More Than Just Reading Aloud: Strategies for Oral Test Administration

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More Than Just Reading Aloud Strategies for
Oral Test Administration
Emergency Cardiovascular Care Update
ConferenceLas Vegas, Nevada, June 14, 2008
Tom Schmitz Mary S. Barber-Schmitz Twin Cities
Area Chapter American Red Cross
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Presenter Contact Information

• Mary S. Barber-Schmitz, NREMT-B,American Red
  Cross Instructor Trainer Twin Cities Area
  Chapter American Red Cross
  
• mbarberschmitz_at_yahoo.com ? 612-770-4906

• Tom Schmitz, NREMT-B,American Red Cross
  Instructor TrainerTwin Cities Area Chapter
  American Red Cross
  
• tschmitz_at_yahoo.com612-872-3237

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Conflict of Interest Disclosure

• Commercial/industry
• None to disclose
• Potential intellectual conflicts
• None to disclose

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Presentation Composition
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Types of Learning Objectives

• Psychomotor Objectives (physical abilities)
• Able to perform effective chest compressions
• Able to correctly open the airway
• Able to perform continuous cycles of CPR
  effectively
  
• Cognitive Objectives (purely knowledge)
• Knows signals of a heart attack
• Knows characteristics of effective chest
  compressions
  
• Knows sequence for performing skill steps
• Affective Objectives (attitudes beliefs)
• Willing to respond in an emergency
• Respects other providers
• Sincerely intends to wear gloves every time

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Assessing Achievement

• TYPES OF OBJECTIVES
• Psychomotor
• Cognitive
• Affective

• COMMON METHODS OF ASSESSMENT
• Skills tests
• Written tests
• Generally no formal assessment in classroom

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Multiple-Choice Written Tests

• One method of assessing achievement of cognitive
  learning objectives
  
• The most common method used in national training
  programs for first aid, CPR, and AED
  
• The type of written test for which our oral
  testing strategies have been developed
  

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Good Things About Multiple-Choice Written Tests

• Easy for instructor to administer
• Easy for instructor to grade
• Familiar to many students
• Objective(At least in the sense that both the
  test and the scoring system are standardized.)

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Written Test Idealism
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Is This Idealism Justified?

• A student fails the written test.
• Does this mean, for sure, that the student
  doesnt know the material?
  
• Of course not.

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Some Reasons a Student Might Not Pass A Written
Test

• Didnt learn the material, because...
• Didnt pay attention in class
• Learning disability
• Went to a movie instead of studying
• Not able to comprehend language in which class
  was conducted
  
• Illiteracy in primary language
• Course improperly conducted

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Other Reasons a Student Might Not Pass A Written
Test

• Did learn the material, but
• Cant read the test (illiteracy)
• Cant read the test (language barrier)
• Cant read the test (left glasses at home)
• Is distracted while taking the test
• Is exhausted after a full day of class
• Is unfamiliar with multiple-choice testing
• Is unskilled at taking multiple-choice tests

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Written Test Idealism
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Written Test Reality
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Written Test Reality
Good
Not Good
Good
Not Good
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Oral Testing

• We would like to be able to detect caseswhere
  the student has met learning objectives,despite
  being unable to demonstrate this learningusing a
  written test.
• Oral testing can detect some of these cases
• Oral testing cannot detect all of these cases
• We must be careful not to falsely detect cases
  where learning has not actually occurred

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Know The Rules

• Training organizations and programs vary on
• Whether oral testing is allowed at all
• What forms of oral testing are allowed
• Instructors responsible to know and follow
  applicable rules for each course they teach!

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Know The Rules

• Were not addressing the rules of any specific
  program today
  
• Instead, well assume this generic rule
• Oral testing is allowed in any form that does not
  have the effect of wrongly passing those who have
  not met the cognitive learning objectives
  
• Your actual progam rules may be more restrictive

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Strategies for Oral Test Administration
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Plain Old Reading Aloud

• Could help...
• A student who left glasses at home
• A student who is unable to read the written test
  due to being illiterate

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Plain Old Reading Aloud

• Wont help much if the problem is...
• A student unfamiliar with multiple-choice tests
• A student unskilled at multiple-choice tests
• A student taking the test in a non-primary
  language
  
• Not an easy way for anybody to take a
  multiple-choice test

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Suggested Strategies for Oral Test Administration

• Strategy 1 Give An Introduction
• Strategy 2 Consider Answers Separately
• Strategy 3 Make It Concrete
• Strategy 4 Visual Choices
• Additional Tips

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No national curriculum test questions were harmed
in the making of this presentation
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However, resemblance to actual test questions is
not entirely coincidental
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Strategy 1 Give An Introduction
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Strategy 1 Give An Introduction

• You arrive at the scene of a construction
  accident. Which of the following is part of the
  scene size-up?
  
• Determining if the victim is unresponsive
• Assessing movement and breathing
• Checking whether the scene is safe
• Looking for non-life-threatening injuries

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Strategy 1 Give An Introduction

• This is a question about what is and isnt
  included in the scene size-up. All of these might
  be things we do in an emergency, but you need to
  find the one thats part of what we call the
  scene size-up.
• Determining if the victim is unresponsive...Is
  that part of the scene size-up?
  
• Assessing movement and breathing...Is that part
  of the scene size-up?
  
• (etc.)

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Strategy 1 Give An Introduction

• Overcomes some limitations of oral delivery by
  alerting listener to main topic right from the
  start
  
• Improves understanding of both the question and
  the answer choices
  
• Reduces need to reread
• Use along with other oral testing strategies
• Low risk of giving away answer

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Strategy 2 Consider Answers Separately
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Strategy 2 Consider Answers Separately

• Why is it important for an AED to be used as
  quickly as possible on an adult victim?
  
