What is the educational impact of standards-based assessment in a medical degree?

Many medical courses use standards-based assessment, usually reported by a restricted range of categories, but there is little evidence of its educational impact. This study aimed to evaluate the impact on medical student learning of changing to standards-based assessments reported by distinction, pass or fail.

We carried out a prospectively planned before-and-after study within an undergraduate medical course using a questionnaire to compare motivation and approaches to the study, and a diary to compare the number of hours spent studying.

Questionnaire response rates were 607/752 (81%) before the change and 651/780 (83%) afterwards. Daily diary response rates were 1074/1478 (73%) before, and 1304/1844 (71%) after the change. Deep motive declined with class year during norm-referenced assessments but not with standards-based assessment (r = - 0.11 versus 0.01; P < 0.02). Deep strategy increased significantly under standards-based assessments in students in Years 2 and 3 (mean difference 0.64 [0.08-1.2]; P < 0.05) and Year 6 (mean difference 2.0 [0.03-3.9]; P < 0.05). Competitiveness scores declined as students progressed through the course in both cohorts. Students identified themselves as feeling more like a doctor after the change to standards-based assessments. Time spent studying was largely unchanged but the proportions of wanted discretionary study increased from 64% to 71% for students in Years 2 and 3, and from 65% to 70% for students in Years 4 and 5.

The changes were associated with beneficial effects on deep motive, deep strategy, professional identify and intrinsically motivated study. There were no changes in competitiveness and minimal changes in amount of time spent studying.