Chapter 3
Designing Courses for Health Professionals
Part I
Guidebook
CONTENTS
Chapter
1. Defining Competency Based Goals
2. Developing Learning Objectives
3. Linking Evaluation with Objectives
4. Using Evaluation to Design Instructional Activities
5. Planning Sessions
CHAPTER 3
LINKING EVALUATION WITH OBJECTIVES
A. Develop Course Evaluation Activities
B. A Competency Based Evaluation Model
A. Develop a Course Evaluation Activities
Another way of looking at the instructional ladder is to consider the endpoints and checkpoints as evaluation activities or tests which tell the instructor how well students have mastered a given step on the ladder. Objectives, as stated, earlier articulate an instructional intent. We expect that students will meet the objectives. But have they, in fact, met the objectives? Evaluation is our tool for measuring the extent to which students have actually achieved the objectives. Objectives express a hope. Evaluation looks at reality. Figure 6: The Learning Ladder Showing Progress Tests 
Desired student performance G is measured by a Posttest. Entry Level Performance A is measured by an Entry Level Test or a Pre-test. When a Pre-test is used, it is often the same as the Posttest.
The checkpoints B. C, D, E and F are measured by Progress Tests.
Testing Conditions
Examples of testing conditions include:
- a topic or question to discuss
- a procedure to demonstrate
- written questions: multiple choice, true/false, essay
- with or without the use of notes or references
- “in-class” or “take home”
- with or without other people or resources
- self-evaluated, teacher evaluated, evaluated by classmates
- with or without audiovisuals, etc. prepare and deliver a 15 minute talk to…
- demonstrate the correct procedure for..
. – circle correct answers with 80% accuracy…
- take part in a discussion about..
. – play the role of..
. – discuss a solution for..
. – performs on the job skills acquired in the classroom, i.e. cleans wounds, takes sputum tests, diagnoses malnutrition
Assesses the degree to which students perform tasks after instruction.
Posttest
The posttest or final test is often used to grade students, to decide if they are ready to go to the next higher course, or if they should be assigned to a job.
Assesses the degree to which students can perform tasks before instruction.
Pretest
The main reasons for giving a pretest are:
a. to identify students who already meet the objectives, and hence do not need the instruction,
b. to measure how much students have learned from the beginning (pretest) to the end (posttest),
c. posttests and pretests usually include the same or similar items.
A set of conditions used to assess the degree to which students have the skills and knowledge needed in order to begin learning a certain task(s).
Entry Level Test
Note: Both the Entry Level Test and the Pretest are given before instruction begins.
The PRETEST is used to identify students who can already meet the objectives, the ENTRY LEVEL TEST is used to identify students who are/are not ready to begin learning the task.
1. A set of conditions used to assess the degree to which students are learning needed skills and knowledge during instruction.
Progress Test or Check Points
2. A means of checking on student progress and a basis for on-going course revision.
GUIDELINES:
In order to develop your evaluation activities for the course:
1. Use Form 3 below.
2. Specify pre/post test.
3. Specify Entry Test (if applicable)
4. Determine Skill Knowledge Requirements to specify checkpoints or progress tests in terms of conditions and performance.
Form 3: Instructional Objectives/Evaluation
LearningObjective Whengiven..