• Most adults initially suffer respiratory
  emergencies.
  
• The victims chance of survival decreases greatly
  if defibrillation is delayed.
  
• Cardiac emergencies are uncommon in adults.
• Rescue breathing is the best care for sudden
  cardiac arrest.

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Strategy 2 Consider Answers Separately

• When were helping an adult victim, its
  important for an AED to be used as quickly as
  possible. This question is about why this is
  important.
• Here are four possible ideas
• Its important to use an AED quickly because
  most adults initially suffer respiratory
  emergencies...true or false?
  
• Its important to use an AED quickly because the
  victims chance of survival decreases greatly if
  defibrillation is delayed...true or false?
  
• (etc.)

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Strategy 2 Consider Answers Separately

• Strategy is simply to convert answer choices into
  separate true/false questions
  
• Have student answer each true/false question
  independently of the others
  
• Low risk of giving away answer

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Strategy 2 Consider Answers Separately

• Works well for many situations
• Complex wording of question and/or answers
• Non-parallel answer choices
• Negative wording in question and/or answers
• All of the above, None of the above, and
  Both a and c answer choices
  
• Overcomes many common problems related to poor
  multiple-choice test-taking skills

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Strategy 2 Consider Answers Separately

• In performing an initial assessment, you should
  check for all of the following except
  
• Consciousness
• Airway obstruction
• Burns
• Severe bleeding

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Strategy 2 Consider Answers Separately

• This is a question about steps in the initial
  assessment.
  
• Is checking for consciousness part of the
  initial assessment?
  
• Is checking for airway obstruction part of the
  initial assessment?
  
• Is checking for burns part of the initial
  assessment?
  
• Is checking for severe bleeding part of the
  initial assessment?

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Strategy 2 Consider Answers Separately

• Which of the following can be signals of
  respiratory distress?
  
• Altered level of consciousness
• Broken bones
• Changes in skin appearance
• Both a and c

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Strategy 2 Consider Answers Separately

• This is a question about signals of respiratory
  distress.
  
• Can altered level of consciousness be a signal
  of respiratory distress?
  
• Can broken bones be a signal of respiratory
  distress?
  
• Can changes in skin appearance be a signal of
  respiratory distress?
  
• (no need to ask choice d)

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Strategy 2 Consider Answers Separately

• Easy to interpret student responses
• No need to deal directly with negative wording
• No need to even mention all/none/some of the
  above choices
  
• Select choice which matches pattern of students
  T/F answers
  
• If pattern doesnt match any choice, call
  attention to which choices are available

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Strategy 3 Make It Concrete
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Strategy 3 Make It Concrete

• In which situation should you provide CPR?
• The victim is unresponsive, is not breathing, and
  has no pulse.
  
• The victim is breathing but is having trouble
  breathing.
  
• The victim is not breathing but has a pulse.
• The victim is unresponsive but is breathing.

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Strategy 3 Make It Concrete

• Lets say we have four people, and we need to
  find the one who needs CPR
  
• This person is unresponsive, is not breathing,
  and has no pulse. Does he need CPR?
  
• This person is breathing but is having trouble
  breathing. Does he need CPR?
  
• This person is not breathing but has a pulse.
  Does he need CPR?
  
• This person is unresponsive but is breathing.
  Does he need CPR?

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Strategy 3 Make It Concrete

• Works well for many questions about assessment or
  about recognizing signs symptoms (e.g., s/s of
  respiratory distress)
  
• Gesturing to each of the hypothetical victims
  helps make clear that were comparing four
  separate situations
  
• Low risk of giving away answer
• Easy to interpret student response

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Strategy 4 Visual Choices
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Strategy 4 Visual Choices

• When giving abdominal thrusts to a severely
  choking child, where should you place your
  hands?
  
• On the center of the breastbone
• On the sides of the ribcage
• Just above the navel
• On the lower end of the breastbone

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Strategy 4 Visual Choices

• This is a question about where to place your
  hands when giving abdominal thrusts while helping
  a severely choking child.
  
• Ill show you the choices, and you tell me which
  is correct
  
• This is choice a.
• This is choice b.
• This is choice c.
• This is choice d.

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Strategy 4 Visual Choices

• Clarifies choices by giving them visually
• Show on self, another instructor, or on manikin
• Only works well if all choices feasible to
  demonstrate (hard with nonsense choices)
  
• Take care to demonstrate fairly and avoid
  nonverbal cues
  
• Variation Ask open-ended and have student show
  the answer

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Additional Tips for Oral Test Administration
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Additional Tips

• Watch out for questions that are intended to test
  knowledge of terminologydont give away
  
• Take care not to just keep clarifying question
  until correct answer is chosenfor oral test to
  be valid, student must be able to choose the
  wrong answer

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Additional Tips

• During oral testing, it might or might not be
  beneficial for student to have a copy of the test
  and to fill in the answer sheet
  
• Its really OK to write on the test (and it
  might help)
  
• Identify chosen answers question by question, but
  score the test all at once

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Key Ideas

• Even students who learn information may not
  always pass a written test oral testing can be
  useful in such situations
  
• These strategies can make oral testing more
  useful
  
• Take care not to misuse oral testing to pass
  those who should not pass
  
• Know and follow rules for your program

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Credits Acknowledgements

• Thanks to national training organization program
  staff who provided administrative information and
  review

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Presenter Contact Information

• Mary S. Barber-Schmitz, NREMT-B,American Red
  Cross Instructor Trainer Twin Cities Area
  Chapter American Red Cross
  
• mbarberschmitz_at_yahoo.com ? 612-770-4906

• Tom Schmitz, NREMT-B,American Red Cross
  Instructor TrainerTwin Cities Area Chapter
  American Red Cross
  
• tschmitz_at_yahoo.com612-872-3237

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