‘But professor, you no longer take exams… so how do you learn?’

I recently attended an excellent keynote speech on the role of summative assessment in driving learning. During the following question and answer session, a delegate enquired of the speaker, ‘but professor, you no longer take exams… so how do you learn?’.

This fundamental question stimulated further debate, which culminated in a series of comments that can be summarised by:in nature assessment is both evolutionary and summative, as the ultimate test would have been survival, such as outwitting the dinosaurs.

While I mused fancifully over the possibilities that escaping from dinosaurs could provide the basis of a good OSCE station to test both teamwork and personal resilience, I began to reflect on the question ‘professor how do you learn?’. I thought about the contexts when I needed to learn, and how I operationalised the process. Following this contemplation, my first conclusion was that it had little to do with dinosaurs (though my children may beg to differ, as they are sure I had one as a pet!), and more to do with the level of the existing knowledge base, my personal level of knowledge/understanding in the area, and the time available.

In most situations when I need to learn something new, I take advantage of ‘teaching’. This is because I view teaching as a mechanism for the efficient transmission of the accepted wisdom derived from the integrated learning of many, to others. A situation that I feel should significantly accelerate my innate experiential learning response. Yet, when I reflect on a situation where I was recently a ‘student’ in receipt of teaching this is not what happened…  

About two years ago I decided that I wanted to learn to ride a motorbike (some may wish to call this a midlife crisis, I make no comment!). I would like to be able to report that my learning followed the path to changed self-regulation beautifully described by Butler and Winne ¹. A path where following assessment, the external feedback given to me was synthesised, acted upon, internalised, and informed my deliberate practice ² until my self-regulation was changed, and learning had occurred. However, sadly this was not the case. The problem started when high stakes assessment entered the equation. One of these assessments involved demonstrating a series of slow, and high-speed manoeuvres.

During my training, I found there were a couple of manoeuvres that I struggled with (i.e. when I tried, I fell off), the ‘U-turn’, and the ‘Swerve’ around an obstacle. Following my perceived slow progress, I found that I began to fixate on this assessment, seeing it as a barrier to overcome. I began to read tips over ‘how to pass the test’. I started to look at internet forum posts, where people who had previously failed were complaining that the test was unfair because ‘in the real world you would never need to do a U-turn’. This was further fuel to reinforce my view that the test was just an artificial barrier to get through. I even researched when the best time of the day to take the test was, who was the most lenient examiner, and what day they worked on so that I could book my slot accordingly. In short, passing this assessment had become my learning goal. Worse still, as the test got closer, I began to measure my self-worth against passing it. After all, I was a professor, who had successfully passed many assessments, so I should be able to do this. Then I failed it, oh the shame I felt… for about five minutes. Then I laughed, as I realised that I had fallen into what I now think of as the ‘assessment trap’.

I had become the very learner that I complain about every day. A learner with a fixed mindset ³, who had set the wrong goals, and used an assessment with seemingly good utility ⁴ as the goal of their learning, rather than seeing it as a form of quality assurance to inform the journey milestones of reaching their real-world goal of being a safe and competent rider. It was at this point that I reflected ... if I was going to ride on the road, at speed, in traffic, without the ‘metal box’ of a car around me, then it was probably a good idea that I could swerve to avoid things. Moreover, as my sense of direction is not the best (my family is very familiar with our unintended sight-seeing trips), U-turns would more than likely be an essential part of every journey.  So, I embraced the failure, took responsibility, reflected to internalise the feedback from my training and assessment, used my self-efficacy to set myself meaningful goals ⁵, turned up my resilience, and undertook deliberate practice until I could not fail to do it (Figure 1). My newly transformed self-regulation was such that success in the re-test was both a given, and irrelevant, because I had learned in the right way, for the right reasons.

Figure 1. My learning cycle, and the key psychosocial support elements

I am living proof of how easy it is to fall into the ‘assessment trap’, a situation that probably leads to superficial, non-contextualised, non-integrated, and non-reflective approaches to learning by the student that could ultimately lead to patient harm. This is  because once the assessment is passed, and the goal is therefore met, the learner leaves the learning cycle at the assessment stage (Figure 1) with little thought over what they do not know/or cannot do ⁶.

To me, it was also fascinating to reflect on how interrelated my psychosocial skills were to a successful learning outcome (Figure 1). However, it is a realisation that I also find concerning for my students, as data suggest that the prevalence of a fixed mindset amongst university students is high ⁷. This fixed mindset is likely fostered through a combination of  schools ‘teaching to the test’ and parental actions that often absolve their children of personal responsibility so that they can succeed in examinations ⁸. These actions have probably led to the significant number of young adults who have poorly developed psychosocial skills, and consequently maladjusted learning behaviours ⁹. Unfortunately, these are the same young adults who enter a higher education system that frequently ignores the issue, and pushes on with assessment being the arbitrator, and hence the student focus, of progression. I believe we need to transform our approach to learning. To do this we will need to continually focus our learners on why they are on their programme of study, and where they are currently on their developmental journey towards holistic professional capability. This will require thought over:

• Establishing milestones that constitute complex real-world situations to require the integrated use of competencies that provide students with a meaningful reflective focus. Crucially, such milestones need to be informed by assessment that is sufficiently sophisticated and triangulated ¹⁰.

• Actively developing psychosocial skills in our students, as well as supporting their use to fully enable the learning cycle (Figure 1).

• Exposing our students to relevant educational theory, so that they can understand what is being done and why, so that they can maximise their learning.

• Developing expert panel approaches to progression ¹¹ to move from a situation where progression is simply the result of passing assessments, to one that requires:

• Evidence that personal responsibility for learning has been established i.e. feedback has been internalised and appropriately acted upon through demonstrable longitudinal changes to self-regulation.

• Trust for real-world practice is being/or has been established ¹².

• Undertaking research into establishing the real level of capability ¹³ that can be realistically developed within the timeframe of a programme of study. It is way too easy for governing bodies to make a list of competencies that are impossible to meet!

In summary, to facilitate and maximise learning for the real world in today’s young adults, I feel we should consider a transformative paradigm where assessment is not the focus of the learning, rather it forms the quality assurance information to support learning occurring, in the right way, for the right reasons, against real world milestones that are vertically integrated. 

Luke Dawson BSc, BDS, PhD, FDSRCS(eng), FHEA, MA(TLHE), NTF. Director of Undergraduate Dental Education, The University of Liverpool, UK

Email: ldawson@liverpool.ac.uk

References

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