basically a method of recording whether a characteristic is present or an action is performed. DEFINITION: A checklist is a simple instrument consisting of prepared list of expected items of performance or attributes, which are checked by a evaluator for their presence or absence. A checklist enables the observer to note whether or not a trait or characteristics is present.

84. Characteristics: Can be used for formative assessments by focusing on performance of specific skills such as writing skills, speaking skills or action-based skills. Should be carefully prepared and must include all important elements of a specific task that student must know or perform. Each element should be sequentially and carefully included and adequate weightage should be given. Observe one at a time and use only when assessing a particular characteristics.

85. Guidelines to Construct: Express each item in clear, specific, observable and in simple language. Items can be continuous or divided into groups of related items. The items created has to be evaluated by the experts. Avoid negative statements. Ensure that each item has a clear response. Review the items independently. It must be complete and comprehensive in nature. Leave space to record anecdotal notes or comments. Each element should be marked as Present/Absent, inappropriately done and an option “not applicable” can be

86. Sl no Criteria Yes No Remark 1 Identifies the patient and check the physician order       2 Explains the procedure to the patient and relatives       3 Assembles all articles       4 Follow the three checks of medication administration       5 Washes hands       6 Places the patient in comfortable position (sitting/semi flowers position)       7 Remove the medication or drug from the strip without touching the drug       8 Spread mackintosh with towel across the chest of patient       9 Give the medication cup and glass of water to the client       10 Stay with the client until he or she swallows all medications       11 Assist the patient to comfortable position       12 Discard the waste and replaces the articles       13 Washes the hand       14 Document the procedure       CHECK LIST FOR ORAL MEDICATION

87. Rating Scale It is a term used to express opinion or judgment regarding some performance of a person, object, situation and character. Rating scale is an important technique of evaluation. Rating is the assessments of a person by another person. This is one of the oldest methods of personality assessment. There are certain general approaches to assess personality like holistic or overall approach, projective test approach and trait approach.

88. Definition: It refers to a scale with a set of opinion, which describes varying degree of the dimensions of an attitude or a phenomenon being observed.

89. types

90. a)Graphic rating scale A straight line, may be represented by descriptive phrases at various points. To rate the subject for a particular trait a check mark is made at the particular point.

91. b)Descriptive rating scale: This type does not use numbers but divides the assessment into a series of verbal phrases to indicate the level of performance.

92. (c) Numerical rating scale In which numbers are assigned to each trait. If it is a seven point scale, the number 7 represents the maximum amount of that trait in the individual, and 4 represents the average. The rater merely enters the appropriate number after each name to indicate judgment of the person.

93. d)Comparative rating scale: In this person makes a judgment about an attire/attitude/object by comparing it with others/ranking it.

94. CHARACTERISTICS OF RATING SCALE • These are value judgments about attributes of one person by another person. • These are most commonly used tools to carry out structured observations. • These are generally developed to make qualitative judgment about qualitative attributes. • Provide more flexibility to judge the level of performance.

95. PRINCIPLES OF RATING SCALE:  It relates to learning objective.  Needs to be confined to performance areas that can be observed.  Clearly defines mode of behaviour.  The behaviour should be readily observed in a number of situations.  Allow some space in the rating scale for the rater to give supplementary remarks.  3 to 7 rating positions may be provided.

96. PRINCIPLES OF RATING SCALE:  All raters should be oriented to the specific scale as well as the process of rating in general. The rater should be unbiased and trained. Consider evaluation setting, feedback and student participation. Have experts and well informed raters. Change the ends of scale so that good is not always at the top or bottom. Assure that rater autonomy will be maintained.

97. ADVANTAGES: • Easy to administer and score. • Its easy to make and less time consuming. • Easily used for large group. • Also used for quantitative methods. • May also be used for assessment of interest, attitude, personal characteristics. • Used to evaluate performance and skills. DISADVANTAGES: • Difficult to fix up rating. • Chances for subjective evaluation, thus the scales may become unscientific.

98. Critical Incident Reporting Incident: In a health care facility, such as a hospital, nursing home, or assisted living, an incident report or accident report is a form that is filled out in order to record details of an unusual event that occurs at the facility, such as an injury to a patient. Critical Incident: An occurrence or set of events inconsistent with routine operation. It is an unplanned event within the scope of this procedure that causes, or has the potential to cause, an injury or illness and damage to equipment, buildings, plant or the natural environment.

