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General Information

Civic Objective#: 28 Program Year: 2018-2019
Civic Objective: Access the health care system and be able to interact with the providers.
TOPSpro Form #: 028 AAP #: 28.5
Assessment Type: Written, Role Play

Level Range

From: Beginning Low To: Advanced

Language and Literacy Objectives

Language and literacy objectives with an asterisk (*) are suitable for beginning low level students.
4 *Describe symptoms of an illness.
5 *Perform actions in response to a physician’s directions/instructions in a role-play.
6 *Complete a medical health history form.
12 *Make medical appointments and transfer appointment information onto a calendar.

Additional Assessment Plan Tasks

Task: 1

Description: Make an Appointment

Content A (8 items, 16 points possible)
Given a calendar listing previously scheduled appointments and activities, student will perform a level-appropriate role-play with the examiner who will take the part of the health care provider. Student will make a medical appointment by telephone and communicate up to 8 appropriate utterances, such as a greeting, a statement of name, a closing and up to 5 interactions (BL-BH=3, IL=4, IH-A=5). BL-BH will be able to accept the first date/time given. IL-A will need to negotiate for another date/time.

Content B (2 items, 2 points possible)
Student will write the appointment date and time on a separate piece of paper and will show it to the examiner after the role-play.

Points Possible:18Level:Beginning Low - Advanced
Scoring Rubric Points
Content A
Utterance is appropriate, clear, and has correct content. There may be errors, but they do not interfere with meaning. 2
Utterance is appropriate and has correct content. There may be errors that interfere with the meaning, but utterance can be understood with inference. 1
Utterance is incorrect, or there is no utterance. 0
Content B
Appointment date and appointment time are written correctly. 2
Only one (date or time) is written correctly, the other is missing or incorrect. 1
Both appointment date and appointment time are missing or written incorrectly. 0

Task: 2

Description: Complete a Medical History Form
Given an agency-created patient medical history, student (IL-A) will complete an authentic medical history form. Student (BL-BH) will complete an authentic medical history form with a reduced number of sections that student needs to complete. This can be accomplished in a variety of ways such as: (1) giving BL-BH the complete form given to IL-A students and highlighting the sections BL-BH students need to fill out (2) giving BL-BH a reduced form which includes only those sections of the authentic application (given to IL-A students) that are assigned to BL-BH students.

These authentic forms are optimally internet based (see internet guidelines on the IEL Civics website) but can be a paper based ones.

Points Possible:18Level:Beginning Low - Advanced
Scoring Rubric Points
Content
90% of the items assigned to the Intermediate Low-Advanced level students are correct 16
80% of the items assigned to the Intermediate Low-Advanced level students are correct 14
70% of the items assigned to the Intermediate Low-Advanced level students are correct. 12
80% of the items assigned to the Beginning Low- Beginning High level students are correct 10
70% of the items assigned to the Beginning Low- Beginning High level students are correct 8
Less than 70% of the items assigned to the Beginning Low-Advanced level students are correct 0
Legibility, Neatness, and Spelling
Neat and legible. Spelling errors do not interfere with meaning. 2
Not neat or legible, or spelling errors interfere with meaning. 0

Task: 3

Description: Visit a Doctor

Content A (6 items, 12 points possible)
Student will perform a level-appropriate role-play with the examiner who will take the part of a health care provider. During a simulated visit to the doctor, student will make up to 6 appropriate utterances, such as a greeting, a closing, and up to 4 interactions (BL=2, BH=3, IL-A=4) with the doctor that include a description of the illness, symptoms, and responses to the doctor’s questions.

Content B (2 items, 4 points possible)
Student will use level-appropriate clarification techniques as needed in order to comprehend the doctor’s (examiner’s) diagnosis and instructions (e.g., You have the flu, fill this prescription, take one pill twice a day and get a lot of rest.) and take notes on them or remember the information (BL can have support such as a list on which they circle the information.) After the role play the examiner will check the student’s comprehension of the information learned by asking up to 2 level-appropriate comprehension questions (BL=1, BH-A=2) that students will answer orally.

Points Possible:16Level:Beginning Low - Advanced
Scoring Rubric Points
Content A
Utterance is appropriate, clear, and has correct content. There may be errors but they do not interfere with meaning. 2
Utterance is appropriate and has correct content. There may be errors that interfere with meaning, but the utterance can be understood with inference. 1
Utterance is inappropriate, incomprehensible, or incorrect or there is no utterance. 0
Content B
Utterance has correct content. 2
Utterance is incorrect or there is no utterance. 0

Rating Scale

Total Points Possible: 52
Advanced: 46
Intermediate High: 41
Intermediate Low: 36
Beginning High: 24
Beginning Low: 19
View Civic Obj & AAP List