Higher order assessments would require direct observation, structured feedback on performance, or skills-based evaluations in simulated or real patients [ 22, 23].
This is supported by the work of Jensen et al. [ 116] who found that high order questions stimulated deep conceptual understanding and retention, and correlated with higher performance on both subsequent high order assessment items and low-order assessment items.
In contrast, higher-order assessment questions are often those that ask students to: predict, design, apply, defend, propose, or judge.
Analyses of learning gains demonstrated that students who were prompted to engage in systematic self-explanation scored significantly higher than those in the unprompted condition, especially on higher-order assessment questions.
While both objectives and assessments created by TAs in RPD are higher order (levels 3 and 4), assessment items measured a wider range of cognitive processing levels (as evidenced by the larger SE in Figure 2), leading to better alignment across all assessment items.
In addition, the findings from Kassim and Zakaria (2015) showed that the teachers had difficulties in constructing higher order thinking questions for students' assessment.
Second, the psychometric approach is considered to be too reductionist (Huddle and Heudebert 2007) for the assessment of higher order competencies, such as the ability to work in a team, professional behavior, and self-reflection, which are increasingly deemed to be essential for medical professionals but cannot be meaningfully assessed detached from the authentic context (Kuper et al. 2007).
Modified Essay Questions (MEQs) are often used to assess these higher order abilities in preference to other forms of assessment, including multiple-choice questions (MCQs).
The instructors designed assessments of higher order thinking skills (HOTs) and lower order thinking skills (LOTs).
Thus, the teaching of eco-medical literacy could be used to reinforce higher order problem-solving competencies using criteria-based assessment practices.
Innovations in teaching and assessment, like spiral curriculum, teaching in context, teaching for transfer and assessment for learning (rewarding understanding and higher order cognitive skills), are required to improve anatomy education.
