Phys. Journal No. 3, December 2008.pmd


Introduction:

Article

Summative Assessment (Written) in Undergraduate Physiology
Curriculum in Bangladesh:  Reflection of Educational Objective

Ali T1, Begum N2, Begum AA3, Shamim KM4, Ferdousi S5, Bennoor KS6

Background: A new curriculum for undergraduate medical education has been introduced for all
universities in Bangladesh since 2002. It is expected that this new curriculum will improve the
qualitative level of medical education. According to this curriculum the assessment system for the
students has also been modified. This new scheme gives more emphasis on certain evaluation
procedures in written examination to be customized. For example, short essay questions (SEQ) are
preferred to long descriptive and short answer questions (SAQ). Questions should be specific answer
oriented and targeted towards assessing the level of cognitive domain of the examinees.

Objective: The present retrospective analysis was done to observe the qualitative status in the written
assessment procedure in Undergraduate Physiology after the implementation of the new curriculum
by comparing the setting of the different question types under new curriculum with that of the old
curriculum. This study was done also to identify the areas that warrant modification.Methods: This
study analyzed all new and old curriculum based written questions of the assessment examinations
(except MCQ) for undergraduate Physiology course from 2001 to 2006, under 4 different universities
in Bangladesh. In total 63 question papers on physiology were included for evaluation. Data were
statistically analyzed by proportion test using SPSS software.Results: The analysis indicates that
there are significant improvement in type of questions (SEQ, SAQ and combined) and language
(specific vs. non specific) field. However improvement in all the fields of medical education was
statistically insignificant.Conclusion: Therefore, it may be concluded that the question setting
procedure of the written examination according to the modern assessment technique has partially
fulfilled

J Bangladesh Soc Physiol.2008 Dec;(3):61-65.
For author affiliations, see end of text.

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great alteration has been occurred in
the attitude and style in the medical
education worldwide to make it more

To meet the global need of these objectives
changes in medical course curriculum and
assessment technique became essential in
Bangladesh. In this country a set up for
undergraduate medical education was continued
from the preliberation period up to 1988. Then a
great change was brought in curriculum in 1988
by making it more community oriented3.

Although, it was a combined product of
reorientation of medical education (ROME) and
community oriented medical education (COME)

A
motivated and time oriented.1 In 1988, world
conference on medical education in Edinbergh2
gave emphasis on a national health priority based
curriculum, community oriented educational
settings, self directed student centered active
learning and use of assessment technique
ensuring achievement of professional
competence and social values.

J Bangladesh Soc Physiol. 2008 Dec;(3):61-65 61



62 J Bangladesh Soc Physiol. 2008 Dec;(3):61-65

but a thoroughly revised new curriculum for
undergraduate course in medicine was
implemented in 2002 in Bangladesh aiming at
qualitative improvement in medical education4 .

This new problem oriented curriculum for
undergraduate medical education was introduced
following the recommendations of medical
educationist and it was approved by Bangladesh
Medical and Dental Council4 .

Assessment is a very important component of
medical course curriculum. Medicine itself is a
profession in which accurate and responsible
assessment is of cardinal requirement. The
assessment procedures have a powerful influence
over learning process5. Scientific studies
confirmed that it is the evaluation system rather
than the educational objectives or curriculum or
instructional techniques that have the most
profound impact on what the students ultimately
learn6. As study of the whole curriculum is
laborious and time consuming, Rotem in 1982
showed an easy approach to review curriculum
that was based on analysis of examination
system7. Modern assessment technique
prescribed in the new curriculum in Bangladesh
includes Short Answer Question (SAQ and
Multiple Choice Question (MCQ) for written
aptitude4.

In the past, long essay questions were commonly
used in written section of examination to assess
the cognitive ability of students. But these
traditional essay questions could not yield the
expected answers and wide variation in student’s
interpretation was noted. Therefore, it showed
limited validity, poor reliability and less
objectivity8. On the other hand, wording in SEQ
limits the scope of the content and directs the
student towards a precise and specific response
that makes it more reliable and valid8. In addition
SAQ carries greater objectivity and reliability and
their range of subject areas testes is extended9.

Very few study focusing assessment technique
in undergraduate Physiology in Bangladesh has

been carried out.  One comparative study on
SOE1 and another on OSPE10   are available. But
no published data on written assessment
technique in undergraduate physiology has been
reported in Bangladesh. Therefore, the present
retrospective analysis was done to observe the
qualitative status in the written assessment
procedure in Undergraduate Physiology after the
implementation of the new curriculum by
comparing the setting of the different question
types under new curriculum with that of the old
curriculum. This study was done also to identify
the areas that warrant modification.

Methods:
Total eighty five question papers for written
examination in Physiology in First Professional
Examinations held under Dhaka, Chittagong,
Rajshahi, Shahjalal University from January
2001 to July 2008 were collected. Under old
curriculum 57 question papers and under new
curriculum 28 question papers were studied.
They were grouped as Gr I (New curriculum)
and Gr II (Old curriculum). Both the groups were
again sub grouped as A (Dhaka University), B
(Chittagong University), C (Rajshahi University),
D (Shahjalal University). All the questions were
categorized into recall, understanding, problem
based, combined and uncategorized according
to their assessing power. Again, the questions
were marked as SAQ, SEQ, combined according
to answer length and specific, nonspecific,
combined according to forms of their language.
All these different types of questions were
expressed in percentage out of the total questions
in new and old curriculum under individual
university. Data were analyzed statistically by
proportion Z test.

