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 U.~
,-

MEDICAL EDUCATION UNIT

NEIGRlHMS
SHILLONG
 .-

t: i ._---. ~-
I
~~~ CONTKI5UTOKS ~~~
Animesh Mishra
animesh.shillong@gmail.com
Md. Yunus
(drmdyunus@hotmail.com)
Yookarin Khonglah
(yookarink@gmail.com)
HAND BOOK
W.V. Lyngdoh
(drval@rediffmail.com) ON BASICS OF MEDICAL EDUCATION
Rituparna Barooah
(drrituparnabarooah@gmail.com)
Tanie Natung
(natungtanie@gmail.com)
Editors
R. Hajong
(ranendrahajong@gmail.com)
Ivfa. 1funus
Himesh Barman 1fooKarin 1<lJOYljfaIJ
(himeshbarman@gmail.com)
Sourabh G. Duwarah
(Sgd7@rediff.com)
Musaraf Hussain
(masarafhussain@yahoo.co.in)
Amitav Sarma
(dramitav2007@rediffmail.com) MEDICAL EDUCATION UNIT
Sharat Agarwal NEIGRIHMS
(drsharat88@yahoo.com) SHILLONG
M. Agarwal
(drmanika89@yahoo.com)
Arup Jyoti Baruah
(arupbaruah06@gmail.com)
Lanalyn Thangkhiew
(Ianalyn@gmail.com)
Abhijeet Bhatia
(abhijeetbhatia77@gmail.com)

,.,
---.••...••..... -

.,
 DISCLAIMER

HAND BOOK ON BASICS OF MEDICAl EDUCATION

This 'Hondbooh on Basics of Medical Education' is prepared
h sole intention of benefiting the participants of the Basic course
W rh hop on Medical Education Technologies. It is aimed towards
First Edition 2015 Imlzing teaching learning, attitude, orientation and for self directed
rnlng.
Copy right (c) 2015 by: re is no conflict of interest during preparation of this boot?
Medical Education Unit, NEIGRIHMS
A team of resource Faculty members from NEIGRIHMS, Shillong
with an academic bent of mind, compiled this boot? tat?ing articles from
All right reserved including the right to reproduced this book or he designated resource persons.
parts thereof in any from or in any language.
The 'Hondbooh on Basics of Medical Education' is strictly not
for sale" non- transferrable and is exclusively for personal use of the
Published by : Individual participants of Basic Course Worhshop on Medical Education
Medical Education Unit, NEIGRIHMS Technologies.
No part of this boot? shall be copied or circulated.
Word Processing & Computer Typing & Layout Setting by :
The Editorial board has tohen every effort to verify authenticity
Mr. S. Rahman (Designer & Printer) of information, however, to the fullest extent of the law. Neither the
Mr. Mike Tenison Sun (Stenographer of MEU, NEIGRIHMS)
Medical Education Unit, nor its editors!authors! contributors! reviewers
or the sponsors assume any liability for any injury and! or damage to
Printed at: persons or property as a matter of products liability, negligence or
Monolith Digiprint otherwise, .or from any use or operation of any methods, products,
Near Shillong Press Club, Lower Lachaumiere
instructions, or idea contained in the material here in.
Shillong - 793 001
Apart from the participants of Basics Course Wort?shop on MET,
Emial : bulu0123@gmail.com
the subject matter provided in this Hondbooh would be useful for
Ph: 9774483493
teachers of medical profession, educational administrator and planner
involved in the development of training programme for Human
Resources for health.

·4
 FOREWORD

- - tiatwM~"
"&~ i4 wWO#e~a6kt~aft

~Md~~~~~
1. Medical Council of India ftMU 06-~ - ~~ eoefea,ue, ~ «e a44i4t ~
Md ~ eue ea« dea ~ to fea,ue, aIZi aft ~
2. Regional Centre for MET
King George's Medical University, Lucknow 06tk~.
7wkwe~~~Md~
3. Medical Education Unit of
Pondicherry Institute of Medical Science
i# med«at ~ .. "J0It~, tk 'UJf.e 06- teadett ku
Pondicherry .. ' ~~~9iuettto~, ~Md

4.' National Teacher Training Centre JIPMER,

~.
Pondicherry 7~ "~~~~06-~~"
~ a.~ ~ ~ O«JZ, ~ Md attefflItt4
5. NEIGRIHMS, Administration, Shillong. to ~ tIti4~, ·1Mt ft'tMi4 to de~ etJitIt
6. Monolith Digiprint, Shillong. ~ ~ Md~ ~ tk tmUf dea~ tk
~,

+T
Prof. A. G. Ahangar (MS, MCh)
Department of CTVS
&
Director, NEIGRIHMS
 PREFACE

Th quality of end products of any system of education

I" lid ( lot on skills and orientation of the teachersThis Handbook
I th ompilation by our Faculty and aims to enable teachers to
'"ply many of the Educational principles in their day to day teaching.

Many of the examples given in this Handbook have been

, II rated from workshops and textbooks and we do not claim any
pI prietary over them.

We do hope that this Handbook will,be accepted and help

o raise the level of knowledge and skills of Medical teachers, better
sessment and better learning for students which will ultimately
translate to better health care for the masses.

Yookarin Khonglah Md. Yunus

Secretary- Chairman,
Editorial Board Editorial Board

.'.
 CONTENTS

y t m pproach to education 1
\h Barman
IIIII't

'rln Ipl s of adult learning 4

tutunarna Barooah
)( nomy of educational objectives - an introduction 8
vookorin Khonglah

Mlcroteaching 17
W. V. Lyngdoh, M. Hussain & R. Hajong
urriculum 22
T. Natung

Teaching learning process 26

Himesh Barman

'I. Principles of assessment 30

Amitav Sarma & Sourabh G. Duwarah

8. Interactive teaching methods - large group sessions 36

Rituparna Barooah

Interactive teaching methods - Small group sessions 39

Himesh Barman

10. Motivation 46
Rituparna Barooah
11. Giving feedback 49
Rituparna Barooah

12. Effective use of media in teaching learning 53

Sharat Agarwal & Manika Agarwal

13. Essay type questions 57

Arup Jyoti Baruah

14. Short answer questions 62

L. Thangkhiew & Arup J. Baruah

..
 M APPROACH TO EDUCATION
15. MCQs and Item analysis
Sourabh G.Duwarah Himesh Barman
16. OSCEs and OSPEs 71
Arup Jyoti Baruah m
V 11'111 i functional entirety which consists of a number of
17. Clickers (Classroom response systems) 76
IMI"I'III"" t III ••nd interrelated components or sub systems. A system
Md. Yunus & Animesh Mishra
I lid It i influenced by its environment.
18. Assessment of knowledge - at a glance 81
Md. Yunus & Abhijeet Bhatia V t m:
" of two types
1) Op n system
)(I d system
1\ y t m which responds to changes while functioning is an open
III (running car) whereas a system that cannot be changed once it
I III d to function is a closed system (diwali rocket). An open system
I 1I0lld to the environment and the outcome. If the system is ineffective
If III Ill! I( nt then an open system can revise the process, whereas a closed
V It III 'l unresponsive or very slowly responsive.

M die. I college as a system:

Medical colleges are institutions set up to produce qualified health
1.111'professionals. It can be viewed as a system. All medical colleges have
11l'.lilutional goals (eg., educate students to produce qualified health
plllf ionals) which constitute the system-goals. Many departments
within medical colleges working in an interrelated fashion to achieve the
'.Y'll m-goals can be viewed as subsystems. Sociopolitical and economic
1I',Ilities constitute system environment of the college which constitute
th system environment which may be conducive or non-conducive.

unctional stages of the system:

( Input )_ ( process) -- ( Output )- -~ CExpected J

<,( Actual)
Fig 1: The Stages of Medical College as a system as it functions
1

.1.
~~~~~~ lJANOnOOKONBASICSMEDICALEDlJCATION ~~~~~
•• __ - II 1111001, ON BASICS MEDlCALEDtlCATION ~~~~~=
1) Inputs:
uutput will be a qualified health care professional. The
a)Learners
M.I~I.1111l1IpllH 1\ will be such that the 'product' will not exit if it does
b)Teaching learning resources
I I I 11,1111
'output specifications'. Ideally, the expected outcome
-Hurnan resources including teachers and support st II
I II ,11I11 the actual outcome to be hundred percent effective. If
-Infrastructure
IIPIII • grossly inferior to the expected output then the system is
-Finances
IIvI Another aspect is the efficiency of the system which depends
-Time
of ost, time and resources spent to achieve the output.
11111I11

2) The process:
The process cycle consist of three steps h r as a system specialist:
11,lditionally, a teacher is a human resource input, but an
1111hll fwd teacher can become a system specialist. The teacher has to
I I V.111l1 to plan guide and implement a systematic educational process
III III or h r department.

Aims and objectives are based on the desired outcome/ quality of

the product (output specifications). This is basically the expected
characteristics of the learner when he passes out of the college.
That means the objectives are learner oriented and not teacher
oriented.
Planning and implementation of the teaching-learning process will
depend upon the teaching learning resources available (curricular
time, faculty strength and experience, learning resource material
and funds)
Planning and implementation evaluation is based on its purpose
and objectives to be achieved by the learners.

2 3
 __ • --' II II I()OI, ON BASICS MEDICAL EDt "CATION ~~~~~~

PRINCIPLES OF ADULT LEARNING ( 11111I'pt I arning

HIIII' It rning and
Rituparna Barooah I'lObl m solving
Objectives: •• 1.,.,'.1 ,'1111 pi of learning have thereby evolved which enhances
At the end of the chapter, the reader will be able to : I will II applied in various teaching learning activities.
1. Define the learning process and enumerate the theories and levels dlill I an individual who has attained full maturity and
of learning I 11"'1 II nd is capable of choosing and taking care of activities
2. Discuss the characteristics of adult learners and adult learning 1111 h '> llf including learning by way of systematic and sustained
principles II' III III words of H.D Thoreau "They know enough who know how
3. Discuss ways to incorporate adult learning principles in teaching- I ut"
learning experiences lIel/.IBo y (adult learning) is a theory that holds a set of assumptions
I 1111 huw dults learn. Andragogy emphasises the value ofthe process
Learning is a conscious and an active process of acquisition of new f II •u nrn that are problem-based and collaborative rather than
knowledge, skills and attitudes, resulting in a permanent change in IltllI I I
behaviour as an outcome of internal motivation or interactive experience It .11 () mphasises more equality between the teacher and learner.
with the environment .There may be an associated phenomenon of 'I P' II iples of andragogy relies on the characteristic of the adult
constant unlearning of previously learnt experience. I 1111' i. ., his abiltv to think in a logical and rational manner, so that he
Learning experience describes the teaching-learning activities that I II If II ct upon his experience and learn from his own previous
recognize the role of learners in the educational process. 1,,"lt nce and experience of others .He adopts his unique educational
Theories of learning has been many to explain the process of learning 1IIIII,d t and which could be academic ,vocational, personal or social and
from several aspects which are not mutually exclusive but complementary. fl. vr-lop his personalized style in order to meet his learning needs.
Knowles defined theory as a comprehensive, coherent and internally
consistent system of ideas about a set of phenomenon.To enumerate few Mell olm Knowles gave a working model of Andragogy:
of the teaching learning theories: I II tated 6 principles of Adult learning which needs to be adhered to
• Social cognitive theory Willi planning a teaching learning session.
• Transformative learning • Adults are internally motivated and self-directed
• Conditioning theories Adult learners resist learning when they feel others are imposing
• Self directed learning information, ideas or actions on them.
• Experiential learning • Adults bring life experiences and knowledge
to learning experiences
Taking learning through eight levels namely 'Experience is adult learners' living textbook' - (Lindemann 1926)
1. Signal learning Adults like to be given opportunity to use their existing foundation
2. Stimulus response learning of knowledge and experience.
3. Motor chaining • Adults are goal oriented
4. Verbal chaining " Adult students .learn when "they experience a need to learn it in
5. Discrimination learning order to cope more satisfyingly with real-life tasks or problems"
4 5
~~~~~~ HAl\'D nOOK ON BASICS MEDICALEDtJCATION ~~~~~~ • __ -- ••••II \1\11 BOOKON BASICSi\IEDICALEDtJCATION ~~~~~~

• Adults are relevancy oriented '"H '"I('r' t and respect their individual style of learning
• They understand more about a topic when it is directly relevant III I IIC1wl,'d ing the wealth of experiences
the work context. Meaningful learning experiences that are clearly .1Id," them as a colleague
linked to goals need to be provided 1111ow 1 ing expression of ideas, reasoning and feedback
• Adults are practical 1'11", hi ducational formats for adult learners could range from:
They want to move from theory to hands-on problem solving and Will k hops (preferred format as they are flexible and provide more
need more involvement "III r c tion
• Adult learners like to be respected 'linin rs
Adult learners need to be respected for their personalized style and
short courses
preferred teaching learning method of learning.
I (II wships
Various strategies that could be applied are: hI ractive lectures

• Training programmes should be relevant to the profession In II group discussions and exercise
• Set up a graded learning program that moves from more to less H Ie plays and simulations .
structure, from less to more responsibility and from more to less I xperimentallearning
direct supervision Integrated longitudinal programmes
• Develop rapport with the student, encourage interaction • er coaching and mentoring
• Let students express opinions • Self directed learning
• Encourage enquiry • Computer aided instructions and online learning
• Provide feedback • Distance learning
• Be goal oriented with clear set objectives
• Encourage library, journals, internet use R f:
• Give projects/tasks • MLWeb discussion Psgfaimerlitserv

• Find out about student - their interests and past experiences • Medical Education:Principles and Practice;KR Sethuraman,Santosh
(personal, work and study related) Kumar ,N Ananthakrishnan

• Assist them to draw on those experiences

• Facilitate reflective learning
• Provide real case-studies
• Ask questions that motivate reflection, inquiry
• Provide a variety of experience
• Promote active participation by allowing students to try things
rather than observe.
• Pay attention to development of skill

6 7
 _---- II \NIIIIOOK ON BASICS MEDJCALEDUCAfION ~~~~~~

TAXONOMY OF EDUCATIONAL OBJECTIVES - AN INTRODUCTION lid of th class, the student would be able to enumerate the
IIpplyln the stomach and demarcate their territories of supply
Yookarin Khonglah Iv 1\ diagram.
Objectives
At the end of this chapter the reader should be able to: MY'IUI.IOS of objectives:
1. Understand the concepts of educational objectives.
I'lih For the teachers
2. Differentiate types of educational objectives.
3. Identify the important sources which help in the formulation of I what is expected at the end of Awareness of what the students should be
educational objectives.
taught
4. Understand the domains of learning.
5. Formulate educational objectives belonging to the three domains I knowledge and skills to be Choosing appropriate teaching-learning
of learning.
activities

Introduction of the criteria by which Planning for assessment and acceptable

The first -step of educational planning involves deciding and
conveying the objectives ofthe educational program in a systemic manner.
In other words, for teachers and students to work successfully towards
achievement, a clear description or outline of the goals is necessary. The
goals stated with clarity and in concrete terms are usually referred as
objectives.
Definition of educational objectives
An educational objective is a statement describing the expected
results of learning as seen by a change in behaviour or performance of
the student. In other words, educational objectives state what the learner
should be able to do at the end of the course. Educational objectives are
also called learning objectives since they are student centred as opposed
to teaching objectives which are teacher oriented and refer to the intention
of the teacher.
The following is an example of a learning and a teaching objective:
Teaching (or teacher's) objective:
The teacher would clearly explain the anatomy of the blood supply ofthe
stomach
Learning objective:
8 9
will be judged performance levels
of Educational objectives
I h following three statements are educational objectives of
dll" I( r t types:
(1\)l\t the end of the MBBS course, the student would be able to provide
preventive and curative care to the individual and the community
in health and in sickness.
(Il) At the end of this learning period, the student would be able to
plan and carry out a blood sampling session for a group of adults in
the community.
) The student would be able to draw 5 ml of blood sample from an
adult in not more than two attempts.
All the three statements are in terms of learner behaviour and fit the
d finition of educational objectives. What then is the difference between
Ih se three statements?
tatement A - is an institutional goal. It is broad, comprehensive and
(I ar. It refers to the capabilities of the individuals trained by the
In titution. These institutional goals are called institutional objectives.
Statement B - pertains to the role of a department. It is called an
Intermediate or departmental objective. Department objectives are
d rived from the institutional objectives. One institutional objective may
ive rise to several departmental objectives.
~~~~~= I-lAND BOOKON BASlCS MEDICAL EDliCATION ~======:- • •••• II \ I) 1l()OKON BASICS MEDICAL EDliCATION ~~~~~=
Statement C - is specific and pertains to a particular learning activity. It Ilc I bjectives should also caterto the special needs of the
II It.

