Developing Miller’s Pyramid to Support Students’ Assessment Literacy

Abstract

Assessment literacy is increasingly recognized as an important concept to consider when developing assessment strategies for courses and programs. Assessment literacy approaches support students in their understanding of assessment expectations and help them both understand and optimize their performance in assessment. In this teaching tip, a model for assessment literacy that builds on the well-known Miller’s Pyramid model for assessment in clinical disciplines is proposed and contextualized. The model progresses thinking from assessment methods themselves to consideration of the activities that need to be built into curricula to ensure that assessment literacy is addressed at each level of the pyramid. The teaching tip provides specific examples at each of the levels. Finally, the relevance of this work to overall curriculum design is emphasized.

Assessment approaches in undergraduate health professions education: towards the development of feasible assessment approaches for low-resource settings

“…The assessment approaches used for the assessment of competence in CBE can be structured around Miller’s competency pyramid as shown in Fig. 3 below [ 39 , 40 ]. Miller’s Pyramid presents a framework that can be used to assess levels of clinical competence from cognitive levels of knowledge (knowing and knowing how), application of knowledge (showing), practical application of the knowledge in a practice setting (doing) [ 40 ].…”

“…3 below [ 39 , 40 ]. Miller’s Pyramid presents a framework that can be used to assess levels of clinical competence from cognitive levels of knowledge (knowing and knowing how), application of knowledge (showing), practical application of the knowledge in a practice setting (doing) [ 40 ]. Miller’s pyramid has become the beacon of assessment frameworks in CBE as it allows assessment of all facets of competence, which include knowledge, skills, and attitude.…”

Veterinary students’ views on surgical entrustable professional activities and the impact of COVID‐19 on clinical competence development

“…A student's self‐assessment of their own skills is an important aspect of the final‐year programme, but imposter syndrome and the resulting inability to accurately assess one's own abilities is a known phenomenon among medical students and throughout higher education. 27 , 28 , 29 These students may be daunted by the scale of the tasks ahead of them and, knowingly or unknowingly, underreporting their abilities. It is possible that students perceive procedural skills to be more challenging to master due to the anxiety surrounding negative outcomes in ‘real patient’ scenarios compared to the granular skills that have no ‘life‐or‐death’ consequences.…”

“…Firstly, this may be an inaccurate assessment on the part of the students, as they are self‐reporting their own perceptions. A student's self‐assessment of their own skills is an important aspect of the final‐year programme, but imposter syndrome and the resulting inability to accurately assess one's own abilities is a known phenomenon among medical students and throughout higher education 27–29 . These students may be daunted by the scale of the tasks ahead of them and, knowingly or unknowingly, underreporting their abilities.…”

A Guide to Assessment in Veterinary Medical Education: 3rd Edition

“…It is also strongly linked to the notion of reflective practice as discussed in 'Portfolios' in Section 2. Examples of the types of activities that can be built into curricula to address assessment literacy aligned to Miller's pyramid are given in Rhind et al (2021)…”