99. The purpose of the incident report is to document the exact details of the occurrence while they are fresh in the minds of those who witnessed the event. This information may be useful in the future when dealing with liability issues stemming from the incident

100. TYPES OF INCIDENT

101.   NEAR MISS This is where the incident did not result in harm, loss, or damage, but could have, this is referred to as a ‘Near Miss’. This may be clinical or non-clinical. Near-miss reporting is just as important in highlighting weaknesses in systems, policies/procedures, and practices. If near misses are reported and learned from and any necessary corrective action is taken, they can help to prevent actual incidents of harm, loss or damage from occurring. Near misses should be reported within 24hrs of working days.

102. ADVERSE EVENTS Adverse Incident (Clinical) An event or circumstance arising during clinical care of a patient that could have or did lead to unintended or unexpected harm’. Adverse Incident (Non-Clinical) ‘An event or circumstance that could have or did cause unexpected or unwanted harm, loss or damage to any individual(s) involved (including patients but not related to clinical care, staff, visitors etc ) or damage to/loss of property/ premises in the hospital. It should be reported within 2 hrs. INCIDENT REPORTING (STAFF) It is a requirement of all Hospital staff that they report any incident, accident or potential incident which has caused or has the potential to cause harm, loss or damage to any individual involved or loss or damage in respect of property premises for which the hospital is responsible.

103. HOW TO REPORT AN INCIDENT ● Obtain the proper forms from your institution. Each institution has a different protocol in place for dealing with an incident and filing a report. ● Start the report as soon as possible. Write it the same day as the incident, if possible, because if you wait a day or two your memory will start to get a little fuzzy. You should write down the basic facts you need to remember as soon as the incident occurs, and do your report write-up within the first 24 hours afterward. ● Provide the basic facts. Your form may have blanks for you to fill out with information about the incident. If not, start the report with a sentence clearly stating the following basic information given in the Incidence form.

104. ● Write a first person narrative telling what happened. For the meat of your report, write a detailed, chronological narrative of exactly what happened when you report to the scene. Use the full names of each person who is included in the report, and start a new paragraph to describe each person's actions separately. ● Be thorough. Write as much as you can remember - the more details, the better. Don't leave room for people reading the report to interpret something the wrong way. Don't worry about your report being too long or wordy. The important thing is to report a complete picture of what occurred. ● Be clear. Don't use flowery, confusing language to describe what occurred. Your writing should be clear and concise. Use short, to-the-point, fact-oriented sentences that don't leave room for interpretation.

105. Be accurate. Do not write something in the report that you aren't sure actually happened. ● Be honest. Even if you're not proud of how you handled the situation, it's imperative that you write an honest account. If you write something untrue it may end up surfacing later, putting your job in jeopardy and causing problems for the people involved in the incident. ● Submit your incident report. Find out the name of the person or department to whom your report must be sent. When possible, submit an incident report in person and make yourself available to answer further questions or provide clarification.

106. PERSON RESPONSIBLE FOR THE IMMEDIATE MANAGEMENT OF THE INCIDENT The person responsible for the immediate management of the incident (e.g. the nurse in charge of the ward at the time an incident occurs), should undertake an immediate assessment of the situation, in order to determine any immediate treatment and/or ongoing care needs of the affected person, and/or the extent of any loss/damage to property and any other immediate action required (e.g. removal and isolation of faulty equipment). The situation/scene should be made safe.

107. ROOT CAUSE ANALYSIS Root Cause Analysis’ is a structured investigation process that aims to assist in the identification of the root or underlying cause(s) of a particular event or problem by determining WHY the failure occurred and the actions necessary to prevent or minimize the risk of recurrence. A ‘Root Cause’ is a failure in a process that, if eliminated, would prevent an adverse incident from occurring. Training for the relevant staff on incident grading/investigation and root cause analysis will be provided as part of the risk management training program.

108. FAIR BLAME CULTURE In an organization as large and complex as the Hospital, things will sometimes go wrong. The wrong assessment should not be one of blame and retribution, but of learning, a drive to reduce risk for future patients and staff. Blame cannot, and should not, be attributed to individual healthcare professionals. Identifying and addressing dysfunctional systems is, therefore, the key to reducing the risk of harm for many patients and staff through incident form. It is understood that fear of disciplinary action and subsequent sanctions may discourage the staff from reporting incidents and, therefore, continues to be developed within a culture of ‘fair blame’. The Management approach following incidents will therefore focus on ‘what went wrong, and not who went wrong’.

