Optimising the diagnostic accuracy of First post-contrAst SubtracTed breast MRI (FAST MRI) through interpretation-training: a multicentre e-learning study, mapping the learning curve of NHS Breast Screening Programme (NHSBSP) mammogram readers using an enriched dataset.

BACKGROUND: Abbreviated breast MRI (FAST MRI) is being introduced into clinical practice to screen women with mammographically dense breasts or with a personal history of breast cancer. This study aimed to optimise diagnostic accuracy through the adaptation of interpretation-training. METHODS: A FAST MRI interpretation-training programme (short presentations and guided hands-on workstation teaching) was adapted to provide additional training during the assessment task (interpretation of an enriched dataset of 125 FAST MRI scans) by giving readers feedback about the true outcome of each scan immediately after each scan was interpreted (formative assessment). Reader interaction with the FAST MRI scans used developed software (RiViewer) that recorded reader opinions and reading times for each scan. The training programme was additionally adapted for remote e-learning delivery. STUDY DESIGN: Prospective, blinded interpretation of an enriched dataset by multiple readers. RESULTS: 43 mammogram readers completed the training, 22 who interpreted breast MRI in their clinical role (Group 1) and 21 who did not (Group 2). Overall sensitivity was 83% (95%CI 81-84%; 1994/2408), specificity 94% (95%CI 93-94%; 7806/8338), readers' agreement with the true outcome kappa = 0.75 (95%CI 0.74-0.77) and diagnostic odds ratio = 70.67 (95%CI 61.59-81.09). Group 1 readers showed similar sensitivity (84%) to Group 2 (82% p = 0.14), but slightly higher specificity (94% v. 93%, p = 0.001). Concordance with the ground truth increased significantly with the number of FAST MRI scans read through the formative assessment task (p = 0.002) but by differing amounts depending on whether or not a reader had previously attended FAST MRI training (interaction p = 0.02). Concordance with the ground truth was significantly associated with reading batch size (p = 0.02), tending to worsen when more than 50 scans were read per batch. Group 1 took a median of 56 seconds (range 8-47,466) to interpret each FAST MRI scan compared with 78 (14-22,830, p < 0.0001) for Group 2. CONCLUSIONS: Provision of immediate feedback to mammogram readers during the assessment test set reading task increased specificity for FAST MRI interpretation and achieved high diagnostic accuracy. Optimal reading-batch size for FAST MRI was 50 reads per batch. Trial registration (25/09/2019): ISRCTN16624917.

Does 'summative' count? The influence of the awarding of study credits on feedback use and test-taking motivation in medical progress testing.

Despite the increasing implementation of formative assessment in medical education, its' effect on learning behaviour remains questionable. This effect may depend on how students value formative, and summative assessments differently. Informed by Expectancy Value Theory, we compared test preparation, feedback use, and test-taking motivation of medical students who either took a purely formative progress test (formative PT-group) or a progress test that yielded study credits (summative PT-group). In a mixed-methods study design, we triangulated quantitative questionnaire data (n = 264), logging data of an online PT feedback system (n = 618), and qualitative interview data (n = 21) to compare feedback use, and test-taking motivation between the formative PT-group (n = 316), and the summative PT-group (n = 302). Self-reported, and actual feedback consultation was higher in the summative PT-group. Test preparation, and active feedback use were relatively low and similar in both groups. Both quantitative, and qualitative results showed that the motivation to prepare and consult feedback relates to how students value the assessment. In the interview data, a link could be made with goal orientation theory, as performance-oriented students perceived the formative PT as not important due to the lack of study credits. This led to low test-taking effort, and feedback consultation after the formative PT. In contrast, learning-oriented students valued the formative PT, and used it for self-study or self-assessment to gain feedback. Our results indicate that most students are less motivated to put effort in the test, and use feedback when there are no direct consequences. A supportive assessment environment that emphasizes recognition of the value of formative testing is required to motivate students to use feedback for learning.

Formative peer evaluation instrument for a team-based learning course: Content and construct validity.

