This month, the IAMSE Publications Committee review is taken from the article titled Enhancing Examination Success: the Cumulative Benefits of Self-Assessment Questions and Virtual Patient Cases, published in Medical Science Educator (4 August 2022) by Martha P. Seagrave, Lynn Foster-Johnson, John B. Waits, Katherine Margo, and Shou Ling Leong.
Researchers in medical education agree that assessment not only measures learning progress, but it also enhances it. Test-enhanced learning (TEL) is a cognitive phenomenon where the act of retrieving information from memory through testing enhances long-term retention. The TEL approach emphasizes frequent and low-stakes testing in various formats to reinforce learning and improve memory.
The article by Seagrave and colleagues, “Enhancing Examination Success: the Cumulative Benefits of Self-Assessment Questions and Virtual Patient Cases” highlights the relationship between TEL and summative exam performance. This retrospective quantitative study is notable because it analyzed data from twenty medical schools and over 1,600 students in clinical settings. The students in a family medicine clerkship were provided with embedded formative questions in virtual patient cases. Immediate feedback was given to students about their selected answers. At the end of each virtual case, optional clinical case-based multiple-choice questions were available as self-assessment questions (SAQ). The authors reported that student who earned higher scores in formative assessments performed better in the final summative exam. Moreover, completing at least one SAQ was associated with a higher final exam score.
Overall, this multi-institutional study provides valuable insights into how TEL can significantly improve learning outcomes in medical students and predict performance in summative assessment. This research suggests that medical educators should consider including low-stakes formative tests throughout the medical curriculum to ensure student success.
Monzurul Roni, PhD
Teaching Associate Professor
Department of Health Sciences Education and Pathology
University of Illinois College of Medicine