Developing a Blueprint for Theory Assessment of Anatomy of Superior Extremity for the First Year MBBS Students

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International Journal of Research & Review (www.ijrrjournal.com) 114
Vol.6; Issue: 7; July 2019
International Journal of Research and Review
www.ijrrjournal.com E-ISSN: 2349-9788; P-ISSN: 2454-2237
Original Research Article
Developing a Blueprint for Theory Assessment of Anatomy of Superior
Extremity for the First Year MBBS Students
Dr. Hina Sharma1, Dr. Dharamanjai Kumar Sharma2, Mr. Kartikeya Sharma3
1Assistant Professor, Geetanjali Medical College and Hospital, Udaipur
2Professor and Head of Department of Surgery, Rabindra Nath Tagore Medical College, Udaipur
32nd Year M.B.B.S. Student, Government Medical College, Kota
Corresponding Author: Dr. Hina Sharma
ABSTRACT
Background & Aims: A regular problem encountered in framing a question paper is its content and
construct validity. By preparing a blueprint for assessment these can be avoided. So this study was
carried out to sensitize the faculty about blueprinting and prepare a validated blueprint for theory
assessment of superior extremity. Learners’ feedback for the provided blueprint was also taken.
Material & Methods: After sensitizing the faculty about blueprinting, competencies and specific
learning objectives were unanimously formulated and blueprint was prepared and validated.
Then it was shared with the 1st year MBBS students in the beginning itself. Assessment of part
completion was done and students’ feedback was taken on the blueprint.
Result: Both faculty and students strongly agreed with the importance and role of blueprint for
assessment in learning.
Most of the students and faculty wanted blueprint for the whole course.
Conclusion: Blueprinting should be an integral part of assessment and should be prepared for both
theory and practical assessment of the whole course of Human Anatomy.
Key words: Blueprint, valid, assessment
INTRODUCTION
Times are changing and so is method
of dispensing and assessing medical
education. Gone are the days when the
theory assessment was totally a one man
show. That was the time when assessment
of learners was on the mercy of whims and
fancies of the examiner. He could assess the
whole course by one long question, too
lengthy paper, [1] give importance to
unimportant topics, leave must know areas
of knowledge and so on. Thus the content as
well as the construct of the question paper
was not relevant. There is paper setter bias
and affinity for some topics. [2] Almost
every teacher now agrees that haphazard
development of test should be avoided. [3]
Assessment should be valid. [4] There ought
to be more stress on assessment for learning
rather than assessment of learning. [5]
Knowing that ‘assessment drives learning’,
it is only fair to reveal the assessment
pattern to the learners besides planning a
valid assessment. A blueprint brings about
congruence between the three pillars of
education- evaluation content, learning
objectives and learning experiences. [6] A
learner centred blueprint sets a positive tone
[7] and the learners are motivated to gain the
requisite knowledge once they are aware of
the expectations from a medical graduate
and the consequences of achieving the
required level of knowledge and skill. So
blueprint is a detailed plan of action [8] for

Hina Sharma et.al. Developing a Blueprint for Theory Assessment of Anatomy of Superior Extremity for the
First Year MBBS Students
International Journal of Research & Review (www.ijrrjournal.com) 115
Vol.6; Issue: 7; July 2019
achieving a particular goal. Apart from
achieving alignment of learning objectives
with assessment, [4] blueprinting also helps
in prioritization of teaching-learning. [9]
Therefore this blueprint was prepared to aid
the learners and remove bias of examiners
while preparing a question paper for part
completion of the anatomy of superior
extremity. This study is unique and seems
first of its kind in that developing a
blueprint of a preclinical subject has been
attempted in India.
METHODOLOGY
The study was conducted in the
department of Anatomy, Geetanjali Medical
College and Hospital, Udaipur over a period
of one year from April 2018 to April 2019.
The ethical clearance was obtained in April
2018 prior to commencement of the study.
Faculty of the department of Anatomy was
sensitized about blueprinting and their
queries were resolved.
Specific learning objectives (SLO)
were formulated for the competencies of
superior extremity. Domains were decided
for each SLO as per the Miller’s pyramid.
Level (core or non-core) was assigned to
each SLO. Teaching method was decided,
example Didactic Lectures, Small Group
Teaching, Demonstration, etc. Assessment
items were assigned and Anatomical
importance (A) and Clinical importance (C)
was determined for each SLO on a Likert
scale of 1 to 3. Thus weighting was
calculated for each region of superior
extremity and accordingly marks were
calculated out of a total of 100 marks.(Table
1)
Table 1 Blueprint for theory assessment of superior extremity
A question paper template was also prepared on the basis of the blueprint.(Figure 1) A
questionnaire was prepared for validation of blueprint by experts.
Then the blueprint (Figure 2) was shared with expert faculty of Anatomy in various
cities (Table 2), via Google Forms, for their feedback and validation. Validation was obtained
from thirteen experienced experts. Most of the experts had undergone training in ‘Advanced
Course in Medical Education’.
No.
Credentials
City
State
1
Professor & Dean
Gwalior
Madhya Pradesh
2
Professor & Head of Department
Dungarpur
Rajasthan
3
Professor & Head of Department
Vis Nagar
Gujarat
4
Professor & Head of Department
Udaipur
Rajasthan
5
Professor & Head of Department
Ludhiana
Punjab
6
Professor & Head of Department
Amritsar
Punjab
7
Professor
Ludhiana
Punjab
8
Associate Professor
Gandhinagar
Gujarat
9
Associate Professor
Ahmedabad
Gujarat
10
Associate Professor
Udaipur
Rajasthan
11
Associate Professor
Udaipur
Rajasthan
12
Associate Professor
Puducherry
Union Territory
13
Assistant Professor
Udaipur
Rajasthan
UNIT
Anatomical importance (A)
Clinical importance (C)
A X C
Weighting (W)
A x C
TOTAL
Marks
W x 100
Pectoral region
3
3
9
0.15
15
Axilla
3
3
9
0.15
15
Back
1
1
1
0.02
2
Shoulder and scapula
3
2
6
0.10
10
Arm
3
2
6
0.10
10
Nerves
3
3
9
0.15
15
Forearm
1
1
1
0.02
2
Hand
3
3
9
0.15
15
Joints
3
3
9
0.15
15
Total
59
99

