"Optimizing Learning in Integrated Curriculum"-Comparative Effectiveness of Online and Face-to-Face Formative Assessments: Mixed Methods Study.

Background: Assessment is a critical component of teaching and learning and serves as the foundation for how learners demonstrate success in achieving learning objectives. Formative assessments (FAs) and timely feedback play a crucial role in integrated curricula, whereas basic and clinical sciences are taught in a coordinated manner. Feedback-based FA supports student learning, and teachers can determine learning gaps to monitor progress in learning. Based on existing evidence, limited literature compared the effect of online versus onsite FA on summative performance in a fully integrated curriculum. Objective: This study aimed to examine the effectiveness of online versus on-site FAs and feedback on summative assessment in the integrated medical curriculum. Methods: This study used an exploratory mixed methods approach to delving into students' experiences with face-to-face versus online FA and feedback, and its effect on their summative performance in the integrated Bachelor of Medicine, Bachelor of Surgery program. This study was conducted at Fakeeh College for Medical Sciences in Jeddah, Saudi Arabia. A total of 143 consenting students were recruited into the study. The students in the study were distributed voluntarily into 2 groups regardless of age, sex, or academic performance. Group 1 (n=92) was assigned to receive online FAs and immediate online feedback throughout the module using the Speedwell system. However, Group 2 (n=51) was assigned to receive onsite FAs and face-to-face feedback throughout the module in the examination hall in the college. The quantitative part of the study involved analyzing student scores of summative assessments in 2 groups exposed to online and onsite FA and feedback. The qualitative part aimed to explore students' perceptions of FA and feedback. Results: The passing rate in summative examinations (quiz, midmodule, and final) was higher in the onsite group (61.2%, 51%, and 62.7%, respectively) compared with the online group (53.3%, 48.3%, and 45.7%, respectively). However, the difference was statistically significant only in the quiz examination. Four key themes were identified from the qualitative analyses regarding participants' different experiences of FA and feedback: the accessibility of the examination format facilitates flexibility in learning; FA is a means of recognizing learning opportunities; FAs help shift student attitudes toward learning; and the last theme is opportunities for discussion and personalized feedback. Conclusions: This research sheds light on the intricate interplay between assessment modalities and student learning outcomes by demonstrating that onsite FA followed by onsite feedback is more effective than online FA and feedback in fostering student engagement and promoting deep understanding and improving students' performance in summative examinations. Thereafter, this study contributes to the ongoing discourse surrounding effective assessment practices in contemporary educational settings.