The hidden secrets of a pretest

Hi, I’m Erin, and I am totally an assessment nerd.

Graphic that says "Assessment is comprehensive, uses a variety of sources and techniques, authentic learning experiences are designed developed and evaluated, criteria are established for assessment

To many that may sound like I just love giving tests–but it is so much more than that.

During one of my previous lives doing one-to-one and small group sexuality education with adults with intellectual and developmental disabilities (IDD), creating assessments was my favorite, and arguable the most crucial step in tailoring the knowledge that needed to be given to the learner’s assets.

Welcome to my pretest rationale.

Arguably, pretesting is my favorite. Knowing what the learner’s base knowledge is, what deficits are present, and their comfort with the subject matter are the three basic needs the assessment fulfills. There is also research that shows a correlation between “unsuccessful retrieval attempts” (aka, bombing a pretest) and better information retention. However, there are many other reasons to pretest.

Attitudes about sexuality topics can be discerned from listening closely to the words used, how body language shifts, and which topics are passed. For example, someone who passes on questions about sex acts they have participated in may be communicating a number of things: they are embarrassed to talk to a stranger about these things, they feel shame about the way sex acts have happened, they may be a survivor of sexual assault or abuse (which is more likely than not in the IDD population), or they might not understand what you are talking about.

This idea of an open interview speaks to the explanatory model of assessment (Skinner, 2007, p. 305). By using the explanatory model of assessment, the types of phrases and ideas used by the learner to answer questions, compared to interviews with care staff and team members, will indicate where misinformation and negative attitudes are originating from so they can be addressed subtly and without creating an adversarial environment, or, conversely, the positive and affirming language that could indicate previously unidentified allies for the educator to rely on for support.

A tried and true method of assessment for me, which relies on the explanatory method of assessment, is the body Q&A. I created what are basically magnetic paper dolls, with layers of clothing to remove and an internal layer of the musculo-skeletal system with some bonus internal organs.

I place this activity at the end of the pretest. Because we will eventually be looking at naked bodies, male and female, I like to have the interview part of the assessment as a buffer. I use that time to build rapport and establish trust and respect.

When I bust out the visuals, I begin by explaining that these are drawings of people and that they have on several layers of clothing (my people have both an outer clothing and underwear level). It is important to me that I let the learner know that I am going to defer to their comfort level regarding seeing naked bodies. This added level of control can take what could otherwise be a very uncomfortable and triggering event and gives power to the learner.

While this assessment tool’s purpose is to determine knowledge around anatomy, it serves a sneakier purpose: the development of a shared lexicon. Rather than saying, “Point to the clavicle,” I prefer to point at a body part and ask, “What is this?” Winifred Kempton, one of the pioneers in sexuality education for people with IDD, repeatedly stressed the importance of developing a shared lexicon. Creating a common lexicon for providing instruction (e.g. using the medical terminology penis, but the learner only knows the colloquial dick) and allows the educator to sandwich terminology to introduce medically accurate terms (Kempton, 91, p. 99).

More ways to teach new vocabulary.

There is another benefit to using the anatomical assessment tools. I include the internal organs slice, not only to test knowledge, but it gives a little bit of insight into the level of abstract thinking the learner is comfortable with. This may not seem like a valid measure to assess abstract thinking skills, but follow me with this: Arms, legs, external genitals, teeth, and eyes–these are things we can see and touch. They are concrete anatomy. Now take the lungs, heart, brain, uterus, and kidneys. We know where they are because people have told us. Most of us have not seen or touched out internal organs. As far as our own tangible evidence of beneath the skin, we could be filled with fairy dust and wood shavings.

When looking at the internal slice as part of an assessment, there are a few levels of questions that can asked. Start with, “What is it?” If someone is excelling at those questions, you might also want to ask the learner what the body part does. If that is also an achievable set of answers, you could ask how a part does what it does.

If done in a deliberate way, the pretest can give so much information:

  • Learner knowledge level on concrete topics
  • Learner dis/comfort with different topics, graphic images, etc.
  • Learner’s level of abstract thinking skills
  • A road map for developing the education plan
  • A common lexicon to work from to communicate lessons
  • Learner’s attitudes about different topics
  • Potential Allies and Roadblocks present in the care team
  • Hints toward past trauma and a warning about possibly triggering topics
  • A solid argument for why proceeding in one way may be more effective than another.
  • Demonstrable rapport, respect, and higher comfort with the learner because you were sensitive to their needs and encouraged them to make their own decisions during the assessment process.

Looks like a pretty high outcome for about 45 minutes of work.

References and Resources

Letter-sized Anatomical models for download.

Legal-sized Anatomical models for download.

The Special Education FLASH Curriculum Assessment Tool.

Kempton, W. (1991). Sex education for persons with disabilities that hinder learning: A teacher’s guide. Santa Barbara, CA: James Stanfield Company, Inc.

