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T.S. Köhler, B. Schwartz (eds.), Surgeons as Educators,
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Measurement in Education: A Primer
on Designing Assessments
Collin Hitt
So you want to assess students on their attitudes and beliefs, on their surgical skills,
or on their knowledge and reasoning. This chapter will help you to find, or even
design, the right assessment tool.
Your choice of tool will depend on what you want to measure. You might use a
survey questionnaire, a third-party rating of surgical performance, or a multiple-
choice test. No matter what kind of assessment tool you use and no matter what
you’re trying to assess, take the following advice. Before you ever use a tool to
assess students, first use it to assess yourself.
If you’re giving students a survey questionnaire, fill it out for yourself. If you’re
rating their surgical performance, rate your own recent performance in the same
way, or have a colleague do so. If you’re giving students a test, take that test. In
doing so, you will gain a greater understanding of what you’re actually measuring.
Measuring skills and attitudes and knowledge is messy. Healthcare professionals
are accustomed to working with concrete numbers – blood pressure, oxygen levels,
and so forth. Surveys and tests and rating forms are designed to give us numerical
scores, and the numbers they produce have the appearance of being precise. For
example, a student may score a 3.88 on the Duckworth Grit scale, or a resident may
receive a 5.11 mean score on an operative performance rating during a laparoscopic
cholecystectomy. But these scores are not like vital signs. They are not precise mea-
sures. There’s no better reminder of this than to take an assessment for yourself.
In order to assess skills well, we must accept this uncomfortable fact. Even when
using the best tools available, the numbers we collect do not perfectly capture the
skills we’re trying to measure. Substantial “measurement error” is always involved,
and because such error is involved even in the best of circumstances, we have little
C. Hitt, PhD
Department of Medical Education, Southern Illinois University School of Medicine,
Springfield, IL, USA
e-mail: [email protected]