THE EFFECT OF FEEDBACK ON STUDENTS PERFORMANCE AT THE END OF SEMESTER EXAMINATIONS IN HEALTH TRAINING INSTITUTIONS PDF

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UNIVERSITY OF CAPE COAST THE EFFECT OF FEEDBACK ON STUDENTS PERFORMANCE AT THE END OF SEMESTER EXAMINATIONS IN HEALTH TRAINING INSTITUTIONS ITHIEL KORKOR ZOTORVIE PATIENCE TSRAH ANTHONY AKPATSU JAMES ATTA AGLAH 2014 UNIVERSITY OF CAPE COAST i THE EFFECT OF FEEDBACK ON STUDENTS PERFORMANCE AT THE END...

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THE EFFECT OF FEEDBACK ON STUDENTS PERFORMANCE AT THE END OF SEMESTER EXAMINATIONS IN HEALTH TRAINING INSTITUTIONS James Aglah

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UNIVERSITY OF CAPE COAST

THE EFFECT OF FEEDBACK ON STUDENTS PERFORMANCE AT THE END OF SEMESTER EXAMINATIONS IN HEALTH TRAINING INSTITUTIONS

ITHIEL KORKOR ZOTORVIE PATIENCE TSRAH ANTHONY AKPATSU JAMES ATTA AGLAH

2014 UNIVERSITY OF CAPE COAST

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THE EFFECT OF FEEDBACK ON STUDENTS PERFORMANCE AT THE END OF SEMESTER EXAMINATIONS IN HEALTH TRAINING INSTITUTIONS

+ BY JAMES ATTA AGLAH ITHIEL KORKOR ZOTORVIE PATIENCE TSRAH ANTHONY AKPATSU

A Project submitted to the Department of Science and Mathematics Education of the Faculty of Education, University of Cape Coast, in partial fulfillment of the requirements for award of Bachelor of Education Degree in Health Science Education

OCTOBER, 2014

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ABSTRACT Effective teaching and adequate feedback is a powerful way of enhancing learning. Teachers need to seek and learn from feedback (such as from students’ responses to tests) as much as do students, and only when assessment provides such learning is it of value to either. This study was to assess the effect of feedback on students’ performance at the end of semester examinations in HTIs in Central Region. The study specifically sought to find out the different feedback strategies and their contribution to students’ performance. Data was collected through the use of questionnaire involving 460 students and 50 tutors. The result demonstrates that the type of assessment tools used in the HTIs were quizzes, assignment, project work and examinations which take the form of fill in the blank spaces, MCQs and essay questions. Tutors give an average of (1-3) quizzes which is determined by class size. The results also indicate that feedback does not have any impact on their academic performance however, students would have performed better if feedback was given to them on time, meanwhile optimal timing of feedback might vary based on the feedback’s content. Time allocated for teaching and learning is limited for tutors to use some of the instructional period to give feedback to students also, class size pose a problem in giving feedback to students. Without feedback, students go through various courses without assessing their progress only to fail at the final examination such as the licensure examination. Tutors and students should

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be encouraged to use technology for assisted learning and unlimited and timely feedback, also peer review is another strategy for managing the load to ensure lots of timely feedback; it's essential, however, for tutors to train students to do small-group peer review.

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TABLE OF CONTENTS Page DECLARATION

ii

ABSTRACT

iii

TABLE OF CONTENTS

v

LIST OF TABLES

vii

APPENDICES

x

CHAPTER ONE: INTRODUCTION

1

Background to the Study

1

Statement of the Problem

4

Purpose of the Study

5

Specific Objectives

5

Significance of the Study

5

Delimitation

6

Limitation

6

Definition of Terms

6

Organization of the Rest of the Study

7

TWO: REVIEW OF RELATED LITERATURE

8

THREE: METHODOLOGY

45

Research Design

45

v

Population

45

Sample and Sampling Procedure

46

Data Collection Instrument

47

Data Collection Procedure

47

Data Analysis

48

FOUR: RESULTS AND DISCUSSION

49

FIVE: SUMMARY

70

CONCLUSION

71

RECOMMENDATION

73

REFERENCES

74

APPENDIX A- Instrument for Data Collection

81

B- Introductory letter

94

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LIST OF TABLES TABLE

Page

1.

