Measuring and Supporting Success

Re-evaluating how MD students are assessed

You take a course. It ends with an exam. You get a mark. You move on (or not).

For many years, that was the pattern of evaluation students encountered in university. But with the introduction of the Foundations Curriculum, the MD program has introduced new ways to assess student performance – formally known as programmatic assessment – and use this information to help students reach their goals.

The effort is being led by Dr. Richard Pittini, Director of Evaluations, and Dr. Glendon Tait, Director or Student Assessment. The Foundations Curriculum, which draws on principles that align with the Royal College’s Competency by Design framework for residency evaluation, was a chance to take a fresh approach to MD program student assessment. The aim, Tait explains, is to “shift the emphasis from assessment of learning to assessment for learning.”

“It’s really about shifting the emphasis,” he says. “We want students to have regular opportunities to not only get feedback, but also reflect on the feedback they receive as part of facilitated feedback conversations, since we know our self-assessment skills, on our own, are limited.”

The approach is supported through a variety of tools, including optional tests such as weekly quizzes and a Progress Test, offered three times a year. This is in addition to required mastery exercises, which are exams delivered every one-to-three weeks that assess content mastery within a block of time. Each mastery exercise consists of 20-to-40 multiple choice questions. In addition, students are required to meet twice a year with an Academy Scholar who is assigned to each student. Academy Scholars act as personal coaches who review student performance and self-assessments and dialogue with the student about strategies for optimizing success.

Powering this process is the MD Program Learner Chart, which was developed from scratch by U of T’s Faculty of Medicine. It enables students to review and reflect on their performance and take personal responsibility for their progress toward achieving competency. It draws multiple data sources into a single user-friendly interface. It was developed by Medicine’s Discovery Commons, with Tait serving as the faculty lead. Usability feedback from students and Academy Scholars helped refine the final product.

The Progress Test, which Pittini helped develop along with Wilson Centre education scientist Dr. Mahan Kulasegaram, allows students to face the sort of questions they’ll encounter in final licensing exams.

“The intention isn’t that students will ‘pass’ at the beginning; how could they,” Pittini explains. “Instead, it’s a chance to chart a student’s growth and competency over time. It gives us – both the students and the program – a window to see if they are on track to reach the level of knowledge they’ll need by the time they finish the program.”

The revised assessment tools help identify areas of deficiency for students at any earlier stage and reduce the focus on “make or break” exams. It also helps program leaders and administrators – including a new Student Progress Coordinator – identify options and resources for students that can help get them back on track.

The new approach to evaluation and assessment was first introduced as part of the launch of Year One of the Foundations Curriculum last year. It is now being implemented in Year Two, with future plans to expand it into Clerkship.

“We want to create a seamless approach for students, beginning in the first year of the MD program and continuing through residency,” says Tait. 

For more information, visit the Assessment - Foundations Curriculum FAQ.