Grades in formative workplace-based assessment: a study of what works for whom and why.

Abstract:

CONTEXT:Grades are commonly used in formative workplace-based assessment (WBA) in medical education and training, but may draw attention away from feedback about the task. A dilemma arises because the self-regulatory focus of a trainee must include self-awareness relative to agreed standards, which implies grading. OBJECTIVES:In this study we aimed to understand the meaning which medical students construct from WBA feedback with and without grades, and what influences this. METHODS:Year 3 students were invited to take part in a randomised crossover study in which each student served as his or her own control. Each student undertook one WBA with and one without grades, and then chose whether or not to be given grades in a third WBA. These preferences were explored in semi-structured interviews. A realist approach to analysis was used to gain understanding of student preferences and the impact of feedback with and without grades. RESULTS:Of 83 students who were given feedback with and without grades, 65 (78%) then chose to have feedback with grades and 18 (22%) without grades in their third WBA. A total of 24 students were interviewed. Students described how grades locate their performance and calibrate their self-assessment. For some, low grades focused attention and effort. Satisfactory and high grades enhanced self-efficacy. CONCLUSIONS:Grades are concrete, powerful and blunt, can be harmful and need to be explained to help students create helpful meaning from them. Low grades risk reducing self-efficacy in some and may encourage others to focus on proving their ability rather than on improvement. A metaphor of the semi-permeable membrane is introduced to elucidate how students reduced potential negative effects and enhanced the positive effects of feedback with grades by selective filtering and pumping. This study illuminates the complexity of the processing of feedback by its recipients, and informs the use of grading in the provision of more effective, tailored feedback.

journal_name

Med Educ

journal_title

Medical education

authors

Lefroy J,Hawarden A,Gay SP,McKinley RK,Cleland J

doi

10.1111/medu.12659

subject

Has Abstract

pub_date

2015-03-01 00:00:00

pages

307-20

issue

3

eissn

0308-0110

issn

1365-2923

journal_volume

49

pub_type

杂志文章,随机对照试验
  • Medical education accreditation in Mexico and the Philippines: impact on student outcomes.

    abstract:CONTEXT:Accreditation of medical education programmes is becoming increasingly prevalent worldwide, but beyond the face validity of these quality assurance methods, data linking accreditation to improved student outcomes are limited. Mexico and the Philippines both have voluntary systems of medical education accreditat...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.2011.04212.x

    authors: van Zanten M,McKinley D,Durante Montiel I,Pijano CV

    更新日期:2012-06-01 00:00:00

  • The superiority of three-dimensional physical models to two-dimensional computer presentations in anatomy learning.

    abstract:BACKGROUND:Although several studies (Anat Sci Educ, 8 [6], 525, 2015) have shown that computer-based anatomy programs (three-dimensional visualisation technology [3DVT]) are inferior to ordinary physical models (PMs), the mechanism is not clear. In this study, we explored three mechanisms: haptic feedback, transfer-app...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.13683

    authors: Wainman B,Wolak L,Pukas G,Zheng E,Norman GR

    更新日期:2018-11-01 00:00:00

  • Critical performance analysis of rotating resident doctors in Iraq.

    abstract::The present study was undertaken to evaluate the competence of rotating residents in handling clinical problems, falling under the purview of the major clinical disciplines, which they come across during their routine work. Three hundred and one rotating residents (55% of the total) who graduated in June 1981 from the...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1983.tb01124.x

    authors: Al-Chalabi TS,Al-Na'ama MR,Al-Thamery DM,Alkafajei AM,Mustafa GY,Joseph G,Sugathan TN

    更新日期:1983-11-01 00:00:00

  • Edgar Dale's Pyramid of Learning in medical education: Further expansion of the myth.

    abstract:INTRODUCTION:A mythical Pyramid of Learning, usually attributed to Edgar Dale (or the National Training Laboratories [NTL]) and giving student learning retention rates, has been cited in a wide range of educational literature. A 2013 literature review indicated that medical education literature similarly cites this Pyr...

    journal_title:Medical education

    pub_type: 杂志文章,评审

    doi:10.1111/medu.13813

    authors: Masters K

    更新日期:2020-01-01 00:00:00

  • Learning to value ethnic diversity--what, why and how?

