March 30, 2015

Narrative Evaluation System

by Caroline Kim, Doctor of Pharmacy Candidate, University of Maryland School of Pharmacy 

Years ago, I attended elementary school in South Korea. My report card consisted of a letter grade accompanied by a short narrative from my teachers.  These comments stuck with me more than the grades.  They gave me insight into my performance beyond numbers.  They explained areas where I needed to improve — even if I earned a high grade — and areas where I did well despite a poor grade.  The finality of my letter grades was inescapable, but the comments were a source of motivation for further learning.

The purpose of evaluation in education is to guide student development, promote excellence, aid in defining the successful completion of a program, and provide performance evidence.1  The traditional grading system might be effective in promoting high standards, but it fails to capture abstract details related to student performance. Traditional grading systems also provide little room for feedback to guide the future learning process.  I would argue that there is a need for a more effective method of evaluation beyond numerical and letter ‘grade’ classification systems.

The Narrative Evaluation System (NES) is a nontraditional grading system, which provides constructive feedback on student’s performance using a narrative format.  In construct, NES draws heavily from Walter Fisher’s narrative paradigm theory.The theory states that narration and storytelling are the basis of all human communication. 2  In the NES system, the evaluator takes into account the objectives of the course when evaluating the strengths and weaknesses of a student’s performance.  Like traditional evaluation models, NES also recognizes noteworthy student performance.  In addition, NES encourages cooperation and collaboration by personalizing descriptions of student performance. 3 This helps to promote closer relationships between students and instructors.

NES does have some drawbacks.  NES requires a larger time commitment from educators. 3  In order to summarize student performance into a narrative, educators are required to keep detailed notes on each performance and provide suggestions on how students can improve in the future.  NES explores more dimensions of the evaluation process and educators must devote more time and energy to constructive criticism.  Simply put, NES is more difficult than  the simple categorization required in traditional grading systems.  Even after providing narrative comments, some institutions force educators to use traditional grading systems — allowing a comparison between students using the same grading scale.  The NES system supplements traditional evaluation.3   Students who have been evaluated using the narrative evaluation system often request letter grades — in one study more than two thirds did so.4 The most common reason for requesting letter grades was to understand the narrative evaluation by comparing their performance to grades that they are familiar.4 

Very few studies have analyzed the impact of NES on future success.  One study examined whether graduates from a program that used NES remained competitive when it came to admissions into graduate and professional programs.3 When comparing students who graduated from the University of California at Santa Cruz (UCSC) — which uses a narrative grading system — with other University of California campuses which assign traditional grades, the investigators found that UCSC students generally performed as well if not better in terms of acceptance rates into graduate and professional schools.3 

In another study, a survey of UCSC students and alumni explored their attitudes towards NES.  The survey respondents indicated they preferred NES because it pointed out strengths and weaknesses, and helped them grow personally and professionally.  They appreciated how NES promoted cooperation, scholarship, and creativity. 4 However, 62% of undergraduate students surveyed and 54% of alumni surveyed reported some quibbles with NES.4 The problems included the length of time it took to receive the narrative, failure to receive a constructive narrative, or evaluations that were similar to and provided little addition information beyond letter grades. 4 Despite these challenges, 82% of undergraduate students and 78% of alumni favored NES over a traditional letter grade.4 

Figure 1. This table summarizes a surveyed undergraduate and alumni opinions of NES.4

Survey Questions
Undergraduate (%)
Alumni (%)
NES influenced decision to attend the school
Favored NES over letter grades
Requested letter grades
Believed NES worked in their favor
Experienced a problem with NES

Another study compared the effect of NES and a conventional grade system on learning and motivation.5  During the study students were asked to perform certain learning tasks during 3 distinct teaching sessions.  Students were randomized to receive either narrative or numerical grades when completing the learning tasks in sessions 1 and 2, and then took a post-test after session 3.5 Results showed that students who received narrative evaluations had the highest post-test performance.  Moreover, traditional grades depressed creativity and weakened student interests in the subject matter.5 

Currently, at least seventeen colleges and universities in United States and Canada use narrative evaluation (NES).  Some have used this system for over fifty years.  NES can guide students in their learning and help them improve on their weaknesses.  The NES model provides a more complete picture of the student and helps students to distinguish themselves as individuals.  Although it may be time-consuming, educators should consider implementing NES – perhaps in conjunction with traditional grades — to enhance the learning process. 