is called a specific learning objective (SLO). All specific objectives ar - -1011, g., medico-legal skills, communication and
drawn from department objectives. They are clear, concise and II I In mt skills, etc.
unequivocal. 'I r h.rr t ristics ofthe learner and their previous knowledge also
IlIlhll II development of objectives.
Therefore, SLOs are derived from departmental objectives which ar
themselves derived from institutional objectives. of ducational Objectives
u lltk f educational objectives are:
Examples of various levels of objectives H Ie vance to the needs of the learners
( I. rlly and unequivocality
Institutional objective Students will be professionally competent,
I Ibllity
socially relevant and spiritually alive. Ob rvability and measurability
1m' I h purpose of objectives is also to derive an evaluation system,
Department or Intermediate objective Students will be able to apply the knowledge
III "( ry for them to be observable and measurable. This quality, of
of paediatrics for solving common health IIH r fers primarily to SLOs since evaluation is based on specific
II ,tlv s only. Of all the above characteristics, relevance is the most
problems of children
I 'pori nt one.
SLO or Instructional objective Students will be able to diagnose and treat
Ins of learning
pneumonia using IMNCI algorithm.
l du ational objectives are generally structured around classification
V' Ie In known as taxonomies of educational objectives. Among these,
Note that as we move down the list, the precision keeps on increasing as III most commonly used system is the Bloom's taxonomy. In 1956,
does the number of objectives. Be nj min Bloom and his co-workers attempted to classify educational
" Ivities based on the objectives of education. They proposed that such
Sources of Educational Objectives obj ctives fall into three broad categories or domains.
Several inputs are required for generation of educational objectives. 1. COGNITIVE OR KNOWLEDGE (aka Domain of the mind)
a) The first and the foremost consideration is the health needs of the 2. PSYCHOMOTOR OR SKILLS(aka Domain of the hands)
society. This information can be obtained from an analysis of the . AFFECTIVEOR ATIITUDE (aka Domain of the heart)
tasks of a medical graduate and morbidity data from the Each ofthe three broad domains of education is further sub-classified
community., Into a hierarchical pattern. known as levels. The higher levels in this
b) The policy guidelines of the government, the national health hi rarchy are more complex and intellectually demanding than the lower
programmes and the resources available are important I vels. Generally, objectives at the lower levels are mastered first before
considerations. higher level objectives are accomplished and the learners sequentially
c) Educational objectives must cater to the progress in science so that progress from one level to the next. For example, the learners need to
new areas of interest are included. An example of this is newly ttain certain factual knowledge about a topic before being able to
emerging diseases such as Ebola, H1N1, AIDS. understand the underlying concepts. Once they understand the concepts

10 11
 __ -- ..---- II \NI) BOOJ{ON BASICS MEIHCAL EIHICATION ~-~~~~~~
~~~~~~ HAND BOOK ON BASICS M.EDlCAL EDUCATION ~~~~~~

well, they are able to utilize or apply the concepts into practice. Thus, I I valuation: ability to judge the reliability, utility and merit of
knowledge leads to understanding and understanding in turn is necessary II'I '" pro dures and methods on the basis of established criteria.
for application. I lilly to judge the value of a research paper, compare between
f' III III dalities and select appropriate guideline for own patient

Cognitive Domain .1 tlun.

I "'pl('; he learner would be able to outline the prognosis for a
Definition t "' with hypertension.
The cognitive domain is demonstrated by knowledge recall and I I mportant to note that each preceding level is a pre-requisite to
intellectual skills. There are six major categories/levels within the cognitive I In th next level.
domain. They are: I

Level 1- Kn(>wledge: implies the ability to recallor remember previously y homo or Domain
learned materials without much understanding of the meaning. yl hotnc t r domain is involved with skills and is classified as follows:
Example: The learner would be able to define hypertension. Example
Level 2- Comprehension: follows the acquisition of knowledge by the
('( !lying actions after being Teacher demonstrating and students
learners. It is exemplified by the ability to understand the meaning of an
u-rivity performing intubation on a dummy
idea or a concept.
Example: Given a set of blood pressure measurements, the learner ',., (orming an act according to Performing intubation under supervision

would be able to Interpret and categorise them as mild, moderate and

severe hypertension. ...: Performing a series of Intubating a patient in a busy emergency
Level 3 - Application: the learner shows ability to use or apply the learned
u .ts rOOlTI
concepts and ideas.
Example: The learner would be able to predict howanti-hypertensive
therapy should be modified in case the patient develops angina or N t that performing an activity also requires a certain degree of
congestive cardiac failure. line knowledge.
Level 4 - Analysis: implies the ability to separate a complex concept into
component parts and establish relationships between the parts. ie., ability ff ctive Domain
to determine the relevance and usefulness of information and correlate Affective domain deals with attitudes, communication, ethics,
between the information. prof ssionalism and other attributes which are broadly referred to as non-
I Ilgnitive or non-scholastic. It is classified as follows:
Example: The learner would be able to take cognizance of socio-
economic, personal and cultural factors while selecting therapy for a I rvcl Example
hypertensive patient. U.I'civing: Paying attention to what is Paying attention to a mother who is crying in
LevelS - Synthesis: involves construction of new ideas or hypothesis and
hnppcning around the ward
establishment of new relationship between the theories. ie., ability to
write a research proposal or plan an experiment. , UI·~"onding: Participation and exploration, Trying to find out why she is crying
Example: The learner would be able to write a rational and
dcvcl ping interest
individualized prescription for a patient with hypertension.

12 13
~~~~~~ HAN[) BOOK ON BASICS i\IEDlCALE[)l)CATION ~~~~~=- ----....:=. II \NO BOOK ON BASICS MEDIC\.L EDliCATION ~~~~~~

Valuing: Consistent behaviour showing a Saying soothing words to the mother 111I11I of knowledge: factual, conceptual, procedural,
III t,1( () nitive (thinking about thinking)
positive regard

Organization: Clarity about the issue with Realizing that grief is inevitable on death of Original Revised
Evaluation --............
kcreating
no conflicts her child
Synthesis ~ Evaluating
Value complex: Internalizing the Showing to the mother that we care about her

grief Analysis Analyzing

phenomenon

Application Applying

Shift in emphasis Comprehension Understanding

The classification on domains of learning was abbreviated as KSA
Knowledge Remembering
(knowledge, skills and attitudes). However, in the recent times, a greater
attention is being paid to the attitudinal aspects (ethics, communication, Noun Verb
professionalism) of medical training and therefore, it is now abbreviated
as ASK (attitude, skills and knowledge). The classification of various
professional activities into one of the three domains is not in black and Fig 1: Original and revised Bloom taxonomy
white and some overlap will always be there. What is important, however,
is to remember that teaching should cover all the three domains of 110 domain specific action verbs for formulating objectives are listed
learning. luw:
A distinguished professor of surgery, about to retire and looking back
on all he had seen and learned in the previous 45 years, said that the nltlve Domain
greatest advance he had seen, the most important thing he had had to Ih' , ntract, Criticize, Deduce, Describe, Distinguish, Compare, Explain,
learn, was Palliative Care. "We must ensure that never again will young IlIlfYlulate, Identify, Infer, Predict, Evaluate, Select, Specify, Relate
men and women enter our noble profession unable to care for those they
cannot cure, not knowing how to listen, not being ready to learn from y homotor domain
nurses, and not sensitive to their patients' greatest needs". 111\ t, Palpate, Identify, Inject, Insert, Manipulate, Perform, Prepare

Modifications of Blooms taxonomy (Anderson & Krathwold 2001) Aft ctive domain
1. Change of terms: based on the fact that taxonomy reflects different 1\( quire, Exemplify, Realize, Reflect, Locate, Act, Accumulate, Respond,
forms of thinking Il1l1i te, Assist, Approve,Choose.
(thinking is an active process) verbs describe actions, nouns do not.
(Fig 1) u gested Reading
2. Re-organised categories: Synthesis (creating) and evaluation 1. Ananthakrishnan N, Sethuraman KR, Kumar S. Medical education.
(evaluating) interchanged, based on the fact that creative thinking Principles and practice.Z'" Edn,2000.Alumni association of NTTC,
is a more complex form of thin king than critical thinking (evaluating) JIPMER, Pondicherry. '

14 15

. t.
~~~~~~ HAND BOOK ON BASI(:S MEDICAL EDUCATION ~~~~:--.

2. Singh T, Gupta P,Singh D. Principles of Medical Educatlon.d" Edn MICRO-TEACHING

2013.Jaypee Brothers Medical publishers, New Delhi.
3. Bloom BS(Ed).Taxonomy of Educational Objectives- Handbook 1-
Cognitive Domain. New York: David Mckay Company Inc., 1956 ..
4. Harrow AJ. A Taxonomy of Psychomotor Domain. New York; David
Mckay Company Inc., 1972.
5. Krathwohl DR(Ed.). Taxonomy of Educational Objectives- Handbook
II-Affective Domain. New York: David Mckay Company Inc., 1964.
6. Simpson EJ.The Classification of Educational Objectives:
Psychomotor Domain. University of Illinois Research Project No.
OE5,1966.
7. Anderson L.W & Krathwohl D.R. A taxonomy for learning, teaching
and assessing. A bridged Edition. Boston, MA: Allyn and Bacon,2001
IN. V. Lyngdoh
M. Hussain
R. Hajong
I r I 11.1( hlng is a teacher training technique first developed by
I W All n nd his colleagues in the late sixties at Stanford University.
I • hnlque, urrently practiced worldwide, provides teachers an
IllIIIlly I improve their teaching skills by improving the various
II I., k'. c lied teaching skills. With the proven success among the
Ie • .,,,1' ( niors, microteaching helps to promote real-time teaching
I lie '" I'''. Ihe impact of this technique has been widely seen in various
III 01. du tionsuch as health sciences, life sciences, and other areas.
1111 'Hln changes in medical curricula by the Medical Council of India
I III fIllt of medical teachers envisage the need of this special training
I • hI r nd monitoring of their skills for their continued efficient

"I
, •• " 111.111
I
at any age.
,II t of teaching does not merely involve a simple transfer of
" twit eI[' from one to other. Instead, it is a complex process that
Iill.clt- nd influences the process of learning. Quality of a teacher is
I 111011 d on how much the students understand from his/her teaching.
I h•• 1,1 rooms cannot be used as a learning platform for acquiring
p,llll.cry t aching skills. Training of medical teachers in specific teaching
kill ••i major challenge in medical education programs. The pedagogic
kill lor teaching can be acquired only through more structured and
I h"rlp r faculty training techniques. With the introduction of
IIII! r t aching about five decades ago, the lacunae of scientifically proven

I" I'lf ctive methods to be followed in teacher training programs has been

IIVI r ome. The core skills of microteaching such as presentation and

'I 11I1 rcement skills help the novice teachers to learn the art ofteaching
II I'd e and to the maximum extent.

MI roteaching
MI( roteaching is so called since it is analogous to putting the teacher under
01 microscope, so to say, while he is teaching so that all faults in teaching

16 17
~~~~~~ llANO HOOK ON BASICS MEDIC.·\L.EDlJCATION ~~~~~ ••• --_ ••• II \ I) B()OKON BASICS MEDICAL ED{JCATION ~~~~~~

methodology are brought into perspective for the observers to give a
constructive feedback. It eliminates some ofthe complexities of learning
to teach in the classroom situation such as the pressure of length of the
lecture, the scope and content of the matter to be conveyed, the need to
teach for a relatively long duration of time (usually an hour) and the need
to face large numbers of students, some of whom are hostile
temperamentally.
Microteaching also provides skilled supervision with an opportunity
to get a constructive feedback. Classroom teaching is like learning to swim
at the deeper end of the pool, while microteaching is an opportunity to
practise at the shallower and less risky side.
ycle
, 'POll( nts ofthemicroteaching cycle are shown in the following
I t rt with planning. In order to reduce the complexities involved
hili • Ihl tudent teacher is asked to plan a "micro-lesson", i.e., a
t I 1111 f r 5-10 minutes which he will teach in front of a "micro-
I I ••1 W up consisting of 3-4 students, a supervisor and peers, if
Iy. lh r is scope for projection of model teaching skills if required
Ifllh II a her prepare for his session. The student teacher is asked
I I II 1011 ntrating on one or few of the teaching skills enumerated
II I
PLAN

Component Skills Approach

Inherent in the process of microteaching is what is called the component
skills approach, i.e., the activity of teaching as a whole is broken down for
learning purposes to its individual component skills. These individual skills RE-USE
which go to make teaching are: rEEDBACK
DATA

(1) Lesson planning - having clear-cut objectives and an appropriate TEACH

(Implement skill)
planned sequence.
(2) Set induction - the process of gaining pupil attention at the
beginning of the class.
(3) Presentation - explaining, narrating, giving appropriate illustrations RETEACH
and examples, planned repetition where necessary. (HI Implementskill)
(4) Stimulus variation-avoidance of boredom amongst students by FEEDBACK
gestures, movements, focusing, silence, changing sensory channels, (Video/Observers)
etc.
(5) Proper use of audio-visual·aids. HI teaching is evaluated by the students, peers and the supervisor
(6) Reinforcement-recognising pupil difficulties, listening, encouraging II' It, I hecklists to help them. Video recording can be done if facilities
pupil participation and response. pi nnlt. At the end ofthe 5 or 10 minutes session as planned, the teacher
(7) Questioning - fluency in asking questions, passing questions and I ~:Iv n a feedback on the deficiencies noticed in his teaching
adapting questions. 1111 III dology. Feedback can be aided by playing back the video recording.

(8) Silence and nonverbal cues (body language). II ,11Ip, the feedback to help himself, the teacher is asked to replan his lesson
(9) Closure - method of concluding a teaching session so as to bring I I ping the comments in view and reteach immediately the same lesson
out the relevance of what has been learnt, its connection with past '11 .rnother group. Such repeated cycles of teaching, feedback and
learning and its application to future learning. Il't".1 hing help the teacher to improve his teaching skills one at a time.

18 19

-- ---------------

__ . ~1;f!!I ~,:~"i.'7 --
~~~~~~ HANDBOOKONHASICSMEDICALEUUCATION ~~~~~
_--~~ Ili\ND BOOK ON BASICS MEDICALEDtiCATION ~~~~~~
Several such sequences can be planned at the departmental level.
Colleagues and postgraduate students can act as peer evaluators for this
II n D, Ryan K. Microteaching. Massachusetts: Addison-Wesley
purpose. It is important, however, that the cycle is used purely for helping
the teacher and not as a tool for making a value judgement of his teaching ubll hlng Company, 1969.
capacity by his superiors. r 01 y RP.Microteaching for teacher training. Public Health Pap.
11) 14;61:80-8. [PubMed: 4480113]

Advantages
Microteaching has several advantages:
(1) It focuses on sharpening and developing specific teaching skills and
eliminating errors.
(2) Itenables understanding of behaviours important in class-room
teaching.
(3) It increases the confidence of the learner teacher.
(4) It is a vehicle of continuous training applicable at all stages not only
to teachers at the beginning of their career but also for more senior
teachers.
(5) It enables projection cf model instructional skills.
(6) It provides expert supervision and a constructive feedback, and
above all
(7) It provides for repeated practice without adverse consequences to
the teacher or his students.
1111 J. A microteaching experiment at MEDUNSA. S Afr Med J.
J82;62:868-70. [PubMed: 7147122]
Hrown G. Microteaching - A Programme of Teaching Skills,
Phil d Iphia: Herper & Row Publishers Inc., 1975.
nthanam S. Teacher and Learners (Outlines of Educational
, y hology). Madras: Shantha Publishers, 1992;p.27.
lurn y C, Cairns LG, Williams G, Hatton N, Owens LC. Sydney
M roskills, Series 1 Handbook. Reinforcement, Basic Questioning,
V rl bility. Sydney University Press, 1973.
I Turn y C, Ownes LC, Hatton N, Williams G, Cairns LG. Sydney
MI roskills, Series 2 Handbook. Explaining Introductory Procedures
nd Closure, Advanced Questioning. Sydney: Sydney University
I'r s,1977.

Criticisms
Lack of adequate and in depth awareness of the purpose of microteaching
has led to criticisms that:
(1) Microteaching produces homogenised standard robots with set
smiles and procedures, and
(2) It is said to be (wrongly) a form of playacting in unnatural
surroundings and it is feared that the acquired skills may not be
internalised.
However, these criticisms lack substance. A lot depends on the
motivation of the teacher to improve himself and the ability of the
observer to give a good feedback. Repeated experiments abroad have
shown that over a period of time, microteaching produces remarkable
improvement in teaching skills.

20
21

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~ ~f' ~

, . -
 _---- 1I.\Nf) BOOK ON BASICS MEDICAL EDlJCATION ~~~~~~

CURRICULUM I IIp. 01' ir order of Curriculum components are objectives' •

"I' lit planning' • materials'. methods'. assessment. This
T. Natung .11 e i needed because decision about materials and methods
III' ,',I y, approach is more rational and avoids taught-assessed
I , IIIe It.
In teaching institutes we often hearthe word curriculum but we hardly 11I1 It ilium planning should be flexible and same learning objective
try to know its exact meaning. So, what is a curriculum? ,Id III ,I hieved by using different teaching methodology.

Curriculum is a Latin word meaning 'race course' which means we have ulum Development Approaches:
to follow a specific path and a frame within which it has to be followed. I II • ,hI( approaches (i)~ubject - centred (ii) learner - centred and
Curriculum is defined as a 'plan of action which incorporates the learning plllbi
1111 -m -solving
outcomes to be attained over a period of time by exposing the learner to
various learning experiences'. u J t Centred Approach - It gives emphasis to complete the subject
Why do we need a curriculum? It is needed to provide direction to '" I .md the number of lectures/number of topics/number of hours
both the teachers and the students; it assists in the selection of HII d (e.g. contemporary MBBS curriculum).
appropriate learning resource materials and helps to adopt appropriate
teaching-learning activities. Also, it helps in designing appropriate rn r Centred Approach - It gives emphasis on fulfilling the needs
assessment tools and Ultimately, it helps in designing relevant and efficient '1111 I. .irner: students will be active and responsible participants in their
educational programmes. IWII Ie.rrning and it strengthens student motivation, promotes peer
uununi ations, builds student-teachers relationships and promotes
Curriculum Development: t v It rning. (e.g. Learners' intent to crack USMLE/NEET).
There are different types of Curriculum development, of which Zais
model is important. It needs knowledge of (a) Curriculum foundation and r blem Solving Approach -It gives emphasis on the ability to solve a
(b) Curriculum component. lv, 11 problem and involves subject as well as learner - centred
1111'0 hes.
Curriculum Foundation answers four basic questions of Non of these approaches are entirely satisfactory. Hence, Harden et
(i) Why a subject is being taught? I 111 1 84 gave the "SPICES" model of medical curriculum which is Student
(ii) Who is being taught? ., ntr d, Problem-based, Integrated, Community - based, Electives and
(iii) Howa subject will be taught? and y It matte. This is different from the Traditional system which is teacher
(iv) What is to be achieved? ( ntred, information gathering, discipline - based, hospital - based,
, ndard programme and Apprenticeship based.
The main curriculum components are :- 'I unlng of curriculum development should be based on the needs of
i) Objectives (educational), 'h o iety' • needs of the learner's' • learning objectives' • choice of
ii) learning resource materials, III thods' • development and trial' • assessment' • modifications.
iii) learning methods and " ood curriculum should be 'SMART' which stands for 'Specific,
iv) assessment. M, isurable, Achievable, Reproducible and Time bound. The final outcome

22 23
 ~---- .•.•II \NI) Il( )OK ON BASICS JVIEIJICAL ElHiCAI'ION ~~~~~~
~~~~~~ HANI) BOOK ON BASICS MEIHCALEDUCATION ~~~~~~
urrl ulum Evaluation:
of a good curriculum and its implementations are that a medical student (I) Mil ro I vel evaluation and (ii) Macro level evaluation.
should: - (i) have comprehensive knowledge with interpretation of I I v I evaluation, evaluation of each subject ofthe curriculum
human health and diseases including preventive, promotive, curative and f filii/ which is then judged by the teachers, students and subject
rehabilitative aspects (ii) perform practical procedures safely (iii) relate II fI! oils rved by the curriculum evaluation team. Then, the
to patient and family members well and (iv) follow ethical principles in ."'''' IY lid r commendations are given in the end.
medical practices. IlIlh M ro level evaluation, evaluation ofthe overall effectiveness
II whok urriculum is done by the:- (i) students who completed the
Curriculum Evaluation: III lid ar employed (ii) subject experts (iii) principals/teachers
It is a process of assessing whether a Curriculum is achieving its aims I ) offll r In-charge of examinations (v) employers and entrepreneurs
and objectives or not. Do we need Curriculum evaluation or not? What IHI [vl] (IIIrl ulum Experts. Then, the summary and recommendations
would happen if a Curriculum is not revised for a long time? It would f III I I o I vel are given which, along with the summary and
become obsolete; recent developments will not be included; will be less , ,tlIIIII"!ld tlons from micro level are combined to give the decisions
effective & less efficient and may not be relevant for the present time. 'I It. dh( pllne committee. Finally, taking all these into account, revision
So, what should we do to make curriculum efficient and effectiver, We , , I III r II ilium is done.
nave to evaluate, modify, implement and re-evaluate. Therefore, the
purposes of Curriculum evaluation are:- (i) to develop a new curriculum
(ii) to review a Curriculum under implementation and (iii) to remove
'dead woods' and update the existing curriculum.
Who can give meaningful information about Curriculum evaluation? The
resources of Curriculum evaluation are:- students, teachers, subject
expert ,curriculum experts, policy makers (MCI), community, drop-out
':"samples, employers and entrepreneurs.

