By Karen Bobak, DC, EdD, Dean of Chiropractic Education at New York Chiropractic College
The Value of Measuring Student Competency in Health Care Education
In health care education, professional and accreditation standards are typically established to help identify and clarify critical capabilities of the graduating student or entry level practitioner. Professionals are expected to have the ability to identify problems and to connect appropriate solutions to the situation by utilizing expertise developed in their education. Practical skill training is an instructional method that is incorporated into professional programs to facilitate deeper student learning and support the development expected problem solving abilities. It emphasizes the relationship between knowing information and performing a specialized task. Defining competency and establishing clear criteria for these skills can help to provide greater consistency in evaluating overall student performance and provide more transparency in the curriculum as well as a greater alignment between courses. Competency assessment gauges the student performance against previously defined standards and as such, it is critical that there is regular longitudinal review of program assessment data to verify that competency standards are being met.
The Doctor of Chiropractic Program at New York Chiropractic College utilized a collaborative process of administration and faculty involvement in the development of an overarching program rubric to define competency along specific program milestones. This process required careful thought about what a student was expected to know at each level of the program. This collective, participatory approach helped to generate a better understanding of the problem among stakeholders, allowed for the inclusion of long held institutional values and created greater overall ownership of the rubric. The development of this competency-based rubric was begun by outlining the performance expectations of a graduating student and working backwards, defined milestones for each criterion in the rubric. Additionally, it was critical to identify where in the curriculum students were trained in the competencies and how assessment was accomplished. The collaborative approach allowed for a review of existing instructional and assessment practices from different perspectives. Rather than layering progressive classroom experiences within separate courses, the rubric provides a comprehensive framework to link expected skill development. In addition, it provided an opportunity to define and specifically evaluate critical skills such that success in one essential area should not compensate for lack of ability in another skill.
ExamSoft Assessment Rubrics & Solutions
This new rubric allows the program to be viewed as the sum of its parts and provides the program with data that can be used to evaluate the effectiveness of the curriculum in preparing students for practice. It was important to the development process that resources, including faculty and administrative time, be used efficiently and effectively. As such, assessment data should be collected in a consistent timely manner and be easily accessible for analysis. Without an ability to readily access and review data, identification of problems will be delayed forcing curriculum changes to become reactive rather than proactive. Because of its ability to provide longitudinal data review, ExamSoft was selected as the electronic platform to support the Chiropractic program. Lecture assessments as well as practical and clinical skill assessment rubrics can be tagged to competencies. The process is currently underway to enter the overarching program rubric into the electronic rubric platform with a goal of developing links from existing embedded assessments to further demonstrate alignment with competency expectations.
The work of developing a program competency rubric allows the program to align instructional methods and assessments and to develop a framework where each assessment is tagged to relate back to the relevant competency. In this way, the rubric not only provides a structure for professional expectations, but it also becomes a tool that enables the students to visualize the required levels of their performance. Sharing the rubric with students helps to explain critical details of program expectations and encourages them to become active participants in their education. Students can often get lost or confused about what can appear to them as unrelated pieces of information presented across individual courses. A clearly communicated rubric can provide organization and transparency to the curriculum, allowing students to develop meaning beyond separate instructional topics as they are then able to envision detailed performance goals. By accessing their individual strengths and opportunities report through ExamSoft, students are able to visualize their progress through the curriculum against desired levels of performance and address areas of weakness with advisors in a timely manner. Faculty and mentors are also able to provide students with detailed feedback on their actual performance and develop targeted remediation opportunities.
Professional competence is multifaceted, complex and involves numerous areas of skill development. Because of this, it is important that training and assessment be carefully aligned to developmentally support students as they progress through the curriculum. The task of developing a program rubric and aligning assessment measures to demonstrate compliance is significant. However, the benefits to the institution, the students and the profession are great. Competency based assessment focuses on the developing the students’ knowledge and skills along expected standards and supports learner centered instruction and student achievement. The timely longitudinal reviews to ensure that all instructional topics are covered and aligned to competency expectations as well as the review of student assessment data to identify success and areas of weakness are critical parts of evaluating the effectiveness of the curriculum.