109. PRACTICAL EXAMINATION Practical examination is concerned with the assessment of practical performance skills & practice competency acquired by a student during the course of a particular programme. Purposes of Practical Examination To assess the practical skills To assess the development in affect domain To assess the student’s problem solving skills To assess the recording & reporting skills To assess multiple performance task such as assessment, planning, implementation, communication

110. Are integral part of nursing examinations Practical exams are accompanied by oral examinations It is the combination of test methods like rating scales, checklists etc Marking sheets, checklist and rating scales are prepared in advance to improve the reliability of scoring All students are evaluated on same criteria by same examiners

111. ADVANTAGES It provide an opportunity to assess the skills & competency. It provide an opportunity to the examiner for assessing the use of compartmentalized knowledge. An examiner also get an opportunity to assess the communication & interpersonal skills. DISADVANTAGES It not considered an objective method of assessment. It time consuming process. It not feasible for large group. Sometime it considered as unethical to expose patients for examining students.

112. ORAL EXAMINATIONS Are face to face examination between examiner and examinee Theoretical oral examination and practical examination Viva voce is a Latin phrase literally meaning  with living voice,  but is most often translated as  by word of mouth . Furthermore, viva voce is also is termed as an oral examination which consists of a dialogue between the examiner and a student where the examiner ask question and the student replies. The examiner may ask short open questions, multiple choice questions or a series of other type of questions not necessarily related to each other. 

113. Viva Voce In nursing, viva voce is generally used to supplement the practical examination where two examiners, i.e. internal and external, ask several questions related to a particular subject matter. The viva voce might form a part of the validated assessment for a course, assessed by an oral examination. In these situations, the viva voce is a useful tool that in authenticating that the student has got enough knowledge in the subject matter.

114. Purposes of Viva Voce To assess student's ability to communicate with another person. To supplement the information obtained through other evaluation techniques. To use stimulation methods like role play and telephone conversation. To identify and analyse the student's presence of mind. To evaluate the student's spontaneity and mannerism. To acquire soundness of knowledge through various forms of question. To diagnose the student's limitation and weakness and take remedial action.

115. Principles to Conduct Viva Voce The viva should not be limited to a single topic but should cover a range of different issues to avoid the results of the viva being skewed by selecting a topic which the candidate can answer exceptionally well or about which he/she knows nothing of. All questions should be strictly relevant to the purpose of the viva. Do not use long preambles to questions. Examiners should talk as little as possible during the viva. The chair of the examiners must remain in charge of the session and must deal appropriately with any problem candidate or difficult situation. When the last question is being asked, allow the student to complete his/her answer and end the session formally. Viva voce examinations should not normally exceed 30 minutes. Candidates should be examined individually. Candidates should be given adequate notice of the possibility of being called to attend a viva, and this should normally not be less than 24 hours.

116. Advantages of a Viva Voce Provide direct contact with the candidates to assess their communication, presentation skills and overall impression. Provide opportunity to mitigate circumstances into accounts. Provide flexibility in moving the candidates from strong to weak points. Makes students formulate replies without cues, and the reaction is observed for a specific stimulus. Facilitates simultaneous assessment by two or more examiners. Provides an opportunity for the examiner to get feedback on the performance of the students and the university.

117. Disadvantages of a Viva Voce Lacks standardization, objectivity and reproducibility of the result. Permits favoritism and cannot be used for future references. Suffers from undue influence of irrelevant factors. Costly in terms of professional time.

118. OSCE/OSPE It is a modern type of examination often used in various professional disciplines including nursing. An OSCE is designed to test clinical skill performance such as communication, clinical examination, nursing procedure by a student in clinical area where the student is asked to perform a particular task on a patient and is evaluated by the examiner. An OSPE is designed to assess competence in skill performance such as chemical analysis, identification of equipment and interpretation of results, etc. at different stations in a lab set up.

119. OBJECTIVE STRUCTURED PRACTICAL EXAMINATION OSPE Objective Structured Practical Examination (OSPE) is a new pattern of practical examination. In OSPE each component of clinical competence is tested uniformly and objectively for all the students who are taking up a practical examination at a given place.     

120. CHARACTERISTICS Objective: Because examiners use a checklist for evaluating the trainees. Structured: Because every trainee sees the same problem and performs the same tasks in the same time frame.              Clinical: Because the tasks are representative of those found in real clinical situations. An examination. PURPOSE Provide feedback on performance. Evaluate on the basis of clinical skills. Measures minimal competencies.

121. STEPS TO ORGANIZE AN OSPE In order to organize an OSPE one has to set objectives of practical experiences in a given discipline related to a particular subject such as practical examination in medical surgical nursing each student is supported to, 1.  Demonstrate practical skills: this may be done by assisting a student to, a.     Monitor and record oral temperature. b.     Convert 39 degree to F. c.     Attach a heart monitor to a patient.  d.     Test urine for sugar. e.     Start an IV drip on a patient. 2. Make correct and accurate observations: this may be done by assigning a student to, a.      Interpret type of fever from the given graph. b.      Identify the type of arrhythmia from the ECG graph provided. c.      Differentiate between normal and abnormal ECG. These questions may not require the examiners to observe the student in action. These questions can be answered on a paper which can be collected later for evaluation.