    abstract:INTRODUCTION:Learning to value ethnic diversity is the appreciation of how variations in culture and background may affect health care. It involves acknowledging and responding to an individual's culture in its broadest sense. This requires learning the skills to negotiate effective communication, a heightened awarenes...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1046/j.1365-2923.1999.00474.x

    authors: Kai J,Spencer J,Wilkes M,Gill P

    更新日期:1999-08-01 00:00:00

  • Teaching and learning away from the medical centre. The potential contribution of new technology to continuing medical education in the United Kingdom (working document).

    abstract::Continuing education should be convenient, relevant, individualized, systematic and include means of assessment. Educational technology provides the link between teaching and learning; it should accommodate the essential interactions between learner, instructor, environment and material. Media in open learning systems...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1985.tb01328.x

    authors: Cairncross RG

    更新日期:1985-07-01 00:00:00

  • Clinical problem solving: the beginning of the process.

    abstract::The diagnostic thinking process is often described as one of hypothesis generation and testing. Yet descriptions of the clinical problem solver's thinking prior to generation of the first diagnostic hypothesis are lacking. This paper reports a study of this phase in students, house officers and registrars. Theories of...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1982.tb01214.x

    authors: Gale J,Marsden P

    更新日期:1982-01-01 00:00:00

  • Self-explanation in learning clinical reasoning: the added value of examples and prompts.

    abstract:CONTEXT:Recent studies suggest that self-explanation (SE) while diagnosing cases fosters the development of clinical reasoning in medical students; however, the conditions that optimise the impact of SE remain unknown. The example-based learning framework justifies an exploration of students' use of their own SEs combi...

    journal_title:Medical education

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/medu.12623

    authors: Chamberland M,Mamede S,St-Onge C,Setrakian J,Bergeron L,Schmidt H

    更新日期:2015-02-01 00:00:00

  • Are we at risk of groupthink in our approach to teamwork interventions in health care?

    abstract:CONTEXT:The incidence of medical error, adverse clinical events and poor quality health care is unacceptably high and there are data to suggest that poor coordination of care, or teamwork, contributes to adverse outcomes. So, can we assume that increased collaboration in multidisciplinary teams improves performance and...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.12943

    authors: Kaba A,Wishart I,Fraser K,Coderre S,McLaughlin K

    更新日期:2016-04-01 00:00:00

  • Does selection pay off? A cost-benefit comparison of medical school selection and lottery systems.

    abstract:CONTEXT:Resources for medical education are becoming more constrained, whereas accountability in medical education is increasing. In this constrictive environment, medical schools need to consider and justify their selection procedures in terms of costs and benefits. To date, there have been no studies focusing on this...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.13698

    authors: Schreurs S,Cleland J,Muijtjens AMM,Oude Egbrink MGA,Cleutjens K

    更新日期:2018-12-01 00:00:00

  • Longitudinal assessment of the impact of the use of the UK clinical aptitude test for medical student selection.

    abstract:CONTEXT:Medical schools are increasingly using novel tools to select applicants. The UK Clinical Aptitude Test (UKCAT) is one such tool and measures mental abilities, attitudes and professional behaviour conducive to being a doctor using constructs likely to be less affected by socio-demographic factors than traditiona...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.13082

    authors: Mathers J,Sitch A,Parry J

    更新日期:2016-10-01 00:00:00

  • Linked tutorial teaching by teleconference and videocassette.

    abstract::A system for linked tutorial teaching involving several groups of students at different locations has been introduced successfully into the teaching resources of the University of Wales College of Medicine. It utilizes standard telephone equipment supplemented by specially prepared videocassette material. The results ...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1985.tb01344.x

    authors: Hibbard BM,Marshall RJ,Evans RW,Duthie HL

    更新日期:1985-09-01 00:00:00

  • Advanced training in general practice in the UK for overseas postgraduates.

    abstract::The strengths of general practice in the UK as a training environment for overseas doctors intending to implement the World Health Organization strategy 'Health for All by the Year 2000' in primary care are identified. A course of advanced training for teachers and administrators of primary care is described and evalu...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1991.tb00027.x

    authors: al-Bashir M,Bundred PE,Stanley IM

    更新日期:1991-01-01 00:00:00

  • Online testable concept maps: benefits for learning about the pathogenesis of disease.