Curriculum Evaluation process has: - (i) pre-testing/post-testing and (ii)

Formative evaluation.
1. Pre and post testing of curriculum - Here, a pre-test is done, then
the curriculum is implemented and then a post-test is carried out. The
difference between the test scores attributes to the effectiveness of the
curriculum. If the difference is substantial it establishes the strength of
curriculum.
2. Formative Evaluation is carried out at two levels; (i) Process
evaluation which is evaluating the development and implementation
process, (ii) Product evaluation which is evaluating students (product)
for learning outputs in terms of knowledge, skills and attitude during
implementation. There is scope for improvement and modification at
every stage.
25
24
 ------ II/\ND BOOK ON BASICS i\lEDlCAL EIHJCAflON ~~~~~~

TEACHING LEARNING PROCESS

- ~
Increase in the desired
r II 1i),lllonlndas Positive reinforcement: appreciate, smile
Himesh Barman " {r '1I'."lon , etc response: Increase active
participation

The purpose of teaching-learning process is to:

1. create interest in learning for the topic in particular and more
knowledge in general . .. I I, lI,d,I(' action:
Negative reinforcement
2. help the learner to develop lifelong learning habits and attitudes 1" 'I>lIwlnclass
3. to acquire, retain and utilize knowledge
4. to achieve appropriate skills and to enable to use them with
Ope rant conditioning of desirable and undesirable behaviour in
confidence
c hill I rning process

Traditionally,teachers have played a dominant role and learners a

ry of connectionism (Thonglike):
passive role. It is viewed from a teachers perspective as to what a teac~er
w of readiness: it states that when a stimuli response bond is
can do. Earlier it was defined what teacher should teach (teaching
II dy to act, 'to act' gives satisfaction and not to act causes
objectives). Nowadays, it is realized that the educational process sho~ld
1l1l0Y nce. Readiness can be derived from having an objective and
focus on learners and what learners should be able to do (learning
h. vln the need to achieve it.
objectives). Learning objectives define what a learner should be able to
l w of exercise/use: use or exercise strengthens the learning and
do after a teaching learning activity.
ell,u'l weakens the learning
t , w of effect: satisfying effect of learning encourages learning
What is learning?
wh r as annoying effector outcome discourages learning.
Learning is a process which results in relatively permanent change or
modification in the way a learner thinks, feel and do. This is reflected in
I Id theory :
aquisition of knowledge and skills and development of right attitude.
1\1 II lied the cognitive theory of learning. It states that learning is
More effective the learning experience is, better is the learning.
I Imply an addition to the existing complex pattern of or cognitive
!IIHllIring in mind but it is restructuring of the existing pattern or
Theories of learning:
"IIIVt field to make it better organized, more meaningful and more
1. Conditioning theories:
r Thl theory talks about 'the result is bigger than sum of the two'
This expresses learning in terms of stimulation (any event that a person
01 ( ff ct.
can perceive) and responses (reaction to that perceived response).
Classical conditioning theory of Pavlov, according to which learning
""IUllogy vs. Androgogy:
involves a series of conditioned responses, is not so relevent in medical
IlIW refers to the theories and approaches to teaching and learning.
education. Operant conditioning (Skinner), involving positive
II III in realized that the teaching learning principles applicable in
reinforcement of desired spontaneously emitted response and negative
I lit ,II( slightlv different from children. Malcolm Knowles use the term
reinforcement of a undesired response, maybe more relevant to medical
IIdllll{OIlY to describe a set of teaching learning principles specifically
education.
111111 I 0 adults.
26 27
~~~~~~ HAND BOOK ON BASICS MEDICAL EDUCATION ~~~~~
II BOOK ON BA~·;rCSI"IEDIC-\'LEDlJC,\TION ~~~~~~
Knowles principles of androgogy are based on five assumptions about
adult learning: lob) ctive:
1. Adults are independent self directed learners I ''''IIH ob] tive should be written in behavioral terms; what are
2. They have accumulated a great deal of experience which is a rich II vie II oilr h nges expected in the learner after this teaching learning
source of learning , " Iyl''' of objective may belong to cognitive, psychomotor or
3. They value learning that integrates with their everyday life 'IV rlurnaln. The learning objective will govern planning of the
4. They are more interested in immediate problem centered hili ",ullin session. If the objective is cognitive then it will require
approaches than in subject centered one II 11l11l"",lti n to the learner. If the objective is psychomotor then
S. They are more motivated to learn by internal drives than by external , It III••ar best done hands on with opportunity to practice skills.
drives IV! 01 ,'ff ctive domains are most difficult to impart and evaluate
111,11I«1 lot of skill on part ofthe teacher.
Application of Knowles principles for effective teaching learning process:
1. Establish a learning climate is which the learners feels safe and
comfortable in expressing themselves III the main person in focus. The learners must realize that
2. Involve learners in mutual planning of relevant methods and " Ulility ofthe learning is on them. Learners should have some skills
curricula r content 1111"" out of teaching learning sessions and teacher facilitates to
3. Involve learner in diagnosing their own needs- this will help trigger I 1111I kills
internal motivations 111.1 lplln
4. Encourage learners to formulate their own learning objectives- this II II d II ted learning skills
gives them more control of their learning II II It on and self awareness
I II II p.itlon
Elements of an instructional situation:
«.'V, 'I edback to teachers

h r:
learning
, u lu I h a facilitator role. He helps students to cultivate the skills
objective 111111d for ffective learning. Teacher should function as. a planning
1IIIIplt'It1 ntation of a teaching learning session and is responsible for
III I I" of a session. A teacher should cultivate the following
Teacher ( I' ,I Ii s
Learner
nowl dge of the subject mater
I. r lhtator of learner participation
Ahility to serve as model
Ahility to provide feedback
Fig: Learning objective, the learner and the teacher are the three Ahility to perform active evaluation
important component of an instructional situation.
Ahllity to administer and manage the course
28
29

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'~. pr
 ____
PRINCIPLES OF ASSESSMENT
Amitav Sarma
Sourabh G. Duwarah
Assessment refers to any formal or purported action to obtain
information about the competence and performance of a student. It i
the single most important determinant of a student's learning. Teacher
communicate to students their values, priorities and expectations through
assessment. Dunn, Morgan and 0 Reilly (2004) observed that "researcher
have placed student assessment at the peak of the pyramid as regards it
importance in determining student approaches to learning". Not only do
assessments send students messages about what teachers' value, but
students tend to concentrate their energies on assessment tasks because
assessment is the currency of the tertiary environment. We therefore need
to ensure that assessment tasks support, nurture and develop the kind of
learning that teachers want.
The purposes of assessment
The functions of assessment are different for different population:
For students:
1. Diagnostic- to enable students to find out their level of competency/
knowledge/ understanding at the beginning of a course.
2. Feedback - for students to ascertain their progress in relation to
I 10 Ii ense for practice
the learning outcomes of a course.
3. Learning opportunities - to provide students with the opportunities
to develop their mastery of ideas or/and practice skills and
competencies through articulating them in writing/oral work or
other forms of expression.
4. Self-evaluation - to encourage students to make judgments about
the quality of their own work.
5. Motivation- by providing frameworks for developing, reviewing or
extending their understanding (for example, in a piece of research
or a collaborative investigation). For some students a series of
manageable deadlines can also help them to keep engaged with
the subject.
30
-- II I) ". )OK ON BASICS MEDICAL EDl!CATIO]'l ~~~~~~
P,II "IIOIlfor longer term learning-formative assessment can be
II In lu-lp students develop the capacity to self-evaluate.
h ,
"" II. I scertain what students bring into a course so as.to make
r hln .ind learning responsive to students needs and build on
nowl dge.
, dh,H k to gain feedback on student's learning, detect
"II ,,"dt rstandings, assess the effectiveness of their teaching and
"' kl .ipproprlate modifications and adaptations.
, hlng and learning - teachers can use assessment tasks as
r htn and learning tools both through the nature of the tasks
lit 111 ( Iv s and through formative feedback.
I wI//o/lng self-evaluation - teachers can give feedback which
II. outages students to make judgments about the quality of their
wn work.
1IIlIit and professional purposes:
1o P,I or fail
rei •• I t for entry
I I .1 I ct for future courses and programmes
1o wade
o II monstrate institutional standards
1o elect for employment
In I credit for professional occupations
m of assessment
II Ity: A valid assessment task measures the learning that it purports
I valuate.
II bllity: If the assessment information obtained is so unstable that
v ry different picture could emerge if the assessment
process were repeated soon afterwards, then the assessment
c n be seen as unreliable.
rm tive assessment: formative assessment is used primarily for
developmental purposes. The students have a chance to learn
from the assessment and improve on their performance.
31
~~~~~~ llANO BOOK ON BASICS MEIHCU. EIH'CATION ~~~~~ II I) BOOKONBASICSMEDICALEDllCATION ~~~~~~

Summative assessment: It involves a final grading of student learning,

students do not have the opportunity to improve on their
Observation
performance (the sum ofthe performance is measured). ~ lillY Practice based assessmert
Diagnostic Assessment: This is usually done at the beginning of a cours oMniCEX
o M.llti-SourceFeedback

to evaluate what students bring into a course so that their

development can be charted. Initial diagnostic assessment
Oirlcal skills logbook
also enables the teacher to make the learning more
StArvPS - OSCE
responsive to student needs.
Learning outcomes: Learning outcomes for qualifications descri be the
StAIVPS- Viva
general and specific competencies expected from graduates
MCQExam
who. have completed a qualification or programme. These ~~~~~~~~~~==~==~Cou~e-BMST
will include more general attributes which will vary with ~~.
K'loWjl(1!ie ivEQExam
academic disciplines and include competencies such as
research skills, problem-solving abilities, communication and
critical thinking.
,..•••".",,".Iv • essment
Internal assessment: it means the assessment conducted by the teachers
\I lI.llly undertaken at the end of a training programme or teaching
themselves without any external supervision. It is not lilt d l rmines whether the instructional objectives have been
synonymous with formative assessment. Rather, it is in effect 1IIIIy I hieved. The student usually receives a grade or mark. It
summative unless the teachers use it to provide feedback to " wh t has been learnt. Good summative assessment should
I 1111.in lysis of evidence from as many sources as possible. In any
the students. .
I 01 umrn tive assessment it is important that every aspect of the
Miller's pyramid:Miliers pyramid proposes clinical competence at various
I IIh.1II which is considered essential, or which had significant teaching
levels. A student has to first know (factual knowledge) before he till ted to it must be assessed to ensure that a valid report on a
can 'know how' (concept building and understanding). He then ,I "" .tbllitv results. The reasons for doing a summative assessment
'shows how' (competence to perform) and at the highest level 'does' I, I IhI following:

(actually performs).This is closely related to the taxonomy of

1.1' ment of achievement, e.g. obtaining a university degree
learning.
pi id as to the wisdom of continuing with further programmes
01 ••tudv
As each assessment tool, varies in its ability to assess a particular level
III ntrance requirement to an educational institution
of learning, we get the best result when we match the tool with the level
I I I uflcation of com petence
being assessment.
, d. I rminant of programme effectiveness

32 33
~~~~~~ I-lAND HOOK ON BASICS MEDICAL EDtlCATION ~~~~~ _----- 11\ nBOOKONBASICSMEDICALEDliCATION ~~~~~~

Feedback following a summative assessment in many cases is of 1111• mb rrassing: trainers should try to avoid personalizing the
generalized nature. However, with some thoughtful planning the tutor , IIh,1( k.
can invariably provide quality information on individual performances. \Ifill k-nt: has to be individualized for different students.
1111 tru tive: feedback should be constructive and not destructive.

Formative assessment II. h-v.rnt. Students should be provided with relevant information
Formative assessment emanates from a wish to foster learning and 1111 how to improve on performance.

understanding. The idea behind is for the students to know what i

required of them and the learning environment to promote opportunities
that permit the application of their knowledge, skills and attitudes. of Assessment in Medical Education. Tejinder Singh.
Formative assessment must be built into the coursework in a relevant I tYII' h upta.Daljit Singh.2012.
and non-threatening manner. A pl. (Ii al guide for medical teachers. John A. Dent
The assessment can be used in:
• observing practical work
• gauging clinical abilities
• appraising projects evaluating small group discussions
For formative assessment to be effective feedback has to proper.
Feedback tells the students about how they are performing in relation to
the learning situation. It can come in various forms like end-of-term
grades, a verbal reprimand, a prize, or an informal discussion between
trainer and trainee over a cup of coffee. Feedback should concentrate on
both the good aspects of a performance and the not so good. It can come
from within the student (intrinsic) or from another person, e.g. teacher
or trainer. Intrinsic feedback comes from the awareness of one's strengths
and weaknesses. It involves a degree of insight linked to the skill of
effective self-assessment. Feedback from the teacher should concentrate
on improving learning and students will gain in motivation and
information if it is carried out effectively.

Characteristics of effective Feedback

1. Timely: feedback is best given immediately after the response to
learning, if possible
2. Specific: this will ensure that the student knows exactly what was
appropriate/inappropriate about his/her actions
3. Accurate: good feedback necessitates accurate appraisal ofthe
student in the learning situation.

34 35

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·1 -; ~-
 •••• ---~, II \~I) BOOI ••ON BASICS.VIED!CALEDl'CHION ~~~~~~

INTERACTIVE TEACHING METHODS

.md v lue the learners' prior knowledge, learning is bridge
Large group interactive teaching
IIIIIIIIJ" linking what is
II dy kn wn to new information
Rituparna Baroooh
Ikiln/: In rest in the learners.
Objectives: 1111 I« I dult learning principles.
1. To enumerate the principles behind the use of interactive strategie
II II v.rnt
in large group teaching
'"l1ln Iy enthusiastic and interested yourself
2. Enlist and explain interactive teaching strategies for large groups
3. Prepare a large group interactive lecture I 1111 I

f 111111 run fter coverage! Coverage can lead to cognitive stuffing

Lecture, by far is the most widely used educational format in the world.
,"I IHII mi learning
It is the preferred form of instruction by teachers, as the content and pace
I I" I'.on I mannerisms please!
can be controlled by them. I ,II,'IIH late!
It has its etymological roots in the Latin word 'Iectus' (to read). Lecture
probably was the only way knowledge stored in the books could be
Iv t • ching and learning methods and the respective teaching
transmitted to a large number of students.
"lldlll~: models- thinking about what is to be learnt and to be able
Good lecture does not necessarily guarantee good learning,.some of
I 1IIIIId Y urself
the limitations are:
I II 11.111 I iving all pupils an equal opportunity
1. Risk of information overload, inadequate or nonessential information
I 111011 tration-identifying what materials you will use to
2 .Concentration lapse j IIIIIIl.Ir te. Allowing
3. Minimal or no application of higher thinking and application skills
f1"pll' 1o draw, handle and demonstrate
4. Poor long term retention (5% after 24 hrs).
III I II vron giving all pupils an equal opportunity to participate
"I"V ind exhibition and display-organizing the classroom or
These limitations can be very effectively overcome by incorporating
Itlhlll n space. Ways to share their knowledge
'interactive teaching strategies and principles" in the teaching- learning
j till" Bing able to play the game yourself
session. 111111' work -deciding how to divide and assign jobs
1. Three way communication between the teacher and the students
IlIv Ilg,ltionjinquiry-planning the process and how to report
2. Establishment of a conducive atmosphere for learning with
I III lorming- identify clearly the issue or the problem. Letting
cooperation
11111'11' know the rules. Giving a clear summary at the end.
3. Clear goals and objectives
I li"l t h Iping pupils discover and think for themselves
4. Respect the learners' talents, preferred style of learning and opinion
5. Meticulous time management, credibility and commitment
h I thods can you think of?
Ill(
6. Timely and regular feedback.
W vnur subject, know your students', is the basis of good
7. Maintain a positive and open atmosphere
I 'I 11101 a lecture.

37
36

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. ""
' ..
~~~~~~ I-IAND HOOK ON BASICS MEDlCALEDliCATION ~~~~~

The essential components of a good lecture are purpose, content, ••••••I:IDACTIVETEACHING: SMALL GROUP SESSIONS
organization and preparation.