122. 3. Analysis and interpret data: this is one of the important skill components to be judged for the continuity of patient care. The nurse has to perform this task where she may come across normal and abnormal data in relation to patient’s investigation reports. The student asked to interpret, a.      Hemogram: normal or abnormal. b.      Liver function test reports.             c.      Renal function test reports. d.      Laboratory reports.     1. Identify patients problems: in order to organize her work the nurse has to identify the patient’s problems and set priority so as to clear to the immediate needs of the patient, such as to identify, a.       Dyspnoea on the basis of her observations. b.      Rigor following blood transfusion. c.      Coning following lumbar puncture.     d.      CSF Rhinorrhea following head injury.    

123.   2. Plan of alternative nursing interventions in a given situation: in order to provide need based care the nurse plan’s alternative nursing interventions, as in case of air way obstruction the student nurse is expected to, a.      Keep the patient in side lying position. b.      Do oropharyngeal  suction. c.      Check and record vital signs. d.      Start oxygen inhalation if required.      e.      Keep the things ready for endotracheal intubation. f.       Assist the doctor in intubating the patient. In order to assess certain practical skills, the OSPE is organized in the form of several stations through which the candidate rotate to complete one full round.

124. TYPES OF STATIONS Sl No. Stations Question Method of scoring 1 Procedure station Check and record BP Observed and scored by the examiner A using checklist 2 Question station List 5 factors which help in maintaining BP Answer on a sheet provided 3 Procedure station Take oral temperature and record it Observed and scored by the examiner B 4 Question station Convert 39 degree C to F by using formula Answer on a sheet provided 5 Procedure station Test the urine albumin and record it Observed and scored by the examiner C 6 Question station List 5 causes of albuminuria  Nursing Path Answer on a sheet provided

125. HOW TO SCORE STUDENTS IN OSPE? For each specific skill, a checklist is prepared by breaking the skill being tested into essential steps and scores is assigned to each step which is proportional to the importance of the steps related to a particular procedure. The objectivity in assessment is achieved by getting each component tested at one particular station by the same examiner and have the students rotate through all the students. The time allowed is same for all the stations 3-5 minutes is the length of time allocated to each station.

126. ADVANTAGES Helps us to observe and assess student for different professional and clinical skills. Enables us to have an overall view of the student’s performance. Simulations of real life situations.   Controlled and safe.    Nursing Pa Feedback from actors (simulators). Ready availability when required. Stations can be tailored to level of skill to be assessed. Scenarios that are distressing to real patients can be simulated.

127. DISADVANTAGES It is subjective as the student’s score depends on the whims, fancies and moods of the examiner. It is time consuming and there is a lack of standardized conditions in bedside which affects student’s score. The idealized ‘textbook’ scenarios may not mimic real life situation. May not allow assessment of complex skills. Cost. Training issues in setting up the stations.

128. STUDENT'S INSTRUCTION REGARDING OSPE Write your roll no. in bold figures and display it on your white coat so that the examiner can identify the candidate. Student’s are asked to report at a particular time, all of them are collected in a room or hall and explained the procedure of examination.         Student’s may be given instructions that they will rotate around station (numbered    1 – 6) spending 3 minutes at each station.

129. CONCLUSION Because OSCE have been shown to be feasible and have good reliability and validity, their use has become widespread as the standard for performance based assessment, particularly an undergraduate examinations.

130. objective structured clinical examination ( OSCE) DEFINITION OF OSCE “A multi dimensional practical examination of clinical skills , as a tool for assessing clinical competence” PURPOSES OF OSCE 1.Use in both formative and summative assessment in health profession education 2.Identify objective performance criteria for the skill being examined 3.structured the performance criteria in checklist to facilitate the identification of desired clinical skill 4.A requirement for accreditation in many health professional programs

131. USES OF OSCE • Interpersonal and communication skills • History-taking skills • Physical examination of specific body systems • Mental health assessment • Clinical decision making, including the formation of differential diagnosis • Clinical problem-solving skills . Interpretation of clinical findings and investigations. Management of a clinical situation, including treatment and referral Patient education . Health promotion. Acting safely and appropriately in an urgent clinical situation. Basic and advanced nursing care procedure practices.

