Entrustability of professional activities and competency-based training.
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Clinical Competence↗
Biomedical subjects
Olle ten Cate
Publications and source records attributed to Olle ten Cate.
Generalizability of a study sample assessment procedure for entrance selection for medical school.
To optimize the validity of instruments for the selection of students for admission to medical school a close resemblance between selection criteria and activities in medical school and patient care is proposed. A study sample assessment procedure (SSAP), focusing on independent studying, collaboration with peers and providing information to standardized patients, was designed and has been applied as a selection tool at UMC Utrecht Medical School since 2001. The interviews with standardized patients are observed and rated on the quality of information provided and the quality of communication. This study investigates the psychometric properties of this observational procedure. Generalizability theory was applied to estimate the reliability of the SSAP and to compare it with other procedures carried out in the same populations, such as the rating of application forms and a structured interview procedure. Data from three years were analysed. The G-coefficients for the SSAP (0.84 to 0.90) were higher than those for the interview and the application form (0.74 to 0.83 and 0.53 to 0.61 respectively). In conclusion, the SSAP appears to be a feasible and reliable procedure. The number of raters could, if necessary, be reduced from three to two.
College Admission Test↗
Orienting teaching toward the learning process.
Based on developments in educational psychology from the late 1980s, the authors present a model of an approach to teaching. Students' learning processes were analyzed to determine teacher functions. The learning-oriented teaching (LOT) model aims at following and guiding the learning process. The main characteristics of the model are (1) the components of learning: cognition (what to learn), affect (why learn), and metacognition (how to learn); and (2) the amount of guidance students need. If education aims at fostering one's ability to function independently in society, an important general objective should be that one learns how to fully and independently regulate his or her own learning; i.e., the ability to pursue one's professional life independently. This implies a transition from external guidance (from the teacher) through shared guidance (by the student together with the teacher) to internal guidance (by the student alone). This transition pertains not only to the cognitive component of learning (content) but also to the affective component (motives) and the metacognitive component (learning strategies). This model reflects a philosophy of internalization of the teacher's functions in a way that allows optimal independent learning after graduation. The model can be shown as a two-dimensional chart of learning components versus levels of guidance. It is further elaborated from learners' and teachers' perspectives. Examples of curriculum structure and teachers' activities are given to illustrate the model. Implications for curriculum development, course development, individual teaching moments, and educational research are discussed.
Cognition↗
Educational assessment center techniques for entrance selection in medical school.
OBJECTIVE: Dutch higher education is freely accessible for those who have proper high school qualifications. However, admission to medical schools has been limited by government to regulate manpower planning. Selection has been carried out by a national lottery approach since 1972, but in 2000, the Dutch government asked medical schools to experiment with qualitative selection procedures at their own institutions. The University Medical Center Utrecht School of Medical Sciences has used a technique derived from assessment-center approaches to assist in the medical school admission process. Dutch assessment centers use observation procedures in which candidates act in simulated activities that are characteristic of the vacant position. DESCRIPTION: In April 2001, 61 candidates for 23 places were invited for selection days. After a selection interview, candidates were asked to perform activities that are characteristic of course requirements: (1) studying a three-to-five page text about diagnostic and therapeutic procedures of disease A during one hour; (2) explaining the studied procedures to another candidate and receiving information about disease B, studied by this other candidate, during one hour; (3) answering the questions of a standardized patient about disease A in 15 minutes; and (4) answering the questions of a standardized patient about disease B in 15 minutes. A three-person selection committee behind a one-way screen observed the two 15-minute interviews with the standardized patients. The selection committee independently scored content quality of the information that was given to the standardized patients as well as the quality of attitude towards and communication with both patients. The average scores for these three criteria were weighted equally to arrive at a total score. In addition, each candidate received a score resulting from the interview with the other candidate who explained disease B. This score was combined with the other three to a final score. DISCUSSION: The Utrecht medical curriculum may be viewed as a hybrid PBL program. Integration of basic and clinical sciences, patient contacts from the start, training of skills in communication with standardized patients, physical examination, extensive small-group teaching, structured independent studying, and collaboration to prepare for short presentations to peers were all characteristic of the medical school curriculum. Thus, the assessment-center technique reflected the characteristics of the medical school curriculum. First analyses showed satisfactory reliabilities of the three scores (0.79 to 0.92); the average agreement between raters was 0.60. Correlation analysis between scores supported the internal convergent and discriminant validity of the assessment activities. The predictive validity remains to be studied.
Educational Measurement↗