A Second Chance for Learning and Wellness

Assessments are not only tools for measuring mastery of medical knowledge but also powerful promoters of learning and retention. 1,2 However, high-stakes assessments are associated with anxiety and psychological distress in medical students. 3 We describe and present preliminary outcomes for a novel preclinical assessment approach (second-chance quizzing [SCQ]), grounded in principles of assessment for learning and test-enhanced learning, 4,5 but also designed to promote student well-being. The University of Michigan Medical School (UMMS) preclinical curriculum is 1 year with pass–fail grading and quizzes approximately every other week. With the matriculating class of 2019, UMMS initiated the SCQ system, wherein students take a mandatory first quiz during a flexible weekend testing window via ExamSoft. The following Monday, all students are offered the optional SCQ, blueprinted similarly to the first quiz. The higher of the 2 quiz scores contributes to the student’s overall cumulative course grade. The number of students taking the SCQs, student testing behaviors, student performance, and psychometric data were recorded by ExamSoft’s built-in functionalities. End-of-course evaluations contain questions about the SCQ system, including perceived impact on wellness, how students strategized between the 2 available quizzes (2020–2021), and whether these assessments provided additional opportunities for learning and/or to demonstrate mastery of course content. Descriptive analyses have been conducted to understand students’ usage and impact of SCQs. These initial findings will be further explored in the following ways: predictors of SCQ usage (such as student performance) will be examined via logistic regression and ANCOVA and the student-selected testing window compared with pre-SCQs years and between students who engage with SCQs and those who do not will be analyzed by chi-square testing. Between August 2019 and October 2020, 8 courses offering a combined 24 SCQs were completed in their entirety: 20 pairs of quizzes within 6 courses (2019–2020, [n = 177 students]) and 4 pairs of quizzes within 2 courses (2020–2021 [n = 168 students]). The majority of students opted to complete the SCQ—ranging from 84 to 145 students (M = 118.54, SD = 18.67). In 2019–2020, 100% of students completed at least 2 SCQs. Students engaged with 13 SCQs on average—with an average of 8 contributing to their course grade. Overall assessment performance is comparable with previous cohorts. SCQs overall show a median score increase on an individual quiz of only 2.37%. On the 2019–2020 course evaluation, 86.8% of students reported that SCQs improved their wellness although 2.13% reported a decrease. 64.51% felt the SCQs enhanced their learning of material. On the preliminary 2020–2021 evaluations, more than half of students reported using SCQs primarily as practice questions. The moderate score increase between the initial quiz and SCQ is interesting in light of the positive wellness outcomes reported by the students. Our preliminary data suggest that SCQs promote both well-being and learning without compromising the need to measure the attainment of mastery. The 2-quiz assessment process appears to be effective in bridging assessment of and assessment for learning in 1 consolidated program of assessment. Areas for future study include investigating demographic differences in the utilization of SCQs, the impact of these quizzes on long-term retention of knowledge, and quantification of the impact on student wellness using validated well-being scales. Given the heightened appreciation of the detrimental impact of medical education on student well-being, new and impactful strategies to address this national issue are sorely needed. To the best of our knowledge, this is one of the first studies using a 2-quiz assessment process as a strategy to support both learning and well-being

Anxiety · Curriculum · Educational measurement · Mastery Learning · Mathematics education · Medical education · Pedagogy · Clinical Reasoning and Diagnostic Skills · Computer Science · Innovations in Medical Education · Medical Education and Admissions · Medicine · Psychology · Artificial Intelligence

• Classroom Assessment and Grading to Assure Mastery

  James P Lalley, J Ronald Gentile•Theory Into Practice•2009

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