Enhancing Examination Success: the Cumulative Benefits of Self-Assessment Questions and Virtual Patient Cases

Area of Science:

• Medical Education Research
• Digital Learning Environments
• Formative Assessment Strategies

Background:

• Previous research on virtual patient cases (VPCs) and formative assessments is limited to single institutions.
• Studies often focus on specific clinical skills or knowledge areas, lacking a broader perspective.
• There is a need to understand the combined impact of VPCs and self-assessment questions (SAQs) in a multi-institutional setting.

Purpose of the Study:

• To investigate the distinct and cumulative effects of VPC formative assessments and optional SAQs on student exam performance.
• To augment current understanding of the learning benefits derived from feedback-rich virtual learning environments.
• To conduct a large-scale, multi-institutional study to validate findings across diverse educational contexts.

Main Methods:

• A correlational study involving 1,692 medical students across 20 institutions during the 2014-2015 academic year.
• Utilized an online curriculum featuring family medicine VPCs, embedded formative assessments, and context-rich SAQs.
• Employed mixed-effects modeling to analyze the relationship between assessment engagement and final exam scores.

Main Results:

• Higher performance on VPC formative assessments correlated with higher final exam scores.
• Completion and higher scores on associated SAQs further enhanced examination performance.
• SAQ completion provided additional performance benefits beyond engagement with VPC formative assessments alone.

Conclusions:

• This multi-institutional study confirms the positive impact of VPC formative assessments and SAQs on medical student exam performance.
• Optional SAQs offer a significant added benefit to learning when integrated with VPCs.
• Findings suggest future research into the broader impact of formative assessments, optimal integration of VPCs and SAQs, and effects on clinical performance.