132. ORGANIZING THE OSCE • The OSCE examination consists of about 10-15 stations, each of which requires about 4-5 minutes. The number of stations and time spent on each station may vary based on needs of evaluation. • All stations should be capable of being completed in the same time. • The students are rotated through all stations and have to move to the next station at the signal. • As the stations are generally independent, students can start at any procedure stations and complete the cycle •Thus, using 15 stations of 4 minutes each, 15 students can complete the examination within 1 hour. • Each station is designed to test a component of clinical competence.

133. Problems of using OSCE in the Indian scenario • Lack of feasibility due to time constrains. • Shortage of training for use of OSCE. • Shortage of observers/examiners. • Lack of interest in examiners. • Lack of enforced guidelines for practical examination by universities number of students examined and format of evaluation used

134. Advantages of OSCE 1.More valid than the traditional approach to clinical examinations. 2.Examiners can decide in advance what is to he tested and can then design the examination to test these competencies. 3.Examiners can have better control on the content and complexities. 4. Emphasis can be moved away from testing factual knowledge to testing a wide range of skills including advanced clinical skills. 5.More reliable because variables of the examiner and the patient are removed to a large extent. 6. The use of checklists by examiners and the use of multiple choice questions results in a more objective examination. 7. More practical because it can be used with a large numbers of students.

135. DISADVANTAGES OF OSCE Demanding for both examiners and patients. Examiners are required to pay close attention to students repeating the same task on a number of occasions. The time involved in setting up the examination is greater than for the traditional examination.   CONCLUSION The OSCE has several distinct advantages. In view of these, the nurse educators can adopt it as an objective method for clinical evaluation. This will help the students to improve their clinical competence. The emphasis is on assessing what students can do rather than what they know. Therefore, O S C E gives direction for attaining the ultimate aim of the teaching- learning process

136. Attitude Attitude is defined as the predisposition to respond to an idea or object. For instance, in marketing it relates to the consumer’s predisposition to respond to particular product or service Attitudes are Composed of • Beliefs about the subject • Emotional feeling (like or dislike) • Readiness to respond behaviorally • It is complex and not fully understood • It can be changed but they tend to persist • It tends to focus on beliefs • None of the existing devices is very accurate Indicators of Attitude How do we know if someone has positive attitude towards Ice Cream. ➢Behaviour (She rats it) ➢Affective reaction (She likes eating it) ➢Self report (She tells us she likes it) ➢Peer report (she tells us she likes it) ➢Physiological measures (heart rate)

137. SEMANTIC DIFFERENTIAL SCALE Semantic differential scale or the S.D. scale developed by Charles E. Osgood, G.J. Suci and P.H. Tannenbaum (1957), I s an attempt to measure the psychological meanings of an object to an individual. is a scale used for measuring the meaning of things and concepts.

138. T his scale is based on the presumption that an object can have different dimensions of connotative meanings which can be located in multidimensional property space, or what can be called the semantic space in the context of S.D. scale. This is a rating scale that can measure respondent attitudes towards ideas, concepts, items, people, and events. -When the evaluator employ semantic differential questions the data gathered can give a powerful picture of the respondent’s attitude toward the subject being studied. The scale is set up using polar adjectives at each end.

139. Osgood and others did produce a list of some adjective pairs for attitude research purposes and concluded that semantic space is multidimensional rather than unidimensional. They made sincere efforts and ultimately found that three factors, viz., evaluation, potency and activity, contributed most to meaningful judgements b y respondents.

140. This scaling consists of a set of bipolar rating scales, usually of 7 points, by which one or more respondents rate one or more concepts on each scale item.

141. Procedure Various steps involved in developing S.D. Scale are as follows : First of all the concepts to be studied are selected. The concepts are usually chosen by personal judgement, keeping in view the nature of the problem. The next step is to select the scales bearing in mind the criterion of factor composition and the criterion of scale’s relevance to the concepts being judged (it is common practice to use at least three scales for each factor with the help of which an average factor score has to be worked out). One more criterion to be kept in view is that scales should be stable across subjects and concepts. Then a panel of judges are used to rate the various stimuli (or objects) on the various selected scales and the responses of all judges would then be combined to determine the composite scaling.

142. Tips for doing layout for Semantic Differentials To avoid fatigue or boring the respondent, do not use more than 20 lines, and 10-12 adjective pairs is better. Do not put all the "good" adjectives on one side, as it might bias the responses Provide clear instructions for the respondent so that they put their marks in the right place.

143. Advantages S.D. has a number of specific advantages. It is an efficient and easy way to secure attitudes from a large s ample. These attitudes may be measured in both direction and intensity. The total set of responses provides a comprehensive picture of the meaning of an object, as well as a measure of the subject doing the rating. It is a standardized technique that is easily repeated, but escapes many of the problems of response distortion found with more direct methods.

