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Who assesses?

In the previous section we looked specifically at assessing learning needs in teaching situations and suggested that ideally this should be a shared endeavour between learners and the teacher. Assessment of learning needs is a key step in the formative (developmental) assessment processes that should be built into all learning programmes. We can also think of formative assessment as ‘assessment for learning’ as opposed to summative assessments which are primarily designed for ‘assessment of learning’. This does not mean that formal summative assessments should not provide feedback to help the learner progress but that their primary purpose is to assess learner performance against defined criteria.

Teacher-led assessment

The advantages of teacher assessment of needs is that highly competent teachers have experience of the programme, and ‘can evaluate work (or performance) against a reference framework that reflects the pre-set learning objectives and the level expected of students or trainees at a particular stage in a course… (teachers can then) make a judgement on the work and provide… feedback… on that judgement’ (Wood, 2007, p. 4). Make sure you are familiar with any programme/module/placement defined learning outcomes so you can make sure that learners receive opportunities for achieving these and as many opportunities for informal, developmental feedback as is feasible, remembering that each learner will be different.

Summative assessments ­of learning are the formal means (examinations, clinical assessments, etc.) by which the learner is assessed at regular points against defined criteria. Passing allows them to progress to the next stage. Well-designed assessments provide opportunity for feedback to the learner, which helps them identify where their learning has been effective and also where they have a particular area for improvement, further study or weakness. Assessment results can also be used as one of the means or key performance indicators (KPIs) to measure learners’ progress and identify and agree future learning needs.

Highly competent teachers (Wood, 2007, citing Sadler, 1998) are knowledgeable and have a positive attitude towards their teaching practice. They are able to empathise with learners, are reflective about their own and others’ skills and want to see learners improve and develop.

However, there is often variability between different teachers’ skills, experience and expertise, and not all teachers have the same level of interest in and empathy towards learners.

Learner-centred assessment

Assessment for learning is, of necessity, learner-centred and helps learners self-manage their learning and development with teachers, peers and colleagues, all of whom can contribute to how learners’ educational needs are assessed, in formal teaching situations and in the course of professional development planning.

One of the overall goals of health professional education and training is to develop learners’ capabilities to carry out critical, accurate reflection on their own performance. Do they know how well or how competent they are at practical skills, for example? And what about more complex skills such as admitting a patient to a ward or carrying out an initial physiotherapy, occupational health or osteopathy patient assessment. An important component in professional development is ‘self-efficacy’, defined by Bandura (1997) as an individual’s beliefs in their own performance capabilities, including capacity to change or achieve certain goals or actions. Self-efficacy varies depending on the context and the individual in terms of the level of difficulty of a task, generalisability to other situations and the strength or certainty about being able to perform a certain task. For example, taking a history or routine bloods from a healthy adult is very different from taking a history or blood from a child in an acute situation. Later researchers (e.g. Zimmerman, 2000) have identified that self-efficacy is a highly effective predictor of learning and motivation, interacts with self-regulation processes and mediates academic achievement.

Teachers play a key role in helping learners become effective and competent self-directed and independent professionals by providing opportunities for self-assessment of their clinical competence, knowledge, understanding and behaviours, and by pointing out any mismatches between self-perception and observed behaviours. So building in simple questions such as ‘how do you think that conversation went…?’ opens up opportunities for a conversation which enables learners to routinely monitor, reflect on and review performance. This continuous feedback and monitoring helps to align learners’ self-efficacy with their actual practice and performance so that they stay within the bounds of their competence whilst not being held back from learning and practising new skills.

Thinking point
  • Other than yourself, who else is involved in assessing your learners’ educational needs? Patients? Carers? Colleagues? Other health or social care professionals? Their peers? What are the practicalities, advantages and disadvantages of each of these groups in assessing learning needs? How might you involve more people in assessing learners?


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