    abstract:CONTEXT:Concept maps have been used to promote meaningful learning and critical thinking. Although these are crucially important in all disciplines, evidence for the benefits of concept mapping for learning in medicine is limited. METHODS:We performed a randomised crossover study to assess the benefits of online testa...

    journal_title:Medical education

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/medu.12422

    authors: Ho V,Kumar RK,Velan G

    更新日期:2014-07-01 00:00:00

  • 'More shades of grey in my answers': an interview study revisiting attitude erosion during clerkships.

    abstract:CONTEXT:Small declines in patient-centred attitudes during medical education have caused great concern. Although some of the self-report scales applied have solid psychometric foundations, validity evidence for the interpretation of attitude erosion during clerkships remains weak. OBJECTIVES:We sought to address this ...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.12102

    authors: Bombeke K,Symons L,Mortelmans D,Debaene L,Schol S,Van Royen P,De Winter B

    更新日期:2013-05-01 00:00:00

  • 'I will never ever go back': patients' written narratives of health care communication.

    abstract:CONTEXT:Although communication with patients is essential to health care, education designed to develop patient-centred communication often ignores patients' voices. Patient stories may offer a means to explore patient experiences to inform patient-centred communication skills education design. OBJECTIVES:Our research...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.13612

    authors: Denniston C,Molloy E,Rees CE

    更新日期:2018-07-01 00:00:00

  • Postgraduate training and career choices: an analysis of the National Physicians Survey in Japan.

    abstract:OBJECTIVES:This study analyses and discusses recent changes in young Japanese doctors' career paths, in terms of their distribution in different types of facilities and specialties, following changes to the postgraduate clinical training system in 2004. METHODS:Data from the National Survey of Physicians, Dentists and...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.2009.03582.x

    authors: Koike S,Ide H,Yasunaga H,Kodama T,Matsumoto S,Imamura T

    更新日期:2010-03-01 00:00:00

  • A preliminary study of the impact of a handover cognitive aid on clinical reasoning and information transfer.

    abstract:OBJECTIVES:To assess the impact of a written cognitive aid on expressed clinical reasoning and quantity and the accuracy of information transfer during resident doctor handover. METHODS:This study was a randomised controlled trial in an academic paediatric intensive care unit (PICU) of 20 handover events (10 events pe...

    journal_title:Medical education

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/medu.12212

    authors: Weiss MJ,Bhanji F,Fontela PS,Razack SI

    更新日期:2013-08-01 00:00:00

  • Interdisciplinary team interactions: a qualitative study of perceptions of team function in simulated anaesthesia crises.

    abstract:OBJECTIVES:We placed anaesthesia teams into a stressful environment in order to explore interactions between members of different professional groups and to investigate their perspectives on the impact of these interactions on team performance. METHODS:Ten anaesthetists, 5 nurses and 5 trained anaesthetic assistants e...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.2007.02971.x

    authors: Weller JM,Janssen AL,Merry AF,Robinson B

    更新日期:2008-04-01 00:00:00

  • The professional attitudes of Nigerian first year medical students.

    abstract::In a study of the development of professional attitudes in medical students, a modified version of the Medical Attitudes Inventory (Harris, 1974) was administered to 141 male and female first year medical students in Lagos, Nigeria. The results show that the students have well-defined attitudes on certain issues and a...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1978.tb01417.x

    authors: Jegede RO

    更新日期:1978-11-01 00:00:00

  • Assessment of students' experiences in technical procedures in a medical clerkship.

    abstract::This study was designed to provide some insight into the manner and degree of students' acquisition of practical skills. One hundred and fifty-two of a total of 166 students in a medical clerkship during the first clinical year answered a questionnaire. The questionnaire contained fifty-eight different laboratory test...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1983.tb00962.x

    authors: Hunskaar S,Seim SH

    更新日期:1983-09-01 00:00:00

  • Do OSCE progress test scores predict performance in a national high-stakes examination?

