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Background: Active engagement with feedback is crucial for feedback to be effective and improve students' learning and achievement. Medical students are provided feedback on their development in the progress test (PT), which has been implemented in various medical curricula, although its format, integration and feedback differ across institutions. Existing research on engagement with feedback in the context of PT is not sufficient to make a definitive judgement on what works and which barriers exist. Therefore, we conducted an interview study to explore students' feedback use in medical progress testing. Methods: All Dutch medical students participate in a national, curriculum‐independent PT four times a year. This mandatory test, composed of multiple‐choice questions, provides students with written feedback on their scores. Furthermore, an answer key is available to review their answers. Semi‐structured interviews were conducted with 21 preclinical and clinical medical students who participated in the PT. Template analysis was performed on the qualitative data using a priori themes based on previous research on feedback use. Results: Template analysis revealed that students faced challenges in crucial internal psychological processes that impact feedback use, including 'awareness', 'cognizance', 'agency' and 'volition'. Factors such as stakes, available time, feedback timing and feedback presentation contributed to these difficulties, ultimately hindering feedback use. Notably, feedback engagement was higher during clinical rotations, and students were interested in the feedback when seeking insights into their performance level and career perspectives. Conclusion: Our study enhanced the understanding of students' feedback utilisation in medical progress testing by identifying key processes and factors that impact feedback use. By recognising and addressing barriers in feedback use, we can improve both student and teacher feedback literacy, thereby transforming the PT into a more valuable learning tool. van Wijk et al. offer a clear and detailed overview of the barriers students experience using feedback following progress tests, thereby outlining essential steps toward improving their educational value. [ABSTRACT FROM AUTHOR]

The learning benefits of peer assessment and providing peer feedback have been widely reported. However, it is still not understood which learning activities most facilitate the acquisition of feedback skills. This study aimed to compare the effect of a modeling example, i.e., a model that demonstrated how to give feedback, on the acquisition of feedback skills. The participants were second-year bachelor students in pedagogical sciences (N = 111). They were assigned randomly to a "practice condition," in which they practiced giving feedback on oral presentations, or a modeling "example condition," in which a teacher demonstrated how to give feedback on a good and a bad presentation. Students then gave feedback to a presenter in a video (direct feedback measure). One week later, they gave each other peer feedback on oral presentations (delayed feedback measure). On the direct feedback measure, students in the modeling example condition used assessment criteria more often in their feedback, and produced significantly more overall feedback, and significantly more positive and negative judgments than students in the practice condition. There was no significant difference in the amount of elaboration and feed-forward between the two conditions. On the delayed feedback measure, there were no significant differences between the two experimental conditions. The results suggest that, at least in the short term, a modeling example can stimulate the use of assessment criteria and judgments in feedback. The results and implications for future research and practice are discussed.

Comprehension of physiology is essential for development of clinical reasoning. However, medical students often struggle to understand physiological concepts. Interactive learning through Peer instruction (PI) is known to stimulate students' comprehension, but its relative efficacy and working mechanisms remain to be elucidated. In this study, we investigated if and how PI could optimize comprehension of physiological concepts and transfer relative to Self-explanation (SE) which is considered a lower-order type of overt learning. First-year medical students (n = 317) were randomly assigned to either PI or SE in a pre-post test design, followed by a set of near and far transfer questions. In both PI and SE groups post-test scores were significantly improved (p < 0.0001) with PI outperforming SE (+ 35% vs. + 23%, p = 0.006). Interestingly, a substantial number of students with initial incorrect answers even had enhanced scores after discussion with an incorrect peer. Both methods showed higher transfer scores than control (p = 0.006), with a tendency for higher near transfer scores for PI. These findings support PI as a valuable method to enhance comprehension of physiological concepts. Moreover, by comparing the effects of interactive PI with constructive SE we have established new insights that complement educational theories on overt learning activities.

