Table 3. Impact of the switch from summative to formative assessments as perceived by medical students year 2 to 5 (n=305).

Themes	Representative quotes *
Alleviation of stress	Less pressure Relief Much less stress, healthier learning conditions
Decreased motivation for study	I feel less involved in my learning, it comes as a surprise because I thought I was conscientious enough in order not to lose in motivation Less motivation for learning and studying long hours Much more difficult to stay motivated
No impact	No impact No change. I studied as if it was a real exam.
Increased motivation for study	More motivated to study. More time to gain in-depth knowledge. Renewed motivation. I again enjoyed learn new things, for the future, and not just for an exam. I learned more out of curiosity and pleasure, and less according to the learning objectives.
Fear of gaps in knowledge	Anxiety about going on with my studies, without any evidence of my competencies and capacity to pass to the next level. Less involvement in studying, less knowledge acquired All our 4 th year exams cancelled, hence fear for the Federal Licensing Exam
Free time for other activities	Since the assessments were not summative, I could engage in volunteer work at the hospital. It allowed me to participate a little more in the health crisis. I have free time for other activities, it makes me happy.

*the original responses were in French, and were translated for the manuscript