Successful learning and teaching of complex pathology concepts and skills involve efficient two way communication between tutor and learner. This is a challenge for large class teaching with limited teacher time and resources. To overcome this challenge, I introduced an electronic student response system in my pathology teaching sessions to fourth year medical students. Following a successful trial in September 2006, the system has been introduced fully into my pathology teaching sessions to monitor and improve student participation, motivation and learning. The system handheld student remote control key pads (www.keepad.com) are integrated into the PowerPoint program by software (www.turningtechnologies.com). Students respond to questions presented in PowerPoint slides including clinical details with either gross or microscopic images asking pathology concepts. Students respond by clicking appropriate buttons on their remotes. The system collects and analyses student responses and presents a graphic display of comprehensive results. The system also provides detailed statistical reports on individual students, groups, whole class and questions. The system has been in use since September 2006 and preliminary data show an overwhelmingly positive student response with a significant improvement in student participation and learning. Major outcomes from the study are:<ul><li>1.Easy recording of student attendance and participation.</li><li>2.Improvements in student attendance, participation and learning.</li><li>3.Instant student assessment with detailed statistical analysis and reporting.</li><li>4.Instant and interactive assessment feedback and learning.</li><li>5.Instant feedback on whole class student learning. Effective assessment tool for the student and instructor.</li><li>6.Student progress monitoring and early intervention.</li></ul> This presentation is an overview of formative assessment, tips and tricks of the student response system and hands on experience using the system effectively to improve student learning.