6. Developing And Using Clinical Examinations

INTRODUCTION Generally, clinical examinations for licensing (sometimes called performance tests) involve the candidate completing one or more tasks (in licensing this is thought of as services for a client ) that have been selected from the supervised practice Gob analysis) of an occupation or profession. The clinical examination may exist in contexts (occupations) that do not require client interactions. Such contexts include building trades, automobile repair, accounting, etc. The tasks may range from fixing brakes, to preparing a body for burial, to wiring a house, or auditing a set of business interactions. Other contexts require the candidate to perform services or tasks while interacting with a client. Such tasks include filling a tooth, counseling, fitting contact lenses, hair removal, and similar services. These tasks would then be graded as part of the licensure examination. Supervision or scoring of the tasks in the context where interaction is not required is easier than those requiring the presence of the client. Interaction with clients makes the second type of tasks harder to supervise and to grade. In recent practice, some boards have moved from using live clients to using simulations (Yaple, Metzler, & Wallace, 1992). Oral interviews may be required prior to issuance of a license in some contexts, but such entry orals or group interviews are not considered here as clinical examinations as they seldom are tasks germane to the job analysis of these occupations or professions. Tests are used as a proxy to judge the ability of an individual relative to actual performance of a task. It might be useful to consider a continuum of faithfulness to the task ranging from a paper-and-pencil (multiple-choice) test to actual performance of the task. This continuum describes the concept of fidelity, or the degree to which the test requires the same behaviors as those required by the task. Unfortunately, this faithfulness to the task is only half of the equation, the other half is accuracy of the inference made about the candidate\u27s ability to complete the task. This dimension speaks to the measurement concept of validity. Both fidelity and validity are complex, thus making a judgment about ability a complex activity. Human judgment is complex and so intertwined with previous experience that total objectivity is virtually impossible to achieve. So called objective tests, such as multiple-choice tests, generally moderate judgment by being constructed using multiple judges to determine content and to set cut scores, and by being scored in such a manner that individuals who perform the same task in the same way will attain the same score (often scoring is possible by machine or template). Moving along the continuum toward actual performance (i.e., from multiple-choice tests through essay tests, oral tests, and simulations, to actual clinical performance), the potential gain in fidelity can be offset by loss in objectivity. Clinical tests appear on the side of the continuum closest to the actual performance of the task. The discussion which follows offers suggestions for enhancing the objectivity in the development and use of the clinical tests. Making scoring judgments explicit, reducing compounding of judgments, utilizing multiple judges in scoring individual performance, and providing statistical evidence of reliability, validity, and fidelity are among the topics discussed. Performance on a clinical examination generally requires the candidate to use a combination of knowledge gained in training, skills acquired in the education or training program, physical attributes demanded in practice, interpersonal interaction skills, and attitudes. The clinical examination is believed to require candidates to demonstrate their ability to master and apply these different elements in concert. In a discussion with the Advisory Board to Southern Regional Testing Agency (SRTA) at Fort Walton Beach, Virginia, August, 1991, one dentistry board member explained that the clinical examination requires diagnosis, treatment, and patient education cast in the context of dealing with a fearful and uncomfortable patient. It requires practice of the profession along with human management. In dentistry, it was suggested that clinical examination required the candidate to work in the hard-to-reach areas of the mouth without compounding the patient\u27s problems by injury of the areas that make access difficult. Common dental clinical examinations include: one or more types of restoration, prosthetics, and endrodentics

Universities as Catalysts for Community Building among Informal STEM educators: The Story of POISED

POISED: Partners for Outreach in Informal STEM Education; STEM: Science, Technology, Engineering, Mathematic

Revitalization of an Historically Black College: A Maryland Eastern Shore Case by Carl S. Person

This study comprises a multi-faceted case study of the growth and development of the University of Maryland Eastern Shore (UMES), with an emphasis on the leadership of Chancellor William T. Hytche during his tenure from 1975 to 1995. The study takes into account the complex, dynamic, and interrelated internal and external forces that led to the survival and subsequent development of UMES. An attempt was made to describe the relationship of Chancellor Hytche's leadership behavior and the resolution of critical problems affecting the growth and development of UMES during his period as chancellor. The University of Maryland Eastern Shore is an historically black university that has been able to overcome its historical and environmental roadblocks and situate itself squarely in the mainstream of higher education, even though, like other small historically black colleges, UMES faced an uncertain future. Historically black colleges and ii universities (HBCUs) are among America's most valuable resources, but for more than 130 years, these institutions of higher learning had to overcome the obstacles of limited financial and structural resources to provide quality education to hundreds of thousands of Americans of all races and socioeconomic strata. The literature on historically black colleges is limited and significantly devoid of research in the area of black college leadership. The majority of the research on black colleges focuses on issues such as student recruitment, the lack of black males, black college culture, and the effect of court decisions on desegregation and affirmative action. This research utilized the case study method. It can be characterized as primarily a descriptive case study, in that it describes the key events affecting the evolution of UMES, key e..

Patrick K. Murphy

There is extensive literature about the role of the principal in creating a school culture that fosters a positive school climate. How the principal addresses staff culture is among the many issues that affect lasting change. The purpose of this investigation is to examine the activities and behaviors of four suburban high school principals and how they influence change. Cross-case site analysis utilizing ethnographic method of investigation was conducted in four suburban high schools to examine how principals influence change. The culture of each school site was examined from the perspective of principals and department chairpersons concerning elements of change. Data were collected through interviews with principals and department chairpersons. The Developmental Research Sequence (D.R.S.) model was used to identify a set of specific dimensions for more in-depth investigation. This process of analysis provided a method for focusing the study to discover cultural themes and patterns about how principals influence change in high schools. Triangulation of data was addressed by using multiple data sources and multiple method data analysis. The major findings of this study were that principals who influenced change demonstrated a high degree of interest and care for school community members on a professional and personal level. Principals who valued what and how people thought were recognized as being connected to the school culture. It was through this awareness that principals could then channel ideas and provide opportunities to involve people in the change process. Principals recognized for using this type of approach cultivated and nourished a culture that was open to examining and entertaining change for both personal and professional growth and improvement. These res..