  1. Hanson J, Rosenber A, Lane L.Narrative Descriptions should Replace Grades and NumericalRatings for Clinical Performance in Medical Education in the United States. Frontiers in Psychology.  Nov 2013; 4: 1-10.
  2. Fisher W. The Narrative Paradigm: In the Beginning. Journal of Communication. Dec 1985;35(4): 74-89.
  3. Affirmation of Accreditation Self-Study Report. University of California at Santa Cruz. [Internet].  1994 Nov: 22-29. [cited 2015 Mar 8].
  4. Wong M. Assessment and Evaluation of Past and Present Student Attitudes toward the UC Santa Cruz Narrative Evaluation System. University of California at Santa Cruz. [Internet]. 1992 Jun. [cited 2015 Mar 9]
  5. Butler R,Nisan M. Effects of no Feedback, Task-related Comments, and Grades on Intrinsic Motivation and Performance. Journal of Educational Psychology. Jun 1986; 78(3): 210-216.

March 13, 2015

Self-Determination Theory: Supporting Students’ Intrinsic Motivation

by Adrienne Kowcz, PharmD., PGY1 Community Pharmacy Resident, University of Maryland School of Pharmacy

From day one, we are innately curious. Children constantly explores the world around them, and as we grow, we gravitate toward careers and hobbies that interest us.  We are intrinsically motivated to learn more. Educators should capitalize on this desire when designing instruction.  Unfortunately, external motivators play far too great a role in education today.2 Overly prescriptive supervision and standardized evaluations can thwart the learning process, and cause learners to lose interest.

Self-determination theory (SDT) suggests that teachers can capitalize on internal motivation by supporting each student’s natural tendency to be curious and desire for autonomy.  That is, teaching should be guided by students’ interests. If we can find ways to support autonomous motivation in the delivery of instruction, we can achieve optimal learning. Although SDT has been around for 4 decades, Edward L. Deci and Richard Ryan expanded on the theory by refining the differentiation between intrinsic and extrinsic motivation as well as proposing three key intrinsic needs involved in self-determination.1

Motivation is often examined from the perspective as to how we convince others to change their behavior. External factors, such as rewards, punishments, grades, evaluations, and other’s opinions often motivate people. However, SDT explores the intrinsic motivation, or how people are motivated from within when there is no tangible reward or external push. Deci and Ryan postulated that an individual needs intrinsic motivation as well as three intrinsic psychological needs in order to initiate these behaviors and maintain good psychological well-being and self-determination. These universal needs are autonomy, competence, and relatedness. Below is a model that depicts SDT in higher education. These components together form the self-determination model which emphasizes supporting student autonomy in order to achieve positive learning outcomes.

Autonomy relates to people feeling as though they have power over their behaviors. Giving students opportunities for growth and the ability to make their own choices, increases their sense of autonomy and reduces coercion / controlled. One study examined the learning outcomes of college students in a science course where the teachers used two different outcome expectations: one group was told they had to teach the material to others (autonomy supported) and the other group was told they had to pass an exam (controlling behavior).3 Those who had the expectation of teaching others had a deeper conceptual understanding of the material.  Autonomy can be supported in the classroom by teachers reducing the number of evaluations and encouraging active student participation, fostering positive feelings that what students say has purpose in the classroom. Also, teachers should provide a clear rationale for the learning activity. This has been shown to improve student’s effort to learn.

Competence refers to a person’s effectiveness at performing the skill or task. When someone feels competent that they can perform a task, they are more likely to continue to use what they have learned and strive to achieve more. A way to support competence in an educational setting is introducing challenging activities where students can use their previous knowledge and skill. When students perform well, providing feedback about the process can be beneficial to their growth. Not congratulating a job well done, but rather letting the student know that their effort was recognized.  In addition, providing feedback on how to master more has been shown to make students continue to strive for greater results after a compliment.6

Relatedness is the last need that Deci and Ryan believe should be satisfied in order to support self-determination. In a classroom, when students have a sense of belonging, that those around them truly understand and value them, they will more likely have intrinsic motivation to perform the tasks at hand. Acknowledging student’s feelings can help improve that connection. In an education setting, studies have shown that students who feel connected to teachers do better in school than those who are disconnected and do not have a relationship with someone who truly cares about them in the school.4 As professors, we have the ability to get to know students, as well as teach in an inviting environment where we encourage participation and provide positive feedback to encourage growth.

Creating an autonomy supporting environment is not only beneficial in the classroom, but in the clinical environment too. In the study titled Reducing the Health Risks of Diabetes: How Self-determination Theory May Help Improve Medication Adherence and Quality of Life the investigators applied the SDT model to predict medication adherence, quality of life, and physiological outcomes among patients with diabetes.5 Patients were surveyed assessing their perceived autonomy-support from their providers, autonomous self-regulation for medicine use, perceived competence to perform self-management, medication adherence, and quality of life. Results showed that when clinicians elicit patients’ perspectives, just as teachers elicit student’s responses, and support autonomy, patients have higher quality of life, improved medication adherence, and better health outcomes.

