Students' Perception of Formative Assessment as an Instructional Tool in Competency-Based Medical Education: Proposal for a Proof-of-Concept Study

Background: In competency-based medical education (CBME), "Assessment for learning" or "Formative Assessment" (FA) plays a key role in augmenting student learning. FAs help students to measure their progress over time, enabling them to proactively improve their performance in summative assessments. FAs also encourage students to learn in a way where they address their knowledge gaps and gaps in their conceptualization of the subject matter. The effectiveness of an FA, as a learning and development instrument, relies on the degree of student involvement in the corresponding educational intervention's design and implementation. The extent of students' engagement in FA can be evaluated by appraising their perception regarding the educational intervention itself. Objective: This proof-of-concept study aims to develop a systemic understanding of a Formative Assessment as an Instructional Tool (FAIS) implemented in a biochemistry course in the Basic Medical Sciences component of an undergraduate entry, CBME. Methods: The educational intervention in question is an FAIS, which is implemented in a biochemistry course in the first semester of a 6-year bachelor of medicine, bachelor of surgery program. When developing the FAIS, each area of knowledge, skills, and attitudes were considered. Assessment formats are developed per Miller's learning pyramid. This multiphase study is meant to rely on a convergent mixed methods design, where qualitative and quantitative data are independently collected and analyzed. Thereafter, the outputs of analyses are systematically merged using joint display analysis process. Qualitative data are collected through a focus group session that captures the students' perception toward the FAIS. Data collection, integral to this focus group session, is exploratory. The inductive qualitative data analysis follows Braun and Clarke's 6-step framework. The quantitative component of this study revolves around investigating the effect of the FAIS on the course's summative assessment. The summative assessment performance of the 71 students, enrolled in the FAIS cohort, will be compared to that of the students in the non-FAIS cohort. The total duration of the proposed multiphase research study is 6 months. Results: This proposed multiphase study is expected to showcase, from a systemic perspective, the effectiveness of the respective educational intervention. It will shed light on the participating students' attitudes in relation to the usefulness of FA in achieving competency goals and in fostering self-directed learning. The proposed study could also uncover the hypothesized association between the FA intervention and enhanced performance in summative assessments. Conclusions: Our findings will generate evidence regarding the application of FAs, which can be leveraged by other medical educators in contexts similar to those under investigation.