African Journal of
Pharmacy and Pharmacology

  • Abbreviation: Afr. J. Pharm. Pharmacol.
  • Language: English
  • ISSN: 1996-0816
  • DOI: 10.5897/AJPP
  • Start Year: 2007
  • Published Articles: 2288

Full Length Research Paper

Progress test: A review to motivate their use in pharmacy schools in Brazil

Alberto Malta Junior
  • Alberto Malta Junior
  • Pharmacy School, Faculty of Juazeiro do Norte, Ceara, Brazil. Student of the Master Program in Management of Technology and Innovation in Health of the Hospital Sírio Libanês, São Paulo, São Paulo, Brazil.
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José Lucio Martins Machado
  • José Lucio Martins Machado
  • Botucatu Medical School, Universidade Estadual Paulista – UNESP, Brazil.
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Maria Jutta Shadeck
  • Maria Jutta Shadeck
  • Undergraduate Medical Student of Universidade Municipal de São Caetano do Sul, Brazil.
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Anabel Fonseca Ferrari
  • Anabel Fonseca Ferrari
  • Undergraduate Medical Student of Universidade Municipal de São Caetano do Sul, Brazil.
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Carlos Fernando Collares
  • Carlos Fernando Collares
  • Department of Educational Development and Research, Maastricht University, Maastricht, The Netherlands.
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  •  Received: 15 August 2016
  •  Accepted: 22 November 2016
  •  Published: 08 December 2016

 ABSTRACT

Progress Test (PrT) is a longitudinal assessment strategy in which tests composed of contents from all the curriculum are periodically applied to all students of a course. Such strategy allows measurement of deep, long-lasting meaningful learning as well as early detection and remediation of underperforming students. It was introduced more than forty years ago, and it has been used in several health schools in the world, especially medicine. Assessment of students’ knowledge gain and its application over the course is a challenge. PrT has become a relevant method to monitor the development of the student through graduation. There is no culture of using longitudinal assessments in Brazil's pharmacyschools. This scenario is an opportunity for use of PrT. The objective of this work is to make a literature review about how progress test has been used in context of education. The authors also discuss the possibilities of PrT’s application in Pharmacy undergraduate courses in Brazil. PrT has a long history of use by various institutions in the world. Most user experiences come from medical schools, but there are articles showing the application of PrT in dentistry and psychology schools. PrT has been shown to be an effective assessment tool in a problem-based (PBL) and traditional curricula. PrT is recommended as a tool to longitudinal assesses growth in knowledge. Phamacy schools may develop their own framework for PrT collaborations, which could optimize the educational utility of student’s assessment instruments as tools to enhance learning.

Key words: Progress test, assessment, knowledge.


 INTRODUCTION

The Progress Test (PrT) is a longitudinal assessment strategy in which tests composed of contents from all the curriculum are periodically applied to all students of a course, with the expectancy that a progressive proportion of answers will be right (Vantini and Benini, 2008). Such strategy allows measurement of deep, long-lasting meaningful learning as well as early detection of underperforming students. Information obtained from progress testing results also serve as a quality assurance tool for institutional stakeholders to help prioritize efforts on curricular governance and faculty development (Verhoeven et al., 2002). It has been introduced more than forty years ago, and it has been practiced in various health schools in the world, especially medicine (Vleuten et al., 1996; Verhoeven et al., 1999; Finucane et al., 2010; Freeman et al., 2010; Bennett et al., 2010). PrT was developed in the context of problem based learning (PBL), but its use was not restricted to PBL programmes (van der Vleuten et al., 2004; Verhoeven et al., 2005). The PrT values the knowledge acquired during the period of graduation, not individual curricula (Nouns et al., 2012).
 
