You Get What You Reward: A Qualitative Study Exploring Medical Student Engagement in 2 Different Assessment Systems.

IF 5.3 2区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Academic Medicine Pub Date : 2024-11-01 Epub Date: 2024-09-06 DOI:10.1097/ACM.0000000000005848
Joshua Jauregui, Adelaide H McClintock, Caitlin Schrepel, Tyra Fainstad, S Beth Bierer, Sylvia Heeneman
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Abstract

Purpose: Educational impact is dependent on student engagement. Assessment design can provide a scaffold for student engagement to determine the focus of student efforts. Little is known about how medical students engage with assessment. Therefore, we asked the following research question: How do medical students engage with the process of assessment and their assessment data in 2 clinical assessment systems?

Method: This multi-institutional, cross-sectional constructivist grounded theory study of fourth-year undergraduate medical students at the University of Washington and Cleveland Clinic Lerner College of Medicine assessed 2 different assessment systems: traditional tiered grading, in which clerkship grades were summative, and programmatic assessment, in which students received low-stake, narrative feedback across clerkships with progress based on aggregated performance data in student portfolios. All fourth-year students were invited to participate in one-on-one semistructured interviews guided by student engagement theory between September 2022 and January 2023. Verbatim transcripts underwent iterative, qualitative analysis.

Results: Twenty-two medical students were interviewed, 13 from a traditional grading assessment system and 9 from a programmatic assessment system. Three major ways in which assessment systems affected how students engaged with their assessments were categorized into the affective, cognitive, and behavioral domains of engagement: as a sociocultural statement of value, as the cognitive load associated with the assessment system and practices themselves, and as the locus of power and control in learning and authentic practice.

Conclusions: Medical students' beliefs about assessment goals, cognitive burden of assessment, and relationships with others significantly affected their engagement with their assessments. In assessment systems that reward grading and an archetypal way of being, students report engaging by prioritizing image over learning. In programmatic assessment systems, students describe more fully and authentically engaging in their assessment for and as learning. Systems of assessment communicate what is rewarded, and you get what you reward.

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一分耕耘,一分收获:探索医科学生参与两种不同评估体系的定性研究。
目的:教育影响取决于学生的参与。评估设计可以为学生的参与提供一个支架,以确定学生努力的重点。但人们对医科学生如何参与评估知之甚少。因此,我们提出了以下研究问题:在两个临床评估系统中,医学生如何参与评估过程及其评估数据?这项针对华盛顿大学和克利夫兰诊所莱纳医学院四年级本科医学生的多机构、横断面建构主义基础理论研究评估了两种不同的评估体系:传统的分层评分,即实习成绩为终结性评分;程序性评估,即学生在实习期间获得低风险的叙述性反馈,其进展基于学生作品集中的综合表现数据。2022 年 9 月至 2023 年 1 月期间,所有四年级学生都受邀参加了以学生参与理论为指导的一对一半结构式访谈。对逐字记录誊本进行了反复的定性分析:22名医学生接受了访谈,其中13名来自传统的评分评估系统,9名来自项目评估系统。评估系统影响学生参与评估的三种主要方式被归类为参与的情感、认知和行为领域:作为社会文化的价值声明,作为与评估系统和实践本身相关的认知负荷,以及作为学习和真实实践中权力和控制的位置:医学生对评估目标、评估认知负担以及与他人关系的信念对他们参与评估有重要影响。在以评分和原型存在方式为奖励的评估系统中,学生报告说,他们通过优先考虑形象而不是学习来参与评估。而在有计划的评估体系中,学生们则更全面、更真实地参与到他们的评估中,为学习而学习,也作为学习而学习。评估系统传达的是奖励的内容,而你得到的就是你奖励的内容。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Academic Medicine
Academic Medicine 医学-卫生保健
CiteScore
7.80
自引率
9.50%
发文量
982
审稿时长
3-6 weeks
期刊介绍: Academic Medicine, the official peer-reviewed journal of the Association of American Medical Colleges, acts as an international forum for exchanging ideas, information, and strategies to address the significant challenges in academic medicine. The journal covers areas such as research, education, clinical care, community collaboration, and leadership, with a commitment to serving the public interest.
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