144. ATTITUDE SCALE  To assess the attitude or belief of an individual  Designed to measure attitudes of a subject or group of subject towards issues, institution, and groups of people.  “An attitude may be defined as a learned emotional response set for or against something” Barr, David, Johnson Meanings of attitude  Thurstone defines an attitude as the degree of positive or negative affect associated with some psychological objects.  Concept attitude denotes the “sum total of a man’s inclinations and feelings, prejudices or bias, ideas, tears about any specific topic.”  Attitude continuum extending from favourableness through neutral to unfavourableness.

145. ATTITUDE SCALE According to frerman (1965) there are three assumption upon attitude scale;  The scale should deal with a controversial question  An individual’s feelings and insights is regard to the question will determine his responses to various statements  The statements can be scaled regarding the degree to which the favour are opposed to question under consideration Assumptions

146. CHARACTERISTICS  It provides for quantitative measure on a uni -dimensional scale of continuum.  It uses statements from the extreme positive position to extreme negative position.  It generally uses a five point scale as: Strongly agree(SA), Agree(A), Undecided(U),Disagree(D) and Strongly disagree(SD). The individual gets the score as the sum of item credits.  It is usually standardized and norms are worked out  It disguises the attitude object rather than directly asking about the attitude on the subject

147. PURPOSE In educational research , these scales are used especially for finding the attitudes of persons on issues like co-education, religions education, democracy in schools etc depending upon the need of the situation. Some Attitude Scales Methods of measuring attitudes indirectly, used for research purposes are;  Thurstone Technique  Likert’s Method of summated Rating  Guttman’s scale

148. THURSTONE’S TECHNIQUE Attitude is accepted as an uni -dimensional linear continuum. A large number of statements of various shades of favourable and unfavourable opinions. large number of judges exercising complete detachment sort out into eleven piles ranging from the most statements to the most favourable ones. First category each judge places the statements considers most favourable to the object. Second ,those considered next most favourable. Eleventh category considers most unfavourable . Tabulations are made which indicate the number of judges who placed each item in each category. Calculating cumulated proportions for each item and ogives are constructed. Median of the frequency distribution in which the scores range from 0 to 11   Thurstone’s technique is also known as the technique of ‘equal appearing intervals’ statements Scale value

149. LIKERT’S SCALE Subject’s response to each item may be considered as his or her rating of attitude on a 5- point scale. Strongly agree(SA), Agree(A), Undecided(U),Disagree(D) and Strongly disagree(SD). The individual gets the score as the sum of item credits. Collection of a number of statements about the subject. Items that to be either definitely favourable or definitely unfavourable to the attitude All favourable statements are scored from the maximum to minimum. From a score of 5 to 1or 5 for strongly agree and so on 1 for strongly disagree. Total of these scores on all items measures a respondents favorableness. Eg : scale consists of 30 items , the following score values 30*5=150 ( most favourable response) 30*3=90 (neutral attitude) 30*1=30 (most unfavourable attitude) It is thus known as a method of summated ratings. Subject’s response to each item may be considered as his or her rating of attitude on a 5- point scale and the total score is obtained after all these weights are summated , the method is known as SUMMATED RATINGS .

150. GUTTMAN SCALE Guttman applied this model in 1941 that each statement has an idea relationship of one type or another with the exacting measurement of the attitude. Study in investigating a youngsters attitude to career. The item in the questionnaire which following. 1. Military career is an attractive and progressive career. yes no 2. Multinational companies pay a heavy salary yes no Any set of items that produces a pattern of responses is called Guttman Scale.

151. Procedures ( i ) As a first step, the researcher collects a large number of statements which are relevant to the attitude being studied and each of the statements expresses definite favourableness or unfavourableness to a particular point of view or the attitude and that the number of favourable and unfavourable statements is approximately equal. (ii) After the statements have been gathered, a trial test should be administered to a number of subjects. In other words, a small group of people, from those who are going to be studied finally, are asked to indicate their response to each statement by checking one of the categories of agreement or disagreement using a five point scale as stated above. (iii) The response to various statements are scored in such a way that a response indicative of the most favourable attitude is given the highest score of 5 and that with the most unfavourable attitude is given the lowest score, say, of 1.

152. Procedures (iv) Then the total score of each respondent is obtained by adding his scores that he received for separate statements. (v) The next step is to array these total scores and find out those statements which have a high discriminatory power. For this purpose, the researcher may select some part of the highest and the lowest total sc ores, say the top 25 per cent and the bottom 25 per cent. These two extreme groups are interpreted to represent the most favourable and t he least favourable attitudes and are used as criterion groups by which to evaluate individual statements. This way we determine which statements consistently correlate with low favourability and which with high favourability . (vi) Only those statements that correlate with the total test should be retained in the final instrument and all others must be discarded from it .

