Mariam Momani, PharmD
Examinations have been a staple of education, including pharmacy school education, for a long time. These assessments are typically used to evaluate a student's understanding of course material, but their efficacy in promoting meaningful learning and ensuring the development of competent professionals is a subject of ongoing debate. While examinations can have a place in the educational process, a more holistic approach that incorporates various assessment methods is necessary to better align with instructional design principles and promote comprehensive learning.
Instructional design is a systematic process of creating, implementing, and evaluating instructional materials and strategies to facilitate effective learning. It encompasses several principles and methods aimed at maximizing learning outcomes. When examining the role of examinations in pharmacy school education, we must evaluate their alignment with these principles and consider how they should be applied by educators.
Instructional Design and Examinations
One fundamental principle of instructional design is the use of a diverse range of assessment methods to measure different types of learning outcomes. Examinations, often relying heavily on multiple-choice questions, may not adequately assess higher-order cognitive skills such as critical thinking, problem-solving, and practical application of knowledge. Educators should consider incorporating various assessment types, including case-based assessments, oral examinations, and hands-on practical evaluations, to holistically evaluate students' abilities.
Formative assessments that provide ongoing feedback to learners, allows them to monitor their progress and make improvements. Examinations, especially high-stakes ones, often serve as summative assessments, providing limited opportunities for formative feedback. Educators should integrate regular formative assessments throughout the learning process to help students identify areas of weakness and address them proactively. Authentic assessment tasks mirror real-world situations and require students to apply their knowledge and skills in practical contexts. Traditional examinations may fall short in this regard, as they often assess memorization rather than practical application. Pharmacy educators can enhance the authenticity of assessments by incorporating clinical simulations, patient case studies, and medication management exercises into their evaluation methods.
Instructional design principles emphasize active learning, where students are actively engaged in the learning process. When examinations are used exclusively, it may cause students to engage only in passive learning and rote memorization. To foster active learning, educators should incorporate collaborative activities, group discussions, and problem-based learning methods. Effective instructional design encourages the practice of timely and constructive feedback. Examinations typically offer limited opportunities for detailed feedback, hindering students' ability to reflect on their performance and make meaningful improvements. Pharmacy educators should consider integrating post-examination feedback sessions and self-assessment activities to promote reflective learning.
The Limitations of Examinations
While exams can play a useful and convenient role in assessing certain aspects of pharmacy education, they have several inherent limitations that must be acknowledged. Examinations often encourage surface learning strategies, where students memorize only the information needed to pass the test, rather than with the intention of deep understanding and critical application of the knowledge. This misalignment with instructional design principles can lead to graduates who lack the problem-solving skills required in real-world pharmacy practice. High-stakes examinations can induce a lot of test anxiety, which can negatively impact students' performance and overall learning experience. This anxiety may undermine the ultimate goal of pharmacy education and hinder their ability to apply knowledge effectively in clinical settings. Examinations may inadvertently introduce assessment bias, favoring students who excel in test-taking but not necessarily in practical skills or patient-centered care. This can result in a disconnect between assessment outcomes and the competencies required for pharmacy practice. Traditional examinations may not effectively assess the transferability of knowledge and skills to diverse pharmacy practice settings. Graduates may struggle to adapt their knowledge to evolving healthcare challenges and emerging patient needs.
Alternative Assessment Strategies
To align pharmacy school education more closely with instructional design principles and address the limitations of examinations, educators can consider implementing alternative assessment strategies. Objective Structured Clinical Examinations (OSCEs) may simulate real clinical encounters, allowing students to demonstrate their practical skills and decision-making abilities. Using case studies can allow students to apply their knowledge to real patient scenarios, fostering problem-solving skills and critical thinking. These methods may promote authentic assessment and active learning. Incorporating peer and self-assessment into coursework may encourage reflection and self-regulated learning. It provides opportunities for formative feedback and continuous improvement. Lastly, keeping electronic portfolios may allow students to compile evidence of their learning journey, including reflections, achievements, and experiences, which can promote self-assessment, reflection, and documentation of learning experiences.
Conclusion
While examinations have been a traditional method of assessment in pharmacy school education, their efficacy in promoting comprehensive learning and aligning with instructional design principles is questionable. Pharmacy educators must critically appraise their use of examinations and consider alternative assessment strategies that align more closely with instructional design principles. By embracing diverse assessment methods, including OSCEs, case-based learning, peer and self-assessment, and e-portfolios, pharmacy schools can better prepare students for the challenges of real-world pharmacy practice. This approach promotes active learning, critical thinking, authentic assessment, and continuous improvement—key elements of effective instructional design. Ultimately, a more balanced and holistic approach to assessment will contribute to the development of competent and patient-centered pharmacy professionals.
References:
1. Smith, J. K., & Worsfold, K. (2002). Assessment in higher education: Student learning, teaching, programs, and institutions. Assessment & Evaluation in Higher Education, 27(5), 359-369.
2. Van Der Vleuten, C. P. M. (2016). The assessment of professional competence: Developments, research and practical implications. Advances in Health Sciences Education, 21(2), 259-266. doi:10.1007/s10459-015-9610-6
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