The Student will be able to:
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Entry Level Performance
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The Student will be able to…
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Evaluation Activity
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EXAMPLE
Form 3: Instructional Objectives/Evaluation
Learning Objective When given…
The Student will be able to: Evaluation Activity for each Objective
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Task 1: Participate in contingency planning for pre-hospital and hospital based emergency response as well as population protection in the event of a radiation accident. |
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Modify standard hospital plan for managing emergency care to the specific needs of radiation casualties. |
Given questions on how each of three types of contingency plans might be adapted to he exigencies of a radiation accident, the student will demonstrate awareness of the elements that need to be modified and the decision process for making changes. |
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Adjust standard procedures for pre-hospital management of emergency care to the exigencies of a radiation accident. |
Given examples of each type of exigency plan that has been modified for use in a radiation accident, the student will: critique the plans and propose changes as appropriate. |
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Adopt health related components of a municipal plan for disaster control for managing he consequences of a radiation accident. |
Given examples of the 3 types of contingency plans and the characteristics of a possible radiation accident, the student will: adapt each of the plans for use in a radiation accident |
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Task 2: Maintain nuclear preparedness through drills in implementing contingency plans for pre-hospital and hospital care of radiation casualties |
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Collaborate with other emergency medical personnel and administrators in the design of radiation drills. |
Given questions on the purpose, methods and potential outcomes of radiation drills, the student will demonstrate knowledge about the role of drills in maintaining nuclear preparedness, the components of a drill, how it is organized and implemented and the debriefing process. |
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Participate in the drills according to the role(s) assigned. |
Given a depiction in print or through video or a radiation drill, the student will critique the performance of participants in the drill; propose, if appropriate, how performance might be improved. |
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Critique both the contingency plans and the performance of participants in the drill. |
Given a simulated radiation drill the student will perform in the role assigned. |
Learning Objective When given…
The Student will be able to: Evaluation Activity for each Objective
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Task 3: Protect emergency personnel against exposure to radiation |
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Wear appropriate protective clothing |
Given questions concerning the need for protection, consequences of inadequate protection and methods of protection. The student will demonstrate knowledge about the type of protection needed under different circumstances and methods to ensure adequate protection. |
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Use a self-reading dosimeter to monitor personal cumulative exposure to radiation |
Given a drill situation The student will critique the measures taken for the protection of personnel Propose, if appropriate, adequate measures. |
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Limit time of exposure to radiation |
Given a drill situation The student will perform adequately in the personnel protection component of the drill |
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Task 4: Detect measures and asses the potential consequences of acute exposure to high levels of ionizing radiation |
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Differentiate between incidents of external radiation and contamination with nucleotides |
Given questions about a. the use of survey meters and dosimeters and b. anticipated health related consequences at different levels of exposure, The student will demonstrate understanding about how survey meters work and are used and what impact on health might be expected from exposure to specified levels of radiation. |
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Measure exposure to ionizing radiation using survey meters and personal dosimeters |
Given a. a portable survey meter, b. a treatment room and a mannequin contaminated with low but measurable levels of short lived radio nucleotides, c. small encapsulated sources simulating spot contamination, The student will perform a survey to locate areas of contamination, determine their relative intensity and identify the type of radiation being emitted by the source. |
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Assess the potential effect on health of measured levels of radiation |
Given a self reading dosimeter (SRD) The student will demonstrate its use including interpreting the SRD scale and estimating the dose received from the SRD reading. |
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Given a drill situation, The student will perform adequately in the dosimetric component of the drill. |
Learning Objective When given…
The Student will be able to: Evaluation Activity for each Objective
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Task 5: Broaden diagnostic procedures to incorporate detection of contamination and injury due to radiation. |
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Detect signs and symptoms of possible radiation injury (including acute radiation syndrome) on the initial and subsequent patient assessments. |
Given questions concerning the sings and symptoms of different manifestations of radiation injury, The student will demonstrate a knowledge of how to use the patient history and physical examination as well as clinical laboratory and health physicists to make a diagnosis of radiation related injuries. |
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Use clinical laboratory and health physics tests and procedures to identify physical and biological evidence of radiation injury. |
Given case histories of patients with radiation injuries (in print, slides and video), The student will make a diagnosis on differential diagnosis for each case |
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Given a drill situation, The student will perform adequately in the diagnostic component of the drill. |
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Task 6: Modify capabilities for emergency care to include radiological isolation, decontamination and other methods of limiting the spread of radioactive contamination |
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Establish and maintain complete segregation of contaminated and non-contaminated patients, personnel and supplies. |
Given a set of questions on the rationale and methods of isolation precautions, The student will demonstrate an acceptable level of knowledge. |