Research skills are important for university graduates, but little is known about undergraduates' motivation for research. In this study, self-efficacy beliefs and intrinsic motivation for several research activities were measured three times during an undergraduate research project (N = 147 students). In order to promote self-efficacy for writing and collaboration, a collaboration script was developed and tested on half of the students. Twelve students were interviewed three times to gather in-depth information about motivational and self-efficacy beliefs. All measures except intrinsic motivation for research increased significantly during the project. Interview results suggest that enactive mastery and positive social interdependence promoted self-efficacy. Feelings of relatedness seemed to promote intrinsic motivation for writing. Lack of autonomy and low perceived relevance may explain why motivation for research remained stable. The script had no impact on self-efficacy beliefs. Relatedness, autonomy and positive social interdependence may boost motivation for research, but more evidence is needed.

In-course assessment, such as midterms, quizzes or presentations, is often an integral part of higher education courses. These so-called intermediate assessments influence students' final grades. The current review investigates which characteristics of intermediate assessment relate to these grades. In total, 88 articles were reviewed that examined the relationship between intermediate assessment and student grades. Four main characteristics were identified: the use of feedback, whether the assessment is mandatory, who is the assessor, and the reward students get for participating. Results indicate that corrective feedback leads to the most positive results, but elaborate feedback may benefit lower achieving groups. No difference in results was found for mandatory versus voluntary intermediate assessments. Peer assessment seemed to be beneficial, and rewarding students with course credit improves grades more than other rewards. Three scenarios are presented on how teachers can combine the different characteristics to optimise their intermediate assessment.

Individual student success is influenced by the educational environment and student characteristics. One adaptation of the educational environment to improve student success is the introduction of continuous, or in-course, assessment. Previous research already identified several student characteristics that are related to student success as measured by student achievement, like previous achievements, motivation, self-efficacy and gender. The two facets are investigated in a group of first-year undergraduate Law students in the Netherlands, by examining the relationship of different types of continuous assessment and student characteristics with academic achievement. A questionnaire, measuring demographic information, self-regulation and motivational constructs, was completed by 94 students and their grades were requested from the student administration. Repeated measures ANCOVAs with assessment type as the within-subject factor identified that student achievement is not dependent on the type of continuous assessment. Students with higher high-school GPAs got higher scores across assessment types. Male students performed worse than their female peers in courses without continuous assessment, but in courses using any type of continuous assessment, this gender difference disappeared. Intrinsic motivation was a negative predictor of achievement in courses using writing assignments and mandatory homework assignments. Results from the current study indicate that continuous assessment may be a potent measure to improve male students' success by closing the gender achievement gap, and that students with high levels of intrinsic motivation do not benefit from continuous assessment.

Although elaboration has been investigated frequently, there is little evidence for the beneficial effect of elaboration in problem-based learning. A controlled experiment tested the effect of elaboration during problem-based discussion on recall. Sixty-seven students observed a video-recorded, problem-based discussion. In one experimental condition, a tutor in the video encouraged participants to elaborate by asking elaborative questions. In a second condition, the tutor asked superficial questions. After the discussion, all participants studied a text with relevant new information. Elaborative questions had no significant effect on recall of idea units from the text, p = 0.39, ?[superscript 2] = 0.01. High-ability students outperformed low-ability students, p = 0.04, ?[superscript 2] = 0.07, but this effect did not interact with the experimental treatment, p = 0.22, ?[superscript 2] = 0.02. Suggestions for further research are presented.

This study set out to test whether relevant prior knowledge would moderate a positive effect on academic achievement of elaboration during small-group discussion. In a 2 × 2 experimental design, 66 undergraduate students observed a video showing a small-group problem-based discussion about thunder and lightning. In the video, a teacher asked questions to the observing participants. Participants either elaborated by responding to these questions, or did not elaborate, but completed a distraction task after each question. They received either relevant or irrelevant prior knowledge before the discussion. After the discussion, all participants studied a text about thunder and lighting and completed immediate and delayed-recall tests for this text. Elaboration had no main effect on recall, but there was a significant interaction effect between relevant prior knowledge and elaboration. The results suggest that elaboration is helpful for students with more prior knowledge, but harmful for students with less prior knowledge.

