Table of Specifications for the Assessment
Content
Taxonomic Level
Total
Specific Indicators
Complex Procedural Skills
Application
Evaluation
Higher Order Thinking
Weighted Points
1.1
2
      
2
1.1.1
 
4
    
4
1.1.2
  

4
  
4
1.2
2
      
2
1.2.1
  
4
    
4
1.2.2
3
      
3
1.3
      
2
2
1.3.1
  
2
    
2
1.3.2
  
2
    
2
Total
7
12
4
2
25
Assessment method(s) and Weighted Desired:  
  All Indicators Structured observation
    Behavior-based assessment
 
Scoring Method(s): Analytical/Holistic Rubrics
  Specific Indicators Structured Observation Scale (0-2)
     
General/Individual Assessment: Individual
 
Who Assesses: Clinical Instructor
 
Assessment Period: Assessment after each student's affiliation period.

Name of the student: _____________________________

Name of the school/program: _____________________________

Affiliation period: _____________________________

Name of the clinical instructor: _____________________________

Date of assessment: _____________________________

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