For a minute, think from the view point of a patient. You go to a doctor who does not listen to you properly, is rough in his examination and hands out the prescription to you saying 'ask the chemist'. When you try to clarify certain doubts, he shuts you down saying he is too busy and you certain doubts, he shuts you down saying he is too busy and you have already taken too much of his time. Would you ever like to go back to him ? Probably not. For precisely this reason it has been said that medicine is not the drug that works but how and by whom it is given that makes all the difference.

Now, come back to your role as a teacher. Have we ever tried to evaluate this aspect in medical education ? The answer would be a 'No'. And it goes without saying that what is not evaluated is not learnt. Thus, we leave it to chance or take it for granted that a student who has passed the final MBBS examination has also learnt how to effectively communicate with a patient Nothing can be farther from the truth.

You may argue that present examination guidelines do not Provide a scope for this. However, the latest guidelines of MCI have put a great emphasis on this aspect. There is a potent area where such evaluation can and must be done i. e. internal assessment. Since internal assessment is carried out on a continuos basis, you are in a better position to evaluate non - scholastic abilities of the student. Implicit in this is the provision for providing feedback to the student so that he can improve. Non - scholastic abilities can be grouped into one of the categories given below. You will notice that this list is only illustrative and not exhaustive.

You would appreciate that while social and communication skills are being talked about for many years now, inter disciplinary skills are a relatively new addition to the field. It would be right to assume that as more and more psycho - social emphasis is given to medical problems, this list is likely to expand. We will like to point at this juncture that while many of these areas require deliberate training, others are picked up by observing teachers and peers. It is also possible that teaching and training in one area, say ethics, may have a generalising effect on others.

Let us now come down to the brass tacks. How do we evaluate, for example, creativity or communication skills ? One of the problems that you may be facing is that creativity or originality is not directly observable and one is likely to draw subjective interoperations in this regard. However, you can evaluate skills or knowledge that may be based on the above attributes. We must confess that this is a tough area and each one of us may have our own ideas. Association of Indian Universities has attempted to provide some guidelines for this. Just have a look at the following example :

This type of evaluation tool is called a rating scale. This can be completed by the teachers or even by peers. What you should remember is that these attributes are not constant and can change for the better or whose with passage of time - hence you need to evaluate a student repeatedly (eg. once in 3 months) for better results. Here is another rating scale for scientific attitudes :

'Communication skills' is the other important area which needs to be evaluated during undergraduate studies. At many medical schools abroad, audio and video recordings of a student's interaction with patients and observation across a one way glass are commonly used. However, in our kind of setting. this  may not yet be possible. You may consider using one the following methodologies depending upon the situation and your requirements.

a) OSCE Station : Recall that OSCE provides a useful and reliable method for evaluation of skills. The history - taking station, for example, can be modified in such a way that in addition to conventional points on history, the students is also being evaluated on communication ability. Alternatively, an exclusive station can be devoted to communication skills. Look at the following example :

Task

Explain the dosage form of drugs to the mother, whose baby is suffering from throat infection.

Check List :

The example you saw just now represents a negative marking scheme which penalises the student for not performing an important act. There can be another way of this, without involving negative marks. Look at the following example :

Task

Explain to the mother, how to prepare and administer ORS.

Check List :

In this scheme, a student gets credit for such actions which the actually performs. It may not be out or place to mention here that in both the schemes, some element of subjectivity cannot be ruled out.

b) Peer ratings : This type of evaluation is being increasingly used at many medical school abroad. The rationale of using this approach is simple - a student is more natural in presence of his friends rather than his teachers. The experience with this mode in India is almost nil. However, you can still think of some ways by which this important modality can be put to use.

You will agree with us that we do not evaluate these aspects because we are afraid of subjectivity. however, if we look at it like this, that anything which is evaluated will be learnt by the students, we are likely to induce a positive attitudinal change in them by evaluating these abilities.