The impact of programmatic assessment on student learning: theory versus practice.
BACKGROUND
It is widely acknowledged that assessment can affect student learning. In recent years, attention has been called to 'programmatic assessment', which is intended to optimise both learning functions and decision functions at the programme level of assessment, rather than according to individual methods of assessment. Although the concept is attractive, little research into its intended effects on students and their learning has been conducted.


OBJECTIVE
This study investigated the elements of programmatic assessment that students perceived as supporting or inhibiting learning, and the factors that influenced the active construction of their learning.


METHODS
The study was conducted in a graduate-entry medical school that implemented programmatic assessment. Thus, all assessment information, feedback and reflective activities were combined into a comprehensive, holistic programme of assessment. We used a qualitative approach and interviewed students (n = 17) in the pre-clinical phase of the programme about their perceptions of programmatic assessment and learning approaches. Data were scrutinised using theory-based thematic analysis.


RESULTS
Elements from the comprehensive programme of assessment, such as feedback, portfolios, assessments and assignments, were found to have both supporting and inhibiting effects on learning. These supporting and inhibiting elements influenced students' construction of learning. Findings showed that: (i) students perceived formative assessment as summative; (ii) programmatic assessment was an important trigger for learning, and (iii) the portfolio's reflective activities were appreciated for their generation of knowledge, the lessons drawn from feedback, and the opportunities for follow-up. Some students, however, were less appreciative of reflective activities. For these students, the elements perceived as inhibiting seemed to dominate the learning response.


CONCLUSIONS
The active participation of learners in their own learning is possible when learning is supported by programmatic assessment. Certain features of the comprehensive programme of assessment were found to influence student learning, and this influence can either support or inhibit students' learning responses.
Department of Pathology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; Faculty of Health, Medicine and Life Sciences, School of Health Professions Education, Maastricht University, Maastricht, The Netherlands.
Sylvia
S
Heeneman
Andrea
A
Oudkerk Pool
Lambert W T
LW
Schuwirth
Cees P M
CP
van der Vleuten
Erik W
EW
Driessen
D000328:Adult; D004503:Education, Medical, Graduate; D004521:Educational Measurement / Q000379:methods*; D005246:Feedback; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D009426:Netherlands; D036301:Qualitative Research; D013337:Students, Medical / Q000523:psychology*; D055815:Young Adult