Assessment steers learning down the right road: impact of progress testing on licensing examination performance

Area of Science:

• Medical Education
• Educational Psychology

Background:

• Assessment is often seen as a driver of learning, but typically as an undesirable outcome.
• Previous research indicated formative assessments enhance learning at the experimental level.
• Curriculum-level benefits of assessment strategies remained largely undemonstrated.

Purpose of the Study:

• To evaluate the impact of implementing progress tests, a form of periodic formative assessment, at the curriculum level.
• To determine if progress tests could enhance overall student learning and performance in medical education.
• To identify if progress tests could help identify students needing remediation.

Main Methods:

• McMaster University adopted progress testing in 1992-1993 following poor national licensing examination results.
• Progress tests provide objective, cumulative feedback to students.
• The study analyzed examination scores and failure rates before and after the implementation of progress tests.

Main Results:

• Introduction of progress tests led to an immediate increase of approximately 0.5 standard deviation in examination scores.
• A consistent upward trend in student performance was observed after adopting progress tests.
• The failure rate on the national licensing examination decreased significantly from 19% to 4.5% immediately following implementation.

Conclusions:

• Periodic formative assessment, specifically progress testing, demonstrates significant positive effects at the curriculum level.
• Progress testing is an effective strategy for enhancing medical student learning and improving examination outcomes.
• The adoption of progress tests contributed to a substantial reduction in student failure rates on high-stakes examinations.