CoChat
Sign Up
Cited by 39Innovations in Medical EducationStudent Assessment and FeedbackClinical Reasoning and Diagnostic Skills

Formative assessment and feedback in medical education: A practical guide: AMEE Guide No. 189

Open access
Lipnevich, Anastasiya A., Mattern, Krista, Feddock, Christopher·2026·Medical Teacher
DOI 10.1080/0142159x.2025.2569623
Open this paper in CoChat — free accountOpen PDF

Abstract

Formative assessment and feedback are foundational to effective medical education, shaping not only what students learn but how they learn and improve over time. As healthcare education increasingly emphasizes competence, adaptability, and lifelong learning, the strategic use of formative practices becomes essential for fostering reflective, skilled, and responsive professionals. Despite the recognized importance of these tools, implementation often remains fragmented or overly reliant on traditional summative structures. This guide responds to that gap by offering evidence-based, practically grounded guidelines for integrating formative assessment and feedback across medical education contexts. Drawing from both the medical and broader educational literature, we present a coherent framework that includes key elements such as continuous assessment, alignment with learning objectives, inclusivity, validity, timeliness, peer and self-assessment, and technology-enabled feedback. By addressing persistent challenges and illustrating principles with real-world examples, this paper provides educators with actionable strategies to enhance learning and improve assessment literacy within clinical and academic environments.

Verified 2026-10-06 · 1 reference not checked yet

AI snapshot

Written from the paper’s full text.

TL;DR

This AMEE guide synthesizes evidence-based practical guidelines for integrating formative assessment and feedback across medical education, organized around six domains from principles to curriculum integration. It argues that formative assessment and assessment for learning are functionally equivalent and emphasizes continuous, aligned, inclusive, valid assessment plus timely, specific, actionable feedback.

Key findings

  • The guide proposes six main sections: principles of effective formative assessment (frequency, alignment, inclusivity, validity); principles of effective formative feedback (clear, specific, timely, growth mindset); methods (peer assessment, simulations, written/verbal feedback); instructor and learner roles; technology; and curriculum integration.
  • It argues formative assessment and assessment for learning share the same central aim—using assessment evidence to guide instruction and support learner improvement—and that if feedback is generated but not acted upon, the assessment ceases to be formative. Programmatic assessment extends this by strategically collecting multiple low-stakes data points over time.
  • Feedback recommendations include tailoring timing to task complexity: immediate feedback often helps simpler skill-based tasks, while delayed feedback may benefit complex tasks such as clinical reasoning. Specific, actionable feedback outperforms vague comments, and the “feedback sandwich” may dilute constructive feedback and lead students to anchor on praise.
  • Technology and AI can support formative assessment through online quizzes with instant feedback, simulations/VR, feedback analytics, and personalized feedback, but the guide stresses transparency, fairness, privacy, and that AI should supplement rather than replace human judgment.

Methods

  • Design: AMEE Guide No. 189, a practical guide/evidence-based guidelines rather than a primary empirical study, drawing from medical and broader educational literature and real-world examples.
  • Data or sample: No original dataset or systematic sample is reported; illustrative examples come from medical education contexts such as OSCEs, simulations, peer assessment, and quizzes.
  • Main analysis: Narrative synthesis organized into six sections with practice points and a summary table; no quantitative meta-analysis or primary outcome analysis is reported.

Limitations

  • The paper does not include a formal limitations section for the guide itself; it acknowledges broader implementation challenges such as fragmented use of formative practices, alignment with varying curricula, and ensuring technology does not exacerbate inequities.
  • Evident from the text: it is a narrative practical guide without stated systematic search, inclusion criteria, or quality appraisal, so recommendations are synthesized and illustrative rather than derived from a systematic review.
  • Evident from the text: it reports no original quantitative outcomes or effect sizes; cited efficacy evidence is summarized without numbers, and ethical/implementation concerns around AI and technology are discussed but not empirically tested here.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1080/0142159x.2025.2569623

Cites

118 of 119 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 132 cited sources checked · 0 supported · 0 flagged

  • Premisecitation

    Tools like rubrics, checklists, or rating scales, such as the Mini-CEX, provide structured criteria for performance evaluation.

    “Tools like rubrics, checklists, or rating scales, such as the Mini-Clinical Evaluation Exercise (Mini-CEX), provide structured criteria for performance evaluation [53][54][55].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [53] source

      Not checked in the free run.

    • cites [54] source

      Not checked in the free run.

    • cites [55] source

      Not checked in the free run.

  • Premisecitation

    The complexity of implementing effective formative assessment and feedback systems is amplified by the scale and diversity of medical education programs.

