Natl. J. Physiol. Pharm. Pharmacol.(2025), Vol. 15(4): 267-271

Original Research

10.5455/NJPPP.2025.v15.i4.2

Introducing various formative assessment methods in Biochemistry of Phase I MBBS Curriculum

Ranjita Santra¹, Soma Saha², Nabanita Barua^3*, Dinesh Kumar Badyal⁴ and Clarence James Samuel⁵

¹Associate Professor of Pharmacology, Coordinator MEU, Deputy Coordinator of AMC, Deben Mahata Government Medical College, Hatuara, India

²Professor, Department of Anatomy, Calcutta Medical College, Kolkata, India

³Associate Professor, Department of Ophthalmology, Tamralipto Government Medical College and Hospital, Tamluk, India

⁴Convener, NMC Nodal Center for Faculty Development (Med Edu), Christian Medical College, Ludhiana, India

⁵Vice Principal, Professor and Head of Community Medicine, Member of International Board of Lifestyle Medicine, Christian Medical College, Ludhiana, India

*Corresponding Author: Nabanita Barua, Associate Professor, Department of Ophthalmology, Tamralipto Government Medical College and Hospital, Tamluk, India. Email: nabanita_br [at] yahoo.co.in

Submitted: 17/06/2024 Accepted: 04/03/2025 Published: 30/04/2025

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Abstract

Background: Assessment in Competency-Based Medical Education (CBME) focuses on improving learning as an ongoing and longitudinal assessment so that facilitators can identify the needs of the learner, plan remedial measures, and provide learning opportunities to improve learning. Therefore, it is something we do with or for students and not for the students. Formative assessments consolidate the learning process and reinforce appropriate teaching–learning behavior. It is thus necessary that structured formative assessments be incorporated into the regular assessment system of the curriculum to ensure an optimal educational output.

Aim: To design innovative formative assessment methods in a competency-based Biochemistry curriculum for undergraduate MBBS students and teachers and to assess the students’ acquisition and application of the acquired knowledge through the formative assessment methods being applied.

Materials and Methods: This study was conducted in the Department of Biochemistry at Deben Mahata Government Medical College and Hospital of Purulia district in West Bengal. Facilitators or Teachers were sensitized about the newer formative assessment methods namely Teacher’s self-report of content-pedagogical knowledge and periodical logs for the teachers. On the other hand, methods of concept mapping, reflective self-assessment, and multiple choice questions (MCQs) were formulated for the students. All the newly designed formative assessment methods were designed on specific competency areas and discussed with the departmental faculty, tutors, and senior residents through a 1–2 series of group discussions. Teachers then introduced innovations in the continuous teaching process on a number of occasions. Teacher’s self-report of content-pedagogical knowledge was captured in a Likert scale of how they felt about teaching the CBME from 1 (not desirable) to 5 (highly desirable). Periodical logs for the teachers were created through general reporting points.

Results: A total of 97 students studying in Phase I MBBS and learning Biochemistry were enrolled in the study. We found that 64 (66%) were male and 33 (34%) were female students. The newer Formative Assessment methods—concept mapping, reflective self-assessment, and MCQs proved to be beneficial for many students in the subject of Biochemistry as 72% of them felt these methods to be brain-storming and innovative while 36% felt them difficult. Such methods increased concentration in 67% of students, and 80% of students felt that they could correlate better during their performance in assessment. At the outset, solving MCQs proved to be tempting in 72% of the students followed by growing interest in explaining the concept maps in 67% of the students. Reflective self-assessment was easier for 64% of the students. The proportion of students who were present during various occasions of formative assessment supports the importance of the role of feedback in continuous teaching learning. Preparation for the assessment engaged them with the curriculum as per Graduate Medical Education Regulations and enabled better concentrating ability with more power to think and correlate various competencies.

Conclusion: Designing and introducing newer innovative formative assessment methods proved to be fruitful as being introduced gradually after proper orientation of the students and facilitators of Biochemistry in the Phase I MBBS curriculum. The teachers felt motivated to implement these assessment methods from now onwards with continuous feedback to and from the students.

Keywords: Innovation, Formative assessment, Concept mapping, Reflection, Feedback.

