ArticleBMC medical education2025
Challenges in student assessment in medical and health sciences education in Northern Iraq.
Article in BMC medical education, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Faculty perspectives on factors influencing the passing of underperforming health profession students: challenging the 'success-only' culture.Frontiers in medicine · 2026Article
- Analytical Rigor and Conceptual Clarity in Curriculum Implementation Research [Letter].Advances in medical education and practice · 2026Article
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Authors and funding
7 authors.
Funding
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Abstract
backgroundGrading leniency and "Failure to Fail" phenomena have been widely documented in medical education, yet little research has explored these issues in the Middle Eastern context, particularly within Iraq's medical and health sciences education programs. Faculty members often face emotional, cultural, and institutional pressures that influence their grading decisions. These factors can jeopardize academic integrity, student competency, and ultimately, patient safety. This study examines the key factors influencing faculty members' decisions to pass underperforming students or award additional marks beyond academic merit.
methodsA cross-sectional survey was distributed via Google Forms to 350 medical and health sciences educators in Iraq, exploring their grading decisions and the factors contributing to grading leniency and the "Failure to Fail" practices. Logistic regression analysis was conducted to examine the association between educator characteristics with grading leniency and decisions to pass failing students.
resultsA total of 152 responses were received (43.4% response rate). The results show that 38.3% of educators indicated passing students who should have failed, and 67.3% indicated awarding extra marks beyond what was warranted. Faculty members with primary clinical responsibilities were significantly more likely to both pass students who should have failed (OR = 8.3, P = 0.01), and award extra marks beyond what was warranted (OR = 6.1, P = 0.02), while those with more years of teaching experience were more stringent in their marking decisions (OR = 0.17, p = 0.01). The primary factors contributing to Grading leniency were personal (emotional) considerations and learner-related factors, while factors pertaining to available remediation options were the least emphasized. Only 28.3% of faculty members reported that they received institutional training on student assessment.
conclusionsGrading leniency and "Failure to Fail" are key challenges in medical and health sciences education programs in Iraq. Our findings propose next steps for reform in Iraqi medical education system, including standardizing grading rubrics, implementing national assessment guidelines, and establishing mandatory faculty training programs. These reforms are needed for improving academic integrity and setting standards for graduates to become competent members of Iraq's healthcare workforce.
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