    “The complexity of implementing effective formative assessment and feedback systems is further amplified by the scale and diversity of medical education programs [11].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] source

      Not checked in the free run.

  • Interpretationreasoning

    By providing multiple opportunities for learners to demonstrate progress, formative assessment reduces the impact of external factors such as test anxiety or a single poor performance.

    “By providing multiple opportunities for learners to demonstrate progress, formative assessment reduces the impact of external factors, such as test anxiety or a single poor performance.”
    Quote in the paperSubstantial claim
  • Interpretationcitation

    Alignment between assessments and learning objectives ensures that formative practices are both purposeful and effectively targeted.

    “Alignment between assessments and learning objectives ensures that formative practices are both purposeful and effectively targeted.”
    Quote in the paperSubstantial claim
  • Interpretationreasoning

    Formative assessment is inherently more equitable because it emphasizes growth, individualized feedback, and ongoing improvement rather than one-time high-stakes evaluations.

    “Formative assessment is inherently more equitable because it emphasizes growth, individualized feedback, and ongoing improvement rather than one-time high-stakes evaluations.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 39
  • May combine two claims. 50

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    AfL includes practices such as clearly articulating learning intentions, sharing success criteria, promoting dialogue about learning, and providing feedback students can use to improve future performance.

    “According to this framework, AfL includes practices such as clearly articulating learning intentions, sharing success criteria with students, promoting dialogue about learning, and providing feedback that students can use to improve future performance.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisereasoning

    Programmatic assessment relies on systematic aggregation, expert interpretation, and structured mentoring, unlike AfL and formative assessment which are typically embedded within day-to-day teaching.

    “In contrast to AfL and formative assessment, which are typically embedded within day-to-day teaching, programmatic assessment relies on systematic aggregation, expert interpretation, and structured mentoring.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    When learning objectives are clearly defined, students gain a better understanding of what is expected and can direct their efforts toward mastering relevant competencies.

    “When learning objectives are clearly defined, students gain a better understanding of what is expected of them and can direct their efforts toward mastering relevant competencies.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The use of standardized tools reduces subjectivity, ensuring that evaluations are equitable and reliable.

    “Additionally, the use of standardized tools reduces subjectivity, ensuring that evaluations are equitable and reliable [57].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [57] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationnone given

    Transparency in aligning assessments with learning objectives fosters trust, promotes fairness, and supports student motivation.

    “Transparency in aligning assessments with learning objectives fosters trust, promotes fairness, and supports student motivation.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationnone given

    Inclusive formative assessments actively avoid cultural bias and improve accessibility for learners with disabilities.

    “Inclusive formative assessments actively avoid cultural bias and improve accessibility for learners with disabilities.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    Whether labeled formative assessment or AfL, the essential components remain the same: assessment activities are embedded within instruction, tied to explicit learning goals, and used to generate timely and useful feedback that advances learner development.

    “Whether labeled formative assessment or AfL, the essential components remain the same.Assessment activities are embedded within the instructional process, tied to explicit learning goals, and used to generate timely and useful feedback that advances learner development.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In programmatic assessment, each piece of evidence, whether formative or summative, is deliberately gathered to support learner development and guide high-stakes judgments about competence.

    “Each piece of evidence, whether formative or summative, is deliberately gathered to support learner development and guide high-stakes judgments about competence.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [16]

      Not checked in the free run.

    • cites [27] source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Inclusivity is a foundational principle of effective formative assessment, ensuring that all students have equitable opportunities to succeed.

    “Inclusivity is a foundational principle of effective formative assessment, ensuring that all students, regardless of background, ability, or any other demographic characteristics, have equitable opportunities to succeed.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Without purposeful use of assessment data, assessments risk being mislabeled as formative and fail to contribute meaningfully to learning.

    “Without such purposeful use, assessments risk being mislabeled as formative, thereby failing to contribute meaningfully to the learning process.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Clear rubrics improve students' understanding of assessment criteria and enhance their performance.

    “Research demonstrates that clear rubrics not only improve students' understanding of assessment criteria but also enhance their performance.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [56] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Bloom extended formative evaluation to the classroom, emphasizing ongoing assessment to diagnose student misunderstandings and tailor instruction to promote mastery learning.

    “A few years later, Bloom [23] extended this idea to the classroom, emphasizing the use of ongoing assessment to diagnose student misunderstandings and tailor instruction to promote mastery learning.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Formative assessment allows for personalized support, addressing diverse learning needs and helping to close achievement gaps.

