title: Can computer-based assessment enhance the acceptance of formative multiple choice exams? A utility analysis.
abstract: BACKGROUND
  Students' motivation to participate is one of the main challenges in formative assessment. The utility framework identifies potential points of intervention for improving the acceptance of formative assessment [Van Der Vleuten C. 1996. The assessment of professional competence: Developments, research and practical implications. Adv Health Sci Educ 1(1):41-67]. At the Medical Faculty of the University of Cologne, the paper-based version of the Berlin Progress Test has been transformed into computer-based version providing immediate feedback.
  
  
  OBJECTIVE
  To investigate whether the introduction of computer-based assessment (CBA) enhances the acceptance of formative assessment relative to paper-based assessment (PBA).
  
  
  METHODS
  In a retrospective cohort study (PBA: N = 2597, CBA: N = 2712), students' overall acceptance of the two forms of assessment was surveyed, their comments were analyzed, and we analyzed their test behavior and categorized students into "serious" or "non-serious" test takers.
  
  
  RESULTS
  In the preclinical phase of medical education, no differences were found in overall acceptance of the two forms of assessment (p > 0.05). In the clinical phase, differences in favor of CBA were found in overall acceptance (p < 0.05), the proportion of positive comments (p < 0.001), and the proportion of serious participants (p < 0.001).
  
  
  CONCLUSIONS
  Introduction of immediate feedback via CBA can enhance the acceptance and therefore the utility of formative assessment.
authors.affiliation: Dean's Office for Student Affairs, Medical Faculty of the University of Cologne, Germany. yassin.karay@uk-koeln.de
authors.forename: Yassin
authors.initials: Y
authors.lastname: Karay
authors.forename: Stefan K
authors.initials: SK
authors.lastname: Schauber
authors.forename: Christoph
authors.initials: C
authors.lastname: Stosch
authors.forename: Katrin
authors.initials: K
authors.lastname: Schuettpelz-Brauns
mesh_terms: D003162:Competency-Based Education / Q000379:methods*; D003201:Computers; D004504:Education, Medical, Undergraduate / Q000592:standards*; D004521:Educational Measurement / Q000379:methods; D005246:Feedback; D005858:Germany; D006801:Humans; D012189:Retrospective Studies; D013337:Students, Medical / Q000523:psychology*; D013997:Time Factors