Vanessa Lavallard¹
Bernard Cerutti¹, Julia Sader¹, Mathieu Nendaz^1,2 and Monica Escher^1,2
1 University of Geneva
2 Geneva University Hospitals 

Background:
on-site exams were readily replaced by mandatory online formative tests in our institution, during the COVID-19 pandemic. We investigated the performance of the students, their self-assessed performance, and their perception about the switch from on-site summative to on-line formative assessment. 

Summary of work:
all medical students from Years 2 to 5 (n=648) were included. Settings: every test could be taken online two or three times. Students had been asked to estimate their scores before the actual scores were made available. Detailed feedback was then given at the end of the test-taking window. An online survey was also conducted among students about their perception regarding the reorganization of the curriculum activities during the pandemic. 

Results:
formative assessment tests included 2385 examinees, for 3197 attempts. Among the examinees, 30.8% made at least two attempts. Scores increased significantly at the second attempt (median 9.4, IQR 10.8; scale from 0 to 100), and the duration of the attempt decreased (median -31.0 min, IQR 48.0 min). More than half of examinees (54.6%) underestimated their scores, with a higher proportion of women when compared to men, while performers tended to overestimate their scores. A large majority of students (87.9%) approved the switch to online formative tests. Students mostly reported a decreased level of stress, but also a decrease in motivation for learning. 

Conclusions:
medical students welcomed the switch from on-site summative to on-line formative assessment. Although they seemed to benefit from detailed feedback for a second test attempt, a relatively low proportion of them took this opportunity. This might be related to their reported decreased motivation for learning. 

Take-home message:
a switch to remote assessment is not a simple change of format, but a change of paradigm, in which side effects should be carefully monitored. 

References (maximum three) 

Birch E, de Wolf M. A novel approach to medical school examinations during the COVID-19 pandemic. Med Educ Online. 2020;25(1):1785680. 32594865 10.1080/10872981.2020.1785680 7482713 

Stoehr F, Muller L, Brady A, Trilla A, Mahringer-Kunz A, Hahn F, Duber C, Becker N, Worns A, Chapiro J, Hinrichs JB, Akata D, Ellmann S, Huisman M, Koff D, Brinkmann S, Bamberg F, Zimmermann O, Traikova NI, Kloeckner, R. How COVID-19 kick-started online learning in medical education-The DigiMed study. PLoS One. 2021; 16(9), e0257394. https://doi.org/10.1371/journal.pone.0257394 

Jessica Lees¹
Kim Allison¹, Tandy Hastings-Ison¹ and Karen Donald¹
1 The University of Melbourne

Background
Health professional education (HPE) focusses on structured teaching and practice of technical and non-technical skills. Increasingly, there is a pedagogical shift towards an approach that develops self-aware, self-regulated and independent thinking future clinicians. Interest in ePortfolio adoption in HPE has been on the rise because of the implications of ePortfolio on developing self-regulated learning and on student agency. 

Summary of work 
The Doctor of Physiotherapy Program at the University of Melbourne underwent a systematic review and reform between 2018-2020, resulting in a refreshed program that included the embedding of programmatic e-Portfolio across the three-year program. The introduction of ePortfolios was scaffolded by staff and student training in self-regulated learning, self- authorship, and the ePortfolio platform as well as assessment and mentoring. 

Results
The first two-years of the program have been delivered and the success and challenges of the approach closely monitored. Training and mentoring sessions indicate that students have greater capacity for self-authorship and self-regulated learning. Students struggled with the concepts of self- regulated learning, self- authorship and the use of ePortfolios to develop these skills. 

Discussion
This study explores the use of ePortfolios to support self-regulated learning and self-authorship in Physiotherapy education. Our experience describes multiple challenges to this approach. To make sense of our findings, we will make comparisons to the literature related to the use of ePortfolios in HPE and suggest solutions. 

Conclusion
The study will be of interest to educators who are considering or who have implemented ePorfolios in HPE. 

Take-home messages
Building skills in self-authorship and self-regulation is important in HPE and ePortfolios lend themselves to developing these skills however introduction of ePortfolio is not without its challenges and needs to be well scaffolded 

Formal evaluation of our approach and student experiences is planned for the next stage of our study 

References (maximum three) 

Batson, T., Coleman, K. S., Chen, H. L., Watson, C. E., Rhodes, T. L., & Harver, A. (Eds.). (2017) Field guide to eportfolio. Washington, DC: Association of American Colleges and Universities 

Nguyen, L., & Ikeda, M. (2015). The effects of ePortfolio-based learning model on student self-regulated learning. Active Learning In Higher Education, 16(3), 197-209. 

Kristie Matthews^1,2,3
Terry Haines^1,2
1 Monash University, School of Primary and Allied Health Care
2 National Centre for Healthy Ageing
3 Peter MacCallum Cancer Centre

The Monash University Student Telehealth Program enables allied health students to practise person-centred health-coaching via telehealth with volunteers from the community. All students complete pre-learning and assessment online, including three occasions of scaffolded peer-peer student role-plays. 

176 students completed the Student Telehealth Program during 2021-2022. Students were provided with mock-participant scenarios on which to base their peer-peer telehealth role-play. The objective was for the student health practitioner to identify the health and wellbeing priorities and goals of the student playing the mock-participant. Afterwards, students completed a written self-reflection of their learning guided by the Driscoll reflective model(1). Qualitative content analysis of de-identified self-reflection submissions was undertaken to examine student learning and actions from completing progressive mock-telehealth interactions. 

Analysis revealed students used the reflective process to self-identify and pursue growth opportunities that aligned with the objectives of the program. Students expressed increasing confidence in delivering health-related communication using telehealth, in their ability to build rapport, and in clinical decision making. In their role as the mock-participant, students were able to reflect on and apply strategies for enhanced person-centred care delivery. 

Students were able to use a reflective framework to progressively identify learning needs and self-report improvement in applied skills. Although teacher facilitated reflective practice is commonly used in simulation-based education(2), this analysis shows the potential for student led reflection. This outcome furthers the position that assessment for learning is a beneficial approach to foster student-directed and student-centred learning(3). 

A scaffolded assessment for learning strategy using peer-peer role-play and self-reflection has enabled students to develop useful clinical skills in preparation for authentic telehealth interactions with community participants. 

Using repeated peer-peer role-play with self-reflection as an assessment for learning strategy can enable students to articulate their learning needs and apply actions for growth. 

References (maximum three)