Although error avoidance during learning appears to be the rule in American classrooms, laboratory studies suggest that it may be a counterproductive strategy, at least for neurologically typical students. Experimental investigations indicate that errorful learning followed by corrective feedback is beneficial to learning. Interestingly, the beneficial effects are particularly salient when individuals strongly believe that their error is correct: Errors committed with high confidence are corrected more readily than low-confidence errors. Corrective feedback, including analysis of the reasoning leading up to the mistake, is crucial. Aside from the direct benefit to learners, teachers gain valuable information from errors, and error tolerance encourages students’ active, exploratory, generative engagement. If the goal is optimal performance in high-stakes situations, it may be worthwhile to allow and even encourage students to commit and correct errors while they are in low-stakes learning situations rather...

Learning from Errors.

Background and Objectives: The Covid-19 pandemic has caused large-scale disruption in almost all educational programs across the world. Planning and rapid implementation of assessment through an online format presents the next set of novel challenges that must be addressed by academic administrations across the globe.
Methods: This cross-sectional study was conducted between March to August 2020 at the Aga Khan University Medical College. Two hundred medical students of year 1 and 2 participated in the study. We describe the planning, processes, and outcomes of online assessments using video communication platforms conducted at a private university in Pakistan. Standardized protocols were written and piloted, extensive training of student, proctors and staff for preparation and conduct of online assessments were developed. Feedback was recorded after each session and suggestions were incorporated in subsequent high-stakes assessments.
Results: A total of three pilot assessments were conducted to identify issues and process refinement. Commercially available lockdown browser and ZOOM were used in the first pilot; 80% of the class was unable to launch lockdown browser and laptops required repeated reload/reboot. For the second pilot assessment, University’s VLE page & MS Teams was trailed. Issues with internet connectivity, VLE page slowdown, and suboptimal recording feature in MS Teams were identified. For the final pilot assessment, phased launching of VLE page with single test item per page was implemented with success. The students reported that attempting the online exam on VLE with ZOOM support was user friendly. Ninety percent of the class was supportive of the continuing with the online assessments.
Conclusion: In order to device an effective protocol for e-assessments conducting multiple trial runs, and incorporating feedback from all stakeholders is a necessity.
doi: https://doi.org/10.12669/pjms.37.4.3948
How to cite this:Fatima SS, Idrees R, Jabeen K, Sabzwari S, Khan S. Online assessment in undergraduate medical education: Challenges and solutions from a LMIC university. Pak J Med Sci. 2021;37(4):945-951. doi: https://doi.org/10.12669/pjms.37.4.3948
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Online assessment in undergraduate medical education: Challenges and solutions from a LMIC university

Programmatic assessment as a concept is still novel for many in clinical education, and there may be a disconnect between the academics who publish about programmatic assessment and the front-line clinical educators who must put theory into practice. In this paper, we clearly define programmatic assessment and present high-level guidelines about its implementation in competency-based medical education (CBME) programs. The guidelines are informed by literature and by lessons learned from established programmatic assessment approaches. We articulate five steps to consider when implementing programmatic assessment in CBME contexts: articulate the purpose of the program of assessment, determine what must be assessed, choose tools fit for purpose, consider the stakes of assessments, and define processes for interpreting assessment data. In the process, we seek to offer a helpful guide or template for front-line clinical educators. We dispel some myths about programmatic assessment to help training programs as they look to design-or redesign-programs of assessment. In particular, we highlight the notion that programmatic assessment is not 'one size fits all'; rather, it is a system of assessment that results when shared common principles are considered and applied by individual programs as they plan and design their own bespoke model of programmatic assessment for CBME in their unique context.

Key considerations in planning and designing programmatic assessment in competency-based medical education.

High-stakes exams including admissions, licensing, and maintenance of certification examinations are commonplace in health professions education. Although exam scores and performance can often serve gate-keeping purposes, the broader goal of health professions education is to foster deep, self-directed, meaningful, motivated learning. Establishing strong support structures that emphasize deep learning and understanding rather than exam scores can be beneficial to preparing learners who have the knowledge base to be excellent practitioners. This article offers guidance that can be used by academic support centres, medical educators, learning specialists, and faculty advisors, or even test-takers, to help learners to balance score achievement and knowledge development, while simultaneously cultivating more efficient and motivated studying and increasingly self-regulated learning. This series of tips details considerations for building academic success supports, fostering a growth mindset, planning efficient and effective studying efforts, utilizing test-enhanced learning strategies, exam-taking skills practice, and other support structures that can help strengthen learning experiences overall.

Twelve tips on guiding preparation for both high-stakes exams and long-term learning.

The COVID-19 pandemic disrupted medical education. In-person classes and clinical rotations were urgently canceled, followed by a historic and unprecedented migration to online teaching. Most medical school courses were not designed to be fully online, and faculty and students are novices in the process. The purpose of this article is to provide recommendations for educators to optimize their approach to online curricular transformation. Mindful teaching online creates presences that set climate and support discourse, establish routines that build practice, model professional expectations, and challenge but support learners.

/pdf/mindful-medical-education-online-rd2v336i9v.pdf

Mindful Medical Education Online.

Programmatic assessment supports the evolution from assessment of learning to fostering assessment for learning and as learning practices. A well-designed programmatic assessment system aligns educational objectives, learning opportunities, and assessments with the goals of supporting student learning, making decisions about student competence and promotion decisions, and supporting curriculum evaluation. We present evidence-based guidance for implementing assessment for and as learning practices in the pre-clinical knowledge assessment system to help students learn, synthesize, master and retain content for the long-term so that they can apply knowledge to patient care. Practical tips are in the domains of culture and motivation of assessment, including how an honour code and competency-based grading system can support an assessment system to develop student self-regulated learning and professional identity, curricular assessment structure, such as how and when to utilize low-stakes and cumulative assessment to drive learning, exam and question structure, including what authentic question and exam types can best facilitate learning, and assessment follow-up and review considerations, such exam retake processes to support learning, and academic success structures. A culture change is likely necessary for administrators, faculty members, and students to embrace assessment as most importantly a learning tool for students and programs.

Twelve tips for embedding assessment for and as learning practices in a programmatic assessment system.

PURPOSE
Applying effective learning strategies to address knowledge gaps is a critical skill for lifelong learning, yet prior studies demonstrate that medical students use ineffective study habits.


METHODS
To address this issue, the authors created and integrated study resources aligned with evidence-based learning strategies into a medical school course. Pre-/post-course surveys measured changes in students' knowledge and use of evidence-based learning strategies. Eleven in-depth interviews subsequently explored the impact of the learning resources on students' study habits.


RESULTS
Of 139 students, 43 and 66 completed the pre- and post-course surveys, respectively. Students' knowledge of evidence-based learning strategies was unchanged; however, median time spent using flashcards (15% to 50%, p < .001) and questions (10% to 20%, p = .0067) increased while time spent creating lecture notes (20% to 0%, p = .003) and re-reading notes (10% to 0%, p = .009) decreased. In interviews, students described four ways their habits changed: increased use of active learning techniques, decreased time spent creating learning resources, reviewing content multiple times throughout the course, and increased use of study techniques synthesizing course content.


CONCLUSION
Incorporating evidence-based study resources into the course increased students' use of effective learning techniques, suggesting this may be more effective than simply teaching about evidence-based learning.

Jennifer Meka

Papers

Twelve tips for embedding assessment for and as learning practices in a programmatic assessment system.

Using instructor-developed study resources to increase evidence-based learning strategies among medical students: A mixed-methods study.