Introduction: Competence has been a term subject to many interpretations over the years. This discrepancy in agreement is not due to the clash of minds but mostly the fruit of differences in expectations and legal requirements of local healthcare systems. As a result, the assessment of competence has been subject to dynamic changes with abundance of literature published to address its properties from different angles. This research project is designed to explore a number of unknowns: firstly, we aim to explore what it is meant by competence and compare it to how it is defined by the regulators. Once this is established, such expectations are to be compared to the expectations of the Educational Supervisors (ESs): the trainers who are in charge of training the newly qualified dentists. The next goal of this project is to shed light on how students perceive competence and explore the assessment methods that reflect such competencies best. Once known, these assessment methods will be explored in the national level to understand how they are implemented. The project also aims to explore if such assessment methods could be improved and finally, to examine if new assessment methods can be introduced to the field of medical and dental education with significant benefits and advantages. Methodology: A mixed-method approach was chosen, consisted of qualitative, quantitative and descriptive statistics. Results: Profile of a competent newly qualified dentist as described by the regulatory bodies, ESs and students was discussed. The most reflective assessment methods to illustrate students' competencies were identified and their use at national level explored. We looked at the bench marking of the OSCEs and where the line of competence is drawn, and finally, we developed a new mathematical model that can predict competence after observing a number of clinical encounters. Conclusion: Several conclusions and recommendations were drawn and discussed at their relevant chapter.

Mémoire (M.Ed.)--Université du Québec à Chicoutimi, 1998. / Document électronique également accessible en format PDF. CaQCU

Submitted by Kely Alves (kely.alves@unifenas.br) on 2018-07-31T16:56:35Z No. of bitstreams: 1 Dissertação Flávia Matos.pdf: 868333 bytes, checksum: 75207be4679ddfd22055131d0846333d (MD5) / Approved for entry into archive by Kely Alves (kely.alves@unifenas.br) on 2018-07-31T16:57:10Z (GMT) No. of bitstreams: 1 Dissertação Flávia Matos.pdf: 868333 bytes, checksum: 75207be4679ddfd22055131d0846333d (MD5) / Approved for entry into archive by Kely Alves (kely.alves@unifenas.br) on 2018-07-31T16:58:19Z (GMT) No. of bitstreams: 1 Dissertação Flávia Matos.pdf: 868333 bytes, checksum: 75207be4679ddfd22055131d0846333d (MD5) / Made available in DSpace on 2018-07-31T16:58:49Z (GMT). No. of bitstreams: 1 Dissertação Flávia Matos.pdf: 868333 bytes, checksum: 75207be4679ddfd22055131d0846333d (MD5) Previous issue date: 2018-02-26 / Although the objective structured clinical examination (OSCE) is considered golden standard for the assessment of clinical skills, the exam is both expensive and complex. On the other hand, structured oral examinations (SOE) have much simpler application and lower cost. Nonetheless, SOE may have lower validity and reliability. Objective: To compare Medical students’ academic performance and perception in regard of assessing skills through OSCE and SOE. Method: Two tests were designed (OSCE and SOE) to evaluate five obstetrical skills in a mannequin (the first three Leopold maneuvers, fundal height measurement, and fetal heart rate auscultation). The SOE assessed skills separately and the OSCE evaluated the skills after the analysis of a contextualized case. Students of the 4th term of Medical School were distributed into two groups. In the first phase of the study, Group 1 performed SOE, and Group 2, OSCE. Three weeks later, in the second phase, the same tests were applied inversely. Tests were applied by the same teacher, who employed the same checklist in both tests. In the second phase, a survey about students’ perception towards both test types was also applied. The mean score in each question was compared, as well as the final score, concerning the following crossings: test type in each of the two phases; test type regardless of phase; intragroup OSCE and SOE, and scores of the first and second stages, regardless of test type, as well as between groups, regardless of phase. Students’ perception was analyzed according to frequency distribution and grouping of open-ended answers by similarity. Results: 21 students participated in the study: 13 in Group 1, and 8 in Group 2. No difference was found in all the other crossings, except for the scores between phases. As for the intragroup comparison, the final score and the question 2 (fundal height measurement) score were superior in the second phase in both groups. The comparison between mean scores of the first and second phases, regardless of test type, demonstrated that the scores of the second phase were superior in the final score and in all questions, except for the second and third Leopold maneuvers. The scores’ improvement on the second day may