Integrated online formative assessments in the biomedical sciences for medical students: benefits for learning
BMC Medical Education
Integrated online formative assessments in the biomedical sciences for medical students: benefits for learning
Gary M Velan 2
Philip Jones 1
H Patrick McNeil 0
Rakesh K Kumar 2
0 South West Sydney Clinical School, Faculty of Medicine, The University of New South Wales , Sydney 2052 , Australia
1 Office of Medical Education, Faculty of Medicine, The University of New South Wales , Sydney 2052 , Australia
2 Department of Pathology, School of Medical Sciences, Faculty of Medicine, The University of New South Wales , Sydney 2052 , Australia
Background: Online formative assessments have a sound theoretical basis, and are prevalent and popular in higher education settings, but data to establish their educational benefits are lacking. This study attempts to determine whether participation and performance in integrated online formative assessments in the biomedical sciences has measurable effects on learning by junior medical students. Methods: Students enrolled in Phase 1 (Years 1 and 2) of an undergraduate Medicine program were studied over two consecutive years, 2006 and 2007. In seven consecutive courses, end-ofcourse (EOC) summative examination marks were analysed with respect to the effect of participation and performance in voluntary online formative assessments. Online evaluation surveys were utilized to gather students' perceptions regarding online formative assessments. Results: Students rated online assessments highly on all measures. Participation in formative assessments had a statistically significant positive relationship with EOC marks in all courses. The mean difference in EOC marks for those who participated in formative assessments ranged from 6.3% (95% confidence intervals 1.6 to 11.0; p = 0.009) in Course 5 to 3.2% (0.2 to 6.2; p = 0.037) in Course 2. For all courses, performance in formative assessments correlated significantly with EOC marks (p < 0.001 for each course). The variance in EOC marks that could be explained by performance in the formative assessments ranged from 21.8% in Course 6 to 4.1% in Course 7. Conclusion: The results support the contention that well designed formative assessments can have significant positive effects on learning. There is untapped potential for use of formative assessments to assist learning by medical students and postgraduate medical trainees.
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Background
Assessment has sufficiently powerful effects on learning to
be the de facto curriculum [1]. This includes not only what
is learnt, but also students' approaches to learning [2-4].
Formative assessments are designed for the purpose of
giving feedback on performance and suggestions for
improvement, and are intended to promote students'
learning [5,6]. Formative assessments that provide timely,
relevant and supportive feedback (not just grades) can
contribute to improved learning outcomes [7]. In
contrast, summative assessments are predominantly utilized
for grading and certification at the end of a period of
study, often without providing feedback to students on
their performance. Indeed, one of the major weaknesses
of most modern higher education programs, as evidenced
by course evaluation surveys, is failure to provide
adequate feedback to students on their learning [8]. It should
be noted that the provision of diagnostic and remedial
feedback has been found to be one of the most potent
influences on student achievement [9]. If the purpose of
assessment is to foster better learning outcomes, it could
be argued that formative assessment is the most
important assessment practice [10].
Paper-based formative assessments have a number of
limitations [11]: students must be gathered together and
invigilated; individualized feedback is time-consuming,
and might not be feasible with large class sizes [12]; and
analysis of question reliability and validity can be tedious.
In contrast, Web-based formative assessments offer clear
advantages for students: immediacy of feedback;
flexibility in time and place of undertaking the assessment;
feedback can provide links to learning resources, thereby
providing motivation to study; opportunity for repetition;
and interactivity [11]. Furthermore, a comparative study
has reported that online formative assessments might be
of greater benefit for learning than paper-based
equivalents [13]. These are persuasive arguments for moving
from paper-based to online formative assessments.
Web-based formative assessments also support equity and
inclusiveness by allowing students to attempt each
assessment anonymously on multiple occasions, at any time,
and from virtually anywhere. This permits students with
family responsibilities and work commitments to access
the assessments at times that are most convenient for
them. Many students, particularly those from culturally
and linguistically diverse backgrounds, fear
embarrassment if found to be in error, which might inhibit their
propensity to clarify misconceptions directly with a
member of academic staff (...truncated)