Himesh Barman
Evaluation of lectures should be a standard protocol in educational
10111' re recognized as being a highly effective way for adults,
institutes. Peer feedback is increasingly used for evaluating lecture
III! ular for professionals to learn. However, the reasons for
(Siddique et al 2007).
", •• 11 roups should be dictated by the educational objectives

Reflection and self assessment should be followed by acquisition of

'"n. mall group work is characterized by student participation
I r tlnn, Having a small group does not automatically make it
skills and knowledge of ways of improving lectures, insight and will to
'V It I possible to have a small number of students and a tutor
change. P llic Ip tion by the students remains minimal- in which case it
I III I didactic lecture.
Ref:
.'ML Web discussion PSGFAIMERlitserv 1ift11,.1(tI,rl!.tl of a small group session:
• A practical guide for medical teachers; 4th Edn; John A Dent and RM hllllotllO participation, small group work is also characterized by
IN Ilk on a task and reflection on the work completed. There are
Harden
lor that can be used to characterize a small group which
""I."nlll 1101 nly the content of a teaching session, but also the process
II I urung is achieved. For a small group teaching session to be
I hoth the teacher and learners should have an awareness ofthese

up Ize: The number of students in a group does not conform

fly hard and fast rule. Conventionally a small group is between
I) P rticipants in size. Numbers in small groups are, however,
" IjtH ntlv fixed by curriculum demands and the generation of
IlIlIpln based on a yearly intake.
up dynamics: There are many theoretical models describing
I h lnteractions of learners with each other and with the facilitator
11111/1 roles that learners will assume in a small group. For
11111>' ,in the clinical environment, seniority and specialty may
lit 1.1 roup's dynamic to as much an extent as the personalities
If IIII' individuals themselves. Some learners may view a session
,Ill, sessment rather than a learning opportunity. This may alter
I he .imount individuals are willing to contribute (and risk getting it
wron J'). It is important that the group facilitator has an
PI"f r iation of these issues and aims to positively influence a
10llP'S dynamics.
I u ion style: Can broadly be either convergent (or closed or
" ,I( hi r-centred) or divergent (or open or learner-centred). In a
38 39

-
--- -----,
~:"
~~~~~~ HA\,DBOOKONBASICSMIWICALKDVCAI'ION ~~~~~

convergent session, the facilitator acts as the conduit through which ••• ---- II II BOOKON BASICSMEDICALEDtlCATION ~~~~~~

discussion and ideas flow and the dialogue occurs between him or up s: re an extension of buzz groups, where pairs join up to
her and each learner. With a moderate amount of practice, most ._IDLlr •. tl" II fours to eights, until the whole group reports back to the
facilitators are able to control the direction of discussion and reach
a pre-determined end-point. This style is most suited to impartin
_'"tlt.to, 'III" developing pattern of interaction can ensure
II VI r rticipation. The tasks should become increasingly
new knowledge or delivering a prescribed syllabus within a fixed
, II • Ilh groups amalgamate to limit repetition and boredom.
time frame.

1\11 inn r group discusses an issue or topic while the outer

Structure of small group discussion:
" t II , looking for themes, patterns, and the soundness of
Some common structures of small group discussion are:
'flliUn,I" , I I fig 2. The outer group then offers feedback, not only on
, I md the ideas discussed but also critiques the inner group's
Buzz groups:
II", two groups then swap over roles.
Students are asked to turn to their neighbour to discuss a question for a
few minutes, see Fig 1. This offers a sense of participation and enables
1/ r ups?
students to freely express ideas they would have been unwilling to reveal
, -rdvantages to using small group teaching over larger class
to the whole group.
II 111<1 pendent learning. The following are a few examples:

~.
.
• •
~ Fig 1: Buzz session
"

,
IIlllwizes
111111

III

I III ,
students with an adult approach to learning, a generic
y will need for the rest oftheir professional lives.
II lit ges students to take responsibility for their own learning.
ntered models of learning tend not to encourage
, I III to take responsibility for their own learning.

ft'OUTfJOlt

. .•
~
Ji
~

II
" ,111111I01

'1I1tll
/11

/11
s deeper understanding of material. Small group work
now- ••tudents to bring to the group their own prior learning and
HI pI ions (or misconceptions) of material previously learnt .
can then develop from this point .
Ill/rages problem-solving
ourages participation.
skills.
The nature of social interactions means
II I Ihl yare usually more enjoyable than solitary pursuits. The
Fig 2: Fish bowl
I 1111 lit of enjoyment and its influence on motivation may
m ouruge students to learn.
t t VIlops - interpersonal skills - communication skills - social team
w rkln skills - presentation skills.
I fl( nurages an awareness of different views on issues and has
f101f ntial to encourage an attitude of tolerance. Personal
I r tanding of an educational issue can be attained in a number
, w IY" but small groups make it possible to turn such
40
41

I _

,""
~~~~~~ I-lAND BOO I\:.ON BAS.ICS MEDIC·\LEDUCATION ~~~~=- _.--- IIANI> BOOKON BASICS MED.ICALEDlICATION ~~~~~~

understanding into a 'coherent, rational and professionally IIlIh ,II vkills sessions
defensible position that can be clearly articulated' (Walker 1998). III unun I ation skills sessions·
Notwithstanding these advantages, small group work should only b
I" II"" III based learning tutorials-
adopted when it is the most efficient approach to achieve these benefits/
I IIlIh ,II t aching sessions-
objectives. It should not be considered as a panacea for learning.
II w rd-based-
.imbulatorv cere] outpatient-based -
There are disadvantages of small group work.
( ommunity-based
• Results in more-time being spent to master the topic area. This can
III1Port roups
sometimes be 'problematic, time constraints being a feature of
students
modern life.
tutors.
• The expertise ofthe tutor may also be considered as a potential
problem. The role of the tutor can be crucial to the success of any
I th role of the tutor?
small group work. Staff may be more familiar with traditional modes
III IIII' uccess of small group work is the tutor working either alone
of teaching and may need training in the specific role of a small
II hor,ltion with a co-tutor.
group tutor.
• The logistics of running small groups may be difficult, as more rN,tI"I'on I tutorial role
teachers, more rooms and more resource material may be required. I I ,1',1' of the traditional tutorial group the tutor normally states
• The preparation of resource material to support small groups is ''I' r t lv s of the session (usually known to the participants
also an important part of the process and requires considerable , 11(1), initiates the process, invites learner input (often prepared),
time and expertise. (II ussion and brings the session to an appropriate close.
I 1111111 Ih session the tutor 'leads from the front' (often literally)
What kind of small group session? I I 1",lIly in control. The tutor's effectiveness is derived from a
In the context of a medical undergraduate curriculum a variety of small 1IIIIIIItI of
group sessions may be relevant. At one end of the spectrum is the 11111,111 ability,
structured, teacher-centered, tutorial group usually focusing on an
I lilli, III xpertise,
identified task and often pursuing a series of conclusions (a differential
It ,II II n experience and
diagnosis perhaps or a patient management plan. At the other end is the
unstructured, student-centered, discussion/dialogue group, the principal I" 1',0111enthusiasm.
purpose of which is to exchange views on a topic and promote reflection I II II .unlng groups are of undoubted value in selected circumstances.
I 11 , Of discussion, however, may be relatively narrow, the
(attitudes to patient care perhaps or interpersonal communication).
Between these two extremes all manner of group structures and functions I 1111111 t elf-learning limited and interaction between learners at
exist, limited only by the imagination and creativity of the course II hy
organizers and individual tutors. Examples include: .
• seminars· "'·""II,.,d tutorial role
IIIPoly,small group learning signifies a process in which the
• workshops
I IOPoNh r provide much of the initiative, explore .options, test

42 43

--- - - - -----
.- .~. ~
~~~~~~ IlANDBOOKONBASICSMEDlCALEDUCATION ~~~~~. ••• --~. II \NnBOOl(ONBASICSMEDIC,\LEIH)CAT'ION ~~~~~~

hypotheses, develop solutions, elaborate on-going actions (includin 111111 of the tutor's own learning experiences may assist in this
clinical investigations and treatment) and review outcomes. Role-playing ".'~II, 11"ldY Iso be useful for the group to discuss the tutor's role and
and the performance of practical procedures may be an integral part of t Ih,1I this will change as the learners become increasingly
••• 11I111_1 "I oil handling their own affairs. Ultimately the tutor may merge
such sessions.
The role of the tutor in these circumstances varies according to the It ,nllp uch that an observer might have difficulty distinguishing
stage of academic development of the learners, their familiarity with the rOIllI"oIrner. This is the greatest challenge for the traditional teacher,
process, their maturity as a group, and the frequency and duration ofthe I II I Iy 10 b initially uncomfortable with the thought of losing control
tutorials. If the small group session is one of a linked series, say within an " wlrW t t1 session to become untidy or 'even worse'.
'organfsystemfproblem-based' course, continuity of contact with a single
tutor or pair of tutors has much to recommend it. " hupurtance during the discussion itself include: .
I ,IIc p.ition of all group members (may require control of
Requirements for the tutor: 1,",11l,1I1t students and encouragement of quieter ones; a co-tutor
Preparation I I V IH' particularly helpful in this regard)
III Ie ,III hinking (assimilation, interpretation and synthesis of
• Rehearsal
II I""".ltion) articulation ofthoughtsfviews (an essential generic
• Skill: Studies have also shown that while content expertise may be
II)
useful in small group teaching, facilitation skills are essential.
I 11\1'1 Int raction (enhancement of understanding, growth of
Evidence suggests that the basic skills of small group facilitation'
111111,.11 t pect and promotion ofteam working) . review of
may be acquired in 12 to 24 hours of experiential training.
III" , I V(' ('keeping on track')
1111' 1'"111 nt summary of achievements (encouragement of
A few practical points remain:
II, I , on) .
• Tutors should be the first to appear at the appointed hour not the
" , t v.•uon of agreed time constraints (development oftime
last (regrettably all too common).
"I 11.111' III nt skills). The emphasis on these and other individual
• Preferably, they should make a point of turning up at least 15
1 "'''. Will vary with circumstances and some goals may only
minutes before the session starts in order to check the venue, the
seating and the resources, to trouble-shoot and
u- I Ie .IIly be achieved in the context of serial sessions.
• To set an example
rol of the student?
I h. I "dc nt is, of course, the key figure in any learning event but
Conduct of the session
It 1"I'.IIlv commitment of the individual learner is absolutely
The success of small group learning may be judged by the extent to which
trust is created and collaboration fostered. This is critical in the case of a
r I It "tII the success of small group learning.
I h' will II lude undertaking prior reading, actively and
linked series of tutorials but should be aspired to in all instances. As with
11111 IIV Iy contributing to the conduct of the session and
all such events the opening few minutes can make or mar the entire
!tvr Iy r flecting on the issues raised.
session. In 'one-off' situations or early in a series the tutor will wish to set
IlId, lit also has an increasingly important role in assessment
the scene, state the objectives and suggest some basic ground rules. At
IIII.llIon.
this and subsequent stages ofthe session the tutor should endeavour to
I 1111 till r membered that student groups may function entirely
visualize the students' learning needs specifically from their point of view.
II ,,, I'll IV in the absence of a tutor

44 45
 ••••• -...;:..::., IIANI> HOOK ON BASICS j\IEDICAL EDl!CATION ~~~~~~

MOTIVATION ."1'/""1111 to meet the need arises only after fulfilment of need of the
IId"I. Unless the lower order needs are met,a student will not be
RituparnaBarooah t d 10 meet the higher order needs required for learning.

Objective: 111111hel been classified as intrinsic or extrinsic.

1. To define motivation and enumerate the hierarchy of human needs
2. To classify motivation I ( If motivation occurs for the love of learning and from the
3. Use and application of motivation in TL(teaching learning) Practice 11011 of a long term utility of a learning task.
• Can I do it?
• Do Iwant to do it? Ivation, some form of extrinsic reward or need acts as the
• What to do in order to succeed? 1.1 tor.

Motivation is an internal state that arouses, directs and maintain I Itlll ctivity that is intended to motivate the learner to learn.
behaviour over a period of time with variable intensity and direction. t t 1••••• ulted in crucial changes in the field of medical education,
1('
There is a strong reason for doing something arising out of the need of a Itlft lrom didactic lectures (teacher centred and subject based) to
person. I I III ( ( ntered learning(interactive and problem based).
I,,,
.It Ie nal objectives are achieved only when there is synchrony
Theories of motivation are: 1111 11I.11<h with the intrinsic (need for future professional task) or
• Behaviourallearning theory is related to reinforcement, rewards I t (pi rformance in the examination) motivation.
and Incentives I 111,\1, III make that happen, it is mandatory that the objectives of
• Attribution theory(Weiner) based on perception of self, others and lilt "I h,' r levant to future professional needs and skills.
fundamental attribution error, explanation of success and failure, lulllll{.11hi vement always produces extrinsic reward of some kind;
attributes for success and failure, locus of control and self efficacy I I' how outstanding achievers maintain their motivation
• Humanism theory is based on perceived and felt human needs
'" JI"II)
IIV assessment and immediate feedback on students'
Human needs were classified by Maslow into seven categories according &III.~'flllIl /III I••01 reat motivating factor towards meeting the educational
to degree of priority. I
They are: I, IItl vtudents to concentrate on the tasks, rather than be
Class1. Physiological needs t II by t.illure',
Class 2. Need for security .1111.11{ 1\, highly motivated scientist who has not been rewarded
Class3. Social needs III , II IIf ( a singer who has not been rewarded for singing, an
I

Class4. Need for esteem and acknowledgement Itll hd not been rewarded for inventing, a teacher who does
Class5. Need for self actualization III "II ching and a learner who has invested all his resources
II
Class6. Need to know and understand \I "h'Mn to learn!'
Class7. Aesthetic needs
III III' motivated to learn what they need to learn, not what we
(1-4 are deficiency needs; 5-7 are growth needs) ( It till m. Teach them in ways they would want to learn as it
46 47
~~~~~~ HAND BOOK ON BASICS MEDICAL EIHJCAfiON ~~~~~

would reward them quicker. Small time gratification acts as a extrinsic

motivator. GIVING FEEDBACK
Another great motivator is social relevance, context and emotional
involvement of the content of learning in a friendly, conducive and Rituparna Barooah
nonthreatening environment with simultaneous multiple sensory
stimulation.
nd understand the process of feedback and its types
In order to build positive expectancies th need, importance and purpose of feedback
• Ensure alignment of learning objectives ,assessments and
instructional strategies
• Identify appropriate level of challenge
dh.1I k I an essential component of the teaching learning process.
• Provide early success opportunities
I II'. tlllll d scribing student's performance in a given activity that is
• . Articulate expectations: desired learning for the course and what
I I I 10 uide their future performance in that same or related
students are expected to do to demonstrate that learning
ItV" hi. edback ( Endes 1983) Constructive feedback from the teacher
• Provide rubrics II. 1",lrner insight into his or her actions and their consequences.
• Describe effective study strategies " • k .illows all the stake holders to ,review their individual progress
• Establishing and maintaining a supportive course climate by , II III ( • \ fully achieve both personal and programme objectives.
effective interpersonal and interprofessional relationships, establish 11I111I1U d deliberate practice is necessary for maintenance of many
ground rules for interaction. Set tone for the climate from the initial II' plllf sional competence, for which feedback is an essential
contact and setting up processes to get feedback on climate and III lit In Ericsson's framework, the following conditions lead to
performance and programme in a timely and effective manner. • 1111. IIIf nt through deliberate practice.
• Know your students and individual differences w. II defined task or objective
I II 1.1I1!'d and immediate performance
• Show honest enthusiasm yourself.
Ippmlunities to improve by performing same or related task
II pI lIt dly
Further reading
• Medical education: principles and Practice Ed 2000.
lit. r k iven as part of formative assessment help the learner
Ananthanarayan,santosh kumar and Sethuraman
of any gaps that exist between their desired goal and their
• Understanding Medical education ,evidence ,theory and practice
"I knowledge, understanding or skills and helps them to take
Edited by Tim Swanwick
1'1111 ••t ps to meet the goals (Ramaprasad 1983; Sadler1989)
•••I,llrrllll III nt in learning through assessment depends on the provision

ell IInd effective feedback, active involvement of the students

.wlIl rning, adjusting the TL procedure according to the results
"Wilt and the need for the students to be able to assess
"""tll,plv .md understand how to improve (Brennan, 2006)
• '.1 ions can vary:
I,