be related to the testing effect. Conclusion: the test type did not influence students’ performance. Most candidates preferred the OSCE type. / Apesar do exame clínico objetivo estruturado (OSCE) ser considerado padrão ouro para avaliação de habilidades clínicas, ele é uma prova de organização complexa e de alto custo. Por outro lado, as provas do tipo prática-oral estruturada (POE) são de aplicação mais simples e de menor custo, ainda que possam apresentar menor validade e confiabilidade. Objetivo: comparar o desempenho acadêmico e a percepção de alunos de Medicina na avaliação de habilidades por OSCE e POE. Método: foram elaboradas duas provas (OSCE e POE) para avaliação de cinco habilidades obstétricas em manequim (três primeiras manobras de Leopold, medida de útero-fita e ausculta de batimentos cardíacos fetais). A POE avaliou as habilidades isoladamente e o OSCE avaliou as habilidades após a análise de um caso clínico contextualizado. Estudantes do 4º período do curso de Medicina foram distribuídos em dois grupos. Na primeira fase, o Grupo 1 realizou a POE e o Grupo 2 o OSCE. Na segunda fase, 3 semanas após, aplicou-se novamente as mesmas provas, de modo invertido. As provas foram aplicadas por um único avaliador, que utilizou o mesmo checklist nas duas provas. Na segunda fase, aplicou-se também um questionário sobre a percepção dos alunos em relação aos dois tipos de prova. Comparou-se a nota média em cada questão e a nota total nos seguintes cruzamentos: tipo de prova em cada uma das fases; tipo de prova independentemente da fase; OSCE e POE intragrupo e notas da primeira e da segunda fases, independentemente do tipo de prova, bem como entre os grupos, independentemente da fase. A percepção do aluno foi analisada por distribuição de frequência e agrupamento das respostas abertas por semelhança. Resultados: 21 alunos participaram do estudo, sendo 13 do Grupo 1 e oito do Grupo 2. Não houve diferença entre as notas das questões e a nota total, entre os dois tipos de prova, nas duas fases do estudo. Também não se observou diferenças em todos os outros cruzamentos, exceto quando se comparou as notas entre as fases do estudo. Na comparação intragrupo, a nota total e a nota da questão 2 (útero-fita) foi superior na segunda fase nos dois grupos. A comparação entre as médias das notas na primeira fase e na segunda fase, independentemente do tipo de prova, demonstrou que as notas da segunda fase foram superiores na nota total e em todas as questões, exceto na 2ª e 3ª manobras de Leopold. A melhora das notas, no segundo dia, pode estar relacionada ao efeito teste. Conclusão: o tipo de prova não influenciou o desempenho do aluno. A maioria dos alunos preferiu a prova tipo OSCE.

Att ha en mångfald av arbetskraft har idag blivit en viktig fråga för att kunna fånga in en mängd olika kompetenser, kunskaper och förmågor. Många företag uppmuntrar idag arbete med mångfald och inkludering eftersom de hävdar att de ökar kreativiteten och i utsträckningen vinsten för företaget. Trots detta kämpar många företag idag med att genomföra sådant arbete på ett framgångsrikt sätt. En metod för att skapa förutsättningar för mångfald och inkludering är att studera förställningar om kompetens och bedömnings-processer. Bedömning av kompetens ligger exempelvis till grund för beslut om befordran i karriären. Bedömningen inkluderar ett ställningstagande om vad kompetens är och i sin tur vem som är kompetent. Kompetensbegreppets komplexitet och normers påverkan på bedömningsprocessen komplicerar sådana ställningstaganden. Som ett försök till att försäkra att kompetens bedöms objektivt tillämpar många företag idag olika formaliserade rutiner för arbete med inkludering och mångfald. Den här studien syftar till att ge en djupare förståelse för hur karriär, bedömning av kompetens och formaliserade rutiner samspelar. En fallstudie har genomförts inom en verkstadsindustri som i rapporten benämns som Organisation A. Syftet med undersökningen var att utifrån föreställningar om kompetens, kompetensbedömning och karriär studera hur en formaliserad teknikerkarriär påverkar en organisations möjlighet till att skapa inkludering och mångfald. För att uppfylla syftet formulerades följande frågeställningar. Hur är teknikerkarriären strukturerad? Vilka förutsättningar skapar teknikerkarriären för likvärdig bedömning av kompetens? I studien har en teknisk karriärväg undersökts inom Organisation A. Examensarbetet är en del av utbildningen Civilingenjör och Lärare på KTH. Ingenjörsdelen av arbetet speglas i arbetets tekniska utgångspunkt där en organisation med teknikintensiv verksamhet har fått stå i fokus. Lärardelen av min utbildning tillämpas genom att relatera organisationens tekniska karriärspår till liknande organisationer inom undervisning och diskutera likheter och skillnader i bedömningsprocesser. För att besvara forskningsfrågorna har intervjuer med medarbetare och fokusgrupper med chefer genomförts.  