Assessment of Attitudes, Ethics and Communication Skills in a Competency-Based Undergraduate Medical Curriculum

Abstract

Affective learning outcomes are difficult to objectively analyse and assess as they refer to feelings and internal processes of the mind and heart. These cannot be quantified by traditional testing methods. The available methods rely on qualitative self-reflection and the observation of simple to complex internally consistent qualities of character. Just as in the other domains of learning, the validity and reliability of these assessments need to be ensured. The assessment of the affective domain requires careful observation of specified behaviours by multiple observers. Miller’s pyramid, Krathwohl’s levels and Epstein’s conceptual frameworks can be used to devise suitable assessment plans for the complex and varied competencies in this domain. Many techniques including paper-based tests, self-administered rating scale, faculty and peer assessment, simulations, reflections, portfolios, observed clinical encounters, collated views of co-workers, record of incidents of unprofessionalism, critical incident reports, patient surveys and global view of supervisor have been used for assessment of affective domain. The effective utilization of these assessment tools needs to factor in the ground realities that exist in different medical colleges. The acceptability and feasibility of using resource intensive assessment methods needs to be carefully balanced against their contributions towards increasing validity and reliability