48
49

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---------
--

..
~~~~~~ HAND BOO~ 0:" BASICS MEDICAL EDllCATION ~~~~~ /I \~D BOOKON BASICS MEDICA1~EDlICATION ~~~~~~

• Brief ongoing feedback-short, occurring frequently, in the context II, r rlv factors-poor rapport/concern about 'breaking bad news'
of regular activities e.g rounds, practicals etc dlllt'l ont perception about feedback
• Formal midcourse feedback-scheduled in advance with planning "IIIICh t and culture

between teacher and learner, sessions usually longer than half an III II ~ '('tV s the educational programme in:
1\. V ('W of the teaching learning method and necessary
hour and prior to summative evaluation.
"I"dlll tion in tune with the learning style of the learner
• End of course feedback-feedback following summative assessment
with reflection and mentoring to help the learner improve (Kracklov
I I dlle ational programme:
and PohI2011) M ••krn feedback a regular feature of the educational experience
'" our ges development of expertise (Ericsson 2004)
The purpose of feedback is formative i.e. to provide insights to the " " quir ment for accreditation.
learner that helps him make adjustments in performance AND .t IIdl nts must receive regular information about their
demonstrate improvement. Cf summative assessment which d. v. lopment and progress. This should include feedback on both
111I nt.nlve and summative assessment' General Medical Council
communicates a decision on performance whether the learner has
I( I') mce the consequence of ineffective feedback is often
achieved expected outcome.
I nill nt, attention to the important principles for effective
Feedback can be provided in a positive way or negative manner. I dll,l k session in order to IMPROVE the performance next time
"" '.t k j performed has gained importance.
Feedback helps the learner achieve the educational objectives by
• Reinforcing good performance Ii ,II ff ctive feedback are:

• rectifying mistakes
l inu Iy, fr quently (preferably immediate),
expected by both
nd learner in an environment that fosters constructive
II ,11111'1
• reference point for summative assessment
I ,dh,H k with a view to improve performance.
• demonstrates commitment of the learner
I I I 'Ilion to time and place-formal, mutually convenient with
• insight for actual performance ,I! 1/11 t time in
I , III .t ndards-feedback is to be measured against well defined
Students value teachers who give constructive feedback adapted to I I
professional requirement (King1999). first hand data and personal observation by the teacher
11111
po itive communication strategies like open ended
III
Most teachers, though they recognize the importance of feedback find
1 "I' lit , reflections ,two way communication, active listening,
it difficult to do so.
III .Iglll questions, being selective ,behaviour oriented with
1'111 WoII ness of the learners background.
Difficulties and barriers in providing feedback may be due to I c 'Ipl lvI', onstructive and nonjudgmental criticism well balance
• 'too busy' /Iack of appropriate space lit 1"1 IIIV and negative comments
• unclear about the use and purpose of feedback ""lIld h designed to address decisions and actions, concluding
It" .rn etion plan.
• do not know how to give feedback
50 51

----- -- -

~ ,~ \1-1-

"
~~~~~~ I-I.."-NUBOOK ON BASICSMEIJICALEDlJCATION ~~~~~

For a successful feedback encounter: IFF!ECTIVE USE OF MEDIA IN TEACHING-LEARNING

1. Advance and detailed planning is necessary with intimation to the
learner Sharat Agarwal
2. Feedback session should be interactive-the purpose of the feedback Manika Agarwal
should be reviewed together agreeing upon the goals.
11I,.lIlyof the learning experience and outcomes requires a special
The learner should be invited to self assess and provide his own I "", only with the methods ofteaching but also with the ways in
feedback before the assessor responds.Confirm learner's understanding II 'I lid nt uses his/her cognitive abilities. The conceptual teaching
before concluding the session and conclude by summarizing the II It • ,Ip,lble of eliciting deep cognitive processing for an appropriate
interactions with suggestions offered by the learner as well as the teacher. I 1"11/lit of ethical and intellectual development. There is also a need
3. Respond to defensive reaction by I if'. II ching and learning in an integrated manner, along with
• Identify and explore the issue II ••"'"lIing and development of higher-order thinking skills. The
• Keep a positive focus I 1"11'"I f thinking can only come about at the cost of reducing the
• Ask the learner to own up part of the problem and take 11I1III tt.idttional contents that includes the use of only chalkboard
responsibility I II n/atron of the contents. The teacher's role is not just to deliver
• Offer time out 'n",,,,,alllltl but also to scaffold and to respond to students' learning
4. Reflect on the session and your skill,providing insights to strengthen
1llIllolrly, the students' role is not just to copy new information,
your feedback skills II III 0 tively make sense and construct meaning. The most
• What went well? Which techniques were effective?
IlIiI;IIIII"II,1 101< tor in learning is the baseline knowledge of students and
• What different strategies can be adopted next time?
IIIWIt I e is constructed by building or enhancing concepts on
'" ~nowl dge. The activation of existing knowledge is an obvious
Some other forms of providing feedback may be:
II ,Hluliin any workable model for teaching. The schema activation,
1. Checklists: for the competencies to be assessed and points for
I \ III Iruction, and schema refinement model for teaching, coupled
reflection
It "ll ouragement ofthe students to engage in deeper processing
2 . Computer based feedback
I 1I~1/l1" Ive credible and robust basis for teaching and present the
3. Peer feedback
I 11Ie 1\' In structured and organized way. It is also the responsibility
III r to facilitate learning, encourage thinking and try to relate
Suggested Reading:
• A practical guide for medical teachers ;4th ed. John A Dentt,Ronald III oldy known. It would be more productive if the teacher
.M. Harden . Ih significance of the knowledge gained in future / practical
• Principles of Assessment in Medical education: Tejinder Singh, I Ill! student become eager to know and learn. The student
Anshu IV' n an opportunity
to apply acquired knowledge in various
II! h s analysis, synthesis, evaluation and problem-solving.
II I lobe interaction between students and exchange of views
I 10 tered by the teacher so that conflicting views can be
I I, III ussed and resolved.

52 53
~~~~~~ HAM) nOOK ON BASJCSMElllCALEDliCATION ~~~~~ _----==- r IAN I) BOOK ON BASICS MEDICAL EDUCATION ~~~~~~

Teaching with integrated tools (PowerPoint and chalkboard) facilitat
the students and involve in "schema refinement" as the teacher review
what has been covered and emphasize the key points made. One of th
most useful activities for the student is to make a summary in his/her
own words of the main thrust of the session and to annotate this in relation
to previous learning and possible future applications. There is no doubt
that learning is better when the learner is active rather than passive.
Appropriate learning should be meaningful, achieved on a wide range of
stimuli where lies the importance of various audio-visual aids as learning
resources, frequent practice in varied contexts and group discussion is
also necessary for effective learning. We have to keep in mind various
learning resources or tools at our disposal viz.,
I 'WI' II int or drawing simple slides on the board only. The integrated
Electronic
• Over head projector
• Slide projector
hIlI lit ted teaching (horizontal and vertical)
liking point sessions
WlI,k hops
,,"IN nces
'I liVe r, learning is more likely to be effective and efficient if learners
r ""l( d as to how well they are doing. Teaching with PowerPoint
I hl'tt r concepts and this is more elaborated when the teacher
II hi'. Important contents of the topic on the board. It has been found
wI" II ( ntents such as figures and flow charts used on PowerPoint
h II I II topic is elaborated on chalkboard, the students are more
111«1 /I t time to ask the questions compared to showing slides on
hili with PowerPoint and chalkboard keeps the students engaged
Hli v.1I d. Their attention remains focused on the subject matter
II I ultimately leads to better absorption of the core knowledge of
1111 III . PowerPoint presentation is an essential instrument of health

• Computer f hlll.11 in teaching. It offers a tremendous number of options for

• Smart boards III. II n slides. Having choices of fonts, color schemes, display
". ound, and graphics providing an opportunity to enhance a
Non Electronic ," 11101'1 in different ways. However, it should be kept in mind that
1IIIIIIIIdl use of PowerPoint features can substantially degrade the
• Books
Illy III .1 presentation. In medical schools, it has also been seen that
• Handouts
I ., IIII' physicians / teaching faculty do not pay adequate attention
• Chalk and board IlIIfIl i.1t preparation of PowerPoint due to their busy schedule and
• Models & Simulation devices I l'elW( rPoint slide making to their secretarial staff. In such scenario,

• Flip charts 1111 "I( ulty can neither deliver the lectures adequately, nor can they
II II Ih students atactive learning standards. A common fault of
And also various teaching methods which includes- ,1'111111 presentations is the use of slides with too many lines per slide,

1. Lecture I' IIY words per line, lines that extend too far inferiorly on the slide,
2. Lecture discussion Iltll I unr , distracting animation effects, too many graphs, and poor
3. Seminar hI In . In such situation neither the lecturer will be revealing
4. Symposium III till I arner be learning adequately. Teaching with chalkboard
_"UI ••.1i Ihl I arners actively and the learners always become attentive
S.
6.
Panel discussion
Group discussion "I' the teacher is writing and providing knowledge on the board.
7. Tutorials I uhuonal method, the teacher can easily engage the learners
8. Role play Iu loIll e students think on each written or discussed point on the

54 55
~~~~~;;;;;; [IANI) HOOK ON BASICS .VlEJ)lCAL EDUCATION ~~~~~
board. However, there are few limitations of this tool. The teacher may
avoid writing or drawing a figure or flow chart on the board. In medical
teaching support of illustrations is very important to develop a concept
of that organ/structure/system/procedure. Therefore, the students may
face difficulty to understand the ideas/concept of the content on the
chalkboard. Considering all these facts both the tools of teaching have
some strength and weaknesses. Integrated (PowerPoint and chalkboard)
method of teaching is a more suitable tool of teaching and learning at
undergraduate medical schools than PowerPoint or chalkboard alone.
Traditional teaching on one hand fulfils the need of understanding the
subject and on the other ,empowers them with the skill of reproducing I, )
diagrams whereas supplementation with power point enhances
understanding due to visualization of 3D diagrams and real pictures of
various clinical conditions, the task which also can be accomplished by
the use of smart boards, another powerful form of teaching, which brought
into fore the concept of 'Multimedia mode of teaching. & 'Computer aided
learning (CALl'.
Therefore, to conclude there is a requirement of paradigm shift in the
concept of teaching in medical education, keeping the very famous
pyramid for promoting retention in learner groups i.e., HI
Learninq Pyramid
average
student
retention
rates r I v, lopment and evaluation of teaching programs
I, ,1/. ling future performance
lIujll"'tI "' III ,IllY thing so complex as the delivery of professional services
Source: National Training Laboratories. Bethel, Maine
"Tell me, and I forget. Show me, and I remember. Involve me, and I
understand" (Chinese proverb)
56
"
.,
:
ESSAY TYPE QUESTION
Arup Jyoti Baruah
•. IY Iype question is defined as "A test item which requires a
II , urn posed by the examinee, usually in the form of one or more
t
, ., of a nature that no single response or pattern of responses
II I. II s correct, and the accuracy and quality of which can be
I IIhl' tively only by one skilled or informed in the subject"
M. tal~aker 1951 (A psychologist, educator and former president
." por tion that selects high school students as National Merit
.III••nt Drives Learning", this classic statement by George E. Miller
J ,. IH) ncapsulates in a single phrase the central role of assessment
fo,,,, of education. Particularly in medical education where the
111 h, it is impossible to overstate the importance of assessment.
I•oil., hools are some of the most conservative in their choice of
I III In thods, eschewing the new and embracing the tried and
" 111'01(' d.
Driven Assessment, if conducted properly, serves multiple
II.f
of the purposes of medical student assessment are:
IIHn
I I ". II rmine whether the learning objectives that are set a priori
'f/I1('t
"I'po, l of student learning
,lllic anon and judgment of competency
Jlld, rvtanding of the learning process
(Amin & Khoo, 2004; Newble, 1998)
" " assessment method can provide all the data required for
ful physician. (George Miller 1990).
I ,om~on tool used for assessment of knowledge is the essay
III Indian context, most of the universities commonly use
57
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~~~~~~ I-IA " I) BOOKON BASICS \IEDICALEDliCATION ~~~~~ = llANO BOOK ON BASICS "!EDleAL EDlJCATION ~~~~~

unstructured essay question as an assessment tool. Usually thes Poor reliability and inconsistency in marking
questlonsare framed in such a way that the student enjoys the freedom, lime consuming and difficult to mark; inefficient
within the subject context, to determine the nature and the scope of th III I·wn ral, a large number of essay questions are required to have a

answer. III hrp dth in content coverage, making it very impractical in terms of
Let us take an example of a few unstructured essay questions: I ·.pt nt in administering and grading the examination.
Discuss briefly about shock.
Discuss RNTCP. Ifl ation of essay question:
,:- Write an essay on PEM. II II ( rtain modifications in framing the essay type questions the
I eleVity, validity and reliability of such a common tool of assessment
These types of questions enable a student to respond freely on basis I III enhanced.
of their factual recollection, comprehension, analysis, synthesis,
evaluation or occasionally bluffing capabilities. Hence we can appreciate I tured Essay Question (SEQ): These types of questions differ from
that in these types of questions every individual student may respond in 111 Iructured component in freedom regarding nature and the scope
a different way or write a different answerfor the same question. So these f 111 answer, The framing of such question provides the student the
are known as Free Response Questions. II 1.llle regarding points to be included in the answer. They are hence
These questions are helpful in assessing higher domains of learning I known as Restricted Response Questions. Examples of 5EQ
and comprehension. But because of the level of subjectivity involved in Discuss shock and its management in relation to a splenic injury.
assessment of these questions which reflect in marking pattern, this tool Write an essay on protein energy malnutrition discussing the
of assessment is criticized primarily for subjectivity and disparity in tiopathogenesis, clinical feature and management.
marking .This suggest that EQ per se are not unreliable but only the I

marking system which makes it 10 ks so. ctlfl d Essay Question (MEQ): This type of question is framed in a way
Hence an examiner with a deliberate effort can add to the validity and 1111 II resembles a 'series of short answer questions'. This type of
reliability of the essay type questions. III .11 ns usually provides a limited amount of relevant data followed by
, w questions based on the supplied relevant data. In context to a clinical
Advantages of essay type question: I u.u ron student may be provided with a limited amount of patient data
Easy to frame 1111 I II n asked to write a brief answer to a question which can be
Allowing the students free and effective expression I CI", ively followed by some further relevant information regarding the

Can test higher domains of learning like comprehension, analysis, .md then by additional questions. .
synthesis and evaluation l r.tmlng of MEQshould be done very skillfully so as to avoid answer to
Unlike the MCQ or other forms of objective test, essay questions II pr vious question and to avoid the student from being penalized
cannot be answered by looking at the choices II .uodlv for the same error.
Disadvantages of essay type question: f .imple of a traditional Essay Type Question and how it is converted
Lack of objectivity 111/1 d \1 Q and MEQ for improving objectivity, reliability and validity.
Pursuing objectivity by "over-structuring" the question may
trivialize the question and therefore compromise objectivity It onal essay
(5chuwirth & van der Vleuten, 2003) I" . (I ibe the diagnosis and management of Thyrotoxicosis (15 marks)

58 59
 SEQ •••••~~~~ HAND BOOl\: ON BASICS MEJ)JCAL EDl'CATION ~~~~~~

1. a) Describe the symptoms and signs of thyrotoxicosis (5marks) To conclude, it is evident that there are various means and measures
b) Outline the investigations (5marks) Increase the validity, reliability and objectivity of an essay type question.
c) What are the various modes of treatment? (5marks) hi very common and time tested tool for assessment and evaluation
n playa very vital role in testing higher cognitive domains of learning
The above SEQ can be made problem based and converted to MEQ like nalysis, synthesis, evaluation and problem solving ability of a student
A 46 year old female patient comes to you with a history of generalized II onstantly demanding and a challenging profession like the medical
weakness, palpitation, excessive sweating, and heat intolerance for the j nce.
last one year. In spite of a good appetite, she has lost lOkg of weight
during this period. f rences:
a) What is your provisional diagnosis? Justify (2marks) 1. Singh T, Gupta P,Singh D. Principles Of Medical Education, Fourth
b) What investigations will you advise to support your diagnosis? Edition, Gwalior, Jaypee Brothers ,2013.
(5marks) 2. Ananthakrishnan N., Sethuraman K.R., Kumar. 5, Medical Education
c) Outline the steps in the management of this patient Principles And Practice Second Edition, Pondicherry, Alumni
(8marks) Association NTIC JIPMER, 2000.
Guidelines for construction of essay type questions and its modified
versions:
1. Questions should be clear & specific & exact limit should be set.
2. Avoid:-
a) What do you think?
b) What is in your opinion?
c) Discuss?
Instead use:
'",
a) Enlist, Enumerate or Define
b) Compare & Contrast
c) State your reason
d) Describe (acceptabl )
3. Match the question to sp ific I t1ttlinlt oh] tiv. Communicate
clearly to the students what is xlH t. d
4. Use simple, clear and straight f rw.ud 1.111/111"1\( ,
5. No options- and better compari on, if opl ( (I'. Iht y hould be from
same topic and should match th (lIfflllllly II wi
6. In "Write briefly ..." type of qu tion •.•1I11.lIlIy how 1I/ll'fly mto
number of words or lines of stand.n d p." ,WI .pll
7. Scoringsystem:Splitthetotalm rk ••110111«11111 II II JI.lrl of the ,
question topic. May be indicated III 1111 p.lp 'I (I II II III,).