School of Respondents

49

2.

Background Information of the Respondents

50

3.

Type of Assessment used by Tutors

51

4.

The Class Size of Respondents

53

5.

Frequency of Assessments in the Last Semester

54

6.

Respondents’ View about Assessment and the Timing of Feedback

55

7.

Respondents’ View on Feedback

56

8.

The Effect of Seeing the End of Semester Examination Scripts or Licensure Examination Script

59

9.

School of Tutors

60

10.

Demographic Information about Tutors

61

11.

Type of Assessment Used by Tutors

62

12.

Class Sizes that Tutors Teach

63

13.

Factors that Determine the Number of Assessments Per Course in a Semester

64

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14.

How Feedback is Delivered in HTIs

65

15.

How Tutors Give Feedback

66

16.

Benefit of Feedback Given to Students

67

17.

Challenges Associated with giving Feedbacks to Students

68

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CHAPTER ONE INTRODUCTION Back ground of the study Assessment is done in our everyday life in order to monitor our progress so far. Assessment is very vital in every educational institution including health training institutions. Boston (2002) cited Black and Wiliam (1998b) to define assessment broadly to include all activities that teachers and students undertake to get information that can be used diagnostically to alter teaching and learning. Under this definition,

assessment

encompasses teacher

observation,

classroom

discussion, and analysis of student work, including homework and tests. Assessments become formative when the information is used to adapt teaching and learning to meet student needs. When teachers know how students are progressing and where they are having trouble, they can use this information to make necessary instructional adjustments, such as re-teaching, trying alternative instructional approaches, or offering more opportunities for practice. Different forms of assessment such as formative and summative assessment are used by health training institutions. The former is used while learning is on-going to monitor whether what has been taught has been understood or the skills demonstrated has been grasped. Periodic observations, quizzes, and performance

tasks can provide teachers with information about what students know and can do and where more and/or different instruction is needed. Formative checks for understandings during instruction can often lead to a teacher deciding to use a different instructional strategy because the one initially used was ineffective for some students. The later, happens at the end of all the learning process. This is the final assessment to evaluate the whole learning process. Summative assessment takes the form of project work, end of semester examinations, licensure examinations conducted by the various regulatory bodies e.g Nurses’ and Midwives’ Council (NMC), Medical and Dental Council (MDC), Allied Taskforce), etc. Various factors affect students’ performance in the health training institutions which may include the psychological and emotional state of the student, the tutor student relationship, financial state of the students among others. Academic performance is affected by a number of factors including admission points, social economic status and school background. Geiser and Santelices (2007), and Acato (2006), all argue that admission points which are a reflection of the previous performance influence future academic performance. Throughout the teaching and learning process, students need multiple opportunities to practice and to receive timely, specific feedback about what they are doing well and what they still need to work on without penalty or fear of being graded. If a teacher observes that some students do not have the background to

grasp a concept or skill or have misconceptions that will interfere with learning, he/she can design activities that provide the appropriate background information or that clear up misconceptions before beginning the lesson on a new topic. Formative checks for understandings during instruction can often lead to a teacher deciding to use a different instructional strategy because the one initially used was ineffective for some students. Effective teaching and adequate feedback is a powerful way of enhancing learning. Teachers need to seek and learn from feedback (such as from students’ responses to tests) as much as do students, and only when assessment provides such learning is it of value to either. (Hattie &Timperley, 2007) According to Anne Davies (an international expert on assessment for and of learning), formative assessment promotes learning because it encourages students to take risks, make mistakes, and then work differently as a result. Mistakes are seen as important because they provide assessment evidence for learners to use as feedback. This feedback helps learners understand what is not working and figure out what alternate strategy will work. Students must understand that mistakes are part of the learning process so that they will be willing to take the necessary academic risks. “Setting appropriate assessment tasks is a principle of good teaching” (Ramsden, 2003, p 96)

