Specifications Grading:  A step towards competency-based education?

By:  Erika L. Kleppinger, PharmD, BCPS

Competency-based education (CBE) is being discussed for health professions education, but  transitioning to full CBE may be difficult.  A recent AACP Task Force described five essential elements of CBE:¹  

• Meets health care and societal needs
• Outcomes based curricular model
• De-emphasized time
• Learner-centered culture
• Authentic teaching and learning strategies aligned to assessments.  

Most higher learning institutions use letter grade scales to determine GPA. When compared to assigning grades, descriptive feedback is more helpful in improving student learning.²  As a result, experts have suggested moving away from traditional grading systems and towards alternative grading strategies such as competency-based assessment and pass/fail grading.²  Specifications grading principles align with CBE essential elements; therefore, this may be one method to ease the transition to CBE.³

What is specifications grading?  

Specifications (specs) grading encompasses learning-centered components, aspects of competency-based education, and concepts of contract grading.  Core principles include:⁴ 

1. Course assessments aligned with learning objectives.
2. All assignments graded pass/fail.
3. Clear expectations (specs) provided to students, correlating to B-level work or higher and aligned with the desired competency.
4. Feedback relates to performance on assignment specifications.
5. Limited opportunities to revise assignments for unacceptable work.  
6. Tokens may be provided with instructor-defined ways of earning or usage.
7. Advanced learning options offered for self-motivated students.
8. Assignments grouped into bundles for each letter grade with higher grades requiring more skill or content mastery.
9. Students decide what grade they would like to achieve based on the specifications designated for that letter grade.

My experience with specs grading

My curiosity with specs grading stemmed from frustration with students focusing more on the points received on assignments than their actual learning.  In January 2023, I redesigned a 1 credit hour, 6-week self-care elective for P2 and P3 students using a specs grading approach.  The class met synchronously on Zoom for 2 hours each week and students recorded group presentations on a selected self-care condition.  Grading bundles were created for A, B, and C with students earning an F if the C-level bundle was not met.  Assignment categories are outlined in Table 1.  Students received detailed specifications via the learning management system (Canvas) for each assignment and were required to use a token to revise and resubmit unsatisfactory work to maintain the selected grade bundle.  All students started with 1 token and could earn additional tokens by completing reflections or submitting an assignment at least 24 hours early.  Twenty-two students participated in the course with the final grade distribution of 17 As, 4 Bs, and 1 C.  

Table 1: Selected Assignments for Self-Care and Nonprescription Pharmacotherapy Course:

Assignment	A Bundle	B Bundle	C Bundle
Presentation Objectives	Write 1 lower-level and 2 higher-level learning objectives.	Write 1 lower-level and 1 higher-level learning objective.	Write 2 lower-level learning objectives.
Self-Care Topic Group Presentation	B and C bundles + create a written patient case summary.	C bundle + present a self-care patient case role-play.	Present a self-care condition overview and summary of treatment options.
Patient Handout	Create a handout unrelated to presented topics.	Create a handout related to presentation topic.	Not required
Final Exam	Score ≥ 85%	Score ≥ 75%	Score ≥ 65%

What I learned…

While a considerable amount of time was spent redesigning the course, I was able to provide more feedback instead of focusing on allocating points for each assignment.  Most incomplete assignments were because students did not pay attention to the detailed  specifications.  By using the grade bundles, I also have a clear picture of what each student learned in the course.  Similar to experiences at other pharmacy programs⁵, integration of specs grading with Canvas was a big challenge.  Students were confused with their grade  in the course because the gradebook was not set up in a traditional way, although frequent discussions during class helped their understanding.  Students seemed to appreciate the flexibility with using tokens, however keeping track of tokens and assignment resubmissions was challenging on my part.  While I was able to keep all documentation on Canvas, I had to constantly check submissions, which took a significant amount of time.

I continue to reflect on my experience and brainstorm ways to improve the course for next year, including building assignment specs as rubrics in Canvas, changing to live group presentations instead of recorded, and allowing for more flexibility with assignment deadlines.  I am considering allowing  one resubmission of each assignment instead of tokens to streamline my workload while maintaining flexibility for students.  While I think the grading scheme worked well for a small elective course, more experience is needed prior to implementing this strategy for larger courses, given the gradebook challenges and student perceptions.

Is this a step towards competency-based education?  I think it is, even if it is a small one. What are your thoughts and experiences with specs grading?

Acknowledgements

I would like to acknowledge Alex Lassard and Holly Webster for their work during an academic APPE rotation which contributed to this post.  Both are student pharmacists in the Class of 2023 at Auburn University Harrison College of Pharmacy.

References

1. Competency-based education task force.  2021-22 American Association of Colleges of Pharmacy Competency-Based Education Joint Task Force White Paper.  Retrieved from AACP Council of Faculties Community Discussions.  Posted August 8, 2022.  
2. Cain J, Medina M, Romanelli F, Persky A. Deficiencies of Traditional Grading Systems and Recommendations for the Future. Am J Pharm Educ. 2022;86(7):8850. doi:10.5688/ajpe8850
3. Townsley M, Schmid D. Alternative grading practices: An entry point for faculty in competency‐based education. The Journal of Competency-Based Education. 2020;5(3). doi:10.1002/cbe2.1219
4. Nilson LB, Stanny CJ. Specifications Grading: Restoring Rigor, Motivating Students, and Saving Faculty Time. Stylus Publishing; 2015.

5. Joseph ML, Miller SW, Diec S, Augustine JM.  Successes and challenges in implementing specifications grading in skills-based laboratory courses: Experiences at two college of pharmacy. Curr Pharm Teach Learn.  Published online March 8, 2023.  https://doi.org/10.1016/j.cptl.2023.02.025 

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Pulses is a scholarly blog supported by Currents in Pharmacy Teaching and Learning