Effect of online formative assessment on summative performance in integrated musculoskeletal system module

BACKGROUND The impact of web-based formative assessment practices on performance of undergraduate medical students in summative assessments is not widely studied. This study was conducted among third-year undergraduate medical students of a designated university in Malaysia to compare the effect, on performance in summative assessment, of repeated computer-based formative assessment with automated feedback with that of single paper-based formative assessment with face-to face feedback. METHODS This quasi-randomized trial was conducted among two groups of undergraduate medical students who were selected by stratified random technique from a cohort undertaking the Musculoskeletal module. The control group C (n = 102) was subjected to a paper-based formative MCQ test. The experimental group E (n = 65) was provided three online formative MCQ tests with automated feedback. The summative MCQ test scores for both these groups were collected after the completion of the module. RESULTS In this study, no significant difference was observed between the mean summative scores of the two groups. However, Band 1 students from group E with higher entry qualification showed higher mean score in the summative assessment. A trivial, but significant and positive correlation (r(2) = +0.328) was observed between the online formative test scores and summative assessment scores of group E. The proportionate increase of performance in group E was found to be almost double than group C. CONCLUSION The use of computer based formative test with automated feedback improved the performance of the students with better academic background in the summative assessment. Computer-based formative test can be explored as an optional addition to the curriculum of pre-clinical integrated medical program to improve the performance of the students with higher academic ability.