Traditional methods of assessment in higher education, such as examinations and essays, still dominate the majority of curricula (Struyven et al, 2005; Pereira et al, 2016), despite being criticised in the literature (Sambell et al, 1997; Scouller, 1998; Medland, 2016). Sambell et al (1997) reported that students had negative opinions about conventional assessment methods, going so far as to suggest they negatively affected the learning process. Medland (2016) therefore recommended that higher education assessment systems move away from the testing culture, where students merely ‘learn to pass’, towards an assessment culture, where students ‘learn to learn’, and proposed that this could be fostered by the implementation of varied and innovative methods of assessment, in which students are active participants.
Assessment undoubtedly provokes student anxiety, as students generally wish to perform well (Bryan and Clegg, 2006). Student perception of, and reaction to, the transition from conventional to innovative assessment strategies are also arguably affected by the way in which the assessment is introduced (Brown, 2003; Glasner, 2003) and, when faced with innovative methods of assessment, student anxieties are heightened (Bryan and Clegg, 2006; Turner et al, 2013). Institutional support, reflection and mentoring are therefore key in preparing students for the assessment (Epstein and Hundert, 2002). Students should be active partners in the development of new methods of assessment, and their evaluation is critical for continuous improvement (Reece and Walker, 2007; Biggs, 2011).
Two innovative methods of assessment were introduced in the 2015 undergraduate midwifery curriculum: a group debate was implemented with first-year students, and a ‘webfolio’ was piloted with third-year students, which will be discussed along with the importance of building student confidence to undertake an unfamiliar method of assessment.
Debate
Group debates have been used as a teaching method in various disciplines (Doody and Condon, 2012), but have not been widely used in healthcare education as a method of assessment and are under-reported in midwifery education literature. Group debates are therefore innovative in midwifery curricula, but require careful student preparation. It was hoped that debate would develop skills of critical thinking; data gathering, analysis and synthesis; appreciation of opposing viewpoints; and persuasion, as well as promoting teamwork, citizenship, co-operation, organisation and presentation (Doody and Condon, 2012; Education World, 2015).
These skills are also required by midwifery students to function effectively as members of a wider healthcare team (Epstein and Hundert, 2002), where critical analysis and evaluation of a clinical situation to facilitate diagnosis and management are paramount. Pedagogically, debate mirrors Bloom's (1956) taxonomy, in particular encouraging students to develop the higher cognitive skills of analysis, synthesis and evaluation (Doody and Condon, 2012). Midwives need to advocate for women's choices (Lucas, 2011) and therefore are also required to foster an appreciation of opposing viewpoints. Thus the group debate, while being a method of assessment, also equips students with skills required for the ‘real world’ of midwifery (Dijkstra et al, 2016). Huxham et al (2012) compared students' performance in both written and oral assessments, and found that students performed better in oral assessments, which, despite initial anxieties, acted as a powerful tool in developing professional identities. Orr (2010) reported that students also valued the opportunity for group work, as this was seen as authentic and effective preparation for life after graduation.
Development of group debates
The format of the debate was decided based on the recommendations of the available literature (Doody and Condon, 2012; Chan, 2014). Students in their first year chose their own teams so they felt comfortable and confident in their groups. The motions for debate reflected the module learning outcomes, in keeping with the principles of constructive alignment (Biggs, 2011), and module topics. The motions were contentious statements, and students were allocated the motions and their positions ‘for’ or ‘against’ the motion, often requiring them to argue the motion from a viewpoint that they would not naturally hold. This encouraged critical and abstract thinking and developed advocacy skills (Doody and Condon, 2012).
Preparation for any assessment is crucial, particularly with innovative methods (Epstein and Hundert, 2002), but an assessment method that requires public speaking may present a further challenge to some students (Huxham et al, 2012; Turner et al, 2013; Chan, 2014). Students were thoroughly prepared at the beginning of the module, with the purpose of the debate and the roles and responsibilities clearly defined and provided in documented form for reference. Students were made aware of assessment criteria and had the opportunity to participate in a formative group debate so they could visualise a debate ‘in action,’ and build their confidence. Tutorial support and allocated preparation time within the module were also provided.
