title: Formative assessment promotes learning in undergraduate clinical clerkships.
abstract: BACKGROUND
  Clinical clerkships, typically situated in environments lacking educational structure, form the backbone of undergraduate medical training. The imperative to develop strategies that enhance learning in this context is apparent. This study explored the impact of longitudinal bedside formative assessment on student learning in a medical clerkship.
  
  
  METHODS
  We studied a class of 4th-year students completing a 14-week medical clerkship at the University of Cape Town in South Africa. Clinician educators assessed student performance during weekly bedside teaching sessions using blinded patient encounters (in which students had no prior knowledge of the patient's diagnosis or access to the clinical records). Student feedback was standardised using performance rating scales. The impact of formative assessment on student learning was determined from questionnaire responses.
  
  
  RESULTS
  A total of 575 formative assessments took place during the study period. Students perceived blinded patient encounters to be a valuable learning activity that improved their clinical reasoning skills and assessed progress fairly. They reported that feedback helped inform them of their level of competence and learning needs, motivated them to read more, and significantly improved their participation in patient-centred learning activities. Participating clinicians agreed that this formative assessment strategy enhanced the learning potential of bedside teaching sessions.
  
  
  CONCLUSIONS
  Longitudinal formative assessment, using blinded patient encounters, was successfully integrated into undergraduate clerkship bedside teaching. According to both students and staff this assessment strategy enhanced bedside learning and improved student participation in patient-centred learning activities during the clerkship.
authors.affiliation: Department of Medicine, University of Cape Town, South Africa. Vanessa@uctgsh1.uct.ac.za
authors.forename: V C
authors.initials: VC
authors.lastname: Burch
authors.forename: J L
authors.initials: JL
authors.lastname: Seggie
authors.forename: N E
authors.initials: NE
authors.lastname: Gary
mesh_terms: D002982:Clinical Clerkship / Q000592:standards*; D002983:Clinical Competence; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D006801:Humans; D018794:Problem-Based Learning / Q000379:methods*; D013019:South Africa; D011795:Surveys and Questionnaires