    “Additionally, it allows for personalized support, addressing diverse learning needs and helping to close achievement gaps [61][62][63].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [61] source

      Not checked in the free run.

    • cites [62] source

      Not checked in the free run.

    • cites [63] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Miller's Pyramid of Clinical Competence serves as a valuable framework, emphasizing progression through four levels: 'knows,' 'knows how,' 'shows how,' and 'does.'

    “Miller's Pyramid of Clinical Competence [49,50] serves as a valuable framework, emphasizing progression through four levels: 'knows,' 'knows how,' 'shows how,' and 'does.'”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [49] source

      Not checked in the free run.

    • cites [50] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Programmatic assessment shifts the focus from isolated assessment events to the strategic collection and integration of multiple low-stakes data points over time.

    “Gaining prominence in medical education, programmatic assessment shifts the focus from isolated assessment events to the strategic collection and integration of multiple low-stakes data points over time [16,27].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [16]

      Not checked in the free run.

    • cites [27] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Scenarios in simulations that represent diverse patient demographics help students develop cultural competence and sensitivity.

    “For instance, scenarios in simulations should represent diverse patient demographics, such as variations in age, gender, ethnicity, and socioeconomic status.This approach helps students develop cultural competence and sensitivity, as these skills are critical to effective medical practice [64].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [64] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The strategies endorsed by AfL are substantively aligned with those found in the formative assessment literature.

    “While AfL places particular emphasis on the learner's active role in the assessment process, the strategies it endorses are substantively aligned with those found in the formative assessment literature.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Scriven first introduced the term formative evaluation to describe collecting information during development or implementation of an educational program to improve it.

    “Scriven [20] first introduced the term formative evaluation to describe the process of collecting information during the development or implementation of an educational program in order to improve it.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Significant challenges remain in ensuring alignment with varying curricula, gathering longitudinal evidence of student growth, and developing flexible implementation models that accommodate diverse learning objectives and timelines.

    “While technological advancements offer promising solutions through digital platforms, high-fidelity simulations, and streamlined feedback mechanisms, significant challenges remain in ensuring alignment with varying curricula, gathering longitudinal evidence of student growth, and developing flexible implementation models that can accommodate diverse learning objectives and timelines [12,13].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [12]

      Not checked in the free run.

    • cites [13] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Cultural humility improves patient care, and formative assessments provide opportunities for students to practice these skills.

    “Tervalon and Murray-Garc ıa [65] emphasize the role of cultural humility in improving patient care, and formative assessments provide valuable opportunities for students to practice these skills in a controlled and supportive environment.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [65] source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Effective feedback is fundamentally future-oriented; it aims to bridge the gap between current performance and desired learning goals by providing clear guidance on how to improve.

    “Effective feedback is fundamentally future-oriented; it aims to bridge the gap between current performance and desired learning goals by providing learners with clear guidance on how to improve [81].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [81] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Immediate feedback is not always a requirement; some tasks benefit from delayed feedback in terms of learner outcomes.

    “However, studies in general education [75] and industrial-organizational contexts [76] suggest that immediate feedback is not always a requirement; in fact, some tasks benefit from delayed feedback in terms of the impact on learner outcomes, as it provides learners with the opportunity for self-reflection and deeper processing of their performance.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [75] source

      Not checked in the free run.

    • cites [76] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    This approach encourages learners to take ownership of their progress and fosters a more meaningful dialogue between instructor and student.

    “This approach encourages learners to take ownership of their progress and fosters a more meaningful dialogue between instructor and student.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given

    Assessments administered too frequently might overwhelm students, leading to heightened stress and anxiety.

    “For example, assessments administered too frequently might overwhelm students, leading to heightened stress and anxiety.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Peer assessment, when implemented with clear guidelines and adequate training, serves as a valuable complement to instructor-led evaluations, providing diverse perspectives on performance and promoting active engagement in the learning process.

    “When implemented with clear guidelines and adequate training, it serves as a valuable complement to instructor-led evaluations, providing diverse perspectives on performance while promoting active engagement in the learning process [86,87].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [86] source

      Not checked in the free run.

    • cites [87] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    This level of specificity not only clarifies expectations but also builds learners' confidence in their ability to improve.

    “This level of specificity not only clarifies expectations but also builds learners' confidence in their ability to improve [79,80].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [79] source

      Not checked in the free run.

    • cites [80] source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Together, validity and efficacy evidence offer a comprehensive understanding of how and why formative assessments are effective tools in education.

    “Together, these components offer a comprehensive understanding of how and why formative assessments are effective tools in education.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Structured debriefings after formative simulated tasks can normalize errors and encourage reflective learning.

