Using assessment in pharmacology to drive learning in the right direction

Assessment is the driver of learning and the gatekeeper of success. The direction of driving (alignment with learning outcomes) and the type of gate (assessment method and design) determine what is learned and what is required to pass through the gates. Data from studies on prescribing competencies and medication errors suggest that some students may be passing through these gates with inadequate knowledge/understanding of pharmacology and therapeutics, with potential consequences for patient safety. ¹ , ² , ³ Though diverse assessment methods are well reported in other disciplines, the literature contains few pharmacology‐specific examples of curricular assessment. This special issue fills that gap by providing examples of different forms of assessment in evaluating student learning of pharmacology and pharmacology‐related competencies. ⁴ , ⁵ , ⁶ , ⁷ , ⁸ It also highlights the importance of assessment feedback as a tool for driving student learning.

For staff, assessment results provide feedback that can inform both curriculum and instructional design. In this issue, Click et al. ⁹ demonstrate that their students performed better on both local and national exams after a shift to a curriculum that was both integrated and incorporated active learning and Weeda and Quesnelle, ¹⁰ used assessment to ensure equivalency between their legacy and new curriculum. In an excellent example of assessment outcomes informing instructional design, supervisor observations from an authentic workplace‐based assessment, ¹¹ involving student pre‐prescribing, were used to inform discussions in the associated tutorials.

For feedback to be useful to students, it needs to be provided with sufficient time for students to review it and use it to inform their learning. This type of assessment is usually low‐stakes and is called formative assessment. Formative assessment and feedback are key components of inclusive assessment and are critical to driving student learning in the right direction, as well as the development of the metacognitive skills needed for students to become lifelong learners ¹² , ¹³ , ¹⁴ Examples of formative assessment and feedback evaluated in this issue include partial credit scoring of MCQs, ¹⁵ supervisor/preceptor feedback on medication review and prescribing in real‐world settings ¹¹ , ¹⁶ and non‐linear slide decks for the assessment and learning of higher order thinking skills. ⁶ These approaches provide feedback that allows students to inform their learning and calibrate their expectations.

Drawing on the limited literature on formative assessment and feedback in pharmacology specifically, as well as in STEM, health professions and the broader education literature, Angelo ¹⁷ and Hepburn ¹² provide guidelines on best practice in the area. These papers identify increased workload as a factor that can impede the adoption of best practice in formative assessment and feedback provision. AI may provide some opportunities to minimize this workload, and in this issue, Berg et al. ¹³ outline their experience of providing a large cohort of students with AI‐generated feedback, Thesen et al. ¹⁸ evaluate different AI based methods of generating USMLE quality multiple‐choice questions, and Gerard et al. ¹⁹ describe a multitool approach to using AI to evaluate the quality of multiple‐choice questions. While AI shows promise here, caution is advised, especially in ensuring inclusive assessment. ¹⁴

While the studies published in this special issue highlight the growing body of work in pharmacology assessment, the number of non‐pharmacology‐specific papers that authors had to draw on indicates significant gaps in the literature. This may be a result of the increasing integration of health professions programmes, which require integrated assessments. However, the same assessment methods do not work equally well for all disciplines, and integrated assessments can sometimes allow students to score well while neglecting certain disciplines. ²⁰ Therefore, even with integrated curricula and assessments, there is a need for pharmacology‐specific evaluation of assessment methods. In addition, if we want to ensure that our assessments are inclusive, we need to challenge ourselves to start asking, ‘For whom did this assessment task work, and why?’ There are many reasons why students perform poorly on assessments, several of which relate to the assessment task itself. If we can gain a deeper understanding of what works, for whom and when, we can start to refine our assessments to ensure maximum impact in driving learning in the right direction and ensuring that all students with the requisite pharmacology knowledge pass through the gate.