Students’ Perception of Formative Assessment as an Instructional Tool in Competency-Based Medical Education: Proposal for a Proof-of-Concept Study (Preprint)

Abstract

BACKGROUND In competency-based medical education (CBME) “Assessment for learning” or “Formative Assessment (FA)” has a key role to play in augmenting student learning. FAs measure students’ progress over time, assisting them to improve their performance in summative assessment. They also encourage students to learn in a way to address their gaps in knowledge and conceptualization. However, effectiveness of FAs as a training instrument relies on the degree of student involvement in their design and implementation, which can be effectively evaluated by appraising their perception with regards to FA implemented in the medical program. OBJECTIVE The key objective of this proof-of-concept research study is to evaluate students’ perception regarding a Formative Assessment as an InStructional Tool (FAIS) implemented in the Biochemistry course in the Basic Sciences component of an undergraduate entry Competency-Based Medical Curriculum (CBMC). In addition, this study aims to evaluate the impact of the FAIS on the overall student’s performance in the summative assessment. METHODS FAIS will be implemented in the phase- 1/semester-1 course of Biochemistry. When developing FAIS each area of knowledge, skills, and attitudes will be considered. Assessment formats will be developed based on the understanding of Miller’s learning pyramid. The “student knows” and “student knows how” will be assessed by Multiple Choice Questions (MCQs), and long-cases. “Student shows” will be assessed by lab examinations and Objective Structured Practical Exam (OSPE). “Student does” will assess the students’ competences of analysis of biochemical data. The assessments used to assess “student knows”, “student knows how”, and “student shows” will be standardized assessments. “Student does” level assessments will be unstandardized assessments. Focus group sessions will assess students’ perception towards FAIS. Data collection, integral to the focus group sessions, will be exploratory. The inductive qualitative data analysis will follow the Braun and Clarke’s six-step framework. To evaluate the effect of FAIS on summative assessment, the performance of the 71 students in the cohort in the summative assessment exposed to FAIS will be compared to a cohort, which was not exposed to FAIS. Analysis of Variance (ANOVA) will be performed on all student scores for both the cohorts in their summative assessments. A P-value of 0.05 will be used as a level of significance. RESULTS This study is at the protocol development stage, and as such, no results are available. The total duration of the proposed research is 6 months. CONCLUSIONS This study will evaluate if majority of medical students appreciate the use of formative assessments to achieve competency goals, specifically self-directed learning skills. An added outcome will be if formative assessment intervention is associated with better performance in summative assessments.