Melbourne Medical School Collected Works - Theses
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ItemPost-test feedback: knowledge acquisition & learning behaviours( 2015)This study, situated within the conceptual framework of assessment for learning, was motivated by the desire to find a practical way of providing informative and useful post-assessment feedback to medical students. The work was informed by the theories of test-enhanced learning and the principles of good feedback. It employed mixed methods to explore the impact of the study interventions on learning behaviour and knowledge acquisition. Set within an authentic medical educational setting, this study modelled an innovative method for production and distribution of individualised feedback reports following written multiple choice assessment. Year two students in a graduate entry medical program received four modified progress tests during their academic year and were randomised into three feedback groups. Feedback formats were selected to provide information about performance and guidance for learning without requiring release of test questions and answers. All feedback groups received test scores and some form of instruction based elaboration. Two groups were provided with variations of item level verification and instruction based elaboration, while the other group received normative data with general (rather than item level) instruction based elaboration. Outcomes of interest included study diaries, progress test scores, summative examination results, questionnaires and semi-structured interviews. Triangulation of the research data was used to interpret results. Outcomes from this study suggest there was a learning benefit from the test and feedback interventions. It appears that this benefit was achieved through direct interaction with the tests, and through the ability to self-monitor levels of knowledge and evaluate the effectiveness of study activities. Behaviour changes identified as a result of the study interventions included general study prior to tests, increased study following tests and feedback, and altered study behaviours involving different content, techniques and study aids. Of the three feedback types provided in this experiment, feedback consisting of grades, general instruction based elaboration and normative comparison appeared to be most easily interpreted and provided motivation for study, but resulted in inferior performance for students in the lower quartile of the cohort. This experiment demonstrates that it is feasible to produce and distribute individualised post-test feedback reports following paper based clinical vignette MCQ tests within a clinical learning environment. It highlights the potential of regular formative assessment to play an important role in directing focus of study and clarification of expectation of study depth and breadth. Medical students are often considered a relatively homogenous and high achieving cohort, yet results of this study suggest their responses to feedback are influenced both by the type of feedback information provided and the students’ relative ability within their learning cohort.