PURPOSE: Team-based learning (TBL) is an evidence-based approach to promote teamwork. Peer evaluation (PE) is an essential component to shape future team engagement and promote reflection. As PEs vary in use, implementation, and assessment, this study establishes the content and construct validity of a formative PE tool for a TBL course. METHODS: A ten-item instrument was developed based on a comprehensive review of PE literature and was critically edited by a team of experienced educators. Each student in a graduate histology course rated peers at two timepoints on a scale from Never to Always (0-3). The instrument's factor structure was analyzed by dividing the response set (D1 and D2); with D1 utilized for exploratory factor analysis (EFA) and D2 for confirmatory factor analysis (CFA). Cronbach's alpha assessed internal consistency. RESULTS: Data from 158 students across four cohorts were included in the analyses (D1, D2 = 972). A three-factor solution had good overall internal consistency (alpha = 0.82), and within the subscales ranged from 0.67 to 0.81. The factor structures were resonant with existing literature on (1) preparation, (2) providing feedback, and (3) feedback receptivity and attitude. CONCLUSION: This study establishes evidence of content and construct validity of a formative PE instrument for a TBL course.

Using word cloud as a formative assessment classroom technique in physiology.

Formative assessment is a valuable tool in medical education as it allows students to reflect on their own learning and make necessary corrections. The use of innovative techniques in formative assessment can make it more engaging and effective for students, particularly utilizing electronic tools. A word cloud is a visual representation of data that is created using text inputs from a group of individuals. The resulting image shows the most frequently used words in a larger font, allowing quick understanding of the common themes and concepts in the group's responses. Mentimeter is an online platform for interactive presentations where students can provide their responses to a question, which can then be visualized as a word cloud. The study aims to explore the benefits and drawbacks of using word cloud formation as a formative assessment technique in the classroom, utilizing the online platform Mentimeter.NEW & NOTEWORTHY The current study was conducted to present a novel formative assessment classroom technique using Mentimeter. The benefit of this novel technique is that it is easy to implement, quick, anonymous, and strengthens student's conceptual learning. It also gives the teacher an opportunity to give feedback and stress commonly committed mistakes.

Experiences of medical students and faculty regarding the use of long case as a formative assessment method at a tertiary care teaching hospital in a low resource setting: a qualitative study.

INTRODUCTION: The long case is used to assess medical students' proficiency in performing clinical tasks. As a formative assessment, the purpose is to offer feedback on performance, aiming to enhance and expedite clinical learning. The long case stands out as one of the primary formative assessment methods for clinical clerkship in low-resource settings but has received little attention in the literature. OBJECTIVE: To explore the experiences of medical students and faculty regarding the use of the Long Case Study as a formative assessment method at a tertiary care teaching hospital in a low-resource setting. METHODOLOGY: A qualitative study design was used. The study was conducted at Makerere University, a low-resource setting. The study participants were third- and fifth-year medical students as well as lecturers. Purposive sampling was utilized to recruit participants. Data collection comprised six Focus Group Discussions with students and five Key Informant Interviews with lecturers. The qualitative data were analyzed by inductive thematic analysis. RESULTS: Three themes emerged from the study: ward placement, case presentation, and case assessment and feedback. The findings revealed that students conduct their long cases at patients' bedside within specific wards/units assigned for the entire clerkship. Effective supervision, feedback, and marks were highlighted as crucial practices that positively impact the learning process. However, challenges such as insufficient orientation to the long case, the super-specialization of the hospital wards, pressure to hunt for marks, and inadequate feedback practices were identified. CONCLUSION: The long case offers students exposure to real patients in a clinical setting. However, in tertiary care teaching hospitals, it's crucial to ensure proper design and implementation of this practice to enable students' exposure to a variety of cases. Adequate and effective supervision and feedback create valuable opportunities for each learner to present cases and receive corrections.

The mediating role of goal orientation in the relationship between formative assessment with academic engagement and procrastination in medical students.

