Progress testing: critical analysis and suggested practices

Educators have long lamented the tendency of students to engage in rote memorization in preparation for tests rather than engaging in deep learning where they attempt to gain meaning from their studies. Rote memorization driven by objective exams has been termed a steering effect. Progress testing (PT), in which a comprehensive examination sampling all of medicine is administered repeatedly throughout the entire curriculum, was developed with the stated aim of breaking the steering effect of examinations and of promoting deep learning. PT is an approach historically linked to problem-based learning (PBL) although there is a growing recognition of its applicability more broadly. The purpose of this article is to summarize the salient features of PT drawn from the literature, provide a critical review of these features based upon the same literature and psychometric considerations drawn from the Standards for Educational and Psychological Testing and provide considerations of what should be part of best practices in applying PT from an evidence-based and a psychometric perspective.