STATEMENT OF THE PROBLEM In recent years, the Ministry of Health(MOH) have increased the number of intake of students into the HTIs as well as creating other allied institutions such as to train more Health Assistants and Community health Nurses to meet the workforce demands of the service delivery in the country. In the annual report of the Human Resource for Health Development (HRHD) of the MOH in 2011, it was reported that 9,117 trainees were admitted in the 2008/2009 academic year. The number rose to 9,348 in 2009/2010, and 9,782 in 2010/2011 academic year. It also reported that there were 23,000 trainees in the health trainee institutions as at 2011 with an annual intake of 11,000 trainees, Nursing and Midwifery students making up 7,500 while the rest is made up of other allied health professionals mainly from Kintampo. This increase in the number of trainees has resulted in very large class sizes and a burdening student – to – tutor ratio. With such staggering numbers, tutors are virtually frightened to give assessment that would require marking of scripts and returning feedback in the academic semester. Without feedback, students go through various courses without assessing their progress only to fail at the final examination such as the licensure examination. These high levels of student failure have become of much concern and main subject of discussion in meetings and reviews of tutors and heads of health

institutions nationwide. (Nurse Educators’ Group (NEC) conference minutes, 2014.) PURPOSE OF THE STUDY To assess the effect of feedback on students’ performance at the end of semester examinations in HTIs in Central Region. SPECIFIC OBJECTIVES 1. To determine the various types of assessments used in the HTIs. 2. To identify the factors that determines tutor’s choice of a particular type of assessment. 3. To determine the impact of feedback on students’ performance. 4. To determine the challenges involved with giving feedback at the HTIs. SIGNIFICANCE OF THE STUDY The outcome of this study will help inform tutors of HTIs on the role of feedback on their trainees’ performance. It will also inform Stakeholders in drawing up policies which will help promote effective feedback delivery system at HTIs. The various HTIs used in the study will be privileged to get copies of the study findings.

DELIMITATION There are five HTIs in the Central Region but four were initially chosen to be used for the study namely, Cape Coast Nursing and Midwifery Training College (NMTC), Ankaful Nursing Training College (NTC), Twifo Praso NMTC and Winneba Community Health Nursing Training School (CHNTS). The study covered only final year students instead of including first and second years because the later ones were on vacation. LIMITATIONS OF THE STUDY Permission was not granted for one of the four schools earmarked to be studied limiting the study to three schools which affected the sample size. There were some non-respondents resulting from the fact that some final year students were preparing to write their final licensure examination and so researchers used only on those who readily availed themselves and returned the questionnaire. DEFINITION OF TERMS NMC – Nurses’ and Midwives’ Council MOH – Ministry of Health GHS – Ghana Health Service MDC – Medical and Dental Council HTI – Health Training Institutions

HRHD – Human Resource for Health Development

ORGANIZATION OF THE REST OF THE STUDY Chapter two deals with the review of related literature. Methodology is discussed in chapter three. Chapter Four is the presentation of results and the discussion of the various findings. Chapter five contains the summary, conclusion and recommendation(s) for the study.