    abstract:CONTEXT:Progress tests, in which learners are repeatedly assessed on equivalent content at different times in their training and provided with feedback, would seem to lend themselves well to a competency-based framework, which requires more frequent formative assessments. The objective structured clinical examination (...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.12942

    authors: Pugh D,Bhanji F,Cole G,Dupre J,Hatala R,Humphrey-Murto S,Touchie C,Wood TJ

    更新日期:2016-03-01 00:00:00

  • Portfolio-based learning: continuing medical education for general practitioners--a mid-point evaluation.

    abstract::In October 1994 a project was initiated by the General Practice Continuing Medical Education Tutors in the Department of General Practice at Sheffield University. The project sought to evaluate the efficiency (effort expended) and effectiveness (distance travelled) of a model of continuing professional development for...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1997.tb00038.x

    authors: Challis M,Mathers NJ,Howe AC,Field NJ

    更新日期:1997-01-01 00:00:00

  • Performance correlates in a postgraduate psychiatric examination.

    abstract::This paper has reported some aspects of an analysis of the correlates of success in candidates' first attempts at the postgraduate psychiatric examinations of the R.A.N.Z.C.P. These are developed to suggest some attributes which selectors of trainees could take into account. Profitable future areas for research are de...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1981.tb02482.x

    authors: Mellsop G

    更新日期:1981-05-01 00:00:00

  • Predictive validity of the multiple mini-interview for selecting medical trainees.

    abstract:INTRODUCTION:In this paper we report on further tests of the validity of the multiple mini-interview (MMI) selection process, comparing MMI scores with those achieved on a national high-stakes clinical skills examination. We also continue to explore the stability of candidate performance and the extent to which so-call...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.2009.03407.x

    authors: Eva KW,Reiter HI,Trinh K,Wasi P,Rosenfeld J,Norman GR

    更新日期:2009-08-01 00:00:00

  • Teaching medical students about family planning: experiences from a primary health care course in Lagos, Nigeria.

    abstract::In 1979, the College of Medicine, Lagos, Nigeria embarked on a new curriculum, which places more emphasis on primary health care in line with the needs of the country. This paper discusses one aspect of the primary health care course, family planning, which involves teaching a practical subject to a large number of st...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1986.tb01040.x

    authors: Olukoya AA,Oyediran MA

    更新日期:1986-01-01 00:00:00

  • Multiple choice question tests in physiology: a preliminary attempt to apply the minimum pass level.

    abstract::At the mid-term test in Part I Physiology at the University of Zagreb the students (n = 280) were graded by our standard pass level (SPL) arbitrarily set at 54% correct answers (SPL = 0.54). The test consisted of 50 items of the one best answer type. Items were selected from the pool by one examiner to conform, by his...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1994.tb02552.x

    authors: Pokrajac N,Culo F

    更新日期:1994-09-01 00:00:00

  • Ethnography in health professions education: Slowing down and thinking deeply.

    abstract:CONTEXT:Ethnography has been gaining appreciation in the field of health professions education (HPE) research, yet it remains misunderstood. Our article contributes to this growing literature by describing some of the key tensions with which both aspiring and seasoned ethnographers should productively struggle. METHOD...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.14033

    authors: Bressers G,Brydges M,Paradis E

    更新日期:2020-03-01 00:00:00

  • Ethnic and social disparities in performance on medical school selection criteria.

    abstract:CONTEXT:Medical schools in Western societies seek measures to increase the diversity of their student bodies with respect to ethnicity and social background. Currently, little is known about the effects of different selection procedures on student diversity. OBJECTIVES:This prospective cohort study aimed to determine ...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.12536

    authors: Stegers-Jager KM,Steyerberg EW,Lucieer SM,Themmen AP

    更新日期:2015-01-01 00:00:00

  • Evidence-based education: development of an instrument to critically appraise reports of educational interventions.

    abstract:OBJECTIVES:Educational interventions may ultimately impact on patient care as well as affecting individuals' learning. Critical evaluation of educational literature by those involved in designing and developing educational interventions is therefore important. A checklist instrument for critically appraising reports of...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1046/j.1365-2923.1999.00479.x

    authors: Morrison JM,Sullivan F,Murray E,Jolly B

    更新日期:1999-12-01 00:00:00