E 'Controversy on the testing of medicine - some observations from the trenches!
Following the controversy over medical school these days strikes me as a curious asymmetry between the 'entrance exam' is to 'enable', on the one hand, and all other assessments to which medical students in Italy are subject in the 6-year degree course. The former are multiple-choice quiz, the latter almost exclusively 'oral questions'. In common, however, that they are all theoretical. So the time may be propitious to cast his eye on a larger scale on all current systems of evaluation of our future doctors. The question we must ask is this: we are sure that the assessment tools we use today (exams oral quiz) give the right assurances to the Italian public on the expertise of those who graduated in medicine and their ability to practice?
I come to the point. Providing care for the physician is not only a matter of academic skill. In its simplest form, concerns the application of knowledge and scientific knowledge to the problems of sick people, with the result that these people are more desirable. In response to growing demand for guarantees of professionalism in health in Europe and worldwide, the international research of medical education in the last twenty years has provided many new tools of assessment. For example, most medical schools in Europe now believe that almost an ethical evaluation of medical students to focus on their abilities to apply their knowledge and provide care in front of a real patient, to show, in short, what they can 'do' in the context in which they will work, and to be observed and evaluated during the process. Very different, it seems, from the 'tell' just what 'know' in principle to a board of examiners in any classroom in the bowels of a hospital. Well, in Italy categorically resists the latter instrument. Ie a system where the predominant high subjectivity of assessment through oral examinations only theoretical, and no, I say no, pay attention to how the student interacts, communicates, or reason with a sick person in the flesh. Which we know is something else!
If the controversy about the entrance exams will be a remarkable result that in future the way we assess the future doctors will be subject to a systematic comparison not only with Europe, (alas, almost absent from our classrooms), but also with the right expectations of society and institutions. Need to examine the rationale, curriculum elements, places of learning, and especially the instruments used to assess the outcomes of individual students, not only in terms of knowledge. but also in terms of 'competence' with the patient. No shortage of examples from the best European and international schools. First, we must enrich our basket of assessment tools with the most modern tools based on international experience. Second, medical schools must all make the effort to align the evaluation of the student to practical and professional context in which the physician will work and do not keep students glued to the classrooms and away from sick for years and years. Third, the appraiser needs to align the goals of his course with the tools to evaluate not only what the student 'knows', but also what the student can demonstrate can 'do'. In any case, explicit criteria mean more transparency, more reproducibility between a candidate and another, more equitable and less controversy: 'Last but not least' medical evaluations should be more focused on people than they are currently ill. Finally, and finally, only with a scientific and empirical approach to the evaluation we will finally be able to move the debate in Italy the right to access and / or graduate in medicine far more important to guarantee that the new graduates know 'do' and 'be 'Doctors in Italy and Europe. Huon Snelgrove
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