    “For example, structured debriefings after formative simulated tasks can normalize errors and encourage reflective learning, transforming mistakes into valuable teaching moments.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Through feedback, students gain a clearer understanding of their strengths and areas for improvement, empowering them to set goals and strategies for ongoing progress.

    “Through feedback, students gain a clearer understanding of their strengths and areas for improvement, empowering them to set goals and strategies for ongoing progress.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationnone given

    Students may anchor on the initial praise statement and thus overestimate their performance, limiting opportunities for meaningful improvement.

    “Students may also anchor on the initial praise statement and thus overestimate their performance, limiting opportunities for meaningful improvement.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Feedback is a cornerstone of formative assessment, providing learners with essential insights into their performance and guiding their development.

    “Feedback is a cornerstone of formative assessment, providing learners with essential insights into their performance and guiding their development [8,72].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [8] source

      Not checked in the free run.

    • cites [72] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Peer assessment exercises encourage learners to articulate their reasoning, compare approaches, and refine their understanding through dialogue and critique.

    “This exercise encourages learners to articulate their reasoning, compare approaches, and refine their understanding through dialogue and critique [89,90].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [89] source

      Not checked in the free run.

    • cites [90] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Research on assessment clarity highlights its role in reducing performance disparities and enhancing fairness.

    “Research on assessment clarity highlights its role in reducing performance disparities and enhancing fairness [66,67].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [66] source

      Not checked in the free run.

    • cites [67] source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Providing step-by-step instructions, glossaries, and preparatory materials ensures all students have a shared understanding of what is required.

    “Providing step-by-step instructions, glossaries of terms, and preparatory materials ensures that all students have a shared understanding of what is required.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Peer feedback enhanced students' communication skills while simultaneously maintaining a supportive and collegial learning environment.

    “Lovink et al. [88] found that peer feedback enhanced students' communication skills while simultaneously maintaining a supportive and collegial learning environment.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [88] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Engaging in the evaluation of peers develops critical self-reflection abilities and appreciation of diverse viewpoints.

    “By engaging in the evaluation of peers, students develop critical self-reflection abilities while learning to appreciate diverse viewpoints, fostering a richer learning experience [93].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [93] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Peer assessment in clinical training improves interpersonal skills and contributes to readiness for team-based environments.

    “Cestone and Michaelsen [95] demonstrated that peer assessment in clinical training improves interpersonal skills and contributes to readiness for teambased environments.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [95] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Such measures level the playing field and reduce unnecessary cognitive load, allowing students to focus on demonstrating their abilities.

    “Such measures level the playing field and reduce unnecessary cognitive load, allowing students to focus on demonstrating their abilities.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Objective Structured Clinical Examinations (OSCEs) have become a cornerstone of medical education, offering structured and standardized environments to evaluate clinical skills systematically.

    “Objective Structured Clinical Examinations (OSCEs) have become a cornerstone of medical education, offering structured and standardized environments to evaluate clinical skills systematically [79,80,97].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [79] source

      Not checked in the free run.

    • cites [80] source

      Not checked in the free run.

    • cites [97] source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Clear and transparent instructions are a cornerstone of inclusive formative assessment.

    “Clear and transparent instructions are another cornerstone of inclusive formative assessment.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Guiding students to focus on specific competencies ensures that their critiques remain relevant and actionable.

    “For example, guiding students to focus on specific competencies, such as clinical reasoning or communication, ensures that their critiques remain relevant and actionable [94].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [94] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    By offering timely and specific guidance, feedback helps learners make meaningful adjustments and nurtures a supportive learning environment.

    “By offering timely and specific guidance, feedback helps learners to make meaningful adjustments and nurtures a supportive learning environment where students can actively engage with their learning process.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Psychologically safe environments improve learning outcomes and enhance student well-being.

    “Dong et al. [68] found that psychologically safe environments not only improve learning outcomes but also enhance student well-being, reinforcing the importance of inclusive and supportive formative assessment strategies in medical education.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [68] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    Feedback that is vague or inconsistent can demotivate learners, leaving them uncertain about how to improve.

    “Similarly, feedback that is vague or inconsistent can demotivate learners, leaving them uncertain about how to improve.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Seeking student feedback helps identify barriers to inclusion and promotes a culture of continuous improvement.

    “This process helps identify barriers to inclusion and promotes a culture of continuous improvement [69].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [69] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    By balancing frequency, clarity, and relevance of assessments, educators can maximize impact on learning while minimizing negative side effects.

    “By balancing the frequency, clarity, and relevance of assessments, educators can maximize their impact on learning while minimizing negative side effects.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    This forward-looking perspective is critical in medical education, where ongoing development of complex competencies requires continuous reflection and adjustment.