Seventy students participated in an experiment to measure the effects of either providing explanations or listening during small group discussions on recall of related subject-matter studied after the discussion. They watched a video of a small group discussing a problem. In the first experimental condition, the video was stopped at various points in time, enabling the participants to verbally respond to the discussion. In the second condition, they listened to the same discussion, without contributing. In the control condition, they listened to a discussion that was not related to the subject-matter subsequently studied. After the discussion, all participants studied a text and answered questions that tested their recall of information from this text. No immediate differences in recall were found. One month later, participants who had actively engaged in explaining remembered more from the text. The conclusion appears justified that actively providing explanations during a discussion positively affects long-term memory. (Contains 2 figures and 1 table.)

Background: Clinical workplace learning takes place in a dynamic and complex learning environment that is designated as a site for patient care and education. Challenges in clinical training can be overcome by implementing blended learning, as it offers flexible learning programs suitable for student-centered learning, web-based collaboration, and peer learning. Objective: The aim of this study is to evaluate the Small Private Online Course (SPOC) by interns’ first impressions and satisfaction measures (N=20) on using the SPOC. This study describes the design process of a SPOC from a theoretical and practical perspective and how it has been integrated into a clinical internship in internal medicine. Methods: The design of the SPOC was based on general theoretical principles that learning should be constructive, contextual, collaborative, and self-regulated, and the self-determination theory to stimulate intrinsic motivation. Interns’ impressions and level of satisfaction were evaluated with a web-based questionnaire and group interview. Results: Interns thought the web-based learning environment to be a useful and accessible alternative to improve knowledge and skills. Peer learning and web-based collaboration through peer interaction was perceived as less effective, as student feedback was felt inferior to teacher feedback. The interns would prefer more flexibility within the course, which could improve self-regulated learning and autonomy. Conclusions: The evaluation shows that the SPOC is a useful and accessible addition to the clinical learning environment, providing an alternative opportunity to improve knowledge and skills. Further research is needed to improve web-based collaboration and interaction in our course. [ABSTRACT FROM AUTHOR]

Problem: Effective clinical workplace learning depends on interprofessional and multidisciplinary learning. However, traditional patient wards are centered around patient care and not so much around education. Other barriers such as time constraints also contribute to suboptimal interprofessional and multidisciplinary learning. Intervention: Six formal and informal learning activities that aimed at stimulation of interprofessional and multidisciplinary learning were designed and introduced in our patient ward to enable optimal integration of clinical practice and learning. Context: The study took place in an internal medicine inpatient ward where daily patient care is performed by specialized teams consisting of different healthcare professionals from the departments of Endocrinology, Nephrology, and Infectious Diseases. In the traditional ward setting, interprofessional and multidisciplinary learning mostly takes place during shared clinical activities. In this article, we describe the development and implementation of a Clinical Teaching Unit to support learning between different healthcare professionals. Impact: The intervention was evaluated with an online questionnaire among 108 nurses, student nurses, clerks, residents, supervising clinicians, and managers. Open-ended questions (response rate 65%) were used to determine the changes in the workplace experienced by the participants since the introduction of the Clinical Teaching Unit and what influenced their learning process and motivation to learn. Closed questions (response rate 46%) aimed to measure the effect of our intervention on collaboration, learning, and the quality of care and education. The results of the open-ended questions showed that participants experienced more interprofessional collaboration and learning. This took place in a less hierarchical, safer work climate which also resulted in perceptions of a better quality of patient care and education. The closed-ended questions showed that the intervention resulted in perceptions of improved collaboration, work culture, quality of care, education, and learning conditions. Lessons Learned: The findings imply that implementation of a Clinical Teaching Unit not only facilitates the integration of patient care and education but also the integration of different professions working together. From the intervention, we also learned that a successful Clinical Teaching Unit requires investment of time and staff, clear communication between healthcare professionals, and dedication of teachers within all professions. [ABSTRACT FROM AUTHOR]

Engaging students in research during medical school could contribute to creating an academic attitude among students, which underlies practicing evidence-based medicine in future professional practice. However, attempts to involve undergraduate students in research during medical training remain inadequate. Most medical schools educate large numbers of students at the same time, especially in early phases of medical training. Large scale education on the one hand and individually providing students with authentic research experiences on the other hand is considered not that easy to achieve. Drawing on our own experiences, existing literature and theories we propose twelve tips to design and implement a course in which authentic individual research experiences can be provided to a large group of undergraduate students. [ABSTRACT FROM AUTHOR]