Understanding Formative and Summative assessment- for residents.

What is the difference between formative and summative assessment?

Formative assessment

The goal of formative assessment is to monitor student learning to provide ongoing feedback that can be used by instructors to improve their teaching and by students to improve their learning. More specifically, formative assessments:

• help students identify their strengths and weaknesses and target areas that need work
• help faculty recognize where students are struggling and address problems immediately

Formative assessments are generally low stakes, which means that they have low or no point value. Examples of formative assessments include asking students to:

• draw a concept map in class to represent their understanding of a topic
• submit one or two sentences identifying the main point of a lecture
• turn in a research proposal for early feedback

Summative assessment

The goal of summative assessment is to evaluate student learning at the end of an instructional unit by comparing it against some standard or benchmark.

Summative assessments are often high stakes, which means that they have a high point value. Examples of summative assessments include:

• a midterm exam
• a final project
• a paper
• a senior recital

Information from summative assessments can be used formatively when students or faculty use it to guide their efforts and activities in subsequent courses.

Who You Are? Notes of Spiritual journey

YOU ARE NOT YOUR THOUGHTS

·     You are not your thoughts.

·     You are not your mind.

·     Thoughts and mind are both names of the same thing.

·     You are one which contains mind/thought.

·     You are being in which thoughts and emotions live.

·     You are awareness or consciousness in which all experiences live and are manifested.

·     Notice that awareness never leaves you because you are that awareness. Thoughts are there and go but you remain there which knows thoughts like knowing all other experiences i.e. sense perception, feelings, emotions, etc.

·     Think about the nature of that awareness, which is borderless, timeless, no objective quality at all, ever-present, and aware of itself.

·     You are present between two thoughts. Even you remain there when any thoughts come as you notice them. You are that noticing who notices that thought. Give it whatever name which is present all the time even when you are in deep sleep. You remember a time before sleep and a time after awakening. In between these two events/thought awareness lives. Awareness does not live in time; it has no duration. Duration of that sleep is the name given by the mind which lives in time.

·     Thought should not be valued too much. This is just like monkey living on this branch of a tree and jump to another branch next second. Thoughts give you the illusion of a separate self, which will never be found when investigated. People attach themselves deeply to that separate self and earn a lot of suffering. Our liberation from suffering depends on how soon we realize the illusory character of our own self which lives only in thoughts.

Anion Gap Other Than Metabolic Acidosis

Conventionally Serum Anion Gap is calculated as: 

                                                                  Serum AG  =  Na - (Cl + HCO3)

•            Na  is Primary Cation
•            CL+HCO3 are Primary Anion

Serum AG  =  All unmeasured anions – all unmeasured cations

What are Unmeasure Anions?

• Any ion in the serum other than Na, Cl, or HCO3

Causes of lower Serum AG

•Hypoalbumin

•Hyperkalemia

•Hypercalcemia

•Hypermagnesemia

•Lithium toxicity

•IgG multiple myeloma

Negative Serum AG:

•      Rarely seen.
•      Laboratory error ( this is not reproducible)
•      Overestimation of serum chloride:  marked hyperlipidemia, salicylate intoxication, bromide intoxication ( in past bromide used as sedative