Skinner, D., & Weisner, T. S. (2007). Sociocultural studies of families of children with intellectual disabilities. Mental Retardation & Developmental Disabilities Research Reviews, 13(4), 302-312. doi:10.1002/mrdd.20170

6 responses to “The hidden secrets of a pretest

  1. Really, really, really appreciated this post on pre-test and I have a sense that varying modifications of this kind of pre-test can work with other non IDD populations like young children.

    I have never worked with an IDD group but I know from experience that creating a shared lexicon in other situations is important. This is something that would happen along the way because of how I do design workshops and lessons, but I never thought of it as something that I can and should do intentionally or deliberately, so I this is a great insight for me.

    It also really amazing that one can get so much information from a pre-test. Thanks for this Erin!

  2. This information is something that I plan on using within my own educational presentations and really enjoyed reading about creating a shared lexicon within an IDD population and how you can appropriately apply it to other populations as well.
    Implementing sexuality education within the IDD population does not come without challenges. I appreciate your creative and innovative approach when implementing an assessment and that is also tailored to each of the needs of the participants. This will increase both your outcomes and their own increase in knowledge regarding the material that you present.
    I like how you take the time to fill in the learning gaps with “the base knowledge, the deficits and their comfort level” as there are many instructors who don’t have the time or desire to do that. I also enjoyed reading about the explanatory method of an assessment as a tool and the link that you provided that was written from an MD perspective. You can get 10 different answers depending upon how you ask the question. Being able to rephrase the question in a way that the learners will comprehend the info presented is ideal but does not always work out that way. Sounds like you are very passionate about this population and are eager to apply new concepts and ideas into your presentations regarding sexuality education.

  3. Of course, what is a PRE-test without a POST! Great post! Get it? A post as the medium to get the information about the pre-test to us, but not an actual post test? Great pun, moving on.

    This is a really important topic that I struggle with sometimes. When it comes to pre-tests, I’m always at a loss for how to structure some collectible, hard-copy, verifiable data. This type of assessment is fantastic! When I get too caught up in assessment logic, I forget that a conversation about what the learner already knows is a valid type of assessment, too! I begin to wonder what happens if one is unclear about what knowledge the student has. You had mentioned so many possibilities for what the avoidance of answering a question could entail (embarrassment, shame, sexual assault survivor, etc.). What if the message is not received by the educator or the reason for the avoidance is unclear? I would imagine asking more questions to ascertain the reason, but I am always thinking of various ways to ask the right questions. Indeed, if an educator is not asking the right questions, the objectives (and consequently, goals) may never be met.

    • Because of my terrible memory, I have also found that recording the assessment is really helpful because then i can just be conversational, rather than trying to write notes the entire time. It also feels a lot less like a test and more like a conversation.

      Also, you and the puns, Mark.

  4. Erin,

    I had a lightbulb moment when I read your post. I knew what pre-tests were, and why they are important, but I never put together that pre-tests are a great way to ascertain the comfort level students/participants have, and that this is such an important part to sexual education because so many people are uncomfortable. When you said “Knowing what the learner’s base knowledge is, what deficits are present, and their comfort with the subject matter are the three basic needs the assessment fulfills,” it clicked for me.

    I will admit I was still a little confused about the Explanatory Model, but I just clicked on your link and went right there! I had never heard of it before. It reminds me of a more holistic approach to medicine which starts with the physician, counselor, and educator understanding how the person thinks because we all see things differently. I really understand how this model is used for cultural competency trainings in medicine. I am curious as to how many of these trainings med students go through.

    How much are your magnetic anatomical models? If an elementary school had the resources, this would be an amazing activity for students to do in small groups. Also, this would be a great resource for parents because it takes the focus off of speaking one-on-one with their child and puts it onto an inanimate object. In this way, the awkwardness is diffused. I can’t remember where I was reading this (I feel like it was a fellow student’s paper or something), but the person was talking about how beneficial it was for children, subject to physical abuse, to point at a figurine, rather than to point to their own body in response to where they were touched. In this way it takes some of the pressure off for the child.

    • Full disclosure–Elliot recommended I include a link to something explaining the model.

      Honestly, I had been doing things via the Explanatory model, probably for my entire life–both on the educator side and on the learner/patient side, and never knew that was what it was called. The medical example is probably the best way to relate it, because most people have had positive and negative experiences with MDs.

      In thinking about it over the course of my medical problems last year, the one’s I did well with were the ones who indulged my need to explain to them in gruesome detail exactly what I was feeling–because, “I’ve had 11 piercings, a tattoo and multiple brazilian waxes, and I would rather do all of them at once with a sunburn than feel this way,” really gets more attention than, “My pain is a 10.”

      I’ve been charging $20 for a pair and $50 for a set (dark, pale, and the internals). People are also more than welcome to print and use on their own if they were so inclined.

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