Ground rules and format were key to the success and flow of the debate, and were discussed at length. Students were prepared to present their arguments and rebuttals, with guidelines provided on technique and structure to ensure the debate remained professional and relevant (Chan, 2014).
Evaluation of debate as an assessment tool
With any innovation, evaluation of the assessment tool is vital (Reece and Walker, 2007), as is eliciting student feedback. A questionnaire was devised to collect quantitative data and qualitative comments, and was completed by 111 students from 3 concurrent cohorts. The results of the quantitative data (Table 1) showed that 93% of students felt that they were well prepared for the debate, and that 87% felt that the assessment guidelines were clear. In total, 93% of students stated that they learned new skills to take forward to subsequent years of study and, more importantly, into midwifery practice. Overall, 91% of students agreed that they enjoyed working as part of a team.
| Strongly Agree | Agree | Neutral | Disagree | Strongly Disagree | |
|---|---|---|---|---|---|
| I was well prepared for the group debate | 50 | 53 | 6 | 0 | 2 |
| The assessment guidelines were clear | 57 | 40 | 11 | 3 | 0 |
| I have learned new skills to take forward into Year 2 | 65 | 38 | 4 | 3 | 1 |
| I have learned new skills to take forward into midwifery practice | 60 | 42 | 5 | 2 | 2 |
| I enjoyed working as part of a team | 68 | 33 | 8 | 2 | 0 |
| I was able to negotiate my role within the team | 60 | 40 | 7 | 3 | 1 |
| TOTAL | 360 | 246 | 41 | 13 | 6 |
Themes
Thematic analysis of the qualitative data was undertaken with the main themes emerging as follows:
Overall the group debate has proved to be an effective and empowering innovative method of assessment.
Webfolio
Within higher education, there have been significant changes in portfolio pedagogy in the last decade, with a progression from traditional paper portfolios to electronic portfolio systems, such as an e-portfolio or ‘webfolio’. Ogan-Bekiroglu and Gunay (2008) describe the creation of a portfolio as a systematic process of collecting and evaluating the end products of student learning. Consistent with a social constructivist pedagogical foundation (Anderson and Dron, 2011) the webfolio encourages an active, learner-centred experience, whereby new knowledge builds on the foundation of previous learning and is subject to social discussion, validation and application in real world contexts (Honebein, 1996; Kanuka and Anderson, 1999). The webfolio allows for the creative design of assessment within a balanced curriculum to help students understand and cultivate professional values and qualities (Chan, 2012; Huang et al, 2012; Green et al, 2014).
The ability of the webfolio to support learning is positively reported in the literature, thereby prompting many universities delivering undergraduate midwifery programmes to consider portfolio use (Lombardi, 2008). As a result, portfolios have become increasingly popular in undergraduate nursing and midwifery education settings. The use of a webfolio as a tool to assess learning in healthcare programmes has been advocated as a way of assisting students to confront the conflicts between assessment preparation and continuous professional development. Despite this, student dissatisfaction has been noted regarding webfolio assessment due to lack of training and guidance (Garrett et al, 2013), uncertainty of purpose (Timmins and Dunne, 2009) and a lack of a common understanding for what a webfolio is (Barett and Carney, 2005).
In light of the mixed evidence surrounding the use of webfolio assessment, a student evaluation was conducted to explore the pedagogical value of the webfolio for final-year undergraduate student midwives in evidencing learning in practice. More specifically, the evaluation explored the advantages of webfolio usage versus traditional paper portfolios in demonstrating the achievement of learning outcomes in clinical practice and the development of reflective skills. This student evaluation formed part of a larger, two-phase pilot study. The first phase of the study involved piloting the webfolio as a stand-alone assessment tool within the development of a new BSc Midwifery curriculum module, prior to formal use in 2018. The second phase involved follow-up focus groups with the students following completion of their webfolios.