BACKGROUND: Academic involvement and academic procrastination are two behavioral variables and are among the challenges of higher education, especially medical education. The purpose of the current research is to investigate the mediating role of goal orientation in the relationship between formative assessment with academic engagement and procrastination in Iranian medical students. METHODS: The present correlational study of path way type, was performed on 388 students of Zanjan University of Medical Sciences in the 2021 selected by a convenient sampling method. Four questionnaires of Goal orientation scale )21-item), the classroom assessment approaches questionnaire (12-item), the Procrastination Assessment Scale- Students (44-item) and the student engagement scale (10-item) were used to collect data. The data were analyzed with SPSS-26 and LISREL-10.2 software. RESULTS: The results of the path analysis showed formative assessment have significant direct effect on mastery orientation (ß = 0.40), performance-approach (ß = 0.14), avoidance orientation (ß = -0.28), academic engagement (ß = 0.32) and academic procrastination (ß = 0.12). Also mastery orientation (ß = 0.13), performance-approach (ß = 0.12), avoidance orientation (ß = -0.25) have a significant direct effect in the variance of academic engagement. As well mastery orientation (ß = -0.43), performance-approach (ß = -0.15), avoidance orientation (ß = 0.30) have a significant direct effect in the variance of academic procrastination. These results confirm the direct hypotheses. Indirect effect of formative assessment to academic engagement (0.21) and academic procrastination (0.27) was significant. CONCLUSION: It is recommended according to the results practitioners provide the basis for promoting academic engagement and decrease academic procrastination through the application of formative assessment and Improve classroom goal orientation.

Test-Only Learning via Virtual Patients to Improve Surgical Illness Scripts of Preclinical Medical Students as a Preparation for Clinical Clerkships: An Experimental Study.

OBJECTIVE: The aim was to determine whether preclinical medical students can develop their illness scripts to a level comparable to that of clerkship students through test-only learning using repeated formative online testlets. METHODS: In this experimental study, participants were 52 preclinical and 53 clinical medical students. The intervention group consisted of preclinical medical students, and the control group consisted of clinical medical students. The intervention group responded to online testlets containing feedback, an innovative formative assessment method called ContExtended Questions, on general surgery for 8 days by spending no more than 30 minutes each day. The control group completed the general surgery clerkship. The performances were assessed using 20 Key-Feature Question items. The intervention group was assessed twice: immediately after the intervention (the immediate test), and again 1 month later (the delayed test). The control group was assessed once, immediately after the clerkship. All performance tests were identical. RESULTS: The preclinical students had a significantly higher mean score on the immediate test (83.1 ± 9.6) compared to the clinical students (75.4 ± 8.9), P < .001. The effect size (Cohen's d) was .83. However, the mean score in the delayed test (76.9 ± 13.6) was not significantly different from clinical students' mean score (75.4 ± 8.9), P > .05. CONCLUSIONS: Test-only learning as a spaced repetition of online formative testlets is effective in preparing preclinical medical students to the clinical clerkship. Through using this approach in preclinical period, they can prepare themselves for the clinical environment to optimize the benefits derived from clerkships.

Does formative assessment help students to acquire prescribing skills?

PURPOSE: Formative assessments can help motivate students and ease students' learning through feedback. There is a pressing need for improvement of clinical pharmacotherapy (CPT) education since junior doctors make many prescribing errors. The aim of this study was to determine whether a formative assessment with personalized narrative feedback helps medical students to increase their prescribing skills. METHODS: This retrospective cohort study was conducted among masters' medical students at Erasmus Medical Centre, The Netherlands. Students made a formative and a summative skill-based prescription assessment, both during clerkships as part of their regular curriculum. Errors in both assessments were categorized by type and possible consequence and compared with each other. RESULTS: A total of 388 students made 1964 errors in the formative assessment and 1016 in the summative assessment. Most improvements after the formative assessment were seen for mentioning the weight of a child on the prescription (n = 242, 19%). Most new and repeated errors in the summative assessment were missing usage instructions (n = 82, 16% and n = 121, 41%). CONCLUSIONS: This formative assessment with personalized and individual narrative feedback has helped students to increase the technical correctness of their prescriptions. However, errors repeated after the feedback were predominantly errors showing that only one formative assessment has not yet enhanced the clinical prescribing enough.