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Given the schematic floor plan and description of a staffing pattern for a hospital emergency unit or a visit to a hospital emergency unit and a description of possible circumstances under which radiation accident victims are transported to the hospital, The student will describe a. the reconfiguration of space and b. operational procedures to be followed in order to ensure adequate isolation conditions. |
Learning Objective When given…
The Student will be able to: Evaluation Activity for each Objective
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Given a drill situation, The student will perform adequately in the patient isolation component of the drill. |
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Carry out decontamination of victims of a radiation accident. |
Given a set of questions on the purpose, rationale and methods of radiological decontamination of patients, The student will demonstrate an acceptable level of knowledge. |
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Given short case histories, in print or on video describing: a patients with different types of radioactive contamination b. measures for decontamination that were taken, The student will a. critique the way in which decontamination was carried out; b. propose alternative ways which might be more appropriate. |
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Given Short case histories ink, print, or on video describing patients with different types of radioactive contamination, The student will propose ways of carrying out decontamination. |
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Given A simulated patient (or mannequin) with manifestations of internal or external contamination and equipment and supplies needed for decontamination, The student will implement (or describe ) decontamination procedures that are appropriate to the type of radioactive contamination manifested. |
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Given A drill situation The student will perform adequately in the patient decontamination component of the drill. |
Learning Objective When given…
The Student will be able to: Evaluation Activity for each Objective
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Task 7: Implement treatment for both medical and radiological emergencies |
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Set priorities for emergency intervention that reflect both medical and radiological considerations. |
Evaluation options for each of the five learning objectives under task 7 can be patterned on those described for the other seven tasks included in the job description. Each can be approached at successive levels of simulation including performance in a radiation drill. |
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Initiate when indicted, prompt treatment for internal contamination. |
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Use surgical techniques that minimize the probability of self-cross contamination. Carry out measures for systematic decontamination |
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Initiate supportive intervention for nausea, vomiting and other possible manifestations of acute radiation syndrome |
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Task 8: Supplement medical records by radiological documentation. |
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Log information concerning exposure levels, medical consequences and interventions for radiation related problems. |
Given questions about the categories of radiological information to log and when and where it should be recorded, The student will demonstrate knowledge concerning appropriate documentation of radiological information in a radiation accident. |
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Start an acute radiation syndrome patient flow chart, when appropriate. |
Given forms provided by hospitals and other competent authorities for documenting radiological information in the event of a radiological accident, The student will initiate a patient flow chart for each case. |
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Complete forms as required by hospital and public health authorities. |
Given case histories in print of patients with possible prodromal manifestations of acute radiation syndrome, The student will complete the forms correctly in a manner that the information can be utilized. |
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Given a drill situation, The student will perform adequately in the documentation component of the drill. |
Learning Objective When given…
The Student will be able to: Evaluation Activity for each Objective
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Task 9: Communicate with victims of radiation professional associates and the general public. |
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Reduce anxiety and fear associated with radiological injury. |
Given staff/students role playing radiation casualties with different patterns of injury, The student will explain to the patient the nature of his/her injury and how it will be treated. |
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Transmit radiological information needed by medical associates and non-medical counterparts to function effectively. |
Given examples of requests (oral and in writing) from hospital administrators for information about he medical consequences of a radiation accident, The student will provide accurate and succinct details such as number of injured, extent of radiological injuries and levels of contamination. |
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Participate in informing the public about health related aspects of a radiation accident. |
Given a description of the medical aftermath of a radiation accident and staff/students role playing members of the public requesting information, The student will provide the information without generating undue alarm |
Entry Level Performance
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Completion of the pre-requisite test at least one week prior to the beginning of the course is required. Applicants whose knowledge and/or skills are screened as inadequate may be offered remedial lessons prior to or in conjunction with the course.
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Evaluation Activity Given an objective test sampling basic knowledge in key areas of emergency medical care, The student will demonstrate a level of knowledge sufficient to benefit from participation in a course on nuclear preparedness. |
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Given a list enumerating basic skills in emergency medical care, The student will indicate
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B. A Competency Based Evaluation Model
Figure 7 is a diagram of the competency based curriculum development and evaluation process. The lines and arrows show decisions which must be made. For example, if a student fails the entry level test, he/she should receive special help and than take the entry level test again.
Figure 7: Planning Evaluation
REVIEW AND SELF-CHECK Examine your COURSE DESCRIPTION, JOB DESCRIPTION and COURSE EVALUATION PLAN. Before going further check (™ ) to make sure you have completed the following. FOR EACH TASK: ( ) 1. Specified pre/post testing that match on-the-job conditions and performance to the extent possible, given the course constraints and resources. ( ) 2. Specified plans to evaluate entry level skills and knowledge before instruction. FOR ALL TASKS: ( ) 3. Combined and eliminated certain evaluation activities, where two or more tasks require the same skills and knowledge.