Hina Sharma et.al. Developing a Blueprint for Theory Assessment of Anatomy of Superior Extremity for the
First Year MBBS Students
International Journal of Research & Review (www.ijrrjournal.com) 116
Vol.6; Issue: 7; July 2019
Post validation the blueprint and question
paper template was shared with the 1st year
M.B.B.S. students, through ‘Whatsapp’
group, before commencement of teaching of
superior extremity.
Part completion theory assessment
was taken on the basis of the blueprint
provided.
Students’ feedback questionnaire for the
question paper and blueprint was prepared
and validated by the faculty. Suggested
changes were incorporated in the
questionnaire. Students’ feedback was taken
post assessment by distributing the
questionnaire sheets and collecting them
back after completion. A total of 93 filled
feedback forms were received. The identity
of students was kept confidential.
Qualitative analysis of the students’
feedback data was done using Microsoft
excel.
RESULTS
Expert faculty of Anatomy gave the
following feedback upon validation of
blueprint: (Figure 2).
Figure 1 Question Paper Template
Figure 2 Link for the Blueprint

Hina Sharma et.al. Developing a Blueprint for Theory Assessment of Anatomy of Superior Extremity for the
First Year MBBS Students
International Journal of Research & Review (www.ijrrjournal.com) 117
Vol.6; Issue: 7; July 2019
Figure 3 Faculty Feedback For What Was Good in Blueprint
Figure 4 Faculty Feedback For What Could Have Been Better in Blueprint
Figure 5 Students' Feedback For The Blueprint
62.5% faculty felt that it is useful for
both faculty and students. 65% faculty
found the framed objectives precise. 53.8%
agreed with the anatomical importance
given on Likert scale to the objectives. 64%
agreed with the appropriateness of clinical
importance given on a Likert scale of 1 to 3
to the learning objectives. 78.6% found the
weighting given to learning objectives
appropriate. 76.9% found the distribution of
marks over the whole of superior extremity
balanced. 69.2% agreed that assessment

