SCALED GRADING. Internationalization is being given too much weight in the discussion of whether it is a good idea to introduce scaled grading at Sahlgrenska Academy, according to Gunnar Tobin, Professor and International Director. In his column, he analyzes how universities in other countries use scaled grading, and concludes that the discussion should instead focus more on the conclusions from educational research regarding scaled grading in higher education.
Whether all courses at the Academy should have grades, namely on a five-point scale, was an issue that raised discussion last year. The question suddenly came up at an Academy board meeting in the spring of 2015, and a decision was made without support from the University Council or the student unions of the Academy. That is, without support from the part of the Academy that can reasonably gather the greatest expertise in education. I think that the scientific basis for or against grading scales has been overlooked in the discussion about the issue. One element of the argument has been the internationalization aspect. The continuing discussion may require clarification that the internationalization factor can be weighted in a proper way.
As i see it, the issue includes various parts. How do we rate the process of learning? What impact do ratings have on our ambition to train students who can cooperate? Can stakeholders select appropriate individuals after they have been trained at Sahlgrenska Academy? Will our students have the same opportunities as other Swedish students to obtain employment inside and outside of Sweden? How will our current grading affect the level of international exchanges at the Academy? There are certainly more aspects, but we can discern two main points. The first questions involved educational issues – which system optimizes learning? The other issues are related to how to hire the most appropriate individual, which can in turn be viewed as a matter of fairness for the individual. Theme from this perspective, it is easy to weigh the issues of internationalization But it is the latter than I am going to discuss.
Well then. How do things look in the outside world? It is a jungle. Firstly, we have examinations that reference criteria in all of our training, while most other foreign universities apply a relative rating on a multi-point scale. This often means that our examination system uses significantly more resources than relative ratings. The jungle is further complicated by the fact that we have 18 different programs at the Academy, which is sometimes forgotten. That is true even in this debate. However, one can generally say that programs at other centers of learning located in faculties other than the health sciences tend to have more point scale-oriented grading systems (for example the pharmacy program). In my analysis, I am focusing on the faculties of medical education That is indeed what we are really discussing? Here, I should use a smiley face.
Most medical schools in europe have traditional grading systems that include several gradations. Training programs just have pass or fail for the entire program. Grading varies in the UK, but in England training programs are tending to, if anything, move from traditional A to F systems (A, B, C, D, F) to a hybrid system in which ratings are Pass/Fail during the first few years while the A to F system is maintained for the later years. The same system is used, for example, for a training program in Freiburg. In the Nordic countries, there is a multi-point system (ECTS) at all medical schools in Denmark and Finland, while the situation in Norway varies from solely P/F to ECTS. In southern and eastern Europe, there are few signs that they intend to abandon traditional grading.
Even in the USA, we can see a tendency towards abandoning the traditional multi-point rating system, at least in the preclinical part of training. Examples of higher educational institutions that use fail and pass in this part of the training include Case Western School of Medicine, Albert Einstein College of Medicine, Rochester School of Medicine, Yale School of Medicine, Stanford and Harvard Medical School. Furthermore, at Stanford they apply the F/P system to the entire program, but in a slightly more complicated way (Pass (+), Incomplete (I), Continuing (N), Exempt (EX), Grade Not Reported (GNR)). The system at Stanford indicates that they use an extremely accurate method to ensure that the student actually reaches an acceptable level. Even the Yale School of Medicine applies the F/P system throughout all training and says on its homepage that “there are no grades and there is no class ranking”. Overall, a total of 71 medical schools applied F/P in preclinical courses in 2013, while the figure had increased to 87 in 2015.
In spite of the trend towards a F/P system applied throughout 81 training programs in the USA, preclinical courses have grading systems that include more than two grade levels. For example Pittsburgh School of Medicine has a three-point scale, while The University of Maryland School of Medicine uses an A-F system. One might argue against the use of the word “trend” in this context, since the international standard has been a more multi-point grading system and any change per se must mean a deviation from this system. However, I think that numbers between 87-81 show that the term “trend” is adequate.
What impact does our two-point scale have on internationalization? Not much. The relative grading process makes it relatively easy. So far, our international coordinators have something in a simple way through dialogue to our partner universities, as well as early contact with the examiners and instructors. And no matter what system we choose, there will be incongruities in many cases, which means this dialogue will still be required. The same applies to the relatively small number of students going in the other direction. Even if considerably large efforts may be made in individual cases, it seems to me unnecessary to introduce a much larger workload for all of the Academy’s teachers (examination of all students) in order to reduce the workload for one individual teacher and one coordinator. I have, in my role as international coordinator, participated in a process in which dozens of our students have been admitted to PhD programs in the USA, the UK and Australia. Even when the inclusion of grading scale is requested in the application process, individual assessments are almost always weighed more heavily.
For most jobs in Sweden, ratings currently play a subordinate role in the selection. The amount of significance that ratings have for applicants to be selected by employers is probably influenced by which ratings the employer recognizes as reliable. We frequently invoke our own proven experience in the debate for and against multi-point grading systems, but experience is quite often based on our own sporadic observations. Instead, let’s take a professional position based on science. The Association of American Medical Colleges has presented several studies illustrating rating issues that are important to many of the questions I mentioned at the beginning of this column and a tip for policymakers is to read them, especially from the viewpoint of how students are already experiencing the learning environment today. Shouldn’t we remember not to deny science when it suits our preconceived notions?
The central questions that should be asked her how ratings affect learning and which taxonomic level of learning we are dealing with, as well as whether a multi-point scale means that it is possible to select the best individual. Of course, the answers to these questions should be in a knowledge organization, based on what educational research says.
So let’s ask the questions that Henrik Sjövall raised in his column: “What impact do ratings have on learning and the kinds of individuals we want to educate in the business of healthcare?”
It doesn’t matter how ratings affect internationalization. No system will be harmonized internationally.
I will allow those with greater expertise than I to determine the answer to these questions, but under the assumption that those who posses the expertise are allowed to have their voices heard. But please leave internationalization out of it.
Gunnar Tobin is International Director at Sahlgrenska Academy International Office (SAIO), which has four international coordinators who work with international collaborations at the Academy.