For phase one of the pilot study, two concurrent cohorts of final year undergraduate student midwives undertaking an optional international placement were invited to take part in the project. Self-selecting and consenting students were provided with a cohort-specific small group tutorial regarding the assessment strategy and the assessment requirements. Before embarking on their international placements, students were provided with theoretical and practical instruction on webfolio building, along with a written instruction booklet. Students were asked to build a webfolio using the software platform Pebblepad, to record the achievement of four set learning outcomes. During their international placement, students were asked to demonstrate achievement of competencies set in their traditional paper portfolio in addition to a webfolio, by way of a comparison. All students were asked to share their completed webfolio with the project lead in order to be assessed formatively. On reviewing the completed webfolios, all students had evidenced successful achievement of learning outcomes in practice, and the innovative nature of the webfolio had allowed for evidence and reflection to be demonstrated by creative and contemporary means.
On their return to the UK, focus groups, involving 8 students in each, were conducted with each cohort. Focus groups explored students' practical experience of webfolio completion and the effects that a webfolio had on student learning compared to paper portfolios.
Themes
Focus groups were recorded and transcribed verbatim to facilitate thematic data analysis, which revealed three main themes.
The findings of this student evaluation tentatively suggest that the webfolio for final-year student midwives tests and extends knowledge and skills and is a valuable assessment strategy that promotes innovative learning.
Discussion
While the debate and webfolio are very different, student evaluation highlighted common themes that can be drawn to promote the pedagogical value of innovative assessment in undergraduate education.
Firstly, this evaluation highlights that both the debate and the webfolio successfully challenged students to perform outside of their preferred learning style. It is acknowledged that students are sometimes reticent towards innovative approaches, and can feel more confident and reassured with conventional assessment strategies. By engaging with innovative assessment methods, however, students have actively broadened their horizons to new ways of learning, and have successfully demonstrated knowledge and skill through an unfamiliar assessment method. This appeared to positively influence the students' perception of, and attitudes towards, innovative assessment strategies.
Secondly, both the debate and the webfolio successfully assisted students in developing transferable skills. Many assessment methods merely assist the student to perform for that particular obstacle, providing little opportunity to demonstrate or develop wider transferable knowledge and skills outside the test (Race, 2003). Students were able to fully articulate the broad range of new skills that they had developed and could appreciate how these skills were transferable to their role as a midwife.
Finally, this evaluation shows that student confidence and satisfaction were positively influenced by the preparation and support provided by the midwifery tutors. Innovative assessment initially provoked anxiety among the students, particularly as the assessments provided increased freedom compared with conventional assessment strategies. During the planning stages, midwifery tutors were acutely aware that student perceptions of, and reactions to, a transition from conventional to innovative assessment methods could be affected by the way in which the assessment was introduced (Brown, 2003; Glasner, 2003), and so attention was paid to ensuring that students understood the requirements and benefits of the assessment. While many students were initially reticent, by fostering increased levels of student independence and responsibility with the debate and webfolio, student confidence and satisfaction with the innovative assessment methods were positively affected. Students felt they were prepared for the assessment and in retrospect viewed innovative assessment positively. This evaluation therefore provides tentative reassurance of the pedagogical value of innovative assessment for undergraduate students undertaking the BSc Midwifery undergraduate programme.
Conclusion
The use of a debate and a webfolio as methods of assessment therefore facilitates the development of multiple transferrable skills for professional midwifery practice. Innovative assessment methods, in which students are active participants, promote deeper learning; however, thorough preparation of students to undertake an innovative method of assessment is vital in fostering student confidence. Evaluation is also important to ensure validity, reliability and quality.
Students enjoy participating in innovative methods that facilitate creativity and allow them to demonstrate knowledge and skills through non-conventional methods and educators should strive to incorporate innovative assessment methods that foster a ‘learning through assessment’ culture.