Hina Sharma et.al. Developing a Blueprint for Theory Assessment of Anatomy of Superior Extremity for the
First Year MBBS Students
International Journal of Research & Review (www.ijrrjournal.com) 118
Vol.6; Issue: 7; July 2019
questions cover all aspects of superior
extremity. 53.3% agreed that the question
paper template includes all parts.
Points suggested for its improvement
were as follows: (Figure 3) 54.5% faculty
wanted blueprint for the whole course.
61.5% faculty wanted to include more types
of questions in question paper template.
23.1% wanted to include 'Show How'
domain also.
Students gave the following feedback:
(Figure 4)
74.2% of the students agreed and
25.8% strongly agreed, i.e. 100% students
agreed that the difficulty level of question
paper was balanced. 58.1% agreed and
33.35% strongly agreed, i.e. 91.5% students
agreed that the question paper covered most
of the regions of superior extremity. 50.5%
strongly agreed and 41.9% agreed, i.e.
92.4% agreed that compulsory questions
were asked from important topics (core
area). 59.1% agreed and 36.6% strongly
agreed (total 95.7%) that the question paper
was neither too short nor too long. 66.7%
strongly agreed 25.8% agreed (total 92.5%)
that blueprint should be prepared for the
whole syllabus of Human Anatomy.
DISCUSSION
There is lack of studies on valid
blueprints for assessment of Anatomy in
India. There is one study that analyzed the
written examination papers of Anatomy and
proved its shortcomings due to lack of a
proper blueprint. [10] Developing a blueprint
for the whole course of human anatomy in a
limited period of time was a big challenge;
therefore a small portion of the whole
anatomy curriculum was taken for initiating
the process. Usually the part assessed in the
beginning is superior extremity; therefore
this study was carried out for developing a
blueprint for its internal assessment after
completion of superior extremity.
The current study was carried out at a time
when the Medical Council of India had not
defined the competencies. As such
competencies and specific learning
objectives had to be formulated. The
domain predominantly addressed here was
cognitive.
Blueprint is said to be a systematic
multistep approach to an assessment [11] and
the steps followed in this study were:
1. Defining the scope of study:
blueprint for undergraduates
(M.B.B.S.) 1st year students, internal
theory assessment of superior
extremity.
2. Detailed formulation of
competencies and learning
objectives.
3. Planning teaching learning methods
to be adopted.
4. Calculating weighting of various
parts of superior extremity and
assigning marks out of 99. One mark
was flexible to make it out of 100.
5. Preparing a guiding question paper
template according to the developed
blueprint.
While deciding on the level of
topics, it was found that most of the topics
are core topics and a mere part completion
assessment cannot replace formative
assessments because a formal written
examination has time constraints.
Assessment of core topics is essential, as
such the question paper template excluded
the ‘nice to know’ topics and incorporated
60 to 70% of ‘must know’ and 30-40% of
‘good to know’ topics.
The experts of Anatomy who
validated the blueprint were from five
different states of India.(Table 2). Most of
the faculty found the blueprint appropriate.
As for the question paper template, only
53.3% found it to be covering all aspects. So
we can make more question paper
templates. It is an ongoing process and after
initialization and implementation there is
always scope for improvisation. A mere
54.5% faculty desiring blueprint for the
whole course was a bit surprising as the
expectation was of 100%. Reasons for this
lack of interest, among the faculty, in
developing blueprints may be taken up as
another study.

Hina Sharma et.al. Developing a Blueprint for Theory Assessment of Anatomy of Superior Extremity for the
First Year MBBS Students
International Journal of Research & Review (www.ijrrjournal.com) 119
Vol.6; Issue: 7; July 2019
Here again if we look at the
students’ feedback we find that 92.5% of
students were in favour of developing a
blueprint for the whole course. As a
personal experience of the researcher of this
study, the students insisted for blueprints of
all the parts and a non-validated blueprint
had to be provided to them. The reason
behind this was that each and every specific
learning objective was defined as ‘must
know’, ‘good to know’ or ‘nice to know’.
Items to assess them were also mentioned.
This acted as an immense guide for the
students because it becomes difficult for
them to know the importance of topics in
numerous books of Anatomy. Each time a
teacher may not be available to point out the
same. It aids in self directed learning of the
learner.
The difficulties faced during this
study need to be mentioned. The anatomical
and clinical importance of the topics had
been assigned as perceived by the
researcher. Clinical importance can easily
be deduced but the anatomical importance
becomes more subjective. Calculation of
weightage in para-clinical and clinical
subjects involves usage of perceived
importance and frequency of occurrence of
disease. In basic subjects, like Anatomy,
frequency of occurrence of disease is
replaced by clinical importance of the topic
for calculating weighting. Clinical
importance of topics was discussed by the
co-author who is a surgeon by profession.
The question paper template did not
incorporate Multiple Choice Questions
whereas that is included in the new
curriculum plan by Medical Council of
India.
Developing a blueprint for practical
assessment of Anatomy is a Herculean task
but it surely must be attempted for more
clarity, subjectivity, reproducibility and
validity of assessment.
CONCLUSIONS
A validated blueprint for theory
assessment of first year M.B.B.S. students
for superior extremity was developed and
shared with students and assessment was
done based on that. An urgent needs for
development of blueprint for assessment
both theory and practical was felt.
Blueprinting should be an integral part of
assessment for both theory and practical
assessment of the whole course of Human
Anatomy.
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First Year MBBS Students
International Journal of Research & Review (www.ijrrjournal.com) 120
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How to cite this article: Sharma H, Sharma DK, Sharma K. Developing a blueprint for theory
assessment of anatomy of superior extremity for the first year MBBS students. International
Journal of Research and Review. 2019; 6(7):114-120.