    “This forward-looking perspective is critical in medical education, where ongoing development of complex competencies requires continuous reflection and adjustment.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Self-assessment encourages critical engagement with learning materials, reflection on work, and self-awareness of academic and clinical development.

    “When incorporated into formative assessment models, self-assessment encourages critical engagement with learning materials, encouraging students to reflect on their work and become more self-aware of their academic and clinical development [120,121].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [120] source

      Not checked in the free run.

    • cites [121] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Annotated exemplars that illustrate exemplary and suboptimal approaches guide learners in recognizing quality benchmarks and understanding the nuances of effective clinical practice.

    “Annotated exemplars that illustrate exemplary and suboptimal approaches can further guide learners in recognizing quality benchmarks and understanding the nuances of effective clinical practice [114].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [114] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    AI simulations can adapt to a learner's performance, providing personalized, dynamic feedback that helps students practice clinical skills, refine decision-making, and improve their diagnostic reasoning in a controlled, risk-free environment.

    “AI simulations can adapt to a learner's performance, providing personalized, dynamic feedback that helps students practice clinical skills, refine decision-making, and improve their diagnostic reasoning in a controlled, risk-free environment [107].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [107] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Educators play a vital role in fostering self-reflection by creating environments that encourage introspection and open dialogue.

    “Educators play a vital role in fostering selfreflection by creating environments that encourage introspection and open dialogue [117].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [117] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Feedback from both standardized patients and instructors provides a dual perspective, helping learners refine their communication approach while enhancing emotional intelligence and professionalism.

    “Feedback from both the SP and instructors provides a dual perspective, helping learners refine their communication approach while enhancing emotional intelligence and professionalism [105,106].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [105] source

      Not checked in the free run.

    • cites [106] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Self-assessment supports the development of clinical skills, accountability, and a well-grounded understanding of professional standards.

    “By encouraging learners to evaluate their own progress and reflect critically on their performance, self-assessment supports the development of clinical skills, accountability, and a well-grounded understanding of professional standardsskills essential for success in medical education and practice [123,126].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [123] source

      Not checked in the free run.

    • cites [126] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Self-reflection bridges theoretical knowledge and practical application, increasing both competence and confidence.

    “These findings highlight the role of self-reflection in bridging theoretical knowledge and practical application, increasing both competence and confidence.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Immediate feedback during simulations is a crucial factor in improvements, enabling learners to correct errors promptly and avoid the formation of bad habits.

    “Immediate feedback during simulations was identified as a crucial factor in these improvements, enabling learners to correct errors promptly and avoid the formation of bad habits.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [104] source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Reflective practice enables professionals to analyze their experiences and adapt to complex clinical scenarios.

    “Sch€ on [115] characterized reflective practice as 'thinking on action' and 'thinking in action,' processes that enable professionals to analyze their experiences and adapt to complex clinical scenarios.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [115]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Technologies advance interactive and engaging assessment experiences that can cater to diverse learning preferences, ensuring students remain engaged and motivated.

    “These technologies also advance interactive and engaging assessment experiences that can cater to diverse learning preferences, ensuring that students remain engaged and motivated [127,128].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [127]

      Not checked in the free run.

    • cites [128]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    AI can deliver rapid feedback but must be designed with fairness and accuracy in mind to avoid bias.

    “A study by Binns et al. [143] found that while AI can deliver rapid feedback, it must be designed with fairness and accuracy in mind to avoid bias.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [143]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Joint assessments between universities and healthcare organizations resulted in more consistent and meaningful evaluations, ultimately preparing students more effectively for clinical practice.

    “A multi-institutional study by Lurie et al. [145] highlighted how joint assessments between universities and healthcare organizations resulted in more consistent and meaningful evaluations, ultimately preparing students more effectively for clinical practice.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [145]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Immediate review process reinforces learning, helps students identify specific areas for improvement, and solidifies correct techniques and protocols.

    “This immediate review process reinforces learning, helps students identify specific areas for improvement, and solidifies correct techniques and protocols [102,103].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [102]

      Not checked in the free run.

    • cites [103] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Approaches such as selecting appropriate content, providing explicit assessment criteria, encouraging feedback-seeking behaviors, supporting a growth mindset, and offering high-quality feedback improve the accuracy of self-assessment and promote deeper engagement with reflection and meaningful action.

    “These approaches not only improve the accuracy of self-assessment but also promote deeper engagement with reflection and more meaningful action in response to feedback [123-125].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [123] source

      Not checked in the free run.