It is expected that the curriculum of the faculty can produce a solid knowledge to the student.  A well-developed curriculum should ensure the development of cognitive, psychomotor and affective skills (Al Alwan et al., 2011). The Ministry of Education published in Brazil the pharmacy courses curriculum guidelines in 2002. This guide has been published to meet the training needed in the face of increased pharmacist insertion in health services, especially public health.  It is intended that the final objectives of a curriculum must relate to the reality of where the pharmacist works, after all, the quality of pharmaceutical services depend on the quality of learning to preparing individuals for the several changes and challenges (Ogaji et al., 2016). In addition to this, the amount of pharmacy courses has multiplied and this fact demands capable assessment tools to qualify learning and harmonize the knowledge taught in institutions. Currently most of the pharmacy courses in Brazil adopt assessment methodology focused on tests at the end of each module. This use promotes the short-term memorisation or unrelated facts rather than promotes deep learning. PrT has become a relevant method to monitor the development of the student through graduation (Langer and Swanson, 2010; Al Alwan et al., 2011; Gold et al., 2015).
 
The central question who guided this review was: What contribution can the progress test give for learning to the schools of pharmacy in Brazil?
 
The aim of this work is to make a literature review about how progress test has been used used in context of education. The authors also discuss the possibilities of PrT’s application in Pharmacy courses in Brazil. 


 MATERIALS AND METHODS

To accomplish this literature review, the authors used the SCOPUS® database. It is one of the largest abstracts and citation database of peer-reviewed literature in the world. The keywords used for research in Scopus® were progress test delimited by inverted commas.  This search was conducted in April of the year 2016.
 
In  Scopus®  database  we  select  as  inclusion  criteria   all   the the original articles and reviews on the progress test in higher education; articles or reviews written in english or portuguese, published between 1990 and 2015; subject area included was only medicine, dentistry, social sciences, psychology and nursing. There were exclusion criteria:  Notes, conference paper and book chapter. The search in database brought articles not relationed to progress test and was not considered to analysis.  Some articles with terms “progress” or “test” isolated, appeared on search results and it was excluded as well.  


 RESULTS

The search finds 128 documents. After applied exclusion criteria, 65 articles were elegible to analysis. The main results are presented in Table 1. To make it easier to understand, it were analyzed considering the following criteria:
 
1. PrT as assessment tool through graduation 
2. PrT as assessment tool through post-graduation 
3. Investigation about standards to PrT
4. Practices to application of PrT
5. PrT used in collaboration
6. PrT as instrument to comparison 
 


 DISCUSSION

The number of pharmacy schools in Brazil is growing. This scenario demands instruments to ensure that the pharmacist is being well formed. For any course of university education, it is important to monitor how it develops the cognition of students. It is argued that the assessment of this growth needs to mix formative assessment elements to improve performance, or summative, for accountability purposes and making decision (Schauber and Nouns, 2010). The relationship between an educational program and the method of evaluation is vital because the tests and examinations lead student learning (Verhoeven et al., 1999). The PrT is a real possibility to assess gain of knowledge by students. Besides that, for students who have submitted to a PrT there were more consistent and significant progress in academic’s results when compared to students without it. That is because students tested continuously tend to retain knowledge more effectively (Schaap et al., 2012). 
 
The set of articles present the evidence that PrT is a valuable method to assess and monitor the student’s advancement (Boshuizen et al., 1997; Verhoeven et al., 2002; Dijcks et al., 2003; Rodrigues and Catarina, 2007; Löwe et al., 2008; De Champlain et al., 2010; Nouns et al., 2012; Al Alwan et al., 2011). Most studies describe experiences of the use of PrT in medical schools, but it is also used in other courses such as psychology, dentistryor nursing (Finucane et al., 2010; Norman et al., 2010; Muijtjens et al., 2008; Schaap et al., 2012; Ravesloot et al., 2012; Sangestani  et  al.,  2013;  Postma  and  White,2015; Ali et al., 2015). Development of PrT in post-graduation training seems possible, but in this revision showed that there is a need for further studies (Kramer et al., 2003; Rodrigues and Catarina, 2007; Löwe et al., 2008; Dijksterhuis et al., 2009; Ravesloot et al., 2012).
 