Result:
In the question papers under new curriculum of
all Universities, percentage of SAQ was higher
and percentage of SEQ was lower compared to
old curriculum. But this difference were not
statistically significant (Figure 1).

Article Summative Assessment in Physiology



J Bangladesh Soc Physiol. 2008 Dec;(3):61-65 63

In all Universities the recall type of questions
were decreased in new curriculum question
papers in comparison to those of old except in
Shahjalal. But this difference was not statistically
significant (Figure 2).

In the question papers under new curriculum of
all Universities percentage of SAQ was higher
compared to old curriculum. But this differences
were not statistically significant (Figure 1).

Figure: 1  Proportions of SAQ of both the
curriculums of different universities

Figure: 2  Proportions of Recall type of questions
of both the curriculums of different universities

Inclusion of problem based questions in Dhaka and
Chittagong Universities was a notable finding in
the new curriculum question papers (Figure 3).

Again percentage of specific type question was
increased whereas non specific type was
decreased in the question papers under new
curriculum in all the universities when compared
to old curriculum. But these changes were also
not statistically significant (Figure 4).

Figure: 3 Proportions of Problem based questions
of both the curriculums of different universities

Figure: 4 Proportions of Specific type of
questions of both the curriculums of different
universities

Table – I
Proportions of different types of questions of
both the curriculums of all universities (n=)

Variables New Old p

curriculum curriculum  value

SAQ 0.66 0.54 1.33 ns

SEQ 0.37 0.46 1 ns

Combined 0 0 0 ns

Recall 0.87 0.88 0.17 ns

Understanding 0.13 0.09 0.68 ns

Problem based 0.01 0 1 ns

Combined 0 0 0 ns

Specific 0.66 0.64 0.22 ns

Non specific 0.39 0.45 0.62 ns

Combined 0 0 0 ns

Summative Assessment in Physiology Article



64 J Bangladesh Soc Physiol. 2008 Dec;(3):61-65

Discussion
The present study was done to observe the status
of the qualitative pattern of the written question
paper setting of the new undergraduate medical
curriculum and to compare it with that of the
traditional one. While analyzing the written
question papers of Undergraduate Physiology
course of the present curriculum in Bangladesh,
the basic problem faced was lacking of the
objective of this course in the terms of amount
of different types of questions, or how much
component of the questions should be of different
levels of cognitive domain, or different types of
languages4. There should be fixed criteria as
written document for setting questions for the
written examinations that fulfill the objectives
of the course. The finding of this study reveals
that, there is an increase in understanding and
specific type of questions in the new curriculum
question papers. Along with this a decline in the
amount of recall and non-specific type of
questions are also observed, though the change
was nonsignificant. Again, increase in the amount
of short answered questions (SAQ), decrease in
short essay questions (SEQ) and absence of long
essay questions in the ongoing curriculum in
comparison to the older one. This observation
has accomplished the task, though partially, to
achieve the target of modern assessment
technique in written question paper setting.
Unfortunately no data was available to compare
these findings.

However, when the question papers under new
curriculum were compared among the four
different universities, there was an increase in
the frequency of understanding type of questions
in three universities than those of Shahjalal and
the difference was significant (p<0.001). Again,
the addition of problem based questions in the
Physiology Written question papers of Dhaka and
Chittagong Universities in comparison to
Rajshahi and Shahjalal, indicates wide variation
in question paper setting among different
universities.

It is important to note that the different variables
of written assessment used in the question papers
under the present study is similar to the methods
adopted by the few investigators of our country
12,13 but the scoring system is different.

Therefore, it may be concluded that the question
setting procedure of the written examination
according to the modern assessment technique
has partially fulfilled.

So, it may be recommended that, proper
orientation and implementation of the evaluators
and educators are imperative to get the desired
benefit from the present undergraduate
Physiology written assessment system.

Author Affiliations
1. *Taskina Ali, Assistant Professor of Physiology,

BSMMU, Shahbag, Dhaka, Bangladesh.

2. Noorzahan Begum, Chairman & Professor of
Physiology, BSMMU, Shahbag, Dhaka, Bangladesh.

3. Anjuman Ara Begum, Assistant Professor of Anatomy,
Rangpur Medical College, Rangpur, Bangladesh.

4. Khandaker Manzare Shamim, Chairman & Professor
of Anatomy, BSMMU, Shahbag, Dhaka, Bangladesh.

5. Sultana Ferdousi, Assistant Professor of Physiology,
BSMMU, Shahbag, Dhaka, Bangladesh.

6. Kazi Saifuddin Bennoor, Assistant Professor of
Respiratory Department, National Institute of Diseases
of Chest & Hospital (NIDCH), Mohakhali, Dhaka,
Bangladesh.

* For Correspondence

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