    • cites [124] source

      Not checked in the free run.

    • cites [125] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Interprofessional simulation experiences improve teamwork competencies and readiness for real-world healthcare environments.

    “Studies have shown that such experiences improve teamwork competencies and readiness for real-world healthcare environments [108].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [108] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Data analytics is transforming formative assessment in medical education by providing detailed insights into student performance, enabling more personalized and effective teaching strategies.

    “Data analytics is transforming formative assessment in medical education by providing detailed insights into student performance, enabling more personalized and effective teaching strategies [134].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [134] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Identification of gaps in procedural skills led to more targeted interventions and improved learning outcomes.

    “This identification led to more targeted interventions and improved learning outcomes, ensuring that students received the support they needed to address specific areas of difficulty.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [135] source

      Not checked in the free run.

    • cites [136] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Simulations support skill acquisition and confidence building in a safe, realistic setting.

    “By replicating real-world challenges without the risk to actual patients, simulations support skill acquisition and confidence building in a safe, yet realistic, setting [100,101].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [100] source

      Not checked in the free run.

    • cites [101] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Considering the roles of both instructors and learners in the assessment process enables medical educators to create a collaborative, self-regulated learning environment.

    “Furthermore, by considering the roles of both instructors and learners in the assessment process, medical educators can create a collaborative, selfregulated learning environment.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationnone given

    As medical education continues to evolve, it is essential that formative assessments are seamlessly integrated into the curriculum and aligned with national competency frameworks.

    “As medical education continues to evolve, it is essential that formative assessments are seamlessly integrated into the curriculum and aligned with national competency frameworks.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given

    Promoting shared responsibility and collective expertise enhances the quality of assessment, ensuring that future healthcare professionals are well-prepared to meet the challenges of modern medical practice.

    “By promoting shared responsibility and collective expertise, this model enhances the quality of assessment, ensuring that future healthcare professionals are well-prepared to meet the challenges of modern medical practice.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationnone given

    Adhering to ethical standards, including the responsible use of AI, and facilitating collaboration with the health professions community enables educators to develop assessments that truly reflect the demands of clinical practice and prepare students to become effective, compassionate healthcare professionals.

    “By adhering to ethical standards, including the responsible use of AI, and facilitating collaboration with the health professions community, educators can develop assessments that truly reflect the demands of clinical practice and prepare students to become effective, compassionate healthcare professionals.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationnone given

    The integration of effective formative assessment and feedback practices into medical education is crucial for preparing learners for the challenges of modern healthcare practice.

    “The integration of effective formative assessment and feedback practices into medical education is crucial for preparing learners for the challenges of modern healthcare practice.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationnone given

    Effective formative assessment involves providing feedback that is timely, specific, and actionable, while promoting self-reflection and critical thinking.

    “It also involves providing feedback that is timely, specific, and actionable, while promoting self-reflection and critical thinking.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    Ensuring that assessments are continuous, aligned with learning objectives, inclusive, and based on sound evidence of validity and efficacy enables medical educators to provide valuable feedback that contributes to student learning and fosters professional growth.

    “By ensuring that assessments are continuous, aligned with learning objectives, inclusive, and based on sound evidence of validity and efficacy, medical educators can provide valuable feedback that contributes to student learning and fosters professional growth.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    Effective formative assessment requires careful attention to the variety of assessment methods used, ensuring that they address the full spectrum of competencies necessary for medical practice.

    “Effective formative assessment requires careful attention to the variety of assessment methods used, ensuring that they address the full spectrum of competencies necessary for medical practice.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    Formative assessment is not merely an idiosyncratic evaluative tool but a dynamic process that supports student learning and growth.

    “To conclude, formative assessment is not merely an idiosyncratic evaluative tool but a dynamic process that supports student learning and growth.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationnone given

    Implementing these guidelines enables medical educators to ensure that their students are not only prepared to meet the challenges of medical practice but are also equipped with the skills, knowledge, and attitudes necessary for lifelong learning and continuous improvement in healthcare.

    “By implementing these guidelines, medical educators can ensure that their students are not only prepared to meet the challenges of medical practice but are also equipped with the skills, knowledge, and attitudes necessary for lifelong learning and continuous improvement in healthcare.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    Self-assessment and reflection, coupled with data-driven insights, can help learners take ownership of their progress and further develop their clinical skills.

    “Self-assessment and reflection, coupled with data-driven insights, can help learners take ownership of their progress and further develop their clinical skills.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationnone given

    Combining written and verbal feedback, integrating peer assessment opportunities, and leveraging technology enables educators to create a rich learning environment that encourages deep engagement and supports continuous improvement.