60
61
 ••• -~~~~ IIAND BOOK ON BASICS MEDICAL EDliCATION ~~~~~~

HOR ANSWER QUESTIONS III~Ie:

L. Thangkhl w
Arup J. Barualt
Short answer questions (SAQs) are written exam questions that all w
an open answer, They elicit short answers that candidates must formulat .
themselves rather than choose from a selection of answers. SA
generally test the lower domains of learning and are framed to avoid bl
due to literary presentation, style etc.
In their simplest form, they require the student to write a word, phras I
number or sentence to complete a statement or a diagram (hence they
are sometimes also called 'supply type' tests). In contrast to multipl
choice questions, which tests passive knowledge, the open answerformat
allows to assess whether the student can actively recall and formulate
their knowledge. The SAQs not only tests recall of facts, but also how
they are understood, interpreted, weighted and applied to solve questions
i.e. they test the depth of knowledge.
Properly constructed, they allow themselves to be marked fairly
objectively, although on certain occasions, some subjective decision about
the correctness of the answer may be required. As a general rule, it can
be said that the longer the expected answer, more is the subjectivity
involved.
Short answer questions can be pr nt d in many forms. Some of the
commonly used formats are:
A. Completion type: These ar prob bly th simplest questions to
frame for testing factual recall. S I 1 tl mpl of facts which must be
essentially known to the student nd wrrt • It down in the form of a
statement. Then block out a cruci I word or pllr, from it, which the
student is required to supply.
Example:
Fact : Vitamin A deficiency cau • Xl roplltlltllllll!l
Question: Xerophthalmia is caused duo to (II'/flll'lI( Y01 Vitamin
Completion type of items can be modifl ,t! 10 I v,IIII,111 .,lightly higher
domains of learning by building th m ",olold did 'I 1111 sequential
I
reactions, drawings and formulae.
omplete the sequence given below by providing the missing links
a
When susceptible bacteria divide in the presence of lactam
ntibiotic are produced.
Label the following diagram (A to F)
i: F-..n.--J.-~I--hnrt-hndJr.-~-+r--'--
J
B. Unique or one best response type: These take the form of actual
qu tions, the examinee having to supply a specific answer. These
II I tions also allow themselves to be marked fairly objectively.
I X mples:
o Write the dose of oral Prednisolone (in mg) for a,30-year old
ady weighing SO kgs
h formula to calculate the body mass index is wt (kg)/
o Classify the following organisms as Gram positive or Gram
negative Kleibsiella pneumoniae, Staphylococcus aureus,
Pseudomonas aeruginosa, E. coli
C. Open SAQ: These are similar to unique answer questions except
they allow for some variation in the nature of the answer, either in terms
of its intrinsic content or in terms of the way in which it is expressed.
Example
Enumerate three side effects of Latanoprost
_ These questions require the student to offer an answer based on his /
her understanding.

62 63
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II 1I111)!)1() U\SJ('SI\H<:UI('\LEIH1CATION ~~~~::;=- •••••~~~~ IIANn BOOK ON BASICS .~n:DICALEDlIC\'TION ~~~~~~

r III n of A vmg selected the questions, it is important to provide a finallay~ut of

JIll woul I)g'. of I .II II qlll".lIo11 ••hould b imple, clear and easy to h Items. Guidelines for answering each test item should be mentioned
und r t nd and 1.111[111.11: tlpptopdtl!!! th tud nt population. Th(1 V ry clearly. Indicate marks allotted to each question so that the student
question should te t an import nt poet and 11 uld r quire a well defin I IlOWS how much time should be spent on it.
task from the student, leaving very littl subj tiv int rpr tation. Th valuation of test items may be carried out by a colleague or a validation
content of the SAQ should measure knowledge appropriate to the desired J Ill! I before using them for actual test situations. The evaluators are
learning goal. For example, uvided with a checklist which seeks information regarding the relevance
a. 'Name three preliminary investigations' instead of saying 'What t III questions to the course content, the specific educational outcomes
investigations will you order?' r ••kills being assessed. They evaluate the items for validity, clarity of
b. A neonate is _ (possible answers: male, female, live baby, I nguage, absence of clues and estimate the 'difficulty level ind~x' ~~d
preterm, post term, pink, 2.5kg etc.) thl 'discrimination index' of the question. They also assess the reliability
The question can be better framed as following:
f the question.
A baby is called a neonate upto of age
M rits of SAQs
Steps for writing SAQs 1. They are easy to construct as compared to MCQs
Design short answer items which are appropriate assessment of the 2. They are more specific than essays and thus more reliable
learning objective. Make sure the content of the SAQs measures They are quicker to answer than essay type questions. Thus the
knowledge appropriate to the desired learning goal. The questions should student can be tested on a wide range oftopics in a short span of
be clear and easy to understand with wordings and language appropriate
time
to the student population. They should be set explicitly and precisely with 4. SAQs are less prone to guessing than MCQs
clear instructions to test the desired knowledge and get the specific It is possible to construct a checklist for responses to ensure
response. Ensure that the item clearly specifies how the question should intermarker reliability and thus objectivity
be answered.
e.g. Should the student answer it briefly and concisely using a single m fit of AQs
word or short phrase? In 1\10 I ca , they test only factual knowledge and not its
As far as possible the question should be positively worded. If negative Ipplh .11 on
question is unavoidable, they should b written in capitals/ italics or lilt yell! "' I
'()V 1.1 mu h yllabus as MCQs
underlined. Example \ 1\ 11111 IIHIII 111111I r qulr dforansweringaSAQascompared
Which drugs should be avoided in p Ii nt with hepatitis? 10 M( II .0 I' uuml» I of qu lions in test paper hence less
Avoid unintentional clues like 'a', or 'an' r 't n w r space' which istoo reliability
proportional to the length of the answ r. 1\1 o lV id words that invite 4. They take longer time to pr p r in ord r to avoid ambiguous
lengthy answers like 'discuss', 'describ " , xpl.un', 'outhn " 'comment', responses
When an answer is to be expressed in num rie••1wItt ••, th unit should be However, SAQs have their own place in assessment of cognitive skills.
stated.
Example: If a room measures 7 metres by Jl m I II , till pC'II'" -t r is
metres (or m).

64 65

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",~~ , , -s C""'-'" "
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 ••_-=-..-=;;; BANI) BOOKON BASICS MEDICAL EDUCATION ~~~~~~

M AN M ANALYSIS Write a stem to include a question or a problem to be solved by

the student.
Sourabh G.Duw r h Write the correct answer after crosschecking for ambiguity.
Recall the common mistakes the students make about this in day
Multiple Choice Questions (MCQs) are the most widely u 'el to day teaching.
assessment method in medical schools for more than SO years. They tI h. Select the most plausible alternatives and arrange them in the form
easy to administer, easy to mark even for a large number of student, of options.
have testing efficiency and are objective. They are a selection type f 7. Read the item and have them read by colleagues for any possible
objective question. However, the only thing objective about them is th I corrections.
they can be marked objectively. Otherwise they are as prone to subjectiv 8. Try the item on a group of student during a class test and calculate
errors as any other test. Therefore, it is important that due care and the facility value and discrimination index of each item. Only those
attention is given while formulating and' writing these questions, items having these values within the acceptable range should be
Conventionally, these questions are known as items. retained for further use.
Most MCQS are written to assess lower level of cognitive skills. Ideally
MCQS should be written to assess higher level of skills as per the six teps to improve the quality of the items
cognitive knowledge levels of Bloom's taxonomy of educational 1. Items should test important learning outcomes,
Objectives. 2. Each item should be complete and independent. If a subsequent
item is dependent on the previous item, students are penalized
Terminology of writing MCQ's twice if they don't know the first answer.
A specific terminology is used in writing an MCQ. This can be explained 3. Should be written in the correct format. ,
by help of the following example. 4. Each item should be based on a single theme. e.g.
Epithelioid cells in granulomatous inflammation are derived from: _
a. lymphocytes In case of sunstroke, the victim:
b. monocytes (a) Should have head lowered
c. eosinophils (b) Has a weak pulse
d. basophils (c) Should be given a stimulant
The question part of the item is call d 'stem'; correct answer (b) is (d) Should have cold sponging
called the 'key' while a, b, and d ar c II d di tracters. The quality of an
MCQ depends upon the distracters i. ., how f r th y re able to distract The options include symptoms, signs and treatment. This MCQ could be
the students who do not know the orr t n w r. hus, a deliberate better written as:
attempt has to be made to provide eft': tiv di tr, t r
The most common feature of sunstroke is:
Steps of writing a good MCQ (a) Weak pulse
The following steps are essential in writlng , If ( II M( o (b) Pale face
1. Select a specific learning objectiv whle h w WIlli 10 test. (c) High temperature
2. Target population for which the it m l11.ul, (d) Excessive perspiration

66 67

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 ~~~~~~ HAND BOOK ON BASICS MEDICAL EDUCATION ~~~~~~
~~~~~~ llANO BOOK ON BASICS MEDICAL EI)t1CATION ~~~~~~
2. Does the item call for information which a physician should know
5. An item should not have a series of true false statements. In such a without consulting references?
question the student has to read each option and decide if it is 3. Is the item appropriate for the knowledge of the examinee?
true. This ends up taking more time and so being unfair to the 4. Is the problem stated clearly?
student. 5. Is the item written with as few words as possible?
6. The stem should be a problem rather than a single word or a passive 6. Are negatives avoided?
phrase. 7. Is each alternative plausible?
7. The statement should be qualified where necessary. E.g.
The infant mortality rate is: Concept of Blue printing
(a) 40 The blueprint is a word borrowed from architecture. It indicates that a
(b) 80 process of assessment needs to be conducted according to a replicable
(c) 95 plan. The use of the blueprint will ensure that, the test has been developed
(d) 120 and mapped carefully against the educational objectives of the course,
In this example, for which region the IMR is required is not specified, ensuring fair representation of objectives. A Blueprint is a plan that
nor is the denominator given. The year under reference is also not explicitly relates outcomes and assessment strategies .It guides the
mentioned. development of assessment systems at a course level and at unit level. It
8. The stem should be complete in itselt and should not depend on also guides the appropriate use of individual instruments and provides
the options. evidence of the design making processes involved in choosing appropriate
9. As far as possible negative words should b avoided. If inevitable, assessment tasks, sampling of subject matter and balance.
they should be highlighted.
10. Abbreviations especially non st nd rd on hould be avoided in Why do we need to use a blueprint?
the stem. The purpose of a blueprint is to explicitly align assessment processes
11. Avoid superfluous and unn dry word . with desire learning outcomes in terms of what will be assessed? how
12. The options should be par II I in ont xt and in grammar. will it be assessed? and to ensure an appropriate range of objectives,
13. The distracters should be su f lh t only low r ability students content and weightage are addressed when devising specific examination
should be distracted by them. instruments.
14. The language used should b ppr prilit I r the students. It is also used to ensure that, the test is using the appropriate methods
15. The options should be arranged in rank rdor, to educational objectives.
16. All ofthe above should be avoid d an opuon s the student can • to prevent unbiased scoring of examination results
guess the answer if he recognizes tw (or tl'( I options. None ofthe • to allow sharing and communication with others
above should also be avoided esp 1.llly.1 ,I di tracter. • to provide a basis for consistency over time
17. Avoid clues in the form of singular/plur II xpn ions or by use of
a/an. Paper setting and blue Printing
1. The objective: the purpose for which blue print is to be made has to be
Checklist for constructing MCQs defined-is the paper to be set for internal or final examination or an
1. Does the item deal with one or more import uu a P cts ofthe entrance examination?
subject?
69
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~~~~~~ I-L'\N[) BOOK ON BAS.ICS MEDICAL EDUCATION ~~~~~~
2. Syllabus or course content should be according to the level of the
student.
3. Time allotted and number of questions which can be within
stipulated period of time has to be examined.
4. The design of the paper has to be decided. What are the types of
questions in a question paper: only MCQs or mixed assessment?
5. If the paper has mixed questions, marks have to be distributed
according to the question type and expected weightage of the
content.
6. Questions have to be framed keeping in mind the Taxonomy of
educational objectives & table of specifications.
7. There has to be an emphasis on professional skill and competence.
8. The length of the question paper should be reasonably feasible for
an average student to answer within the stipulated time.
9. The questions have to be divided on the basis of:
Must know - vital'
Should know - essential
Could know - desirable
60% of questions should be of such type that they can be answered by
average students.
20% by good students
10% by very good students
10% can only be answered by excellent or distinction holders.
70
OBJECTIVE STRUCTURED CLINICAL EXAMINATION AND
OBJECTIVE STRUCTURED PRACTICAL EXAMINATION
Dr. Arup Jyoti Baruah
OSCE was developed in university of Dundee (Scotland) in the early
1975 by Dr. Harden & colleagues. After some modification it was described
in detail in 1979. This method was the subject of an international
conference in Ottawa in 1985 & experience were exchanged about OSCE
& OSPE. Since its introduction as a mode of student's assessment in
medical school in 1975, the objective structured clinical examination
(OSCE) has become a standard method of assessment for both
undergraduate and postgraduate medical students.
It assesses competency, based on objective testing through direct
observation. It is precise, objective, and reproducible allowing uniform
testing of students for a wide range of clinical skills. Unlike the traditional
clinical exam, the OSCEcould evaluate areas most critical to performance
of health care professionals such as communication skills and ability to
handle unpredictable patient behaviour.
Problems in routine clinical examination:
• Variability
• Global Assessment
• Marks awarded by overall impression
• Many abilities are ignored
• Difficulty in terms of time, money and number of pillII'nl ••,lIId
examiners required
• "tests the product & not the process"
OSCEis designed to overcome these deficiencies. The main feature of
OSCEjOSPE is that both the process and the product are tested giving
importance to individual competencies. The examination covers a broad
range of clinical skills much wider than a conventional examination. The
scoring is objective, since standards of competence are preset and agreed
check lists are used for scoring. Where questions are asked in response
stations, these are always objective. Simulations can be used for acute
cases and there is scope for immediate feedback. Patient variability and
examiner variability are eliminated thus increasing the validity of the
71
~~~~~~ HAND BOOK ON BASICS MEDICAl. EDliCATIO!\' ~~~~~~
--i~~~~~ IVL'iD BOOK ON BASICS MEDlCAL EDuCxnON ~~~~~~
exa.min~tion. OSCE,e~sures integration of teaching and evaluation. Variety
maintains student s Interest. OSCE is adaptable to local needs. A large The OSCEexamination consists of about 15-20 stations each of which
number ~f students can be tested within a relatively short time. r quires about 4-5 minutes of time. All stations should be capable of being
W.h~t ISassessed by OSCE? It can assess all the domains of learning- ompleted in the same time. The students are rotated through all stations
cogmtl~e, psychomotor and affective domain. These are generally done nd have to move to the next station at the signal. Since the stations are
by putting up various skill stations- enerally independent, students can start at any of the procedure stations
• clinical skills: history taking, physical examination, technical nd complete the cycle. Thus, using 15 stations of 4 minutes each, 15
procedure, communication, interpersonal skills tudents can complete the examination within 1 hour. Each station is
• Knowledge & understanding designed to test a component of clinical competence. Stations are of two
• Data interpretation types:
• Problem solving
• Attitudes Procedure stations -students are given tasks to perform on patients. At
all such stations there are observers with agreed check lists to score the
OSCE/OSPE Methodology student's performance.

Response stations- students respond to questions of the objective type

or interpret data or record theirfindings of the previous procedure station.

How to prepare OSeE

.......•
....•
Example of a procedure station
Task - Examine the scrotal swelling in this patient.

