Katie Wardle¹
Emma Kelley¹, Victoria Cowling¹ and Sarah Bennett¹
1 UCL Medical School 

Background
E-learning has been shown to be an effective tool in medical education (1). Case of the Month (COTM) is an e-learning formative assessment which runs in Year 6 at UCL Medical School. Each interactive case asks questions surrounding a patient’s journey integrating learning about professionalism and the challenges of clinical practice. Students complete three cases annually within the Virtual Learning Environment. Cases are marked by trained clinicians who provide personalised feedback. 

Summary of work
For Year 6 students in 2022-23, we compared their written and practical summative results with: a) COTM engagement, using the time taken to complete quizzes, and b) COTM performance, using average score for three cases. We aimed to identify if engagement and performance in Year 6 COTM predicts summative results. 

Results 
We found a subtle positive correlation between COTM engagement and summative results, with a gradual increase in summative results for students spending longer on each case. We found a similar positive correlation between COTM performance and summative results. 

Discussion
Students report anecdotally that COTM is a useful tool in preparing for summative assessments and clinical practice. However, this was not strongly evident in this quantitative research project and positive correlations found were not as significant as we had anticipated. Data also showed many outliers, some of whom had been identified as students needing additional support. 

Conclusions

Whilst our results were not as significant as we had expected, we have found from feedback that students do find COTM useful. It continues to offer a good opportunity to identify students needing support. 

Implications for further research 
Further qualitative research will be helpful to explore how students use this e-learning resource and how much they value it in their preparation for summative assessments and future clinical practice. 

References (maximum three) 

1. Leisi Pei & Hongbin Wu (2019) Does online learning work better than offline learning in undergraduate medical education? A systematic review and meta-analysis, Medical Education Online, 24:1, DOI: 10.1080/10872981.2019.1666538 

Abdulaziz Alothman
Matt Homer and Gemma Traviss-Turner


Background
Assessment is considered a key indicator of student learning. Traditionally, students are assessed mainly to measure their level of knowledge and skills to ascertain whether they have met the minimal requirements established by the educational institution. As the concept of student-centred education has become more popular, the idea of formative assessment (FA), also known as “assessment for learning” (AfL), has been on the rise. Identifying the FA components that consistently produce high-quality assessment systems would allow the development and implementation of high-quality FA. 

Summary of work
A scoping review explored the available literature concerning FA design and implementation. The search terms were: formative assessment or assessment for learning (implementation or application), medical and undergraduate. The search was limited to Titles and Abstracts and those published in English. The ‘advanced search’ option was used to combine search terms in seven databases: PubMed, Web of Science, and Ovid (for the following databases: Embase, Global Health, MEDLINE, and PsycINFO). Each included article’s reference list was manually searched for other papers that fulfilled the scoping review criteria. 

Results and Discussion
Only 47 of the 339 publications that the search turned up met the inclusion criteria. The analysis of these articles found that the following were the common critical components required for developing high-quality FAs: enabling environment; creating effective classroom discussions; faculty and student training; commitment from institutions to support FA activities; creating a question bank; embedding in the instructional process; providing specific, timely, and ongoing feedback; activating students as instructional resources for one another; activating students as the owners of their learning;and receiving feedback from stakeholders to inform the development of subsequent implementations. 

Conclusion
The implementation of high-quality formative assessment is a multifaceted process involving several factors that collectively influence the assessment’s overall quality. 

References (maximum three) 

The findings of this scoping review propose a set of components that, if employed appropriately, could assist educators in implementing valid, high-quality FA. 

To achieve high-quality FA, each factor should be taken into account, appropriately used, and professionally implemented during the implementation process. 

Al-Wassia, R., Hamed, O., Al-Wassia, H., Alafari, R. and Jamjoom, R. 2015. Cultural challenges to implementation of formative assessment in Saudi Arabia: An exploratory study. Medical Teacher. 37(S1), pp.S9–S19. 

Black, P. and Wiliam, D. 2009. Developing the theory of formative assessment. Educational Assessment, Evaluation and Accountability. 21(1), pp.5–31. 

Schellekens, L.H., Bok, H.G.J., de Jong, L.H., van der Schaaf, M.F., Kremer, W.D.J. and van der Vleuten, C.P.M. 2021. A scoping review on the notions of Assessment as Learning (AaL), Assessment for Learning (AfL), and Assessment of Learning (AoL). Studies in Educational Evaluation. 71, p.101094. 

Sahar Mohammed¹
Moune Jabre¹, Stella Major¹, Liam Fernyhough¹, Amine Rakab¹ and Thurayya Arayssi¹

1 Weill Cornell Medicine-Qatar 

Peer-assisted learning (PAL) has been recognized as an effective approach to promoting a safe and inclusive learning environment that enhances students' confidence and supports success in parallel to faculty-based teaching and assessment [1]. In this study, we implemented a pilot program to prepare senior medical students (MS) to utilize PAL for formative assessment of learners' clinical skills using a multi-stage training. At our institution, junior MS learn physical exam skills through didactics and deliberate practice with formative assessment facilitated by standardized patients (SPs) who have undergone advanced training on the physical exam technique and assessment. 

We invited 52 senior MS to serve as formative assessors, 14 (27%) expressed interest, and 8 (15%) have completed the training program to date. Through this program, senior MS learned and demonstrated the necessary skills to serve as peer facilitators for formative assessment, including adult learning theories, professionalism, and communication skills, which we validated to ensure their skill competence and understanding of the assessment process. Initially, senior MS observed faculty assessing learners prior to themselves serving as the assessors under faculty supervision. The MS were evaluated on their professionalism, aptitude, and ability to motivate learners through iterative performance feedback until deemed competent to function independently. 

Our preliminary evaluation data indicates this program was well-received as 95% of the senior MS expressed confidence to function independently. On average, the training required 6 hours of dedicated faculty and MS time with variability depending on the amount of iterative practice and feedback sessions needed to achieve independence. Faculty were satisfied with the provision of consistent quality formative assessment to learners. This training program provides high-quality PAL for assessment of clinical skills in a positive and standardized environment. The success warrants an opportunity for future research on utilizing PAL for clinical skills and MS as assessors. 

References (maximum three) 

1.Burgess A, McGregor D, Mellis C. Medical students as peer tutors: a systematic review. BMC Med Educ. 2014; https://doi.org/10.1186/1472-6920-14-115 

2.Yu TC, Wilson NC, Singh PP, Lemanu DP, Hawken SJ, Hill AG. Medical students-as- teachers: a systematic review of peer-assisted teaching during medical school. Adv Med Educ Pract. 2011; https://doi.org/10.2147/AMEP.S14383 

3.Freret T, Rana J, Schwartzstein RM, et al. Twelve tips for implementation of “student-as- teacher” programs. Med Teach. 2017;https://doi.org/10.1080/0142159X.2017.1333591