    “By combining written and verbal feedback, integrating peer assessment opportunities, and leveraging technology, educators can create a rich learning environment that encourages deep engagement and supports continuous improvement.”
    Quote in the paperNot a substantial claim
77 of 77

  • The paper relies on this without support.

    Formative assessment and feedback are foundational to effective medical education, shaping what students learn and how they improve over time.

    “Formative assessment and feedback are foundational to effective medical education, shaping not only what students learn but how they learn and improve over time.”

  • The paper relies on this without support.

    Implementation of formative assessment and feedback often remains fragmented or overly reliant on traditional summative structures.

    “Despite the recognized importance of these tools, implementation often remains fragmented or overly reliant on traditional summative structures.”

  • The paper relies on this without support.

    Continuous assessment plays a critical role in maintaining student engagement and ensuring their learning progresses effectively.

    “Continuous assessment plays a critical role in maintaining student engagement and ensuring their learning progresses effectively.”

  • The paper relies on this without support.

    Medical students bring diverse experiences, perspectives, and learning needs, and assessments should be designed to reflect and accommodate this diversity.

    “Medical students bring diverse experiences, perspectives, and learning needs, and assessments should be designed to reflect and accommodate this diversity.”

  • The paper relies on this without support.

    Addressing assessment-related stress is critical to fostering inclusivity in formative assessment practices.

    “Addressing assessment-related stress is also critical to fostering inclusivity in formative assessment practices.”

  • The paper relies on this without support.

    Peer assessment is widely used as part of formative assessment approaches.

    “Peer assessment is widely used as part of formative assessment approaches.”

  • The paper relies on this without support.

    Structures like the feedback sandwich may not be the optimal approach.

    “However, structures like the feedback sandwich, still recommended in some publications, may not be the optimal approach.”

  • The paper relies on this without support.

    Peer assessment has challenges such as potential bias, discomfort in providing honest critiques, or inconsistency in feedback quality.

    “Issues such as potential bias, discomfort in providing honest critiques, or inconsistency in feedback quality must be addressed proactively.”

  • The paper relies on this without support.

    Structured training is essential for peer assessment.

    “Structured training is essential, teaching students how to deliver feedback that is constructive, respectful, and grounded in objective criteria.”

  • The paper relies on this without support.

    Tools like checklists or rubrics can standardize peer assessment and enhance its reliability.

    “Tools like checklists or rubrics can standardize the process and enhance its reliability.”

  • The paper relies on this without support.

    Immediate feedback following OSCE assessments is invaluable.

    “Immediate feedback following these assessments is invaluable, as it allows educators to clarify misconceptions, reinforce correct techniques, and guide students toward higher levels of proficiency.”

  • The paper relies on this without support.

    Simulations provide controlled, risk-free environments where learners can develop and refine clinical skills, decision-making, and teamwork.

    “Simulations provide controlled, risk-free environments where learners can develop and refine clinical skills, decision-making, and teamwork.”

  • The paper relies on this without support.

    Debriefing sessions provide an essential opportunity for reflection and feedback.

    “Debriefing sessions, often supported by video recordings of the simulation, provide an essential opportunity for reflection and feedback.”

  • The paper relies on this without support.

    Written feedback provides a durable reference that students can revisit, fostering deeper reflection and long-term learning.

    “Written feedback provides a durable reference that students can revisit, fostering deeper reflection and long-term learning.”

  • The paper relies on this without support.

    Verbal feedback facilitates immediate clarification and dialogue.

    “In contrast, verbal feedback facilitates immediate clarification and dialogue, enabling students to ask questions, address misunderstandings, and deepen their understanding of key concepts.”

  • The paper relies on this without support.

    Combining written and verbal feedback enhances the overall impact of feedback.

    “When combined, these approaches enhance the overall impact of feedback by balancing reflection and real-time interaction.”

  • The paper relies on this without support.

    Self-reflection is a cornerstone of lifelong learning and a critical element of professional development in medicine.

    “Self-reflection is a cornerstone of lifelong learning and a critical element of professional development in medicine.”

  • The paper relies on this without support.

    Formative assessment is most effective when instructors and learners engage as active collaborators in the learning process.

    “Formative assessment is most effective when instructors and learners engage as active collaborators in the learning process.”

  • The paper relies on this without support.

    Uninformed global self-assessments, particularly those made without reference to specific standards, are often inaccurate and have limited value in workplace-based curricula.

    “Despite these benefits, research has consistently shown that uninformed global self-assessments, particularly those made without reference to specific standards, are often inaccurate and have limited value in workplace-based curricula.”