•.,. .
:,.
.
Points in the check list:
1. Does he introduce himself to the patient?
2. Does he confirm patient identity?
3. Does he ask for a chaperon?
4. Does he explain to the patient what he is going to do?
5. Does he take permission?
6. Does he provide a screen and respect patient's privacy?
7. Does he ask the patient to expose the whole abdomen and
genitalia?
8. Does he examine both sides of the scrotum?
9. Does he take care not to cause discomfort?
10. Does he palpate the spermatic cord?
11. Does he examine the inguinal lymphadenopathy?
1l1""1.;:':~~0:~:ft
Analyze the results 12. Does he palpate the abdomen (for lymph nodes in case it is a patient
, & use the' same for with a testicular tumour)
~ ~ l' ~'"
""'i~(:" •

,student assessments 13. Does he palpate the supraclavicular nodes?

~~~< :;{~J.L.~A
,'!
14. Does he thank the patient?
72
73

~
." >:. ,~:, :':t- ,~
~~~~~~ I-lAND BOOK ON BASICS MEJ)[CAL.EDliCATION ~~~~~. ~~~~~ llANO BOOK ON BASICS lVIEDlCAL EDUCATION ~~~~~~

Weightage for each item in the check list can be decided by the examiner the same scope and criteria for assessment. This has made it a worthwhile
depending on their importance. Points I, 3, 6, 10 test the affective domain method in medical practice.
which is not usually tested by the clinical examination.
References:
Advantages of oseE: 1. Singh T, Gupta P,Singh D, Principles Of Medical Education ,Fourth
• More objective Edition, Gwalior, Jaypee Brothers, 2013.
• Uniform scenarios for all candidates 2. Ananthakrisnan N., Sethuraman K.R., Kumar.S, Medical Education
• Tests not only skills and knowledge but attitudes also Priniciples And Practice, Second Edition, Pondicherry, Alumini
• Tests the student's ability to integrate knowledge, clinical skills and Association NTTC JIPMER, 2000.
communication with the patient 3. Ananthakrishnan N. Objective structured clinical/practical
• Can be used with large numbers of students examination (OSCE/OSPE). J Postgrad Med 1993;39:82-4.
• Reproducible 4. Zayyan M. Objective structured clinical examination: the
• Provides unique programmatic evaluation assessment of choice. Oman Med J 2011. Jul;26(4):219-222
• Stations can be tailored to level of skills to be assessed 10.S001/omj.2011.SS.
• Less complexity
• Allows for demonstration of eme gency skills
• Valid examination
• Summative & well formative

Disadvantages:
• Development & administration are time consuming & costly
• OSCE involves lots of planning
• The assessment of skills tends to get compartmentalized in an OSCE:
on the whole is not assessed
• The reliability of OSCEis low if there are a small number of stations,
noisy environments, untrained patients & lack of structured
checklists
• Need for standardization of simulated patients & examiners
• Repetitive & boring
• Requires time, effort on the part of examiners during the
examination
The OSCE/OSPEare a highly reliable and valid clinical examination that
provides unique information about the performance of a student. It allows
evaluation of clinical students at varying levels of training within a
relatively short period, over a broad range of skills and issues. OSCE
removes prejudice in examining students and allows all to go through

74 75

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 ~~~~~~ IIANDnOOKONBASICSi\IEDIC·\LEIHJCA'l'ION ~~~~~;;;;
CLICKERS (CLASSROOM RESPONSE SYSTEMS)
Here are a few types of clicker questions.
• Reca" Questions: These questions ask students to recall facts, concepts,
Md. Yunus & Animesh Mishra
What Is a Clicker? or techniques relevant to class. They are often used to see if students did
A clicker (sometimes. called a classroom response system, personal the reading, remember important points from prior classes, or have
response system, student response system, or audience response system) memorized key facts. They rarely generate discussion, however, and don't
is a set of hardware and software that facilitates teaching activities such require higher-order thinking skills.
as the following. • Conceptual Understanding Questions: These questions go beyond
recall and assess students' understanding of important concepts. Answer
A teacher poses a multiple-choice question to his or her students via an choices to these questions are often based on common student
overhead or computer projector. misconceptions, and so these questions work we" to help instructors
identify and address their students' misconceptions.
• Application Questions: These questions require students to apply their
Each student submits an answer to the question using a handheld knowledge and understanding to particular situations and contexts.
transmitter (a "c1icker") that beams a radio-frequency signal to a receiver • Critical Thinking Questions: These questions operate at the higher
attached to the teacher's computer~ . .. levels of Bloom's Taxonomy, requiring students to analyze relationships
among multiple concepts or make evaluations based on particular criteria.
Often these questions are "one-best-answer questions," questions that
Software on the teacher's computer collects the students' answers and include multiple answer choices that have merit. Students are asked to
.produces a bar chart showing how many students chose each of the
select the one best answerfrom these choices.
answer choices.
• Student Perspective Questions: These are questions that ask students
to share their opinions, experiences, or demographic information.

The teacher makes lion the fly" instructional choices in response to the • Confidence Level Questions: Asking students a content question, then
bar chart by, for example, leading students in a discussion of the merits' following that by asking students to rate their confidence in their answers
of each answer choice or asking students to discuss the question in small (high, medium, or low) can enhance the usefulness of information on
groups. student learning provided by the first question.

Teaching with a Clicker Types of Activities

Types of Questions
Many instructors see multiple-choice questions as limited to testing
students' recall of facts. However, multiple-choice clicker questions can
actually serve many other purposes in the class, including assessing
students' higher-order thinking skills. Since clicker questions can be used
not only to assess students but to engage them, some very effective clicker
questions are quite different than multiple-choice questions that might
appear on exams.
76
Teaching with a Clicker takes a number of directions. Teachers will want
to match activities to course content, time constraints, learning objectives,
and their own teaching styles. Some possibilities for Clicker activities
include the following, listed more or less in order of increasing levels of
student engagement.
• Attendance: Clickers can be used to take attendance directly (e.g.
asking students to respond to the question "Are you here today?") or
indirectly by determining which students used their clickers during class.
77
 ~~~~~~ I-lAND BOOK ON BASICS MEDICAL EDt "CATION ~~~~~~
• Summative Assessment: Clickers can be used for graded activities, such
as multiple-choice quizzes or even tests. Some brands of clickers allow
for a "student-paced" mode in which students answer questions on a
printed test at their own pace.
• Formative Assessment: Clickers can be used to pose questions to
students and collect their answers for the purpose of providing real-time
information about student learning to both the instructor and the
stud:nts. Students can use this feedback to monitor their own learning,
~nd Instructors can use it to change how they manage class "on the fly"
In response to student learning needs.
• Homework Collection: Some brands of clickers allow students to record
their answers to multiple-choice or free response homework questions
outside of class and submit their answers via the clickers at the start of
class.
• Discussion Warm-Up: Posing a question, giving students time to think
about it and record their answers via clickers, and then displaying the
results can be an effective way to warm a class up for a class-wide
discussion.
• Contingent Teaching: Since it can occasionally be challenging to
determine what students understand and what they do not understand,
clickers can be used to gauge that in real-time during class and modify
one's lesson plan accordingly. If the clicker data show that students
understand a given topic, then the instructor can move on to the next
one. If not, then more time can be spent on the topic, perhaps involving
more lecture, class discussion, or another clicker question.
• Peer Instruction: The teacher poses a question to his or her students.
The students ponder the question silently and transmit their individual
answers using the clickers. The teacher checks the histogram of student
responses. If significant numbers of students choose the wrong answer,
the teacher instructs the students to discuss the question with their
neighbour. After a few minutes of discussion, the students submit their
answers again.
• Repeated Questions: In the peer instruction approach described above,
students respond to a given question twice-once after thinking about
their answer individually and again after discussing it with their neighbour.
78
~~~~~~ HAND BOOK. ON BASICS MEOICI\.L EDUCATIPN ~~~~~~
Why Use a Clicker?
• To Maintain students' attention during a lecture. Studies show that
most people's attention lapses after 10 to 18 minutes of passive listening.
Inserting a few clicker-facilitated activities every so often during a lecture
can help maintain students' attention.
• To promote active student engagement during a lecture. Posing well-
chosen questions to students during lecture and expecting answers from
each student can cause students to reflect on and assimilate course
content during class.
•. To promote discussion and collaboration among students during class
with group exercises that require students to discuss and come to a
consensus.
• To encourage participation from each and every student in a class.
Asking a question verbally and calling on the first student to raise his or
her hand results in one student participating. A Clicker facilitated activity
can involve not one, but all of the students in the class.
• To create a safe space for shy and unsure students to participate in
class. A Clicker gives students a chance to respond to a teacher's question
silently and privately, enabling student who might not typically speak up
in class to express their thoughts and opinions. A Clicker also enables
students to respond anonymously to sensitive ethical, legal, and moral
questions.
• To Check for student understanding during class. By asking Clicker-
facilitated questions, teachers can determine if students understand
important points or distinctions raised in class. They need not wait until
homework is turned in or exams are completed to do so. Instead they can
receive feedback on a lecture during that same lecture.
• To teach in a way that adapts to the immediate learning needs of his
or her students. If a histogram of student answers shows that a significant
number of students chose wrong answers to a question, then the teacher
can revisit or clarify the points he or she just made in class. If a histogram
shows that most students chose the correct answers to a question, then
the teacher can move on to another topic.
• To take attendance and to rapidly grade in-class quizzes, provided
that each transmitter is assigned to a unique student over the length of a
course.
79
~~~~~~ HA~n BOOK ON BASICS "tEDICALEDLCHION ~~~~~~ ASSESSMENT OF KNOWLEDGE - AT A GLANCE
• To add a little drama to class. There is often a sense of expectation as
wait forthe histogram to appear showing how their classmates answered Md. Yunus & Abhijeet Bhatia
a given question.
Knowledge forms the base of clinical competence and should be given
Challenges in Using a Clicker adequate importance in assessment. Written assessment methods are
While a clicker can facilitate a variety of student-active teaching popular because they are easy to conduct and cost effective when a large
activities, a teacher using a Clicker should be aware of the following number of students have to be tested. We spend considerable time and
challenges. effort in assessing knowledge using written assessment methods. This
can be used to assess a student's comprehension and ability to analyze,
• As with any use of computer technology in the classroom, technical
synthesize and organize information. Unfortunately we often end up
problems can arise. A teacher using a CRS should allow time at the
testing recall abilities and factual knowledge.
beginning of class to set-up and troubleshoot the CRS..
Written assessment methods can have either closed ended or open
• Getting started with a CRStakes some time. Current systems are easier
ended format. When using open ended questions, fewer questions can
to learn and use than older systems, but there is still some start-up time be asked which means lesser content area can be covered.
required. Having an experienced user around is helpful. Adapting lesson The various written assessment tools are:
plans to take advantage of clickers takes ime, too. • Easy questions, structured essay questions, modified essay
• Using a Clicker in class takes up class time. If students do not keep questions
possession of transmitters between classes, some time will be spent at • Short answer questions
the beginning of class distributing the transmitters. Moreover, a few • Multiple choice question
minutes will be needed for students to transmit their answers, and class Each question type has its own advantages and disadvantages.
time will be used discussing student responses. Depending on the purpose of the assessment, one can select an
• When a teacher uses a CRSto check for student understanding during appropriate question type.
class, if it turns out the students do not understanding a particular concept
or application, then the teacher may have to change his or her lesson Essay questions
plan "on the fly./I This can be challenging for teachers who are used to Essay question is the most commonly used format for assessing
preparing their lessons thoroughly in advance or who do not think on knowledge. It has the advantages of being relatively easy to frame,
their feet as well as some. allowing the students free and effective expression. It also tests their
knowledge, reasoning and ability to organize ideas. But the main drawback
is the lack of objectivity. But the essay questions could be improved by
structured essay questions and modified essay questions.
Eg: Define and write in detail about inflammation. (lOmarks).
This question could be could be improved by-
Define inflammation. (2marks)
Explain the process of cellular events in inflammation. (4marks)
How'does killing and degradation take place? (4marks.)

80
~~~~~~ HAND BOOK ON BAS.ICS MEDICAL EDllCATION ~~~~~~ ~~~~~~ l-IAND BOOK ON BASICS lVJEDlCAL EDliCATION ~~~~~~

Short answer questions(SAQ'S) episode, his abdomen is distended, and bowel sounds are decreased.
The SAQ's evoke restricted response and are used in situation where Neurological examination shows mild weakness in the upper arms. These
reliability of scoring and objectivity is preferred. It can be of several types findings suggest a defect in the biosynthetic pathway for
- completion type, best response type, open SAQ etc. a) collagen
b) corticosteroid
Multiple choice questions (MeQ's) c) fatty acid
MCQs can test a variety of skills including higher order ones like analysis 'd) glucose
and problem solving. The MCQs is commonly used due to logistical e) heme
advantage of being able to test large number of candidates in a short
period of time and with minimal human intervention. Good MCQ's
A traditional MCQ or item is one in which a student chooses one answer • "Assess application of knowledge
from a number of choices supplied. One best a~swer question has three '. 'Present a homogeneousset of options
major parts - the stem, lead in and options.
Writing a good MCQ requires training and practice. Mathematical models . Writing the Questions
are available to reduce guessing effect. • Construct stem -include all necessary information to arrive at the
Basic Rules for MCQ's right answer
• Focus item on important concept • Choose lead-in - posea clear question
• Item should assess application of knowledge, not recall of an • Choose distracters
isolated fact
.• Stem must pose clear question - 'Cover the options' test
Item analysis
• All distractors should be homogeneous Item analysis is a means to ensure quality of MCQ's. The MCQ or Item
• Avoid technical item flaws ), needs to be analyzed according to their difficulty and ability to discriminate
between good and average students .
.J

Question paper setting

Written examination is still the widely used tool for assessment and the
instr~~ent used in written examination is the question paper. But often
question paper lacks validity, reliability, relevance and objectivity. So there
is need for systematic approach to the setting of question paper.
A blue print is a template for the question paper setter and the
rln .. examination to assess al] that is expected from a student at the end of a
learning session.

Ref~rence
' .. \\.: .
Tejinder Sihgh, Ansu: Principles of Assessment in Medical Education.
Javpee Publishers, India.

82 83

Faculty Member of
NEIGRlHMS Trained from MCI Recognized Centre for MET
SI Name & Designation
No.
I. Dr. Animesh Mishra,
Professor,
Cardiology Department &
Chairman of Medical Education
Unit
2. Dr. Md. Yunus,
Additional Professor,
Anaesthesiology Department &
Coordinator of Medical
Education Unit
3. Dr. Y. Khonglah,
Associate Professor,
Pathology Department
4. Dr. Sourabh Duwarah,
Assistant Professor,
Pediatrics Deoaartment
5. Dr. Rituparna Barooah,
Associate Professor,
Physiology Department
6. Dr. Amitav Sarma,
Associate Professor,
Anatomy Department
7. Dr. Tanie Natung,
Associate Professor,
Opthalmology Department
8. Dr. Himesh Barman,
Assistant Professor,
Pediatrics Department
9. Dr. A. Santa Singh,
,Professor,
Obs & Gynae Department &
Princioal, NEIGRlliMS
10. Dr. Sharat Agarwal,
Associate Professor,
Orthooaedics Deoartmerit
11. Dr. R. Hajong,
Associate Professor,
General Surgery Department
12. Dr. Sarah Ralte,
Assistant Professor,
Anatomv Deoartment
Email
Animesh.shillong@gmail.com
(Trained from KGMU)
dryunus@hotmail.com
(Trained from KGMU)
yookarink@gmail.com
(Trained from KGMU)
Sgd7@rediff.com
(Trained from KGMU)
drritupamabarooah@gmail.com
(Trained from SRM, Chennai)
dramitav2007@rediffinail.com
(Trained from KGMU)
natunl!tanieliill!mail.com
(Trained from KGMU)
himeshbarm!\l1@gmail.com
(Trained from KGMU)
drsanta@re liffmail. 'om
(Trained fr m K MU)
drsharat88l@vf1h .corn
(Trained from K .MU)
ranendrahaiollg@ mail.com
(Trained from (iMlJ)
sarahzoremi@gn1 iil, om
(Trained from K .MlJ)
84
;;..;;;~~~~~~ HAND BOOK ON .BASICSMEDlCALIWIJC.YI'ION
13. Dr. S.R. Sharma, snnsims sharma@rediff.com 09436731268
Associate Professor, (Trained from KGMU)
Neurology Deoartment
14. Dr. Arup Jyoti Baruah, arupbaruah06@gmail.com 09436163389
Phone No.
Assistant Professor, (Trained from KGMU)
General Surzerv Deoartment
09436114330
15. Dr. W.V. Lyngdoh, drval@rediffinail.com 09862079610
Associate Professor, (Trained from KGMU)
Microbiology Department
16. Dr. Nari Mary Lyngdoh, narilyngdoh@Yahoo.co.in 09862230765
Associate Professor, (Trained from KGMU)
09436160797
Anesthesiology Department
17. Dr. Lanalyn Thangkhiew, lanalyn@gmail.com 09774035964
Assistant Professor, (Trained from KGMU)
Opthalmology Department
18. Dr. Syed Wasim Hasan, drswasimhasan@gmail.com 09615943694
09436336490
Assistant Professor, (Trained from KGMU)
t
Urology Deoartment
19. Dr. Manuj Saikia, manuj saikia@yahoo.com 09436700905
09436706759
Associate Professor, (Trained from KGMU)
CTVS Deoartment
20. Dr. S. Panda, pandadrsubrat@rediffinail.com 09612161655
09436700733
Associate Professor, (Trained from KGMU)
Obs & Gynae Deoartment
21. Dr. MusarafHussain, masarathussain@yahoo.co.in 09435730681
08974823.6(:)3 Assistant Professor, (Trained from KGMU)
Neurology Deoartment
;
22. Dr. Arindom Kakati, arindomkt@rediffinail.com 08014485569
09436766050 Assistant Professor, (Trained from KGMU)
Neurosurgery Department
'1\
23. Dr. Chandan Kr. Nath,
- 'hfln(lal1kllO1.@r«diffinait.,.(;Q.m 09436731274
08974054513 Assistant Professor, (Truin ,(I from KOMU)
I
Biochemistrv Deoartment
,'\ '; 24. Dr. M. Agarwal, Qm111I1ikIlH\l~I)Yllhoo,
'0111 09H(, I r ~~.~
09436994~~J15, Associate Professor, (Trained Irom K<lMI1)
Obs & Gvnae Department
~J l' ,~
5, binod.k.thnk\lr(rl~',III ri] 1'011I (1111'" II, '10
Dr. Binod Kr. Thakur,
)",-")' Assistant Professor, (Trained from K(iMlJ)
09436336~I~i I, Dermatolozv Department
26. Dr. Bhupen Barman, drbhupenb@gmnil.cllll\ (1) IK II)OK \
.i •.. ,., .
Assistant Professor, (Trained from K JMlJ)
094367051i49' General Medicine Denartment
27. Dr. Donkupar Khongwar, donkavitha@gmail.coill ()I)() 1',111 I II)
Assistant Professor, (Trained from K MU)
09774289885 General Surzerv Deoartment
,1' t'
28. Dr. Abhijeet Bhatia abhijeetbhatia77@gmail.com 0<)402154516-
"If";
AssistantProfessor (TrainedfromKGMU)
..
ENT Deoartment
85
 l

