Assessment is the third part of the educational process, the other parts being learning objectives and teaching methods. There are two kinds of assessments—formative and summative—each with a different purpose.

Objectives

The main goal of formative assessment, whether in the form of a self- or trainer-administered test, is to find out how much the learner has learnt. The results chart the process of learning and point directions to where improvements need to be focused. Obviously, formative assessment should be carried out along the duration of a course, rather than at the end. The challenge is to make it easy to conduct and be part of the learning process. In contrast, summative assessment exists primarily to determine if the candidate is qualified or not to practise his or her area of learning.

Criteria of Good Assessment

Both formative and summative assessments make use of tests as instruments of measurement of mastery of learning and competence. There is a need to ensure that such tests satisfy the qualities of:

• Validity—a test is applied to what it is supposed to test, e.g. testing blood sugar for diabetes
  
• Reliability—a test is repeatable
  
• Objectivity—independent examiners agree what is a good answer
  
• Practicality—a test is easy to use
  
• Relevance—a test examines that which is useful in real professional life

Formative Assessment

Formative assessment can be used to assess mastery of learning in any of the six levels of Bloom’s Taxonomy of Learning (see Figure 1). Learning should go beyond recall and interpretation to higher levels. Interpretation of knowledge and beyond need not always be related to closed-book examination. In contrast, the higher the level of learning, the more suitable it is for open-book examination. Examination drives learning. If the level aimed at is only recall, then the candidate will not go beyond that level of learning.

Instruments that can be used for formative assessment include:

• Confidence Checklist
  
• Multiple Choice Questions (MCQ), Modified Essay Questions, Essays, or Picture Quizzes
  
• Random Case Analysis
  
• Problem Case Analysis (Case Study)
  
• Reading Assignments
  

Summative Assessment

Summative assessment may use the same instruments as those used in formative assessment and usually tests all of the following domains:

• Concepts. Some forms of summative assessment examine the understanding of concepts and their application. Instruments such as MCQ, Essays (long and short answer essays) and Slide Interpretation test the ability to recall knowledge, interpret facts, and apply knowledge to analyse problems.
  
• Skills. Practical Examinations test hands-on skills. The scientific subjects usually have such a component. In the context of medicine, we have long and short cases. The long cases test the ability of the doctor to collect clinical information and use them to come to a diagnosis and decide on treatment. The short cases test psychomotor skills, interpretation of information, and application of knowledge.
  
• Ability to respond appropriately. Oral Examinations test the ability of the learner to think on his or her feet. They can give information of the trainee’s ability to interpret information, to apply knowledge and analyse problems. Although the reliability of Oral Examinations is not absolute, they can be used to help decide on whether students pass or fail in borderline cases; they may also be used to decide which of the potential distinction candidates deserves such merit.

Where summative assessment is concerned, it is important that the learning objectives are made explicit from the start. Unless this is achieved, the learner may experience extreme anxiety when faced with summative assessment as he or she tries to guess what will appear in the examinations.

Conclusion

When examining students, one must be clear about what type of assessment one is using and why: summative assessment certifies a learner’s fitness to be released into society as a practitioner, whereas formative assessment tests mastery of content and helps the learner to chart further courses of learning. In other words, one should use assessments wisely.