A Simple and Sustainable Exercise to Enhance Student Self-Reflection on Error-Making, Focus Support, and Guide Curricular Design.

Problem: Self-reflection is a critical component of professional development and clinical practice, but medical students' ability to self-reflect is typically limited. While inadequate self-reflection impacts future clinical decision-making, it may also adversely impact current learning through an inability to identify learning-behavior deficits. This may be exacerbated by common use of multiple-choice questions (MCQ) where incorrect responses provide less insight than other measures for students, faculty, or academic support. To address this, an Error Reflection Method (ERM) was developed to help students focus on 'why' they got an MCQ wrong rather than 'what' they got wrong, thereby promoting self-reflection and a learning-focus on assessment. Understanding students' learning-behavior deficits could also enrich engagement with academic support services and guide curricular design. Intervention: The ERM is a list of 10 common types of exam errors that were either 'test-taking' (unwitting) errors or 'learning-behavior' errors that reflected learning deficits. The ERM is simple, transferable, and sustainable, allowing longitudinal and regular monitoring of individual and collective error-making to focus support and guide curricular development. Context: Undergraduate medical students at the Virginia Tech Carilion School of Medicine, USA, used the ERM in formative assessment review sessions in pre-clinical years to select an error type that best described the cause of each incorrect response. Impact: Initial findings suggest the ERM is robust and associated with improved student performance and curricular development. Analysis of 3,775 student-identified errors showed the error types in the ERM described 96% of errors students made. Learning-behavior errors were more common (76%), but surprisingly, 19% were test-taking errors, allowing academic support to focus on test-taking skills in a population previously thought of as consummate test-takers. The most common error type reported was 'the content looked familiar but I couldn't answer the question' (32%); which we suggest is consistent with shallow learning. This finding has helped steer recent curricular development toward active and applied learning techniques. Lessons Learned: By formally and regularly identifying learning deficits, students may be more capable of addressing them and improve summative exam performance. As well as focusing academic support, understanding common student errors has been useful in guiding curricular design and content delivery. Further potential of the ERM may be realized in faculty development and directing assessment culture toward a learning focus.

Formative assessment and student understanding of structure-function.

The structure and function relationship is a core concept identified by physiology faculty. Prior research has shown this may be a difficult concept for students to understand. Formative written assessments, such as short answer essay questions, allow students to demonstrate their thinking by encouraging students to use their diverse ideas to construct their responses. Varying the context of a question, such as the inclusion of a scenario, may be used to provide insight into the different stages of students' emerging biological expertise. Short answer questions based on the core concept structure↔function were administered to students in a junior level General Physiology course and a sophomore level Human Anatomy and Physiology course at a large southeastern public university. Questions were based on the integumentary, muscular, digestive, and cardiovascular systems. Student responses were scored with a conceptual rubric developed for each question prompt as well as each organ system represented in the question prompts. Students were interviewed to determine if their responses to the short answer questions accurately reflected their thinking. Less than half of the student responses in this study demonstrated a conceptual understanding of the structure-function relationship. Students demonstrated different conceptual understanding of structure↔function concepts depending on the question prompt with a scenario versus the question prompt without a scenario. The question prompts with scenarios versus non-scenarios provided a different context, which may have influenced student explanations. These results suggest that instructors should provide students with questions in varying contexts to allow students to demonstrate their heterogeneous ideas about a concept.NEW & NOTEWORTHY Formative assessment provides feedback to both students and instructors about the process of learning. The core concept structure-function provides a foundation upon which many topics in anatomy and physiology can be built across all levels of organization. This study contributes to existing research about student conceptual understanding of the core concepts. Implications for practitioners include the design of formative assessments and a suite of questions to be used to gauge student understanding of structure-function.

