Progress testing

Progress tests are longitudinal, feedback oriented assessment tools for the evaluation of development and sustainability of cognitive knowledge during a learning process. They represent a cross-section of the knowledge level expected of a graduate. The participants take the test regularly (e.g. 1 to 4 times/year) and, according to their individual learning progress, increasingly achieve better results. They are well established and increasingly used in medical education in both undergraduate and postgraduate medical education. They are used formatively and summatively. They allow feedback for students and faculty on a longitudinal measurement base.

History

Progress Testing was independently introduced at the University of Maastricht, the Netherlands (Van der Fleuten et al. 1996), and the University of Missouri, Kansas City (Arnold & Willoughby 1990) for different reasons (Swanson et al. 1991). In the Netherlands problem-based learning (PBL) was the reason. In PBL the format was meant to encourage deeper learning styles. It was also used to compare students' performance from reformed schools to those from more traditional schools.

Advantages

Progress tests provide even more benefits (Van der Vleuten et al. 1996). Progress tests provide a rich source of information: the comprehensive nature in combination with the cross-sectional and longitudinal design offers a wealth of information both for individual learners as well as for curriculum evaluations.

Progress Testing fosters knowledge retention: the repeated testing of the same comprehensive domain of knowledge means that there is no point testing facts that could be remembered if studied the night before. Long term knowledge and knowledge retention is fostered because item content remains relevant long after the knowledge has been learned. Progress Testing removes the need for resit examinations: every new test occasion is a renewed opportunity to demonstrate growth of knowledge.

Progress Testing allows early detection of high achievers: some learners perform (far) beyond the expected level of their phase in training (e.g. they might have had relevant previous other training) and, depending on their performance, individual and more speeded pathways through the curriculum could be offered.

Progress Testing brings stability in assessment procedures: curriculum changes, changes in content, have no consequence for the progress test provided the end outcomes are unchanged.

Progress Testing provides excellent benchmarking opportunities: progress tests are not limited to a single school nor to PBL curricula and evaluations can easily be done to compare graduates and the effectiveness of different curriculum approaches.

Disadvantages

Naturally, there are disadvantages. The required resources for test development and scoring and the need for a central organization are two very important ones.

Scoring (Muijtjens, Mameren, Hoogenboom, Evers, & van der Vleuten, 1999), psychometric procedures (Shen, 2000) for reducing test difficulty variation and standard setting procedures (Verhoeven, Verwijnen, Muijtjens, Scherpbier, & van der Vleuten, 2002) are more complex in progress testing.

Finally progress tests do not work in heterogeneous programs with early specialization (like in many health sciences programs). In more homogenous programs, such as most medical programs, they work really well and pay off in relation to driving learning and use of resources.

Source: Freeman A, van der Vleuten CPM, Nouns Z, Ricketts C. Progress testing internationally. Medical Teacher 2010; 32: 451-455