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Introduction

Assessment in Competency-Based Medical Education (CBME) focuses on improving learning as an ongoing and longitudinal assessment so that facilitators can identify the needs of the learner, plan remedial measures, and provide learning opportunities to improve learning (Frank et al., 2010). Assessment in Latin is “assidere” which means to “to sit with.” Therefore, it is something we do with or for students and not to students.^[2] Educators have drawn our use of the term formative from Scriven’s (1967) groundbreaking essay about educational evaluation, in which he contrasts summative evaluation with formative evaluation. According to Scriven, if the quality of an early-version educational program is evaluated while the program is still malleable and capable of being improved because of an evaluation’s results—this constitutes formative evaluation. Formative assessments consolidate learning and reinforce learning behavior. It focuses on providing students’ feedback on their performance to improve their skills, knowledge, communication, and learning behavior (Cox et al., 2007). In contrast, when a mature, final-version educational program is evaluated to make a decision about its continuation or termination, this constitutes summative evaluation. However, less is known regarding how formative assessment is related to other objective measures of a student’s performance in terms of understanding the types and depth of questions as set in internal assessment (IA) according to their domains of competencies.

Formative assessments consolidate learning and reinforce students’ learning behavior. It focuses on providing feedback to the students on their performance to improve their skills, knowledge, communication, and learning behavior. Facilitators or teachers adjust their ongoing instructional activities and students adjust the procedures that are currently using to try to learn whatever they are trying to learn. It is necessary that structured formative assessment methods be incorporated into the regular assessment system of the CBME to ensure an optimal educational output. The objectives of this study were to design innovative formative assessment methods of the competency-based curriculum of Biochemistry for the students and teachers and to assess the students’ acquisition and application of the acquired knowledge through formative assessment methods being applied. Faculty, tutors, and senior residents from the Department of Biochemistry were sensitized about the new methods of formative assessment—Teacher’s self-report of content-pedagogical knowledge and periodical logs for the teachers and concept mapping, reflective self-assessment, and multiple choice questions (MCQs) for the students. Facilitators introduced newer formative assessment methods after teaching–learning sessions. These methods have been designed and introduced gradually after proper orientation of the students and teachers of Biochemistry in Phase I MBBS Curriculum based on Competencies. The students gained confidence in performing better in continuous IA and in the University summative examination. The teachers felt motivated to implement newer methods of formative assessment from now onwards with continuous feedback to and from the students.

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Objectives

The objectives of the study were as follows:

1. To design and introduce newer innovative formative assessment methods in competency-based Biochemistry curriculum for the students and facilitators.

2. To assess the students’ acquisition and application of the acquired knowledge through the formative assessment methods.

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Methodology

The study was conducted in the Department of Biochemistry at Deben Mahata Government Medical College and Hospital of Purulia district in West Bengal. Faculty, tutors, and senior residents were sensitized about the newer methods of formative assessment—teacher’s self-report of content-pedagogical knowledge and periodical logs for the teachers and concept mapping, reflective self-assessment, and MCQs for the students. These innovative methods and plans of action were conveyed to the facilitators through 1–2 series of group discussions with due permission and active participation of the departmental head. Newer methods were applied in a number of formative assessments in addition to the conventional and existing method and question bank in the Biochemistry department. Ethics committee approval was obtained before the commencement of data collection.

Teachers introduced newer formative assessment methods on a number of occasions after completing teaching-learning sessions. The teacher’s self-report of content pedagogical knowledge was recorded before each IA examination. The teachers were asked to rate how well contented they felt to teach the CBME curriculum on a 5-point scale, from 1 (not desirable) to 5 (highly desirable). The parameters assessed in the survey were: setting and communicating goals, aligning assessments with learning and instruction, analyzing/interpreting student work through individual interaction, small group discussion, and large group discussion. Teacher logs were created by general reporting points: number of hours the students were engaged with the curriculum as per Graduate Medical Education Regulations (GMER), number of hours the teachers assessed student work with formative assessment, and number of formative assessments in which the new methods of concept mapping, self-reflective assessment, and MCQs they had applied.

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Results

A total of 97 students studying in Phase I MBBS were enrolled in the study. A total of 97 undergraduate students studying Biochemistry took part in the study. Table 1 shows the mean age of the students was 22 years. Out of the 97 enrolled students, 64 (66%) were male and 33 (34%) were female. Introducing newer Formative Assessment Methods was interesting, answers can be seen in Table 1 that the attendance of 88% of students was more than 90%.

As evident from Table 2, the newer Formative Assessment methods—concept mapping, reflective self-assessment, and MCQs proved to be appreciated by many students in the subject of Biochemistry. Among the 97 students enrolled for study, 72% felt that they were more benefitted from these methods of Formative Assessment, followed by 36% who felt that these methods were difficult to follow during Formative Assessment.

The newer and innovative methods increased concentration in 67% of students, and 80% of students felt that they could correlate better during their performance in the formative assessment. At the outset, solving MCQs was tempting for 72% of students followed by growing interest in explaining the concept maps in 67% of students and reflective self-assessment was easier for 64% of the students.

