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An Evaluation of Medical Students' Responses to Structured Exam Feedback from Formative E-Assessments


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Presentation given at the Association for the Study of Medical Education Scientific Meeting in July 2016 in Belfast. This presentation summarises findings from my masters dissertation done for MA in International Education at University of Leicester.

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An Evaluation of Medical Students' Responses to Structured Exam Feedback from Formative E-Assessments

  1. 1. An Evaluation of Medical Students’ Responses to Structured Exam Feedback from Formative E-Assessments Terese Bird, Educational Designer, Leicester Medical School ASME Scientific Meeting 6 Jul 2016 Belfast, Northern Ireland, UK
  2. 2. Leicester Medical School Context
  3. 3. Groupwork Sessions: Learning by Enquiry (Cox et al., 2010) • Students divided into Belbin groups • Same groups meet for every module • Groups work on questions in iPad- workbooks • Answers given the week after or never • Sound process of thinking through to the answer is the point • Junior doctors are “expert guides”
  4. 4. Student study issues • Lecture notes + workbook “answers” = holy canon of notes on iPad • “Revision” happens in the weeks before exams • Concern that study is mainly “remember”
  5. 5. Bloom’s Taxonomy in study
  6. 6. Feedback issues • Feedback is single highest-impact factor in learning (Rowntree, 1987). • NSS feedback scores • End of term is too late Our approach: “Little and often” formative assessments via ExamSoft on iPads
  7. 7. ExamSoft £30 / student / year
  8. 8. Instant answers with additional information
  9. 9. Students log into portal to check progress
  10. 10. Research questions • Do students who engage with the regular formative feedback in the GI unit change their study strategy as a result, and if so in what way(s)? • Do they look at other material they would not have looked at if they hadn’t used the exams? • What new study techniques, if any, did they employ? • Do students who engage with regular formative exam feedback improve learning in “thinking levels” associated with higher elements of Bloom’s Taxonomy? • Does student engagement with regular formative exam feedback enable students’ learning benefits in ways that do not occur when the regular formative exams are not given? • Do students perceive learning benefits enough to engage with structured formative
  11. 11. Examsoft formatives Gastro-Intestinal Unit Autumn 2015 Exam Type When Content Circumstance Session-by-session exams Weekly, from Oct through Dec 2015 Material studied in the past week Exam done in groupwork class sessions, not under exam conditions Christmas 1 Christmas 2 New Year 1 New Year 2 During Christmas break Dec ember 2015–Jan 2016 All questions from session-by-session exams, put together and randomised Four separate exams with the same exam content, offered 4 times throughout Christmas break for self-study whenever students wanted.
  12. 12. Mixed-methods research N=237 Year 2 Gastro-Intestinal Module
  13. 13. How did the formatives change students’ study if at all? • “A mini-revision before the proper revision” – forced earlier study • Uncovered trouble spots which caused them to seek solutions • Back-and-forth communication = feedback loop • Active study
  14. 14. Thinking and learning on higher levels of Bloom’s Taxonomy • If questions were written higher on Bloom’s, students learnt higher on Bloom’s – constructive alignment (Biggs, 1996) • Single Best Answer led to Evaluation and Analysis • Students reacted with Create to using exams in revision • Created document of info on uncovered trouble spots • Created answers when they tested themselves without the multiple-choice “I’m looking for… an explanation for why an answer is the answer. It’s Single Best Answer, there are two that are right, but one’s a better answer.”
  15. 15. Student engagement with formative assessments • 85% of students completed exams in class • 77% of students did at least one outside-of-class exam • Students engaged despite the fact these exams contributed nothing to their official marks
  16. 16. “It’s not clear that I performed better on summatives because of these exams, as the summatives are integrated, but they helped me to learn GI better.” Key words used by students describing the formative exams in module evaluation Winter 2016
  17. 17. Recommendations • Learning objectives and assessments should constructively align “higher on the Bloom’s” (Biggs, 1996) • Explore ways encouraging students to act on feedback received • Advise students regarding their own study: • Active study • Little and often • Throughout the term • Less dependence on writing “definitive” sets of notes
  18. 18. References • Biggs, J. (1996) ‘Enhancing teaching through constructive alignment’, Higher Education, [online] Available from: 96.pdf. • Cox, B., Calder, M. and Fien, J. (2010) Teaching and Learning for a Sustainable Future, [online] Available from: • Rowntree, D. (1987) Assessing Students: How shall we know them?, Revised Ed. London, Kogan Page. Questions? Email me @tbirdcymru on Twitter