An evaluation of the use of continuous assessment in the teaching of physiology

The level of understanding achieved by a class of 160 1st-year medical students was assessed from their answers to exam questions related to a series of physiology lectures in which students were taught for conceptual understanding. Questionnaire data showed that about 90% of the class perceived the subject matter to be relevant.Information collected by interview from a sample of 30 students indicated that frequent summative assessment exerted a profound negative influence over their learning. Students adopted a surface reproductive approach aimed at passing the exams rather than at understanding the subject matter. Lectures failed to affect the way that students represented, structured and selected their knowledge, which remained encapsulated in the textbook context and was non-functional.Assessments comprised a high proportion of multiple-choice questions and emphasized low-level skills resulting in the establishment of a hidden curriculum. Furthermore, the curriculum failed to provide appropriate opportunities for students to consolidate and internalize information presented in lectures. The students had inadequate abstract reasoning and integration skills and so were unable to ignore the hidden curriculum.In the absence of high-level conceptual development students cannot apply theory to practice. It is argued that the early introduction of clinical experiences (in year-2) cannot promote effective integration between theory and practice and the development of an holistic attitude and heuristic thinking, when students lack prerequisite basic reasoning skills and do not know how to learn meaningfully.