Real-life scenario blended teaching approach for nurturing inquisitive learning of central nervous system in medical students.

Among the various systems taught in the preclinical phases, the nervous system is more challenging to learn than other systems. In this report, a novel teaching methodology, "real-life scenario (RLS) blended teaching," is described and its effectiveness in facilitating inquisitive learning in undergraduate medical students is evaluated. This mixed-method study was conducted among three groups (group 1, n = 83; group 2, n = 85; and group 3; n = 79) of undergraduate medical students (18-20 yr) in the neurology and behavioral sciences module. RLS was presented to students in the form of demonstrations, role-plays, videos, and group activities. Group 1 students underwent traditional teaching-learning sessions. Group 2 students underwent RLS blended sessions and were provided with multiple miniassignments in a vignette format. Group 3 students received RLS blended sessions, multiple miniassignments, peer discussions, multiple formative assessments, and facilitator feedback sessions. The student performances on different exams were compared in terms of their group, and their perceptions of RLS were documented. Students exposed to RLS sessions blended with multiple assignments, peer discussions, multiple formative assignments, and facilitator feedback sessions performed well in the final summative assessments (67.87%) compared with those exposed to RLS sessions and assignments (50.21%) or exposed to traditional teaching alone (50.34%). RLS sessions increased students' curiosity and motivated them to learn the subject well. RLS sessions stimulated student interest and facilitated their learning. RLS along with effective use of multiple assignments, formative assessments, and/or feedback sessions significantly improved student learning. This demonstrates the effectiveness of this active method in teaching various subjects with appropriate modifications.NEW & NOTEWORTHY In this report, a novel teaching methodology, "real-life scenario (RLS) blended teaching" is described and its effectiveness in facilitating inquisitive learning in undergraduate medical students is evaluated. Students exposed to RLS sessions blended with multiple miniassignments, peer discussions, multiple formative assignments, and facilitator feedback sessions performed well in the summative assessments compared with those exposed to RLS sessions and assignments or exposed to traditional teaching alone. Students preferred active teaching-learning techniques over the traditional method.

Using Test Question Templates to teach physiology core concepts.

The past ∼15 years have seen increasing interest in defining disciplinary core concepts. Within the field of physiology, Michael, McFarland, Modell, and colleagues have published studies that defined physiology core concepts and have elaborated many of these as detailed conceptual frameworks. With such helpful definitions now in place, attention is turning to the related issue of how to maximize student understanding of the core concepts by linking these "big ideas" to concrete student-facing resources for active learning and assessment. Our practitioner-based view begins with the recognition that in many if not most undergraduate physiology courses assessment drives learning. We have therefore linked published conceptual frameworks to Test Question Templates (TQTs), whose structure promotes transparent assessments as well as the active learning needed to prepare for such assessments. We provide examples of conceptual framework-linked TQTs for the physiology core concepts of Homeostasis, Flow Down Gradients, the Cell Membrane, and Cell-Cell Communication. We argue that this deployment of TQTs has at least two distinct benefits for the teaching and learning of core concepts. First, documenting the connections between conceptual frameworks and TQTs may clarify coverage and assessment of the core concepts for both instructors and students. Second, misconceptions about core concepts may be directly targeted and dispelled via thoughtful construction, arrangement, and iteration of TQTs. We propose that the TQT framework or similar approaches may be applied fruitfully to any sufficiently articulated physiology core concept for high school, undergraduate, or graduate students.NEW & NOTEWORTHY Our students often focus on the grades they need to advance through academic programs. How can instructors harness this understandable interest in grades to help students gain a true understanding of core concepts? The new framework of Test Question Templates (TQTs) shows promise in linking student priorities like test scores to instructor priorities like core concepts.

Fostering formative assessment: teachers' perception, practice and challenges of implementation in four Sudanese medical schools, a mixed-method study.

