Assessments for students from healthcare, including low-income families

Assessment is the core of the learning process. An institution, culture, or society encapsulates its conceptualization of learning and its future aspirations by creating and using assessment. Although the central purpose of educational assessment should be to support learning, assessment is often more focused on qualifications and the reporting of achievement in practice. ?

Faculty who teach low-income students should be aware of how they can best serve the students' needs. When developing a course, it becomes essential to keep in mind the resources students can access when interacting and completing the assignments. For example, if the students enrolled in a Statistics course need to purchase statistical software and use personal devices like laptops, then the faculty need to know how if all the students will have access to it or not. Faculty need to work to meet low-income adult learners' needs to encourage their engagement with higher education.?

Bourke, Vanderveken, Ecker, Bell, & Richie (2020) article on "Teaching is a learning experience": Exploring Faculty Engagement with Low-Income Adult Learners in a College-Community Partnership Program" emphasize that post-secondary accessibility initiatives need to be designed and delivered from a social justice perspective to engage more effectively with the specific needs of low-income individuals. In this study, 11 college faculty participated who were teaching in a college-community partnership program for low-income adult learners in Ontario's urban setting. Faculty deliver tuition-free for-credit courses in neighborhood-based settings called learning hubs designed to facilitate students' progress to a further post-secondary program of study. The findings of these studies were that faculty employ teaching practices that promote both student self-discovery (in terms of learning about the applicability of course content to their everyday lives) and empowerment (boosting the confidence students have in their ability to succeed in an academic setting). This encouraged students to take an active role in their learning and establish connections and ownership between course content and their lived experience. Working closely with students in trusting, non-threatening learning environments helps them develop a new relationship with education. Teaching practices and course delivery need to be alerted to targeted populations' specificity and the demographic heterogeneity that exists within and between marginalized groups. Designed to engage and empower students on their post-secondary pathways, this approach can alleviate some of the barriers students face while capitalizing upon the faculty-student relationship's strengths central to the classroom experience.?

While faculty have to make sure that they empower their students in their class and help them succeed, it is also essential to assess how they can evaluate them in the process. Assessment plays a crucial role in making sure that the students can demonstrate their learning. Timmis, Broadfoot, Sutherland, & Oldfield (2016) focused on addressing the opportunities, challenges, and risks in assessment in the digital era by focusing on the following three questions. "a)What do digital technologies offer for educational assessment? b)How might assessment be different when knowledge and performance can be represented digitally? c) Where is the 'cutting edge' in such developments at present?". The conclusion was that digital technologies have the potential to be a powerful force for change in assessment thinking, policy, and practice.??

While developing assessment, it is vital to identify the types that are best suited for the students based on their area of students. Vinall, & Kreys (2020) conducted a study to determine whether the addition of individual end-of-class formative quizzes, which comprise of higher-level Bloom's questions, could encourage students to reflect on and address deficiencies and improve academic performance. Ninety-seven out of 123 first-year pharmacy students (79%) enrolled in Biochemistry, and Cell and Molecular Biology course participated in a single-blinded, randomized, controlled, crossover study. The course used team-based learning (TBL) pedagogy, and as such the course relied heavily on formative team assessments to support higher level learning The data demonstrate that individual formative end-of-class quizzes comprising of higher Bloom's level questions can improve summative exam performance for lower-performing PharmD students enrolled in a first year pharmacy course. Significantly, quizzes enhanced these students' performance on higher-level Bloom's summative exam questions, i.e., the type of question lower-performing students often struggle with most. Data indicate that including individual formative end-of-class quizzes comprising higher-level Bloom's questions promoted student self-reflection and motivated students to implement self-directed corrective actions. Overall, data support the use of individual end-of-class formative quizzes to help improve summative exam performance for lower-performing pharmacy students, and indicate these quizzes encourage student self-reflection and self-directed learning behaviors. The impact of quizzes on student stress levels is a significant consideration and should be supervised. Lastly, the implementation of individual end-of-class formative quizzes can significantly increase faculty workload, which is also an important consideration.?

Another study on the assessment by De Kleijn, Bouwmeester, Ritzen, Ramaekers, & Van Rijen (2013) highlighted the importance of using online formative assessments when preparing for summative assessments. It aims to provide an understanding of student reasons for using or not using available online formative assessment. This study was piloted in a second-year undergraduate course in physiology for 147 biomedical sciences students. The results discovered various reasons for completing or not completing online formative assessments. Students who did not meet the online formative assessments have unclear reasons that could be student-related, teaching-related and/or mode-related. But the reason for completing was because students acquire: "(a) feed up (what is expected of me in the summative assessment in terms of content and form?), (b) feed back (to what extent have I already mastered the course material?) and (c) feed forward (do I need to study more and if so, what do I need to study?). "?

