Assessment as Learning: A Mixed-Methods Study on Pre-Clinical Medical Student-Led Generation of Scenario-Based Multiple Choice Questions.

Purpose: Learning basic sciences divorced from clinical practices is suboptimal. Several student-centered learning strategies were introduced to enhance self-regulated learning while adopting learning techniques centered on assessment receives much less attention. This study aimed to explore the perception and efficacy of engaging early-phase preclinical medical students in generating scenario-based Multiple-choice questions (MCQs) targeting high cognitive levels. Methods: This study is a quasi-experimental mixed-method study conducted among preclinical second-year medical students. An intervention group involved students who participated in item creation, and a control group included those who did not. The two groups were exposed to mock exams and were asked to complete a self-administered questionnaire and participate in focused group discussions on their perceptions. Results: Out of 135 students, 48.9% created from 1 to 10 items. Item creators had significantly higher formative scores (34.3 ±10.5) than non-creators (29.6 ±10.6) (p = 0.010), and their GPA was also significantly better (B+ grade: 42.4% vs 21.7%; p = 0.015). Despite these academic variations, above 75% of the two groups were satisfied or very satisfied with non-significant variations. Formative assessment positively correlated with GPAs ( Conclusion: The student-led approach to generating clinical scenario-based MCQs demonstrates significant promise as an innovative pedagogical approach in medical education. Involving preclinical students in developing high cognitive levels of MCQs is not merely a tool for evaluation but a versatile pedagogical strategy that can be adapted to various disciplines to enhance learning and engagement and help students transition to the clinical years.