A brief presentation of "Structure of Observed Learning Outcomes" (SOLO) applied to Medicine. A worked out medical example with all the 5-levels of SOLO taxonomy is presented. This should make it easy for Medical educators to adopt and use this innovative way of assessing written answers.

1. ‘SOLO Taxonomy’ –
Structure of the Observed
Learning Outcome
in Medicinein Medicine
Prof K.R. Sethuraman
(SBV — May, 2014)

2. Introduction
• Bloom's Taxonomy
(1956) and Gagne's
hierarchy (1977)
– represent logical
analysis of content
and process of
teaching learning
– they do not help in
assessing the
sophistication of
learning outcome
• To cover this
lacuna, a
hierarchical
structure of the
observed learning
outcome was
described by
Biggs and Collis
in 1982.

3. Objectives of this session
• To understand the SOLO taxonomy as
– Level 1: Pre-structural
– Level 2: Uni-structural
– Level 3: Multi-structural
– Level 4: Relational
– Level 5: Extended Abstract
• To apply this concept to assess real
answer scripts

4. Let us see a worked out
example…
Question asked:
“ExplainExplain Why omeprazole is
used in treating peptic ulcer"

5. Level 1: Pre-structural
• Usually the question is reworded to
resemble an intelligent answer!
– "Omeprazole is used in peptic ulcer
because it is an effective anti-ulcer drug.
Omeprazole helps in quick healing of the
ulcer. Therefore omeprazole is extensively
used as an anti ulcer medication"
How many marks will you award this answer?

6. Level 2: Uni-structural
• contain "generalisations" in terms of just
one aspect
– "Omeprazole is a proton pump inhibitor
(PPI) and reduces gastric acid output.
This effect helps in the healing of peptic
ulcer. Therefore omeprazole is useful as
an anti ulcer medication."
How many marks will you award this answer?

7. Level 3: Multi-structural
• generalisations of a few limited and
independent aspects
– "Omeprazole is a proton pump inhibitor. It
causes reduction in gastric acid output.
This effect helps in the healing of peptic
ulcer. Omeprazole is given in a dose of 20-
40 mg/day. It is an effective anti-ulcer
drug. It is of questionable safety in
pregnancy."
How many marks will you award this answer?

8. Level 4: Relational
• induction and generalisations within a given context
using related aspects.
– "Omeprazole is a first line drug in the treatment of
peptic ulcer because it is a potent proton pump
inhibitor and effectively blocks the secretion of H+
ions by the parietal cells of the mucosal layer of the
stomach.
– Neutralising high acidity helps in healing of peptic
ulcers. Omeprazole is given in the dose of 20-40 mg
per day. The drug has all or none effect on H+
secretion. Therefore sub-optimal dosage will be
ineffective.
– It is of questionable safety in pregnancy. Therefore,
it is better to avoid using it in reproductive age group
females if there is a risk of pregnancy"
How many marks will you award this answer?

9. Level 5: Extended Abstract
• deduction and induction goes beyond Level 4
– “..... While omeprazole is effective in peptic ulcer
management, it is not without risks. Enteric
infections may occur in patients who are on
omeprazole because of the loss of physiological acid
barrier. Long-term safety is questionable because of
reported increase in the incidence of endocrine
adenoma of the pancreas.
– Moreover, acid is not considered the major factor in
peptic ulcer. H. pylori infection is the major factor.
However, omeprazole is used as one component of
various triple drug regimens to eradicate H. pylori and
heal peptic ulcer. Some of the triple drug regimens
utilising omeprazole are...”
How many marks will you award this answer?

10. What level should we aim for
in undergraduate education?
– Level 1: Pre-structural
– Level 2: Uni-structural
– Level 3: Multi-structural
– Level 4: Relational
– Level 5: Extended Abstract
Let us do a group exercise before commenting further…

11. Group Work -1
Assessing answer scripts
Time available = 10 mins
• Assess the answer
• Fit in to a level of the SOLO taxonomy
• Present your opinions in plenary session

12. What level should we aim for
in undergraduate education?
– Level 1: Pre-structural
– Level 2: Uni-structural
– Level 3: Multi-structural
– Level 4: Relational
– Level 5: Extended Abstract
PoorPoor
Mediocre
AcceptableAcceptable
Very GoodVery Good

13. Wrap up of this session
• We understood the SOLO taxonomy as
– Level 1: Pre-structural
– Level 2: Uni-structural
– Level 3: Multi-structural
– Level 4: Relational
– Level 5: Extended Abstract
• We apply this concept to assess real life
answer scripts & to formulate answer-keys