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S J van Luijk

Publications and source records attributed to S J van Luijk.

4 recordsLinked to original sources
PubMed2001

Assessment in problem-based learning (PBL).

Problem-based learning (PBL), a relatively new approach to teaching, has been introduced in several of the medical schools in the Southeast Pacific region. This approach emphasises active, self-directed learning and puts the emphasis on the individual student and his/her role in the educational process. It is well known that assessment plays a large role in influencing student learning behaviour. Therefore, it is important that the assessment process not hamper learning or adversely affect attainment of the goals of the curriculum. If student behaviours are directed toward achieving success on the assessments, instructors' efforts to create a climate of self-directed learning and individual responsibility will be frustrated. This article provides information on the different classes of assessment vehicles available to assess the various domains of medical competence. We pay special attention to the critical relationship between the educational goals of problem-based learning and the different assessment instruments used. We briefly describe some assessment instruments and how it can relate to these goals in a positive manner. We conclude that no assessment instrument is ideal and that each has unique inherent deficiencies. As a consequence, a successful student assessment process requires use of several complementary instruments.

Clinical Competence↗
PubMed2000

Sequential testing in the assessment of clinical skills.

PURPOSE: Educators who use standardized-patient-based (SP-based) tests may save resources by using sequential testing. In this approach, students take a short screening test; only those who fail take a second test. This study investigated whether sequential testing increases efficiency with only a minor decrease of validity. METHOD: In 1994-95, first- through fourth-year (Group 1) and sixth-year (Group 2) medical students at the University of Maastricht took SP-based tests. Each test took two days. In a simulation experiment based on the data from those tests, the authors considered the first day as the screening test and the second day as the second test. They investigated efficiency and validity as a function of the cutoff score of the screening test. They developed and evaluated a new method to determine the optimum cutoff score of the screening test, a method based on minimization of the loss represented by the (weighted) numbers of false positives and negatives in the screening test. RESULTS: The negative predictive value (probability that a student would fail the complete test if he or she had failed the screening test) was low (<60%), while the positive predictive value was high (>96%). Accordingly, stringent pass/fail cutoff scores in the screening test (75% for Group 1 and 80% for Group 2) produced optimum results. Using those cutoff values, only 26% and 11% of 'the students would have had to take the complete test to get a "true" score, while only 0.2% and 0.0% of the students who passed the screening test went on to fail the complete test (false positives). CONCLUSIONS: In a sequential SP-based test, the pass/fail cutoff score of the screening test should be stringent. This can considerably reduce testing time (30% to 40%), while keeping the percentage of false positives at an acceptably low level of less than 0.2%. As an alternative to receiver operator characteristic analysis, minimization of the loss function was found to be an appropriate method to determine the optimum cutoff value of the screening test.

Clinical Competence↗
PubMed1995

Assessment of competence in technical clinical skills of general practitioners.

Technical clinical procedures constitute an important part of the work of general practitioners. Assessment of competence in the relevant skills is important from the perspective of quality assurance. In this study, the psychometric characteristics of three different methods for assessment of competence in technical clinical skills in general practice were evaluated. A performance-based test (8 stations), a written knowledge test of skills (125 items) and a self-assessment questionnaire (41 items) on technical clinical skills were administered to 49 GPs and 47 trainees in general practice. The mean scores on the performance-based test and the written knowledge test of skills showed no substantial differences between GPs and trainees, whereas the GPs scored higher on the self-assessment questionnaire. While the correlation of the score on the knowledge test of skills with the score on the performance-based test was moderately high, the score on the self-assessment questionnaire showed a rather low correlation with the performance-based test. Although performance-based testing is obviously the best method to assess proficiency in hands-on skills, a written test can serve as a reasonable alternative, particularly for screening and research purposes.

Clinical Competence↗