Studien visar hur teknikerkarriärer organiseras utifrån formella och informella strukturer kopplade till bedömning av kompetens och att normer påverkar bedömningsprocesserna. Den observerade teknikerkarriären inom Organisation A bygger på en informell pyramidstruktur som ger utrymme för subjektiva tolkningar av karriärens syfte och mål. Detta möjliggör en syn på medarbetares olika kapacitet att nå till högre nivåer och problematiseras ur ett mångfalds- och inkluderingsperspektiv. Karriärstegens bedömningskriterier ger utrymme för tolkning och det saknas utbildning och stöd för chefer om hur kriterierna bör tolkas och tillämpas. Det är ett resultat av en brist på styrning, som krävs för att säkerställa att karriärprocessen används på det sättet den var avsedd. Bristen bidrar till att normer och fördomar kan fortsätta påverka bedömnings-processen. Organisationens implementerade mångfalds- och inkluderingsarbete tillför viss styrning, men bedöms göras utan försiktighet. Förändringsarbete kräver uppföljning och utvärdering vilket saknas. Organisationen kan dra lärdom av det som inom lärandeforskning benämns som formativ bedömning. Studien visar på en brist i samtliga av de tre centrala delar som ingår i formativ bedömning. Utifrån formulerade slutsatser ges rekommendationer till Organisation A om att ifrågasätta pyramidstrukturens syfte och tillämpa en tydligare styrning i form av utbildning och forum för samverkan. Dessutom ges rekommendationer för hur organisationen kan tillämpa formativ bedömning i karriärstegens bedömningsprocesser. / Having a diverse workforce has become an important issue in today’s organizations in order to capture a wide range of competence, skills and abilities. Today many companies encourage work with diversity and inclusion since they argue that it increases creativity and, in extent, company profit. However, many companies struggle to manage such work in a successful way. A method of creating the prerequisites for diversity and inclusion is to study the perception of competence and assessment processes. Assessment of competence is, for example, the basis for decision making in career advancement. The assessment requires one to decide on what competence is and in turn who is competent. The complexity of the concept of competence and norms being a part of the assessment process complicates such decisions. As an attempt to ensure that competence is assessed objectively, many companies apply different formalized procedures for inclusion and diversity work. This study aims to provide a deeper understanding of how career, assessment of competence and formalized procedures interact. A case study has been carried out in an engineering industry, which is referred to in the report as Organization A. The purpose of the study was to examine how formalized technical careers affect organizations' ability to create inclusion and diversity, based on perceptions of competence, competence assessment and career. To fulfil the purpose, the following two questions were stated. How are technical careers structured? What conditions do technical careers create for equal assessment of competence? In the study, a technical career path has been investigated within Organization A. The thesis is part of a MSc in Engineering and Education at KTH. The engineering part of the work is reflected in the technical point of view of the work where an organization with technology-intensive activities has been placed in focus. The educational part of my degree is applied by relating the organization's technical career paths to similar organizations in education, discussing similarities and differences in assessment processes. In order to answer the research questions, interviews with employees and focus groups with managers within Organization A have been conducted. The study shows how technical careers are organized based on formal and informal structures related to assessment of competence and norms affecting assessment processes. The observed technical career path within Organization A is based on an informal pyramid structure that allows for subjective perceptions of the purpose and goals of the career. This enables a view of employees' different capabilities to reach higher levels and is therefore problematized from a diversity and inclusion perspective. The assessment criteria of the career path provide room for interpretation and there is no education or support for managers how the criteria should be interpreted and applied. It is a result of a lack of management required to ensure that the career process is used the intended way. The shortcoming contributes to the fact that norms and prejudices can continue to influence the assessment process. The organization's implemented diversity and inclusion work provide some management but is done without caution. Processes of change requires follow-up and evaluation which is lacking. The organization can learn from what in learning research is addressed as formative assessment. The study shows a shortcoming in all three key parts included in formative assessment. Based on stated conclusions, recommendations are given to Organization A to question the purpose of the pyramid structure and to apply clearer management in terms of education and forums for collaboration. Additionally, recommendations are given for how the organization can apply formative assessment in career assessment processes.