153. Advantages (a) It is relatively easy to construct the Likert-type scale because Likert-type scale can be performed without a panel of judges. (b) Likert-type scale is considered more reliable because under it respondents answer each statement included in the instrument. (c) Each statement, included in the Likert-type scale, is given an empirical test for discriminating ability and the Likert-type scale permits the use of statements that are not manifestly related (to have a direct relationship) to the attitude being studied. (d) Likert-type scale can easily be used in respondent- centred and stimulus- centred studies i.e., through it we can study how responses differ between people and how responses diff er between stimuli. (e) Likert-type scale takes much less time to construct, it is frequently used by the students of opinion research.

154. Limitations we can simply examine whether respondents are more or less favourable to a topic, but we cannot tell how much more or less they are. There is no basis for belief that the five positions indicated on the scale are equally spaced. The interval between ‘strongly agree’ and ‘agree’, may not be equal to t he interval between “agree” and “undecided”. This means that Likert scale does no t rise to a stature more than that of an ordinal scale, One further disadvantage is that often the total score of an individual respondent has little clear meaning since a given total score can be secured by a variety of answer patterns. It is unlikely that the respondent can validly react to a short statement on a printed form in the absence of real-life qualifying situations. Moreover, there “remains a possibility that people may answer according to what the y think they should feel rather than how they do feel.”

155. LIMITATIONS OF ATTITUDE SCALE  An individual may conceal his real attitude and express socially acceptable opinions only.  An individual may not really know how he feels about a social issue.  An individual may not be able to express his attitude towards a situation in abstract.  It is unlikely that the statements are of equal value in forness or againstness

156. CLINICAL EVALUATION METHOD INTERNAL ASSESSMENT SELF REPORTING AND SELF ASSESSMENT

157. Characteristics of Good Evaluation Instrument

158. Validity  The validity of a test may be defined as the accuracy with which the test measures what it purports to measure.  According to Garrett, “The validity of a test depends upon the fidelity with which it measures what it intends to measure”  Every test is constructed for some specific purpose, and it is valid only for that purpose.

159. Method of Determining validity of a test

160. Reliability Reliability of a test is the consistency with which the test measures whatever it does measure. A reliability test is a thrust worthy test. A reliability test should yield essentially the same (or almost same) scores when administered a second time to the same pupils, provided no learning or forgetting has taken place between the periods of the two testing. The degree of reliability is usually denoted by a coefficient of correlation / reliability coefficient

161. Objectivity

162. Discrimination Power A test should be able to discriminate the respondents on the basis of the phenomena measured. • Here Bad items are eliminated and good items are retained. • A good item is one which is attempted successfully by 50% children. • A good item must discriminate between superior children and backward children. • Suppose an item is successfully answered by all children, that item is a bad item with no discrimination power

163. Method of Discrimination Power Divide the group which pilot sampling is applied into two groups, upper and lower groups. Take the item, say, item number one, and find out how many of upper group have done it correctly. Find out how many of the lower group have done it correctly Convert the difference in the number of correct responses from two groups into an index, using the formula D.P = U- L/N , U and L are the number of correct responses in the upper and lower groups, N is the number of cases in each group If discrimination power is very low and very high it is eliminated The discrimination power ranging between 0.4 to 0.8 are included in the test. Now the test is ready

164. Practicability : If all the criteria is satisfied to conduct a test, but from the practical point of view, it may not be possible to conduct such a test. Economy of time, effort, number of personnel and finance required also has to be of utmost concern for the planner of a test. Comparability : A test possesses comparability when the scores obtained by administering can be interpreted in items of a common base that has a natural or accepted meaning. Two methods for establishing comparability are: (a) Making available equivalent forms of a test (b) Making available adequate norms Utility : A test has utility if it provides the test conditions that would facilitate realization of the purpose for which it is meant. For achieving utility it is essential that the test is constructed in the light of well-through-out purpose and its interpretations are used in obtaining desirable results

165. Objective - Basedness Evaluation is making judgement about some phenomena or performance on the basis of some pre-determined objectives. Therefore a tool meant for evaluation should measure attainment in terms of criteria determined by instructional objectives. This is possible only if the evaluator is definite about the objectives, the degree of realization of which he is going to evaluate. Therefore each item of the tool should represent an objective. Comprehensiveness: It refers to the degree to which a test contains a fairly wide sampling of items to determine the objectives or abilities so that the resulting scores are representatives of the relative total performance in the areas measured. Adequacy : Adequacy of a test means sufficiency and suitability of that test. A good test should include items measuring the objectives and content.

