Level 7 Marking Rubric in relation to the Assignment

Level 7 Rubric Guidance for the Assignment 

This document offers guidance for the interpretation of the Level 7 Marking Rubric in relation to the Assignment. It is not a replacement for the official Level 7 Assignment Rubric and following the given advice does not guarantee any particular awarded mark.

Assignment Title:

Critically evaluate the effectiveness of a management/treatment plan for a given patient scenario with complex cardiorespiratory dysfunction

Knowledge 20%

Knowledge is the statement of facts either sourced from the scenario, textbooks or literature. 

Knowledge involves explaining, defining and describing relevant concepts to the assignment topic. It looks at how well you understand the assignment remit and develop, layer and articulate the knowledge throughout the work.

Consideration should be given to the the sources used for the information – these should be reputable, appropriate sources. Appropriate textbooks should be used, with the most current edition cited where possible. Research articles should be peer-reviewed if possible; articles are more likely to be used in the management section of the assignment, where the research methods and findings are scrutinised. The assignment should be underpinned by sufficient resources which evidences wider reading. Do not become over reliant on one resource.
Communication of the information should involve paraphrasing – direct quoting is not advised in most circumstances. It should be clear that you understand the information you have read and can communicate this to the reader with appropriate terminology and clarity. 

The marker will look for:

Knowledge of the appropriate functional anatomy and physiological processes directly linked to your chosen case scenario and clinical feature. Only include information relevant to the clinical feature chosen from the case scenario.

For example, if you have chosen the asthma case scenario and want to discuss the clinical feature of breathlessness then first consider the anatomical structures which could be affected by pathophysiology of asthma and choose one or two structures to focus on for example airway smooth muscle. You do not have sufficient words to discuss all anatomical structures and function associated with breathlessness in great detail as it is a complex symptom in asthma, so focussing your work on a small aspect, with justification, is recommended. For example, you may focus on breathlessness during exercise or at rest.   First focus on normal structure and function before discussing the pathophysiology. 
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Please note that you are not required to explore the functional anatomy of the whole respiratory system but rather those anatomical parts and physiological processes that are directly affected by the pathophysiology of your chosen case scenario clinical feature.

The knowledge section of the rubric will also look for:

• Clearly structured well-paced explanations: Try not to make big leaps in your explanations, for example, stating that exercise may cause/contribute to breathlessness in asthma due to airway wall changes would be insufficient. The interim explanatory steps would be required. 
• Critical thinking to highlight any different theories in the field; When discussing the normal structure and function or the pathophysiology there may be controversies or varying theories which could be explored. This detail helps demonstrate your full understanding of the literature read in relation to the given case scenario.
• Appropriate M level terminology and depth: Try to ensure that appropriate M level language and terminology is used, for example, refer to ‘respiratory bronchioles’ rather than ‘very small tubes’.  

Ensure that you explain more complex concepts and terminology. For example, when referring to terms such as ‘capillary oncotic pressure’, ‘cardiac index’ or ‘transpulmonary pressure’ it would be advisable to explore these more fully in the context of the assignment topic. However, you can assume basic knowledge such as ‘the heart has four chambers’ and do not need to explain this.

• Do not try and cover too many aspects of the respiratory or cardiac pathology from your chosen case scenario function. For example, heart failure can be attributed to several causes and has many classifications - you could choose the cause and classification most likely to fit the case scenario, justifying your choice.
• Focusing on one treatment/management approach for the chosen clinical feature from the case scenario. 

First, briefly consider recommended current management for the given clinical feature but then focus in on one treatment approach – giving reason for your choice. For example, if discussing management of hypersecretion of mucus in cystic fibrosis, then base your search strategy on one type of treatment, for example, exercise, airway clearance devices, postural drainage or mucolytic agents etc – but not all of them. You will be guided by the quantity of research studies capture by your Search. If there are only 2 studies exploring your chosen management approach, then you will need to broaden the scope of your search strategy by including more search terms or altering inclusion/exclusion criteria. Alternatively, reconsider the choice of treatment.

• Comprehensive knowledge of research methods and process. 

 It should be evident that you understand how research is carried out.

This can be demonstrated in the second half of the assignment during the critical analysis of the research studies. You should be conversant in differing research study designs, sampling, research methods, statistical tests and demonstrate awareness of the possible biases within research. 

A good search strategy for the critical analysis of the research studies included in your assignment.

