Formative Assessments Predict Performance and Promote a Positive Learning Environment

Abstract

At Texas Tech University Health Sciences Center School of Medicine, our curriculum begins with a rigorous and fast‐paced Clinically Oriented Anatomy course. Over the past four years, we have increased and improved the use of formative quizzes and exams to promote higher learning and performance outcomes, clarify examination expectations, and reduce student stress. Prior to starting our curriculum students are offered the opportunity to take a 25 question comprehensive formative pre‐test that previews examination content and USMLE vignette style questions. In the past year, we found that 93% of the incoming class utilized this voluntary resource. An average score of 23% on this pre‐test is consistent with a lack of familiarity of incoming students with human anatomy. To evaluate the effectiveness of our curriculum to bridge this informational gap, we provide students with two formative assessments (practice practical and practice written exam) prior to each summative exam. Computer based laboratory practice exams use digital images of prosected cadavers while didactic exams encompass a range of first, second and third order questions. Post‐assessment question/answer rationales provide students with immediate feedback to help identify areas of strength and weakness. Using this formative assessment approach, we have investigated the ability of formative assessments to predict exam performance and identify “at risk” students early in the course (i.e. after taking the first formative practice exam). Analysis of formative assessment data revealed a strong correlation with graded exam performance (p values ranging from 0.01–0.001 and r values from 0.44–0.70). Furthermore, overall graded summative exams correlate strongly with NBME performance (p = 0.001 and r = 0.92). Indicative of a successful educational experience, students scored an average of 233% higher on the repeat post‐course formative exam. Furthermore, the student’s perception of these formative assessments is very favorable and increases each year. In the past year, we had significantly fewer “at risk” students, and NBME performance was a record high. Thus, we find that formative assessments improve the educational experience, boost exam performance, and reduce student stress.Support or Funding Information(Sponsored by the Department of Medical Education at the TTUHSC SOM.)This study is approved by TTUHSC‐QIRB (approval#17008)