166. CONSTRUCTION AND ADMINISTRATION OF ACHIEVEMENT TEST

167. Planning an Achievement Test Maximum time:- 40-45 mts Maximum marks:-20- 25 marks Nature of the test:- test conducted at the end of a terms, a semester or a session Developing test design The objective Content Form of question Weightage of difficulty levels

168. WEIGHTAGE TO INSTRUCTIONAL OBJECTIVES Sl.No Objective Marks Percentage 1 Knowledge 10 20 2 Understanding 20 40 3 Application 8 16 4 Analysis 5 10 5 Synthesis 5 10 6 Evaluation 2 4 Total 50 100 WEIGHTAGE TO CONTENT AREAS Sl.no Subunit marks Percentage 1 I 15 20 2 II 10 40 3 III 10 16 4 IV 5 10 5 V 10 10 Total 50 100

169. Weightage To Form Of Questions Sl.No Form Of Questions No. Of Questions Marks Percentage 1 Objective Type 25 25 50 2 Short Answer Type 5 15 30 3 Long Answer Type 1 10 20 Total 31 50 100 Weightage To Difficulty Level Sl.No Level Of Difficulty Marks Percentage 1 Easy 10 20 2 Average 30 60 3 Difficult 10 20 Total 50 100

170. Scheme of option: No option Scheme of sections: Sec A & B .Sec –A includes all objective type and Sec-B include short answer and Essay type Guidelines for preparing test designs are Should reflect the predetermined objectives No rule regarding the number of subunits and number of questions under each form Weightage of content depends on the total content area Weightage to form of questions depends on the nature of content and possibility of coverage 60% of item of average difficulty with 20 % on either side is distributed to the student level Modern trend is to avoid option

171. Preparation of blue print for test Blue print for the test is prepared as three dimensional chart including the distribution of questions, objective wise, content wise and form wise Test Blue Prints For Unit On Oxygenation Content Knowledge/ Comprehension Level Of Knowledge Application Analysis Synthesis Evaluation Total Items Principles 2 2 2 6 Factor affecting 3 3 4 10 Pathophysiology 3 3 4 10 Assessment 1 3 4 2 10 Nursing measure 3 3 4 10 Evaluation of care 1 1 2 4 Total items 9 15 18 8 50

172. Construction of item: Blue print dives very definite idea regarding the number of questions to be set from each subunits, their form and scope While setting the questions and final selection, try to maintain the weightage of difficulty level suggested by the design Check whether sufficient time is their to answer all the questions

173. Organization of test Preliminary details such as name of the examination, max. mark and time, instructions for answering the questions should be given at appropriate place Psychologically arrange the questions in order of difficulty level Hierarchical order of the objectives as given in the taxonomy of objectives is the indication of difficulty level Information item is easier than understanding item which is again easier than application item

174. Preparation for scheme of evalaution Make scoring strictly in accordance with predesigned scheme of evaluation In case of objective- type items, a scoring key showing number of the questions and its correct answer is to be prepared. Point method is used to evaluate short answer type Point method or rating method is used to evaluate the essay questions

175. Test administration Steps to be followed in administration of group tests are Motivate the students to do their best Follow the directions closely Keep time accurately Record any significant events that influence the test scores Collect the test materials promptly

176. Principle The guiding principles in test administration are All students should be given fair chance to demonstrate their achievements of the learning outcomes being measured Physical and psychological conducive environment should be provided Avoid being anxious and tense during the test which might interfere their test performance Reassure the students by word and deed that these test will improve their learning Assure them that time limit are enough to complete their tests Thus assure that test is going to improve learning and time limits are adequate

177. Things to avoid Do not talk unnecessarily before the test Keep interruptions to a minimum during the test Avoid giving hints to pupils who ask about individual items Discourage cheating

178. Bibliography Neeraja K P. Textbook Of Communication And Education Technology For Nurses.1ST edition. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2011. PAGE NO: 659- 702 Sankaranarayanan B. Learning & Teaching Nursing. Calicut: Brainfill Publications;2003 PAGE NO: 175 R.Sudha Nursing education principles and concepts , jaypee publications 1st edition page no ;357-362 Basavanthappa B.T. Nursing Education. 2ND edition. New Delhi: Jaypee Brothers Medical Publishers (p) Ltd; 2009. PAGE NO:126-154 Pramilaa R. Nursing communication and educational technology. 1st edition. New Delhi: Jaypee brothers medical publishers (p) Ltd; 2010. PAGE NO: 142-156 Online Library.wiley.com/journal/10.1111/(ISSN)1467- 9752 www.ncbi.nlm.nih.gov .pubmed