The performance of students on formative assessments correlates with their performance on summative assessments. Krasne, Wimmers, Relan, & Drake (2006) explained that formative assessments are structurally designed to assess and provide feedback on students' strengths and weaknesses in the course. Despite the known benefits to student attitudes and learning, medical school curricula have been slow to integrate such assessments into the curriculum. In the study, two types of formative assessments were administered to 146 first-year medical students. They were given a timed, closed-book assessment to evaluate factual recall and image recognition and an un-timed, open-book component to assess higher-order reasoning, including identifying and accessing appropriate resources and integrating and apply knowledge. The discrepancy effects of the Closed-Book and Open-Book formative assessments in loading onto the summative assessments suggest that including a component of Open-Book/resource, an un-timed assessment might provide added value over a strictly Closed-Book, timed format. When healthcare professionals analyze cases, they should not be limited to recalling information. As the knowledge base expands, they become increasingly reliant on their abilities to efficiently and effectively utilize resources. Thus, a component of assessment aimed at accessing and applying knowledge would also promote an increased mastery of these skills.?

References

• Ahn, H. (2015). Economic well‐being of low‐income single‐mother families following welfare reform in the USA. International Journal of Social Welfare, 24(1), 14–26. https://doi.org/10.1111/ijsw.12095?
• Eisenstein, J., & Graf, L. (2015). An online survey of the healthcare needs of undergraduate students at an urban university. DePaul University.?
• Bourke, A., Vanderveken, J., Ecker, E., Bell, H., & Richie, K. (2020). "Teaching is a learning experience": Exploring Faculty Engagement with Low-Income Adult Learners in a College-Community Partnership Program. Canadian Journal of Education, 43(2), 313–340.?
• Timmis, S., Broadfoot, P., Sutherland, R., & Oldfield, A. (2016). Rethinking assessment in a digital age: opportunities, challenges and risks. British Educational Research Journal, 42(3), 454–476. https://doi.org/10.1002/berj.3215?
• Vinall, R., & Kreys, E. (2020). Use of End-of-Class Quizzes to Promote Pharmacy Student Self-Reflection, Motivate Students to Improve Study Habits, and to Improve Performance on Summative Examinations. Pharmacy, 8(3), 167–. https://doi.org/10.3390/pharmacy8030167?
• De Kleijn, R., Bouwmeester, R., Ritzen, M., Ramaekers, S., & Van Rijen, H. (2013). Students’ motives for using online formative assessments when preparing for summative assessments. Medical Teacher, 35(12), e1644–e1650. https://doi.org/10.3109/0142159X.2013.826794?
• Jacquet, G., Umoren, R., Hayward, A., Myers, J., Modi, P., Dunlop, S., Sarfaty, S., Hauswald, M., & Tupesis, J. (2018). The Practitioner's Guide to Global Health: an interactive, online, open-access curriculum preparing medical learners for global health experiences. Medical Education Online, 23(1), 1503914–1503918. https://doi.org/10.1080/10872981.2018.1503914?
• Williams, J., Greenleaf, A., Barnes, E., & Scott, T. (2019). High-achieving, low-income students' perspectives of how schools can promote the academic achievement of students living in poverty. Improving Schools, 22(3), 224–236. https://doi.org/10.1177/1365480218821501?
• Chen, L. (2019). Do colleges around low income areas accept more low income students? Evidence from California State Universities. Applied Economics Letters, 26(7), 601–603. https://doi.org/10.1080/13504851.2018.1488046?
• Claridge, H., & Ussher, M. (2019). Does financial support for medical students from low income families make a difference? A qualitative evaluation. BMC Medical Education, 19(1), 153–153. https://doi.org/10.1186/s12909-019-1573-3?
• Krasne, S., Wimmers, P., Relan, A., & Drake, T. (2006). Differential Effects of Two Types of Formative Assessment in Predicting Performance of First-year Medical Students. Advances in Health Sciences Education : Theory and Practice, 11(2), 155–171. https://doi.org/10.1007/s10459-005-5290-9??
• Arias E, Tejada-Vera B, Ahmad F. (2021). Provisional life expectancy estimates for January through June, 2020. Vital Statistics Rapid Release; no 10. Hyattsville, MD: National Center for Health Statistics. February 2021. DOI: https://dx.doi.org/10.15620/cdc:100392??
• Abigail J Hess. (2019, December 13). The cost of college increased by more than 25% in the last 10 Years-here's why. Retrieved March 14, 2021, from https://www.cnbc.com/2019/12/13/cost-of-college-increased-by-more-than-25percent-in-the-last-10-years.html??