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1.  Limitations of student-driven formative assessment in a clinical clerkship. A randomised controlled trial 
Background
Teachers strive to motivate their students to be self-directed learners. One of the methods used is to provide online formative assessment material. The concept of formative assessment and use of these processes is heavily promoted, despite limited evidence as to their efficacy.
Methods
Fourth year medical students, in their first year of clinical work were divided into four groups. In addition to the usual clinical material, three of the groups were provided with some form of supplementary learning material. For two groups, this was provided as online formative assessment. The amount of time students spent on the supplementary material was measured, their opinion on learning methods was surveyed, and their performance in summative exams at the end of their surgical attachments was measured.
Results
The performance of students was independent of any educational intervention imposed by this study. Despite its ready availability and promotion, student use of the online formative tools was poor.
Conclusion
Formative learning is an ideal not necessarily embraced by students. If formative assessment is to work students need to be encouraged to participate, probably by implementing some form of summative assessment.
doi:10.1186/1472-6920-8-29
PMCID: PMC2396159  PMID: 18471324
2.  Assessment of higher order cognitive skills in undergraduate education: modified essay or multiple choice questions? Research paper 
Background
Reliable and valid written tests of higher cognitive function are difficult to produce, particularly for the assessment of clinical problem solving. Modified Essay Questions (MEQs) are often used to assess these higher order abilities in preference to other forms of assessment, including multiple-choice questions (MCQs). MEQs often form a vital component of end-of-course assessments in higher education. It is not clear how effectively these questions assess higher order cognitive skills. This study was designed to assess the effectiveness of the MEQ to measure higher-order cognitive skills in an undergraduate institution.
Methods
An analysis of multiple-choice questions and modified essay questions (MEQs) used for summative assessment in a clinical undergraduate curriculum was undertaken. A total of 50 MCQs and 139 stages of MEQs were examined, which came from three exams run over two years. The effectiveness of the questions was determined by two assessors and was defined by the questions ability to measure higher cognitive skills, as determined by a modification of Bloom's taxonomy, and its quality as determined by the presence of item writing flaws.
Results
Over 50% of all of the MEQs tested factual recall. This was similar to the percentage of MCQs testing factual recall. The modified essay question failed in its role of consistently assessing higher cognitive skills whereas the MCQ frequently tested more than mere recall of knowledge.
Conclusion
Construction of MEQs, which will assess higher order cognitive skills cannot be assumed to be a simple task. Well-constructed MCQs should be considered a satisfactory replacement for MEQs if the MEQs cannot be designed to adequately test higher order skills. Such MCQs are capable of withstanding the intellectual and statistical scrutiny imposed by a high stakes exit examination.
doi:10.1186/1472-6920-7-49
PMCID: PMC2148038  PMID: 18045500
3.  A method for creating interactive content for the iPod, and its potential use as a learning tool: Technical Advances 
Background
Podcasting is currently a popular means of delivery of information with a large number of podcasts specifically tailored for educational purposes. It can be argued that the passive nature of this teaching methodology limits the educational benefit that can be derived from podcasts. This paper describes the development and construction of interactive material for the iPod, and a survey of student attitudes towards this type of learning material.
Methods
The development of interactive material for an iPod is described in detail. This material was developed and demonstrated to 50 medical students. These students completed a paper-based survey on the potential uses of this technology, before and after a 20 minute presentation in class of an interactive case-study on an iPod.
Results
A technical description of how to develop interactive content for the iPod was created. The results of the student survey indicate a favourable shift in student attitudes after viewing the interactive case. Despite only 15% of the students owning an iPod, 57% of the students were positive about having access to interactive iPod content and 59% believed they would use it whilst travelling. The percentage of students who felt podcasting was a useful means of learning increased from 9% to 41%.
Conclusion
The development of interactive content for the iPod is feasible. There are indications that students view interactive iPod cases as having value as an additional learning resource.
doi:10.1186/1472-6920-7-32
PMCID: PMC2174451  PMID: 17888168
4.  Assessment of an electronic voting system within the tutorial setting: A randomised controlled trial [ISRCTN54535861] 
Background
Electronic voting systems have been used in various educational settings with little measurement of the educational impact on students. The goal of this study was to measure the effects of the inclusion of an electronic voting system within a small group tutorial.
Method
A prospective randomised controlled trial was run at the Royal Adelaide Hospital, a teaching hospital in Adelaide, Australia. 102 students in their first clinical year of medical school participated in the study where an electronic voting system was introduced as a teaching aid into a standard tutorial. Long-term retention of knowledge and understanding of the topics discussed in the tutorials was measured and student response to the introduction of the electronic voting system was assessed.
Results
Students using the electronic voting system had improved long-term retention of understanding of material taught in the tutorial. Students had a positive response to the use of this teaching aid.
Conclusion
Electronic voting systems can provide a stimulating learning environment for students and in a small group tutorial may improve educational outcomes.
doi:10.1186/1472-6920-5-24
PMCID: PMC1180440  PMID: 16000178

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