This should explain:

• The electronic data bases searched (e.g. Google Scholar, PubMed etc) and justification for these
• The key search terms/words used and their synonyms (e.g. ‘’ ‘cystic fibrosis’ ‘mucus hypersecretions’ ‘retained secretions’ ‘airway clearance device’ ‘positive expiratory pressure device’ ‘oscillatory positive pressure device’ etc) and any Boolean operators
• The number of articles captured by the search and the number finally selected for your research article critique (with justification for this selection, for example, based on relevance to the assignment/case scenario having read the abstract)
• The inclusion criteria for your search: for example, human studies, English language, studies in last 10 years (and why you chose these dates), full text articles, randomised controlled trials (or desired study design) etc.  
• Any forward or back chaining
• Any use of books

Analysis 30%

This is the thorough critical appraisal of any research studies used to support your assignment. 

Critical appraisal of the research studies will usually form the second half of your assignment and in this instance; you will be examining the efficacy of one management approach for your clinical feature. Critical analysis could include scrutinising:

• The age of the study - theories, research methods and technologies change over time and may not be comparable to contemporary thinking and standards. However, older seminal studies can be very important in the topic field.
• The study design - was it appropriate for the research question?
• Appropriate inclusion and exclusion criteria for sampling
• Ethical issues
• The length of study – was it appropriate for the factor under consideration
• The population demographic (age, ethnicity, gender ratio/appropriateness, gestation stage, BMI, cultural differences, comorbidities, life-style choices such as smoking/alcohol, etc)
• The sample size (and any withdrawals or dropouts) – was it powered, too small
• Outcome measurements/tools - appropriateness/validity, reliability, sensitivity for the clinical feature chosen in the assignment e.g. dyspnoea in asthma
• Location of the study (as this may influence the population ethnicity used, the technology used in the methodology etc)
• The statistical methods used - were they the best for the data collected?
• The level of statistical significance  – always ensure you sate the statistical significance of the research findings e.g. the actual p values. It is not essential to include every study result – just the ones relevant to the clinical feature being explored.
  Avoid only stating what the researchers did or what their results found - this is too descriptive and does not show any critical analysis of the study methods. 

This is not an exhaustive list and there are other features you could include

NB consider the study findings in the context of the specific case scenario – e.g. is it applicable in terms of demographic – age, ethnicity, gender, culture etc

Synthesis 20%

This involves the bringing together of two or more pieces of information.

• It involves making links between information - either because it is similar, or because it is different, and exploring the relationship between information. This helps to form a balanced, well-structured assignment. Synthesis also involves linking the information to the assignment title/remit whenever possible. In this assignment, the chosen patient, their condition and the chosen clinical feature should be at the centre of the assignment – all written information should be related to these factors.
• The first part of this assignment will focus on normal functional anatomy and  physiology of the structures affected in the clinical feature from your chosen case scenario. It will then explore what happens to the normal structures as a result of the pathology, leading to the clinical feature.
• The second half of the assignment will focus on the efficacy of a management approach for the clinical feature. Links should be made between the first and second half of the assignment. For example, what is the effect of Bronchodilator drugs on airway smooth muscle? What is the effect of ACE inhibitors on myocardial contractility in heart failure?
• Highlight the similarities and differences in the research studies supporting your work. For example, differing sample sizes, population demographics, disease severity, methods used (testing conditions, standardisation, outcome tools/measurements) etc. You can then explore how these may have affected the research findings.
• Try not to write separate paragraphs for each research study. Instead, link together similar studies in the same paragraph/s; you can still point     out where the studies differ too.
• Good synthesis allows a more mature writing style with a balanced view of the
  research. Synthesis often leads to the development of new perspectives and ideas, demonstrating a sound understanding of the topic.
• Synthesis also includes linking your paragraphs together, so that one section
  easily leads to the next. This can be achieved by a ‘joining’ sentence or two either at the end of one section or the beginning of the next. This makes your work flow well and improves the overall structure of the assignment.

Evaluation 20%

This involves appraising the theories and concepts and related to the area of study. 

Mini-summaries: it is helpful to have brief conclusions throughout your work. These summaries are usually between 1 - 3 sentences long and serve to summarise and interpret the paragraphs preceding.

Common places and points to put a mini summary in this assignment could be:

• Throughout your analysis of the research studies supporting the assignment. For example, after 3 studies with similar findings or after 3 studies with contrasting findings.
• At the end of your section appraising the research studies. Here you can make an overall evaluation of the research based on the research findings. It is usually guided by your appraisal of the relative strengths and weaknesses of each study and their findings and is therefore your opinion. It is beneficial give direction and suggestions for future research or clinical recommendations.

Try to comment on any gaps in the literature base which may limit the ability to come to full conclusions about the efficacy of a given management/treatment. 