Formative assessment (assessment for learning) enhances learning (especially deep learning) by using feedback as a central tool. However, implementing it properly faces many challenges. We aimed to describe the perception of medical teachers towards FA, their practice, challenges of implementing FA and present applicable solutions. A mixed-method, explanatory approach study was applied by administering a validated questionnaire to 190 medical teachers in four medical schools in Sudan. The obtained results were further studied using the Delphi method. Quantitative analysis revealed that medical teachers perceived their grasping of the concept of FAs and their ability to differentiate formative from summative assessments as very well (83.7%) and (77.4%), respectively. However, in contradiction to the former results, it was noteworthy that (41%) of them mistakenly perceived FA as an approach conducted for purposes of grading and certification. The qualitative study defined the challenges into two main themes: lack of understanding of formative assessment and lack of resources. Medical teachers' development and resource allocation were the main recommendations. We conclude that there is misunderstanding and malpractice in implementing formative assessment attributed to the lack of understanding of FA as well as the lack of resources. We as well present suggested solutions derived from the perception of the medical teachers in the study and evolved around three approaches: faculty development, managing the curriculum by allocating time and resources for FA, and advocacy among stakeholders.

A qualitative study examining the critical differences in the experience of and response to formative feedback by undergraduate medical students in Japan and the UK.

BACKGROUND: Formative feedback plays a critical role in guiding learners to gain competence, serving as an opportunity for reflection and feedback on their learning progress and needs. Medical education in Japan has historically been dominated by a summative paradigm within assessment, as opposed to countries such as the UK where there are greater opportunities for formative feedback. How this difference affects students' interaction with feedback has not been studied. We aim to explore the difference in students' perception of feedback in Japan and the UK. METHODS: The study is designed and analysed with a constructivist grounded theory lens. Medical students in Japan and the UK were interviewed on the topic of formative assessment and feedback they received during clinical placements. We undertook purposeful sampling and concurrent data collection. Data analysis through open and axial coding with iterative discussion among research group members was conducted to develop a theoretical framework. RESULTS: Japanese students perceived feedback as a model answer provided by tutors which they should not critically question, which contrasted with the views of UK students. Japanese students viewed formative assessment as an opportunity to gauge whether they are achieving the pass mark, while UK students used the experience for reflective learning. CONCLUSIONS: The Japanese student experience of formative assessment and feedback supports the view that medical education and examination systems in Japan are focused on summative assessment, which operates alongside culturally derived social pressures including the expectation to correct mistakes. These findings provide new insights in supporting students to learn from formative feedback in both Japanese and UK contexts.

Diagnostic branched tree as an assessment and feedback tool in undergraduate pharmacology education.

BACKGROUND: Multiple-choice, true-false, completion, matching, oral presentation type questions have been used as an evaluation criterion in medical education for many years. Although not as old as other question types, performance evaluation and portfolio-like assessment types, can be called alternative evaluation, have been used for a considerable time. While summative assessment maintains its importance in medical education, the value of formative assessment is gradually increasing. In this research, the use of Diagnostic Branched Tree (DBT), which is used both as a diagnostic and feedback tool, in pharmacology education was examined. METHODS: The study was conducted on 165 students (112 DBT, 53 non-DBT) on the 3rd year of undergraduate medical education. 16 DBTs prepared by the researchers were used as data collection tool. Year 3 first committee was elected for implementation. DBTs were prepared according to the pharmacology learning objectives within the committee. Descriptive statistics, correlation and comparison analyzes were used in the analysis of the data. RESULTS: DBTs with the most wrong exits are DBTs entitled phase studies, metabolism, types of antagonism, dose-response relationship, affinity and intrinsic activity, G-protein coupled receptors, receptor types, penicillins and cephalosporins. When each question in the DBTs is examined separately, it is seen that most of the students could not answer the questions correctly regarding phase studies, drugs that cause cytochrome enzyme inhibition, elimination kinetics, chemical antagonism definition, gradual and quantal dose response curves, intrinsic activity and inverse agonist definitions, important characteristics of endogenous ligands, changes in the cell as a result of G-protein activation, ionotropic receptor examples, mechanism of action of beta-lactamase inhibitors, excretion mechanism of penicillins, differences of cephalosporins according to generations. As a result of the correlation analysis, the correlation value calculated between the DBT total score and the pharmacology total score in the committee exam. The comparisons showed that the average score of the pharmacology questions in the committee exam of the students who participated in the DBT activity was higher than the students who did not participate. CONCLUSIONS: The study concluded that DBTs are a candidate for an effective diagnostic and feedback tool. Although this result was supported by research at different educational levels, support could not be shown in medical education due to the lack of DBT research in medical education. Future research on DBTs in medical education may strengthen or refute our research results. In our study, receiving feedback with DBT had a positive effect on the success of the pharmacology education.

