To Grade or Not to Grade (the Quiz): The Impact of Two Formative Assessment Grading Approaches on Summative Assessment Outcomes in an Integrated Pre-clinical Curriculum.

Introduction: Formative assessments have overall been shown to improve summative evaluations in medical education. However, it remains unclear if utilizing them for course credit in an integrated curriculum over multiple subspecialties is beneficial for student acquisition of knowledge. We set out to determine if grading formative quizzes had an effect on student acquisition of knowledge via summative assessments. Materials and Methods: In 2020, quizzes remained mandatory, but were not graded for course credit. We collected and compared formative (quiz) and summative (unit exam) score data from student cohorts when quizzes were graded versus not graded. Medical college admission test (MCAT) score, gender, and underrepresented in medicine (URM) status data were utilized to determine if they had effects on outcomes. We used a predefined region of indifference (± 5%) and second-generation Results: Despite a drop in quiz scores after removing course credit, differences in average summative exam scores fully resided within the region of indifference for three of five course blocks, indicating no meaningful differences in summative exam scores existed for those blocks. In other blocks, the difference was not fully nested within the region of indifference; however, all data overlapped with this region, implying exam score differences were inconclusive for these blocks. Conclusions: Our study demonstrates that there is either no meaningful effect on summative assessments or no conclusive detrimental effects when mandatory quizzes are not graded for course credit.