Regardless of setting, supporting autonomy, competence, and relatedness leads individuals — students and patients — to become better learners motivated by their internal desires. When these needs are supported, people gain self-determination and their intrinsic motivation to learn is enhanced.


  1. Deci EL, Ryan RM. The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry 2000; 11: 227-268.
  2. Williams G., Deci E. The Importance of Supporting Autonomy in Medical Education. Ann Intern Med. 1998;129:303-308.
  3. Niemiec CP, Ryan, RM. Autonomy, competence and relatedness in the classroom:Applying self-determination theory to educational practice. Theory and Research in Education. 2009; 7(2): 133-144.
  4. Vallerand RJ, Reid G. On the causal effects of perceived competence on intrinsic motivation: A test of cognitive evaluation theory. Journal of Sport Psychology 1984; 6: 94–102.
  5. Williams, G. Patrick, H. et al. Reducing the Health Risks of Diabetes: How Self-determination Theory May Help Improve Medication Adherence and Quality of Life. Diabetes Educ 2009; 35 (3): 484-492.
  6. Dweck, Carol. The power of believing that you can improve. Dec 2014. 

March 3, 2015

Embracing Mobile Technology – A Gateway to Learning

by Joanna Yala, PharmD, PGY1 Pharmacy Practice Resident, Sinai Hospital 

In an increasingly technological world, teachers and students are being pushed to adapt. Smartphones, tablets, and laptop computers are quickly replacing the conventional blackboard and chalk. I believe that transitioning from traditional note-taking and lectures to incorporating mobile devices and on-line information sharing into our classrooms can positively impact the learner’s experiences.  In this discussion it is helpful to understand what learning and memory entails. Learning is the acquisition of skill, knowledge as well as attitudes, while memory is the expression of what the learner has acquired.1 

As today’s technology constantly develops, we face a dilemma — risking turning away from what is already tried and tested to venturing out into the unknown and untested. As educators, we want to fulfill our duty to prepare our students with the knowledge and skills necessary to equip them for their future endeavors, but we also want to deliver the learning experiences in a controlled, safe environment. Thus, the decision for institutions to shift towards online classrooms and the use of mobile devices in tandem with the face-to-face instruction is critical.

There have been multiple studies that have evaluated the use of the mobile devices (e.g. smartphone, tablet, and computer) as an instructional tool. Social media allows a reflective output for ideas and computer applications have allowed for file-sharing.  These advances have expanded our capabilities and created virtual centers of learning.

An observational study of undergraduate students’ adoption of a mobile note-taking tool was conducted at the University of Chester in the United Kingdom.2  The software tool allowed educators to provide mobile support to students’ learning and provided an array of functions for the gathering and management of information.  The tool allowed students to easily record ideas using voice notes as well as save pictures and handwritten notes. There was positive feedback and recommendations from the test subjects reading the use of this particular platform.  Users felt the tool positively impacted their organizational skills.

In another study conducted by the Center for Teaching Excellence at the United States Military Academy, the best practices for teaching using iPads were explored.3  All the students in this setting had iPads available to them. The participants (teachers and students) deemed the devices beneficial, but the results also revealed concerns with their use such as the need to have access to the Internet, appropriate software applications for peer-to-peer and student-professor interactions, and user competency. Despite these concerns, the student interest in the subject matter seems to be one of the most important factors to consider when selecting the best teaching method. Thus, software developers have continuously tried to design applications that make the learning experience more enticing, convenient, and user-friendly.  Features common to mobile devices include capturing photos, videos of lectures, and hand-written notes as well as accessing electronic documents.

In light of the current capabilities of mobile devices as a tool to enhance instruction, I think they can be effectively used to improve learning. Studies suggest positive behavior changes when students use them for independent study under the guidance of an instructor. Social learning is also cultivated through peer-to-peer interaction with online discussion boards.

The world has evolved so much in the past two decades. Students were once dependent on every word a lecturer said, hurriedly scribbling them down in notebooks. Now we are privileged to access information with just a few taps on a screen – anywhere, anytime. By conditioning ourselves to embrace new methods of presenting and organizing information, educators can provide a gateway to limitless knowledge and possibilities.


1. Kazdin A. Learning and Memory. Adapted from the Encyclopedia of Psychology [Internet]. c2000 [cited 2015 2 Feb]. 4128p.
2. Shepman, A, Rodway P, Beattie C, Lambert J. An Observational Study of Undergraduate Students’ Adoption of (mobile) Note-takingSoftware. Computers in Human Behavior. 2012 ;28 (2): 308-317.
3. Beskow D, Deb A. Increasing Learning with iPads and Social Media [Internet]. Center for Teaching Excellence, United States Military Academy, West Point, New York; 2013 [cited 2015 Feb 2]. 11p.