Effective formative assessment for pharmacy students in Thailand: lesson learns from a school of pharmacy in Thailand.

INTRODUCTION: Formative assessment (FA) is an assessment concept that is of interest in education. The Doctor of Pharmacy program is one of the programs in which FA is usually implemented. This study aimed to describe the correlation between FA scores and summative assessment (SA) scores and to suggest possible key success factors that affect the effectiveness of FA. METHODS: This study employed a retrospective design using mixed methods for data collection. Data in the semesters 1/2020 and 2/2020 of the Doctor of Pharmacy curriculum in a Thailand pharmacy school were used. Three sets of data were gathered, including the course information (e.g. FA methods, FA scores, and SA scores) from 38 records, self-reports from 326 students and 27 teachers, and 5 focus group discussions. The quantitative data were statistically analyzed using descriptive statistics and Pearson correlation, while the qualitative data were analyzed using a content analysis framework. RESULTS: The analysis revealed five main methods that were used for FA, including individual quizzes, individual reports, individual skill assessments, group presentations, and group reports. Of all 38 courses, 29 (76.32%) had significant correlations between FA and SA scores at p-values < 0.05. The individual FA score was related to the correlation coefficient of the courses (p-value = 0.007), but the group FA score was not related (p-value = 0.081). In addition, only the frequency of individual quiz had a significant effect on the correlation coefficient. Moreover, the key success factors which affected the effectiveness of FA were divided into six themes, including the appropriate method, an effective reflection, frequency of assessment, the appropriate score, the adequate support system, and teacher knowledge management. CONCLUSION: The subjects that used individual FA methods provided a significant correlation between FA and SA, while those who used group FA methods did not show a significant correlation. Additionally, the key success factors in this study were appropriate assessment methods, frequency of assessment, effective feedback, appropriate scoring, and a proper support system.

Reflection on the teaching of student-centred formative assessment in medical curricula: an investigation from the perspective of medical students.

BACKGROUND: Formative assessment (FA) is becoming increasingly common in higher education, although the teaching practice of student-centred FA in medical curricula is still very limited. In addition, there is a lack of theoretical and pedagogical practice studies observing FA from medical students' perspectives. The aim of this study is to explore and understand ways to improve student-centred FA, and to provide a practical framework for the future construction of an FA index system in medical curricula. METHODS: This study used questionnaire data from undergraduate students in clinical medicine, preventive medicine, radiology, and nursing at a comprehensive university in China. The feelings of medical students upon receiving student-centred FA, assessment of faculty feedback, and satisfaction were analysed descriptively. RESULTS: Of the 924 medical students surveyed, 37.1% had a general understanding of FA, 94.2% believed that the subject of teaching assessment was the teacher, 59% believed that teacher feedback on learning tasks was effective, and 36.3% received teacher feedback on learning tasks within one week. In addition, student satisfaction results show that students' satisfaction with teacher feedback was 1.71 ± 0.747 points, and their satisfaction with learning tasks was 1.83 ± 0.826 points. CONCLUSION: Students as participants and collaborators in FA provide valid feedback for improving student-centred FA in terms of student cognition, empowered participation, and humanism. In addition, we suggest that medical educators avoid taking student satisfaction as a single indicator for measuring student-centred FA and to try to build an assessment index system of FA, to highlight the advantages of FA in medical curricula.

Digital feedback during clinical education in the emergency medical services: a qualitative study.