  • The paper relies on this without support.

    The integration of technology in formative assessment plays an increasingly crucial role in enhancing the learning experience.

    “As medical education continues to evolve, the integration of technology in formative assessment plays an increasingly crucial role in enhancing the learning experience.”

  • The paper relies on this without support.

    Privacy and data security are paramount in AI use.

    “Privacy and data security are also paramount.”

  • The paper relies on this without support.

    Cultivating collaboration among educators, administrators, and health professionals ensures that formative assessments are meaningful, reflective of real-world practices, and aligned with both national and global healthcare competency standards.

    “In summary, cultivating collaboration among educators, administrators, and health professionals ensures that formative assessments are meaningful, reflective of real-world practices, and aligned with both national and global healthcare competency standards.”
22 of 22

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Research works printed but not linked: 20

  1. Govaerts M, van der Vleuten C, Schuwirth L. Advancing the use of formative assessment: incorporating insights from the theory of formative feedback. Med Educ. 2013;47(2):130–139.
  2. 10.1080/0142159x.2024.1234567 · DOI
  3. Scriven M. The methodology of evaluation. Washington (DC): American Educational Research Association; 1967.
  4. Assessment Reform Group. Assessment for learning: 10 principles. University of Cambridge Faculty of Education; Cambridge UK. 2002.
  5. Sargeant J Watling C. Instructional feedback in medical education. In: Lipnevich AA Smith JK editors. The Cambridge handbook of instructional feedback. Cambridge UK: Cambridge University Press; 2018.
  6. 10.4300/jgme-d-19-00115.1 · DOI
  7. Chatterjee D, Corral J. How to write well-defined learning objectives. J Educ Perioper Med. 2017;19(4):E610.
  8. Van der Kleij FM, Feskens RC, Eggen TJ. The influence of feedback on students’ learning and performance: a meta-analysis. Educ Psychol Rev. 2015;27(1):105–126.
  9. 10.0000/pmid12469676 · DOI
  10. 10.1043/1536-5026-030.002.0091 · DOI
  11. 10.1111/j.1365-2929.2004.02073.x · DOI
  12. Cilliers F, Terblanche M. Medical educators as facilitators of learning: a role that needs to be nurtured. Med Educ. 2014;48(2):106–113.
  13. Sargeant J, Lockyer J, Mann K. Assessment in medical education: from theory to practice. Med Educ. 2008;42(3):254–262.
  14. Mastour H, Eslami S, Nili M. Real time electronic formative assessment in medical education and its impact on learning. Educ Strat Med Sci. 2019;12:61–68.
  15. Brown PL, Roediger HL, McDaniel MA. Quizzes and tests enhance long-term retention in a university psychology course. Learn Instr. 2014;29:14–19.
  16. Bennett D, Chon J, Knox R. The impact of formative quizzes on medical students’ performance in medical education. Med Educ. 2013;47(8):811–818.
  17. Tomlinson CA. Differentiated instruction: meeting the needs of all learners. Educ Leader. 2001;59(1):12–19.
  18. Binns JM, Scott T, Kelly C. Exploring the use of artificial intelligence for assessment in medical education. Med Teach. 2020;42(7):759–765.
  19. Hauer KE, Richards BF, Durning SJ. Faculty development for formative assessment in medical education. Acad Med. 2007;82(10):986–991.
  20. Lurie N, Bowen J, Kaufman A. Collaborative efforts in medical education: a case study. J Med Educ. 2009;44(5):424–431.

Cited by

Sorted by citations

Related

Authors
Lipnevich, A. A., Mattern, K., & Feddock, C.
Affiliations
National Board of Medical Examiners (US)
Corresponding author
Lipnevich, Anastasiya A.
ORCID
Venue
Medical Teacher
Publisher
Informa UK Limited
Published
2025-10-24
Volume
48
Issue
6
Pages
921-940
ISSN
  • 0142-159X (ISSN-L)
  • 1466-187X
DOI
10.1080/0142159x.2025.2569623
OpenAlex
W4415524950
Cited by
37
References
118
Citations by year
2026: 36 · 2025: 1
FWCI
33.10
Type
journal article
Language
en
Open access
Licence
Locations
  • Medical Teacher (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
  • Social Sciences › Education › Student Assessment and Feedback
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
Keywords
formative assessment, feedback, medical education, continuous assessment, learning objectives, peer assessment, self-assessment, assessment literacy, summative assessment, assessment validity
MeSH terms
Formative Feedback, Education, Medical, Educational Measurement, Feedback, Humans, Learning, Guidelines as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review