Do we assess what we set out to teach in obstetrics: An action research study

Background. Medical education empowers students to transform theoretical knowledge into practice. Assessment of knowledge, skills and attitudes determines students’ competency to practice. Assessment methods have been adapted, but not evaluated, to accommodate educational challenges. Objectives. To evaluate whether assessment criteria align with obstetrics learning outcomes. Methods. We conducted a collaborative action research study, in which we reviewed and analysed learning outcomes and assessments according to Bigg’s model of constructive alignment. Data were analysed as per levels of Bloom’s taxonomy. Results. Final-year students have two 3-week modules in obstetrics, with 75% overlap in learning outcomes and assessments. Ninety-five percent of learning outcomes were poorly defined, and 11 - 22% were inappropriately assessed. Summative assessments were comprehensive, but continuous assessments were rudimentary without clear educational benefit. There is a deficiency in assessment of clinical skills and competencies, as assessments have been adapted to accommodate patient confidentiality and increasing student numbers. The lack of good assessment practice compromises the validity of assessments, resulting in assessments that do not focus on higher levels of thinking. Conclusion. There was poor alignment between assessment and outcomes. Combining the obstetrics modules, and reviewing learning outcomes and assessments as a single entity, will improve the authenticity of assessments.