CHAPTER TWO REVIEW OF RELATED LITERATURE OVERVIEW Educational systems use a variety of methods to encourage student learning. In many educational settings, immediate feedback is used to improve student performance. This chapter provides a background on the definition of academic performance, assessment and feedback as well as, the various types of assessments that are used, types of feedback, the effects of feedback to teachers and students and the challenges involved in giving feedback at the HTIs. ACADEMIC PERFORMANCE Academic performance according to the Cambridge University Reporter (2003) is frequently defined in terms of examination performance. Self and peer and assessment are appropriate when used for formative purposes – i.e. to provide feedback on their learning. There is significant evidence suggesting that students learn from receiving feedback from other, as well as from giving feedback to each other (Falchikov, 2005). Various factors affect students’ performance in the health training institutions which may include the psychological and emotional state of the student, the tutor student relationship, financial state of the students among others. Academic

performance is affected by a number of factors including admission points, social economic status and school background. Geiser and Santelices (2007), and Acato (2006), all argue that admission points which are a reflection of the previous performance influence future academic performance. ASSESSMENT Boston (2002) cited Black and Wiliam (1998b) to define assessment broadly to include all activities that teachers and students undertake to get information that can be used diagnostically to alter teaching and learning. Under this definition, assessment encompasses teacher observation, classroom discussion, and analysis of student work, including homework and tests. The word ‘assess’ comes from the Latin verb ‘assidere’ meaning ‘to sit with’. In assessment, one should sit with the learner. This implies it is something we do with and for students and not to students by Green, (1998) as cited by New Zealand, Ministry of Education. Assessments become formative when the information is used to adapt teaching and learning to meet student needs. It becomes summative when it is used to judge students overall achievement after the whole training program. If we think of our children as plants …

Summative assessment of the plants is the process of simply measuring them. It might be interesting to compare and analyse measurements but, in themselves, these do not affect the growth of the plants. Formative assessment, on the other hand, is the equivalent of feeding and watering the plants appropriate to their needs – directly affecting their growth. Formative assessment is assessment for learning. Its focus is on future achievement. Summative assessment is assessment of learning. It assesses what has been learnt in the past.‘Assessment for the purpose of improving student learning is best understood as an ongoing process that arises out of the interaction between teaching and learning.’ (NZC, 2007) ‘Students who have well developed assessment capabilities are able and motivated to access, interpret, and use information from quality assessment in ways that affirm or further their learning.’ (Directions for Assessment in New Zealand, 2009) FORMATIVE ASSESSMENT “An assessment is formative to the extent that information from the assessment is fed back within the system and actually used to improve the performance of the system in some way” (Wiliam& Leahy, 2007,p. 31).

“Formative assessment is defined as assessment carried out during the instructional process for the purpose of improving teaching or learning. What makes formative assessment formative is that it is immediately used to make adjustments so as to form Formative assessment is a process through which assessment-elicited evidence of student learning is gathered and instruction is modified in response to feedback.(Cauley, Richmond &McMillan, 2010) The common thread woven throughout formative assessment research, articles, and books bears repeating: it is not the instrument that is formative; it is the use of the information gathered, by whatever means, to adjust teaching and learning, that merits the “formative” label. (Cauley, Richmond &McMillan, 2010) In the classroom we assess formally through assignments, tests, quizzes, performances, projects, and surveys; or informally through questioning and dialogue, observing, and anecdotal note taking. In any of these instances, we may or may not be engaged in formative assessment: the determining factor is not the type of assessment we use, but rather how we and our students use the information.(Cauley, Richmond &McMillan, 2010)

Assessment for Learning means that the assessment will be used to modify the learning. To clarify Assessment for Learning, we must first consider the term Classroom Based Assessment (CBA) which is contrasted with standardized tests or large scale assessments. Classroom Based Assessment is teacher-designed

assessment. The teacher will choose or design assessment materials, and will apply them to the students. The teacher might or might not use CBA as Assessment FOR Learning. If the teacher uses the results of assessment to modify his or her teaching, then the teacher is using CBA as Assessment FOR Learning. The teacher might modify teaching immediately, or might modify his or her teaching for next year. As well, the teacher could use the results of standardized or large scale assessments as Assessment FOR Learning, if the teacher modifies his or her teaching because of the results. Unfortunately, the results of the test are so slow in coming that modification might not take place for the current group of students. Although formative assessment can be performed after a test, effective teachers use formative assessment during instruction to identify s...