====== HAND BOOK ON BASICS MEDICAL EDUCATION

Dr. Julie Birdie Assistant Professor, 08794732665
Regional Centre for MET Wahlang
Assistant Professor.
Pharmacology Pharmacology juliewahlang@gmail.com
King George's Medical University, Lucknow Department Department,
NEIGRlHMS,
Mawdiangdiang,
Basic Course Workshop in Shillon - 79300 18
Medjcal Education Technologies held at 9 Dr. Himashree Assistant Professor, Assistant Professor,
Community Medicine
09436985886
bhimashre@yahoo.co.in
Bhattacharya Community
NE,IGRlHMS, Shillong (Meghalaya) Medicine Department,
Department NEIGRlHMS,
Date of Workshop_: 26th, 27th & 28th March 2015 Mawdiangdiang,
ShiIlon - 79300 18
10 Dr. Jaya Mishra Associate Professor, Associate Professor, 09774722487
Name of Observer: Dr. R.K. Dixit Pathology Pathology jayamishraxyz@gmail.com
Department Department,
NEIGRlHMS,
List of Participants Mawdian dian
II Dr. Happy Chutia Assistant Professor, Assistant Professor, '09774498277
Biochemistry Biochemistry happy.chutia@gmail.com
SL. Name of Participant Official Address Contact Details Department Department,
Designation &
No Department (Tel./FaIIMobileJEmail) NEIGRlHMS,
Mawdiangdiang,
I Dr. Bhaskar Borgohain Associate Professor, Associate Professor, 09436706397 ShiUon -7930018
Orthopaedics Orthopaedics bhaskarhorg@gmail.com 12 Dr. L Pumima Devi Assistant Professor, Assistant Professor, 09436891578
Department Department, Oncology oncology purnimal2007@yaboo.co.in
NEIGRlHMS, Department Department,
Mawdiangdiang, NEIGRlHMS,
Shillong 7930018 Mawdiangdiang,
··2 Dr. Rajani Thabab Assistant Professor, Assistant Professor, 09612316287 ShiUon - 79300 18
Anaesthesiology Anaesthesiology rtI13bah@Yaboo.com 13 Dr, Lomtu Rongrang Assistant Professor, Assistant Professor, 09485104936
Department Department, Dentistry Dentistry Department rlomtu@yaboo.co.it;
NEIGRlHMS, Department
Mawdiangdiang,
Shillong- 79300 18 14 Dr. Jyoti Prasad Kalita Assistant Professor, Assistant Professor. 08575435250
CTVS Department CTVS Department, emailtojpk@gmail.com
3 Dr. C. Daniala Professor, Professor, 09436312898 NEIGRlHMS,
Radiology Radiology cdan28@rediffmail.com Mawdiangdiang,
Department Department, ShiUon -7930018
NEIGRIHMS, Associate Professor, Associate Professor, 09612646108
Mawdiangdiang, Forensic Medicine Forensic Medicine drdonna@rediffinail.com
Shillona-7930018 I) IHlllment Department,
4 Dr. Tasi Khonglab Assistant Professor, Assistant Professor, 09485030389 NP.lGRflfMS,
Orthopaedics Orthopaedics dr tashi@yaboo com MawditlllAdiong,
Department Department, hllh ••, 79100 I K
NEIGRIHMS, H' II! I) IHII••ft' I, 'I 11••lIll'lIlh 11
Mawdiangdiang, I. u ••••• 11,111'
Shillonz- 79300 18
5 Dr. John A. Lyngdoh Assistant Professor. Assistant Professor, 09436163163
Physiology , Pbysiology johnamote@gmail.com
. Department Department,
NEIGRlIIMS,
Mawdiangdiang,
Shillong- 79300 18
6 Dr. Shikha Assistant Professor. Assistant Professor, 09774168689
Dermatology Dermatology shikha b.thakur@gmail.com
Department Department,
NEIGRIIIM,
Mawdiangdiang, 19 I), AI\I'lIl1t NIIII I
Shillona- 79300 18
7 Dr. Benjamin Nongrum Assistant Professor, Assistant Professor. 09843126227
Opthalmology Opthalmology ben ·nminnongrum@yahoo.com 20 Dr. S.L. Sailo
Department Department,
NEIGRIHMS,
Mawdiangdiang,
Shillong- 79300 18

86
 HAND nOOK ON BASICS :VIEDICALEDliCATION ~~~~~~;.

21 Dr. Clarissa J. Lyngdoh Assistant Professor, Assistant Professor. 09863022802 Faculty Memberl Resource Person for the Mel workshop
Microbiology Microbiology c1arissa.jane@.yahoo.co.in
Department Department, on 26th• zt», 28th March 2015
NEIGRlHMS,
Mawdiangdiang, Phone No.
SI No. Name & Designation Email
Sbillong-793OOl8
22 Dr. Ritesh Kumar Assistant Professor, Assistant Professor. 09402194036 1. Dr. Animesh Mishra, Animesh.shillong0lgmail.com 09436114330
Oncology Oncology riteshkr9@gmail.com (Trained from KGMU)
Department Department,
Professor,
NEIGRIHMS, Cardiology Department & Chairman
Mawdiangdiang, of Medical Education Unit
Shillong- 79300 18 2. Dr. Md. Yunus, drmdyunus@hotmail.com 09436160797
23 Dr. Baphiralyne Assistant Professor. Assistant Professor, 09436700898 Additional Professor, (Trained from KGMU)
Wankhar Radiology Radiology baphi.nick@Vaboo.co.in Anaesthesiology Department &
Department Department,
Coordinator of Medical Education
NEIGRIHMS,
Mawdiangdiang, Unit
3. Dr. Y. Khonglah, yookarink@gmail.com 09436336490
Shill one- 7930018
24 Dr. Star Pala Associate Professor, Associate Professor, 09856624412 Associate Professor, (Trained from KGMU)
Community Community Medicine starpala@gmail.col1l Patholo De artment
Medicine Department
4. Dr. Sourabh Duwarah, Sgd7@rediff.com 09436706759
Department NEIGRlHMS, (Trained from KGMU)
Mawdiangdiang,
Assistant Professor,
Shillong- 7930018 Pediatrics De aartment
5. Dr. Rituparoa Barooah, drrituparnabarooah@gmail.com 09436700733
25 Dr. Alice A. Ruram Associate Professor, Associate Professor, 09436994985
Biochemistry Biochemistry rw-amaiice9@gmail.com Associate Professor, (Trained from SRM, Chennai)
Department Department Physiology Department
NEIGRIl-NS,
Mawdiangdiang, 6. Dr. Amitav Sarma, dramitav20070lrediffmail.com 08974823603
Shillonu-793OOl8 Associate Professor, (Trained from KGMU)
26 Dr. Akash Handique Associate Professor, Associate Professor, 09436114332 Anatomy Department
Radiology Radiology abandique@rediffinail.com
7. Dr. Tanie Natung, natungtanie@gmail.com 09436766050
Department Department (Trained from KGMU)
NEIGRIHMS, Associate Professor,
Mawdiangdiang, Opthalmology Department
8. Dr. Himesh Bannan, himeshbannan@gmail.com 08974054513
Assistant Professor, (Trained from KGMU)
Pcdiatrics De artment
9. Dr. A. SlInlll ingh, drsanta@rediffmail.com 09436994816
1'f(li"'SS(lI. (Trained from KGMU)
Ohs iii (iYIIIII' I) 'Pllli""'"i III
1'1111"1"11 NII(.HIIIM.
0')·111,\\1, 1\
III • hlll'II "'I "I
"III 11,,1
Ilill"'1 Ii
II I II ,,"
I I I

15.

88 89
~~~~~~ HAND BOOK ON BASICS M.EDICA L. EDUCATION

16 Dr. MusarafHussain, masarafhussain®Vahoo.co.in 09435730681 BASIC COURSE WORKSHOP

Assistant Professor, (Trained from KGMU)
Neurology Department IN
17 Dr. M. Agarwal, drmanika89@Yahoo.com 09862123245 MEDICAL EDUCATION TECHNOLOGIES
Associate Professor, (Trained from KGMU)
Obs & Gvnae Deoartment
18 Dr. Binod Kr. Thakur, binod.k.thakur@gmail.com 09774165590
Assistant Professor, (Trained from KGMU)
Dermatology Department
19 Dr. Abhijeet Bhatia, abhijeetbhatia77@gmaiLcom 09402154516
Assistant Professor, (Trained from KGMU)
ENT Department

UNDER SUPERVISION OF
MEDICAL COUNCIL OF INDIA

&

WITH THE GUIDANCE OF

REGIONAL CENTRE FOR MET.
KING GEORGE'S MEDICAL UNIVERSITY, U.P.. LUCKNOW

Scienfipc tfJrOjramme
Date: 26'h - 28'h March 201S (Thus, Fri & Sat)
Venue: Clinical Teaching Room- 1.
NEIGRlHMS. Shillong

Time • 1m, Duration Speaker

'''1''
9:15AM to " •• 10 I
10:00 AM

10:00 AM to
11:30AM

II :30 AM to Systems Approae

1:00 PM Learning Process
Adult Learning

Princrplr III

1:00 PM to Inauguration By Honourabk ""

1:30 PM NEIGRUIMS

90 91
 =--:..... HAND BOOK ON BASICS MEDJC.·\L EDUCATION ~~~~~~
I-lAND BOOI'; O~ II \';(('~ '11'111(' \1 II III ( '\'IION ~~~~~~
-=---- -:::
1:30 PM to Lunch
oc::.=-- .;

io min Day- 3 (28!1!March 2015,)

2:00 PM
Summary of Day- 3 /volunteer from group
2:00 PM to Taxonomy of Inl«IOlll'II()II III nllllllpi III <)(j'min
3:30 PM Learning Taxonomy 01 11'1""'"1'., "'"11"11~ III Dr. Yookarin
Educational learning 1\1It11'~""'I"I'~ Khonglah
Obiectives .l:xP.cs ()I (\hJI'I'IIVI'~ Dr. Binod Thakur
nlllC
"/0111111 Dr. R. Hajong Sessions'
3:30 PM to
5:00 PM
Introduction
Microteaching
to Princinlcs III II"nll"',1I1
""I Dr. W.V. Lyngdoh
H Ifl "Mto
Topic
Duration Speaker
Dr. M. Hussain Assessment of
with lOoe AM MCQS including item analysis 90min
Knowledge Dr. Sourabh
examples Setting of Question paper and
Duwarah
Concept of Blue printing (Optional)
Dr. M. Hussain
- _.- 1111)( AM to
Importance and Formative and Continuous
II fI( A.M Skill of giving .60min Dr. Amitav
Internal assessment
effective Sharma
Importance and skills of giving
feedback
Day- 2 ( 015) feedback
III)( AMto Tea break
Open House - Summary of Day volunteer from group 11 ,'( "M 20min

11 '( "Mto Good Teaching

Time Sessions '1'11,,11' IIon Speaker IJ .'1 Purpose, Objectives, Contents And
UII I'll 'M Practice 60min Dr, R.K Dixit
Activities:
9:00 AM to Introduction to Willi' I~ ('1111111111,,"'1
-
- ;-.=...:;;".--

II!) Ill," Dr. T. Natung Foundation Course, (MCI Observer)

Coml11unication Skills
10:00 AM Curriculum CUfllflllllllll""II""WIII'
Early Clinical Exposure
Pnn"'ples 011'11111111111111
lnte!!rated Teachin2 Learning
ocVCh'PIII\''''''IIIII'v"IIIIIIIIII1 'M to Assessment of
Practical examination, Long case
10:30 AM to Principles of (icl1crtll JlIIJI\IP"'~, 1'11'1"""', I.VI", 10111111 Dr. Sourabh
~ Clinical and .and its improvement
90 min Dr. Arup Jyoti
Practical Skills Baruah
II:OOAM Assessment AhW"nll wilh ol",'IIIVI'_ Duwarah OSCE/OSPE
Oral. and Viva - voce Dr. HimeshBarman
Dr. Y ookarin Khonglah
II:OOAMto Intcractive InICIIII'''V~ 11'1\1h,"p MI'II".I •• 1,0111111 Dr. Ritupama
Dr. Syed Wasim
12:00 Noon Teaching Applll'III""III1II1IW ('"lIlp, Barooah Ito Hasan
After test and
Learning Smull Bl(\lIp 1111<1 ( h"I\1I1 ",,"1111111 Dr. Himesh I 20min
Feedback All Faculty
Methods Barman
(0 Valedictory
Large group
function 20min Dr. A. Santa Singh
SmaUgroup
ClinicaVBed side And Lunch Dr. Animesh
Mishra
Teaching -
~ Dr. Md. Yunus
12:00 Noon Microteaching Gr-l: 1:'Olilin Dr. Himesh Barman
to Practice Gr-2 : Dr. Yookarin
2:00 PM Gr-3 : Khonglah
Gr-4. Dr. W.V. Lyngdoh
Dr. Md. Yunus

2:00 PM to Lunch lO'illfi

2:30 PM

2:30 PM to Approprlate Use Appropriate and effecti ve use (If 1i01l"" Dr Sharat
3:30 PM Of Media Media in Teaching Learning Agarwal
Ilr M. Agarwal
.
3:30 PM to Assessment of Essay type questions and their '0111111 ISr Arup Jyoti
4:00 PM Knowledge Improvement IJllluah
Short Answer questions 1), l.analyn
lhnngkhiew

4:00 PM to Open House Best of Microteaching- From 3011111\ 1)1 Ahhijeet Bhatia
4:30 PM Participant

93
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 ............._. llANO [lOOk 0'\ BASH'S \lEIHCAL EDlC\TlON ~~ ..~ ~ ~ ~ ~ ~ . . HA,\O HOOK ON B·\SI<S MEHICAL Em:C\TIO,\ ~~ ~~~~~

Constitution of Committee for MCI basic workshop to be held Sub-Committee for Orientation Programme for MBBS &
on 26th 28!h March 2015 PG, Faculty. Resident doctors from Medical Education Unit:

Chairman Dr. Md. Yunus

1. Venue/Hall Coordination Committee
2. Registration Committee
3. Inauguration Committee
4. Certificate & Mementoes Committee -
5. Food & Refreshment Committee
6. Committee for Microteaching session -
7. Scientific & Publication Committee
Dr. Y. Khonglah (Chairman)
Dr. Md. Yunus Member secretary Dr. Star Pala
- Dr. S. R. Sharma Members Dr. W.V. Lyngdoh
- Dr. Himesh Barman Dr. Bhaskar Borgohain
- Dr. Saurabh Duwarah
Dr. Manish Kapoor
• Dr. M. K. Saikia ( Chairman)
Dr. Amitav Sharma
- Dr. Arindom Kakati
- Dr. Donkupar Khongwar Dr. Binod Kumar Thakur
- Dr. A. Santa Singh (Chairman)
- Dr. Animesh Mishra In House Faculty Development Programme/ Training
- Dr. S. Panda Programme will be starting from month of April 2014. For this
- Dr. Sarah Ralte purpose a Sub-committee is constituted.
Dr. Nari M. Lyngdoh (Chairman)
The Sub-committee look after in house Training Programme
- Dr. Lanalyn Thangkhiew
of Medical Education Unit.
- Dr. Bhupen Barman
- Mrs. Wanda Dkhar
- Dr. Chandan K. Nath (Chairman) Sub-Committee for Training Programme under Medical
- Dr. Masaraf Hussain Education Unit, NEIGRIHMS:
- Dr. Syed Wasim Hasan
Dr. W. V. Lyngdoh (Chairman) Chairman Dr. Md. Yunus
- Dr. Yookarin Khonglah
Member secretary Dr. Star Pala
- Dr. Md. Yunus
Members Dr. Rituparna Barooah
- Dr. Himesh Barman
- Dr. T. Natung Dr. Yookarin Khonglah
Dr. Ritupama Barooah Dr. Tanie Natung
- Dr. Md. Yunus (Chairman) Dr. Amitav Sharma
- Dr. Yookarin Khonglah (Secretary)
Dr. Himesh Barman
- Dr. W. V. Lyngdoh (Secretary)
Dr. Sourabh Duwarah
- Dr. Abhijeet Bhatia (Co-Secretary)
- Dr. Musaraf Hussain (Co-Secretary)
94 95
 MEDICAL EDUCATIONAL UNIT, NEIGRIHMS

Chairman Dr. Animesh Mishra

Members Dr. A. Handique

Dr. S.Panda
• Dr. W.V. Lyngdoh
Dr. M. Agarwal
Dr. Star Pala
Mrs. W. Dkhar

Co-ordinator : Dr. Md. Yunus

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