title: Explicit feedback to enhance the effect of an interim assessment: a cross-over study on learning effect and gender difference.
abstract: In a previous study we demonstrated by a prospective controlled design that an interim assessment during an ongoing small group work (SGW) session resulted in a higher score in the course examination. As this reflects the so-called testing effect, which is supposed to be enhanced by feedback, we investigated whether feedback following an interim assessment would have an effect on the score of the course exam, and whether the effect is influenced by the gender of the student. During a General Pathology bachelor course all 386 (bio) medical students took an interim assessment on the topics cell damage (first week) and tumour pathology (fourth week). The intervention consisted of immediate detailed oral feedback on the content of the questions of the interim assessment by the tutor, including the rationale of the correct and incorrect answers. It concerned a prospective randomized study using a cross-over design. Outcome measures were: (1) the difference in the normalized scores (1-10) of the course examination multiple choice questions related to the two topics, (2) effect of gender, and (3) gender-specific scores on formal examination. The effect of feedback was estimated as half the difference in the outcome between the two conditions. Mixed-model analysis was used whereby the SGW group was taken as the study target. The scores of the questions on cell damage amounted to 7.70 (SD 1.59) in the group without and 7.78 (SD 1.39) in the group with feedback, and 6.73 (SD 1.51) and 6.77 (SD 1.60), respectively, for those on tumour pathology. No statistically significant effect of feedback was found: 0.02 on a scale of 1-10 (95 % CI: -0.20; 0.25). There were no significant interactions of feedback with gender. Female students scored 0.43 points higher on the formal examination in comparison with their male colleagues. No additional effect of immediate explicit feedback following an interim assessment during an SGW session in an ongoing bachelor course could be demonstrated in this prospective randomized controlled study. Gender analysis revealed a higher performance of female students on the formal examination, which could not be explained by the effect of feedback in the current study. In this particular learning environment, SGW, explicit feedback may have little added value to the interactive learning that includes implicit feedback.
authors.affiliation: Department of Anatomy, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, the Netherlands.
authors.forename: Marleen
authors.initials: M
authors.lastname: Olde Bekkink
authors.affiliation: Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Rogier
authors.initials: R
authors.lastname: Donders
authors.affiliation: Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Goos N P
authors.initials: GNP
authors.lastname: van Muijen
authors.affiliation: Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Rob M W
authors.initials: RMW
authors.lastname: de Waal
authors.affiliation: Department of Anatomy, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, the Netherlands. d.ruiter@pathol.umcn.nl.|Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. d.ruiter@pathol.umcn.nl.
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Ruiter