The massification of higher education (HE) has led to an unprecedented increase in the number of students in the classrooms, resulting in increased workload for teaching staff, sometimes leading to a great reliance on Multiple Choice Questions (MCQs) examinations with limited feedback provided to students. The central role of feedback in student learning is well recognised; however, it is often one of the poorest scoring items in Student Evaluation of Teaching and Learning (SETL) surveys. Teaching staff also need feedback on the quality of the examinations they set. In response to these key teaching and learning issues, this study developed a computer-aided system for providing meaningful and customised feedback on performance to students and the quality of MCQ assessment items to teaching staff. Furthermore, student and staff perceptions of the effectiveness and value of the feedback to learning were evaluated. Student experiences indicated that the feedback was timely, well presented, easy to understand and would aid revision for further study. In addition, the efficient provision of automatically generated item performance information to teaching staff allowed convenient quality assurance (QA) monitoring, informed staff of the progress of students' learning, and enabled modification of teaching to better support student learning.

These findings have potential implications for teaching in biomedical disciplines and adaptation of Western curriculum innovations in Eastern educational contexts. Further work is needed to confirm and understand any epistemological differences and subsequent implications for learning and teaching in medicine.