A Handbook for Teaching and Learning in Higher Education Enhancing academic and Practice

Medicine and dentistry
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of the case are assessed using an OSCE style checklist. Wass and Jolly (2001) argue that
the observed long case can produce an equally reliable and valid assessment as the OSCE,
while testing a more holistic approach to the patient.
Medical students commonly cite that they are rarely, if ever, observed by their tutors
clerking and performing procedures on patients. As the assessments adopted in UK
postgraduate training (see below) filter into undergraduate education this shortfall may
be reduced.
Updating clinical assessment: (3) the viva voce
The viva voce is still used as a summative assessment tool but is regarded by many as
educationally defective and indefensible. It is the least reliable of any form of clinical
assessment because it uses only two examiners and its unstructured format can result in
a very variable interaction. The issue of content specificity has a major effect on its
reliability. It too has undergone ‘objectification’ and, where it is still employed, is much
more structured. While it is still too unreliable to employ as stand-alone summative
assessment, our view is that with station-based interviewing now becoming commonplace
at all stages of medical training, the viva may once again become a popular
formative assessment tool.
Updating clinical assessment: (4) log-books and reflective writing
Log-books have long been used to record clinical exposure and practice. However, in
their traditional form they were often subject to abuse, even in the more supervised dental
environment. This abuse was often a result of short cuts, poor objectives and unrealistic
targets. In response to this criticism, the use of the log-book has changed. Students should
now be encouraged to use them to record and reflect upon clinical events in which they
have taken part, including reflecting on and evaluating their own performance. Entries
in the log-book should be monitored and commented upon, so directing the student’s
learning. Thus they may (also) be used as a formative assessment tool to promote learning,
reflection and personal development, as described in Case study 3.
Case study 3: Reflective log-books and portfolios for
dentistry
Reflective practice has been prominent in undergraduate dental studies and
immediately post-qualification during the vocational training period for many
years. The Dearing Report (NCIHE, 1997) expected that all higher education
bodies would embed a Progress File by 2007 as a means to record achievement,