General reporting points in the teacher log were: number of hours the students were engaged with the curriculum as per GMER=42 hours/week; the number of hours the teachers assessed student work with formative assessment=6 hours/week; and the number of formative assessments in which the new methods of concept mapping, self-reflective assessment, and MCQs they have applied=3/week (Fig. 1).

Table 1. Students studying in Phase I MBBS enrolled in the study.

Table 2. Perception of students towards design and introduction of innovative Formative Assessment Methods (N=97).

Fig. 1. Teacher self-report of content paedagogical knowledge. PARAMETER A=setting and communicating goals; PARAMETER B=aligning assessments with learning and instruction; PARAMETER C=analyzing/interpreting student work through individual interaction; PARAMETER D=small group discussion; PARAMETER E=large group discussion. According to Keppell and Carless 2006.

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Discussion

This study explored the students’ experiences with different methods of assessing the students formatively in the competency-based curriculum. The theory underpinning formative assessment is that it has a positive impact on the learning process of the students which is supported by research findings. This study demonstrated that formative assessment applying newer innovative methods preceding teaching-learning sessions provides proper feedback from the students. This in turn motivates and facilitates their learning process as evident from the perception of students towards exposure to different ways of assessment. This finding is in concordance with a study conducted by Black and William on Formative Assessment (Black and Wiliam, 1998). The proportion of students who were present during various occasions of Formative Assessment with the aid of concept mapping, reflective self-assessment, and MCQs reveals that taking part in the formative assessment was more important than being successful, which supports the importance of the role of feedback in formative assessment.

This finding again supports a study conducted by Carrillo-de-la-Peña et al. (2009) on students from different branches of the health sciences, where the formative assessments were mid-term tests. They also found that students who participated in formative assessment achieved higher marks in the final assessment than students who did not participate, and this may occur in the case of students in this study too. This study is focused on the exposure of students to different innovative methods of Formative Assessment that are in concordance with another study by Marton et al. (2005). The design of assessment tasks is up to the teacher students’ learning is likely to improve if teachers consciously use a series of assessment tasks to facilitate learning in a variety of ways according to Keppell and Carless (2006) on learner-oriented assessment and as similar finding in this study evident from general reporting points in Teacher Log and Teacher self-report of Content Paedagogical Knowledge. The assessment task, which was designed to require a problem-solving approach seemed to encourage the students to apply their knowledge to complete the task, as evident from the methods introduced in this study. This finding correlates with a study conducted by Weurlander et al. (2012). Exploring formative assessment as a tool for learning (Weurlander et al., 2012). The present study did not reveal learning as seen and situated in and or influenced by the socio-cultural context in which it occurs, in contrast to the findings by Leach and Scott (2003) in their scientific research. What emerges from the analysis of students’ experiences of the individual assessment is that it was primarily a trigger for extrinsic motivation. The pressure to study for the formative assessment affected how much time students spent on studying as the number of hours the students were engaged with the curriculum as per GMER in this study as correlated with better-concentrating ability and more power to think and correlate various topics taught in their teaching-learning sessions followed by assessment formatively.

Strength and limitations

The individual innovative assessment methods influenced the students’ learning process to a greater extent because they were forced to explain their thoughts in writing. Preparation for the Formative Assessment gave students an overview of the subject and allowed them to learn basic facts and terminology. The students felt the need to be assessed after teaching-learning sessions by continuous assessment and bidirectional feedback. Formative assessment tool box enabled the students to understand the rest of the course and the teacher and felt motivated to reconstruct their knowledge for facilitating large group teaching as well as small group teaching. Multicentric study with larger sample sizes of the same or different phases can be conducted to assess the outcome and comparability of various newly designed innovative methods for formative assessment across many medical colleges. The same methodology can be applied to all the subjects of the curriculum to compare variability.

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Conclusion

The innovative and newer formative assessment methods proved to be favorable and satisfactory to be implemented after being introduced in this study. These methods have been designed gradually and thereafter introduced after proper orientation of the students and teachers of Biochemistry in the competency-based Phase I MBBS Curriculum. The students gained confidence in performing better in continuous IA as well as in the University summative examinations. The teachers also felt motivated to implement these methods for formative assessment from now onwards with continuous Feedback to and from the students.

Conflict of interest

None.

Funding

None.

Authors’ contributions

All authors contributed to conceptualization, data collection and analysis, and manuscript writing.

Data availability

Collected from the Department of Biochemistry of Deben Mahata Government Medical College and Hospital of Purulia district of the state of West Bengal.

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