Final conclusion: this comes at the end of your work and is generally longer than the mini-conclusions mentioned above. It should relate to the entirety of your assignment but is not simply a ‘list’ or summary of the assignment contents, but instead it aims to answer the assignment remit. It should demonstrate that you have understood and brought together different aspects, ideas and concepts described in the assignment showing a sound overall interpretation. It should link the findings of your studies to the pathophysiology of the clinical feature, commenting on the overall effectiveness of the chosen treatment in the context of the case scenario. It may give recommendations for future research and clinical practice.  Do not include any new factual information in your conclusion.

Presentation 10%

Even though this section has a relatively small % weighting, it is one area that you can easily pick up marks by proofreading your work. Asking friends/colleagues to proofread your work can also be very useful.

Here are some tips to help boost your marks in this section:

Writing style: this is an academic, scientific piece of ‘M’ level writing. It should flow well and be easy to read.  It should avoid awkward or cumbersome sentence construction which is difficult to scan and make sense of.
Try to avoid repetition unless it aids understanding or it is used in summaries.

Spelling and grammar:

• Check that your tenses are correct throughout the work.
• Possessive apostrophes are often written incorrectly, with ‘s and s’ confused.
• Use English rather than American spelling e.g. oedema rather than edema
• Avoid the use of contractions e.g. don’t. won’t, can’t. Instead use the full words: do not, will not, cannot
• Do not write in the first person –i.e. ‘I think that’ or ‘we think that’. Write in the third person ‘It appears that…’. 

Abbreviations

• These can be helpful to keep your word count within limits, however, too many abbreviations can make the work difficult to interpret and adversely affect the reading flow.
• Make the abbreviation on the first mention of the word/s to be abbreviated.
• Use the abbreviation consistently after its first use.
• Avoid abbreviations in titles.
• Try not to use a well-known abbreviation e.g. FVC (forced vital capacity) for any other word abbreviation meaning, as this can be confusing for the reader.

Quotes

Generally, it is not advisable to use quotes in your work. It is better to paraphrase information in your own words, which shows greater understanding. Only use a quote if there is no other way of explaining the fact. In this case, a page reference is required in your reference and inverted commas around the quoted words.  

Word count - 4000

Ensure that your word count is as close to the stated remit as possible. If the word count is above the remit then the marker’s academic judgement will be used to assess what impact this may have on the mark awarded. If the word count is below the remit the marker will again assess whether this influences the quality of the work.

Often your word count will be substantially over the remit during the early stages of writing, but with proof reading, synthesis and editing, this should reduce to the accepted level.

Tables, illustrations and figures

• It is acceptable to include tables, illustrations and figures but they are only useful if they help clarify or explain your work rather than distract from it.  
• If included, please ensure that full labelling is used, with multiple inclusions in chronological order e.g. Figure 1. (name of Table/Figure).
• The label should lie close to the Table/Figure - usually directly above or below. You should make reference to the Table/Figure in the main text and explain what it demonstrates. Ensure that the text/illustration is a suitable size for the reader to view easily and that images are of good pixel quality.

Some students choose to place illustrations in an Appendix which is allowed but this can make interpretation more difficult when separated from the main text. If an Appendix is used, this must be referred to in the main text e.g. Figure 1 (see Appendix A). Any external resources, such as an illustration of the alveoli from a journal, should be referenced appropriately using the Cardiff University Harvard style.

References

NB your assignment has a Reference List not Bibliography.

• All statements in your work should be referenced. These usually come at the end of a statement/sentence.
• All references in the main body and list should be made using the Cardiff University Harvard style:
• All aspects of the Harvard style will be checked including the punctuation used e.g. commas, semi colons, date and use of brackets.
• Where more than one study is mentioned in relation to a statement the oldest research goes first e.g. (Jones 2009; Brown et al. 2012; Davies and Thomas 2015).
• Ensure your reference list is in alphabetical order with suitable formatting and spacing. Ensure the font used for referencing matches that used in the main body - especially if you have cut and paste the reference from another document.
• Use a wide range of appropriate sources - preferably giving a balanced view of the topic.
• Use up-to-date references (last 5 - 10 years) when able although some anatomy and physiology papers may have seminal research which is old but important in the field.
• Peer reviewed journals – try to ensure your sources are peer reviewed (this should be evident on the article itself).
• Avoid secondary citation (where you have not viewed the original work but referenced someone who has). Try to find the original or use an alternative source.

Structure

It is important to have a clear structure to your assignment. It should have a beginning (introduction) middle (main section) and end (conclusion).

Introduction

The introduction should set the scene for the assignment. For example, a brief explanation of obesity (including a definition and classification according to BMI, incidence/prevalence etc.) broadly how it might affect the normal cardiovascular or respiratory function and why it is important to understand these effects of this on normal respiratory or cardiovascular system function. 

• At the end of the introduction, explain what you intend to cover in the assignment to signpost the reader.
• Main body – middle section. This will contain most of your assignment content.
• Conclusion – see above