Despite calls for feedback to be incorporated in all assessments, a dichotomy exists between formative and summative assessments. When feedback is provided in a summative context, it is not always used effectively by learners. In this study we explored the reasons for this. We conducted individual interviews with 17 students who had recently received web based feedback following a summative assessment. Constant comparative analysis was conducted for recurring themes. The summative assessment culture, with a focus on avoiding failure, was a dominant and negative influence on the use of feedback. Strong emotions were prevalent throughout the period of assessment and feedback, which reinforced the focus on the need to pass, rather than excel. These affective factors were heightened by interactions with others. The influence of prior learning experiences affected expectations about achievement and the need to use feedback. The summative assessment and subsequent feedback appeared disconnected from future clinical workplace learning. Socio-cultural influences and barriers to feedback need to be understood before attempting to provide feedback after all assessments. A move away from the summative assessment culture may be needed in order to maximise the learning potential of assessments.
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We are grateful to Sarah Yardley for independently coding some of the interviews, to Adrian Molyneux for setting up the feedback website and to Kirsty Hartley for helping to recruit students for the interviews. Finally, we are most grateful to all the students who took part in the interviews.
Appendix 1: Screencaptures of webpages
The main menu page
An example Skills breakdown Webpage
An example Detailed Comparison Webpage
An example Station Breakdown Webpage
Part of the Next Steps Webpage
Appendix 2: Outline framework for Individual interviews
|About OSCE itself|
How did you prepare for the OSCE this year?|
Please talk me through how you were feeling on the day of the OSCE
Take me through the OSCE—how was that?
How were you feeling at the end of the OSCE?
|About feedback provision|
Please can you talk me through what you did when you went online to look at the feedback|
What conclusions did you draw from the feedback?
How could we make the feedback better for you?
Has the feedback made you think about how you would approach a particular station in a different way in future?|
Do you think the feedback will make a difference to how you will work on the wards, in clinics or in practice?
|Does it matter to you how well you have done in an OSCE, or is it just important to have passed? Why?|
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Cite this article
Harrison, C.J., Könings, K.D., Schuwirth, L. et al. Barriers to the uptake and use of feedback in the context of summative assessment. Adv in Health Sci Educ 20, 229–245 (2015). https://doi.org/10.1007/s10459-014-9524-6
- Assessment for learning
- Summative assessment
- Undergraduate medical education