BACKGROUND: Clinical education is essential for students' progress towards becoming registered nurses (RN) in Sweden. Assessment of caring skills in the Emergency Medical Services (EMS) is complex due to the ever-changing scenarios and the fact that multiple supervisors are involved in the student's education. Currently, assessments of student's skills are summative and occur twice during the six weeks of clinical education. A digitalized assessment tool (DAT) with an adaptation for formative assessment is a new approach to assessment of nursing skills in the EMS. Since new technologies and changes in procedures are likely to affect both students and supervisors, our aim in this study is to describe students' and clinical supervisors' experience of formative assessments using DAT in the EMS. METHOD: This study is qualitative, using semi-structured group interviews (N = 2) with students and semi-structured individual telephone interviews (N = 13) with supervisors. The data was analysed according to Graneheim and Landman's method for content analysis. This analysis generated 221 codes organized into 10 categories within which three themes were identified. The students in this study were nursing students in their last semester and all supervisors were experienced RNs. RESULTS: The results showed that students and supervisors had mainly positive views of the DAT and the formative assessment stating that the information they provided while using the DAT offered opportunities for reflection. The DAT supported the students' learning by visualizing strengths and areas of improvement, as well as displaying progress using a Likert scale. The application improved communication, but additional features linking the assessment tool with the university were requested. The application contributed to transparency in the assessments and was seen as preferable to the traditional 'pen and paper' method. CONCLUSION: A digital system was described in a positive manner, and the assessment using the DAT facilitated reflection and formative assessment. The use of a Likert scale was considered positive in order to demonstrate progression which with advantage could be demonstrated visually.

Flipped classroom applied to Neurosurgery in undergraduate medical education.

PURPOSE: To compare the academic achievement obtained in Neurosurgery in a class of undergraduate students according to the pedagogical methodology employed: flipped classroom (FC) versus traditional lecture. Students' satisfaction with the FC model is also analyzed. METHODS: A quasi-experimental study was designed. The traditional lecture was the pedagogical method employed in teaching units (TUs) 1, 2, and 3 (61, 60, and 66 enrolled students, respectively), whereas TU 4 (69 enrolled students) used the FC methodology. RESULTS: The dropout rate was lower, whereas the academic achievement and the rate of correct answers were higher in TU 4 compared to the rest of the TUs, but these results were not statistically significant. However, the mean score obtained in Neurosurgery was significantly higher in TU 4 compared to the rest of the TUs (p = 0.042). Active learning activities based on clinical cases were positively emphasized. The main weakness was with the time consumed for video-recorded lecture viewing. CONCLUSIONS: The FC approach showed better academic results than traditional lectures when comparing students in the same Medical School during the same academic year undergoing the same exam. The students rated the FC approach positively, considering it stimulating and useful for learning.

Students' perception on flipped classroom with formative assessment: A focus group study.

OBJECTIVE: To explore students' perception on the implementation of flipped classroom (FC) combined with formative assessment during the undergraduate teaching of orthodontic wire-bending skills. METHODS: Third-year undergraduate dental students were taught wire-bending skills via FC teaching method using a series of pre-recorded online video demonstrations. As part of the formative assessment, the students were given the results and assessment rubrics of their prior wire-bending assessment before every subsequent session. Purposive sampling method for focus group discussion was used to recruit eight students comprising four high achievers and four low achievers. Strengths, weaknesses and suggestions for improvement of the FC with formative assessment were explored. Data were transcribed and thematically analysed. RESULTS: Students perceived that FC allowed for a more convenient and flexible learning experience with personalised learning and improved in-class teaching efficiency. The pre-recorded online videos were useful to aid in teaching wire-bending skills but lacked three-dimensional representation of the wire-bending process. Students suggested better standardisation of instructions and access to the marking rubric before and after assessment. CONCLUSIONS: FC teaching with continuous formative assessment and constructive feedback as a form of personalised learning was viewed favourably by students. The implementation of periodic individual feedback can further enhance their learning experience.