The authors have discussed aspects of the  practice  of PrT as the type of questions, reference criteria, use of internet-based tools and costs (Vleuten et al., 1996; McHarg et al., 2005; Rademakers et al., 2005; Muijtjens et al., 2010; Ricketts et al., 2010; Rickets et al., 2010b; Kerfoot et al., 2011; Karay et al., 2012).
 
Several articles present procedures for the achievement of standards for the PrT. Statistical methods, bank of items, better judges for the questions and quality of test are discussed (Verhoeven et al., 1999b; Muijtjens et al., 1998; Muijtjens et al., 2008b; Ricketts and Moyeed, 2011; Anderson et al., 2011; De Champlain et al., 2010; Langer and Swanson, 2010). Despite this development of standards for the PrT represents a challenge (Rickets et al., 2009).
 
Collaborative studies about PrT show mainly the economic benefit (Vleuten et al., 2004; Verhoeven et al., 2005). The PrT can be used for comparison purposes, but there are existing error sources that need to be considered (Swanson et al., 2010; Muijtjens et al., 2007; Freeman et al., 2010; Schuwirth et al., 2010).
 
For comparison purposes, PrT has several features. The studies show that PrT can be used for comparing types of curricula such as problem based versus traditional learning (Verhoeven et al., 1998; Nouns et al., 2012), problem versus lecture based learning (Sangestani et al., 2013), to evaluate effectiveness of curriculum change (Peeraer et al., 2009);  to measure transition of a conventional to an integrated contextual medical curriculum (Van Der Veken et al., 2009), infer performance results among students from different schools (Muijtjens et al., 2007),  and comparison of curricula (Muijtjens et al., 2008; Muijtjens et al., 2008b).
 
Although most studies have been conducted in developed countries, PrT has been applied in countries with few resources (Aarts et al., 2010; Mardiastuti and Werdhani, 2011). Some experiences involving the PrT has been carried out in Brazil, that is a developing country.  Studies about application of PrT in Brazilian medicine schools (Tomic et al., 2005; Sakai et al., 2011) demonstrate the possibility of implementation and execution of it.
 
The use of continuous assessment has emerged as a proposal to improve student learning and develop educational programs in Pharmacy Schools (Plaza, 2007; Szilagyi, 2008; Begley et al., 2013). The Accreditation Council for Pharmacy Education recommends that pharmacy schools can use evaluations that can achieve desired educational objectives. In this context, progress test has been used as both formative assessment as summative (Duncan-Hewitt et al., 2007; Szilagyi, 2008; Anderson Jr and Nelson, 2011; UCL, 2014; Karimi et al., 2014). 
 
The Pharmacy courses in Brazil are guided by a national curriculum guideline (Brazil, 2002). This guideline establishes the profile for formation of the pharmacist. Several institutions have discussed the improvement of the teaching of pharmacy in Brazil (ABERFABIO, 2013). Despite these efforts, the pharmaceutical education still has been very influenced by memorization and repetition of content often disconnected from the reality. In addition, the absence of methodologies like problem based learning left a void for critical and reflexive constructions in the learning process (Almeida et al., 2014; Blouin et al., 2008).
 
The last Pan American Conference on Pharmaceutical Education in 2014 defended the adoption of a competency-based curriculum. Knowledge is an important cognitive component needed to develop competencies (OPAS, 2014). The PrT is a tool to assess knowledge and can fill this need. Pharmacy schools can adapt the PrT to provide assessment that measure the final objectives of their curricula and start an era of evaluation that guides learning and contributes to the quality of education.


 CONCLUSION

There is much evidence about the use of the PrT as an evaluation method to enhace learning in graduation and even pos-graduation. The literature also records studies which seek to qualify the design and implementation of the PrT, presenting proposals for standards, common practices, experiences in collaboration and showing features of the PrT used as comparison tool between types of curricula, learning methods etc. Although most studies describe experiences in medical schools, there are descriptions of the application of the test in other courses in the health area. It was not detected in this review study the use of this test in pharmacy schools. However, we advocate that the PrT can be used by the schools of pharmacy in the same way as is already the case in other courses.


 CONFLICTS OF INTERESTS

The authors have not declared any conflict of interests.



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