Assessment as Learning in Medical Education: Feasibility and Perceived Impact of Student-Generated Formative Assessments

Abstract

Background Self-directed learning is a vital competency, desirable to sustain lifelong competencies in health professions education. Contemporary education practices emphasize this aspect of undergraduate medical education through innovative designs of teaching and learning like the flipped classroom and team-based learning. Assessment as learning can be a unique way to inculcate active learning habits. It charges the student to create formative assessments, reinforcing student-centred deep learning, and critical thinking. This study aims to explore, from a learner perspective, the feasibility and perceived learning impact of student generated formative assessments. Methods The study design employed an educational intervention on a cohort of students in the second year of a six-year undergraduate medical program. The study design involved engaging students' in generating assessments using peer-collaboration, tutor facilitation, and feedback as part of a single course curriculum delivery. The exercise was followed by a mixed methods accrual of student perceptions through surveys. Quantitative survey data was analysed on SPSS. Qualitative inputs underwent thematic analysis. Results Students’ overall score of satisfaction with the educational intervention was 84%. On quantitative analysis, this was strongly correlated with scores for ease and impact on a 5-point Likert scale. The themes that emerged from the qualitative analysis, included: prominent characteristics, immediate gains, and expected long-term benefits of their engagement in preparing the formative assessment. Within the characteristics theme, the following categories emerged: individuals’ engagement, effective interdependencies, novelty, and time requirement. The identified immediate gains included increased motivation, and acquisition of knowledge and skills. As for the expected long-term benefits, they included critical thinking and problem solving, and clinical reasoning. Conclusions As a form of assessment associated learning, student-generated assessments are perceived as viable and constructive, and a stimulating educational exercise by the student-authors. In the short term, the activity constituted for the students a fun, challenging opportunity to deep dive into the content, be creative in designing questions, and improve exam-taking skills. Students expected the long-term effects to include enhancement of critical thinking, and inculcation of student-centred attributes of lifelong learning and peer collaboration, vital to the practice of medicine.