Student progress decision-making in programmatic assessment: can we extrapolate from clinical decision-making and jury decision-making?

Mike TweedEmail author View ORCID ID profile and
Tim Wilkinson

BMC Medical Education201919:176

https://doi.org/10.1186/s12909-019-1583-1

Received: 8 October 2018
Accepted: 30 April 2019
Published: 30 May 2019

Open Peer Review reports

Abstract

Background

Despite much effort in the development of robustness of information provided by individual assessment events, there is less literature on the aggregation of this information to make progression decisions on individual students. With the development of programmatic assessment, aggregation of information from multiple sources is required, and needs to be completed in a robust manner. The issues raised by this progression decision-making have parallels with similar issues in clinical decision-making and jury decision-making.

Main body

Clinical decision-making is used to draw parallels with progression decision-making, in particular the need to aggregate information and the considerations to be made when additional information is needed to make robust decisions. In clinical decision-making, diagnoses can be based on screening tests and diagnostic tests, and the balance of sensitivity and specificity can be applied to progression decision-making. There are risks and consequences associated with clinical decisions, and likewise with progression decisions.

Both clinical decision-making and progression decision-making can be tough. Tough and complex clinical decisions can be improved by making decisions as a group. The biases associated with decision-making can be amplified or attenuated by group processes, and have similar biases to those seen in clinical and progression decision-making.

Jury decision-making is an example of a group making high-stakes decisions when the correct answer is not known, much like progression decision panels. The leadership of both jury and progression panels is important for robust decision-making. Finally, the parallel between a jury’s leniency towards the defendant and the failure to fail phenomenon is considered.

Conclusion

It is suggested that decisions should be made by appropriately selected decision-making panels; educational institutions should have policies, procedures, and practice documentation related to progression decision-making; panels and panellists should be provided with sufficient information; panels and panellists should work to optimise their information synthesis and reduce bias; panellists should reach decisions by consensus; and that the standard of proof should be that student competence needs to be demonstrated.