- Email: [email protected]
Academic staff perspectives of formative assessment in nurse education
Nurse Education in Practice 10 (2010) 205–209
Contents lists available at ScienceDirect
Nurse Education in Practice journal homepage: www.elsevier.com/nepr
Academic staff perspectives of formative assessment in nurse education Lai Chan Koh * Thames Valley University, Faculty of Health and Human Sciences, Paragon House, Boston Manor Road, Brentford, Middx TW8 9GA, UK
a r t i c l e
i n f o
Article history: Accepted 30 August 2009
Keywords: Formative assessment Formative assessment and nurse education Formative assessment and academic staff perspectives Formative feedback and teacher perceptions
s u m m a r y High quality formative assessment has been linked to positive benefits on learning while good feedback can make a considerable difference to the quality of learning. It is proposed that formative assessment and feedback is intricately linked to enhancement of learning and has to be interactive. Underlying this proposition is the recognition of the importance of staff perspectives of formative assessment and their influence on assessment practice. However, there appears to be a paucity of literature exploring this area relevant to nurse education. The aim of the research was to explore the perspectives of twenty teachers of nurse education on formative assessment and feedback of theoretical assessment. A qualitative approach using semi-structured interviews was adopted. The interview data were analysed and the following themes identified: purposes of formative assessment, involvement of peers in the assessment process, ambivalence of timing of assessment, types of formative assessment and quality of good feedback. The findings offer suggestions which may be of value to teachers facilitating formative assessment. The conclusion is that teachers require changes to the practice of formative assessment and feedback by believing that learning is central to the purposes of formative assessment and regarding students as partners in this process. Ó 2009 Elsevier Ltd. All rights reserved.
Introduction Success in higher education for students from lower socio-economic groups and from disadvantaged backgrounds is an important policy goal in the UK and abroad (Yorke and Thomas, 2003). In response to the widening participation, Brown (2004–2005) suggests the need to change the nature of assessment to facilitate the learning of a more diverse student population. The Quality Assurance Agency, an independent body which safeguards quality and standards in UK higher education, states that formative assessment provides students with feedback on progress but does not contribute to the overall assessment, whereas summative assessment measures achievement or failure of a student’s performance (QAA, 2006). Boud (1995) cautions that the two assessments should not be seen separately and that both must be considered together to have a beneficial influence on the learning process. Whilst summative assessment remains central in measuring students’ achievement, there is considerable evidence supporting the importance of formative assessment and feedback on learning, as highlighted in the comprehensive review by Black and Wiliam (1998). Good formative assessment and feedback represents one of the key characteristics of quality teaching in higher education (Ramsden, 2003) and plays a decisive role in learning in nurse education (Santy and Mackintosh, 2000). * Tel.: +44 020 8209 4214; fax: +44 020 8209 4137. E-mail address: [email protected] 1471-5953/$ - see front matter Ó 2009 Elsevier Ltd. All rights reserved. doi:10.1016/j.nepr.2009.08.007
Whilst the potential benefits of formative assessment in the enhancement of learning have been widely acclaimed and much has been written in this area, academic staff perspectives of formative assessment in nurse education are under-researched. The overall aim of this research was to explore how academic staff experience, understand and interpret the process of formative assessment and feedback of theoretical assessment. The findings of the paper offer an insight for teachers of nurse education on issues relevant to the practice of formative assessment and feedback and may provide new evidence for future assessment practice. Literature review Formative assessment is not a new issue. Its nature and purposes have been extensively discussed by Boud (1995) and many teachers would consider formative assessment and feedback important for learning. However, different perceptions about the nature of formative assessment are identified in a study by Bone (2006). The findings show that although formative assessment is reported to be a course requirement, staff are unclear as to whether this is compulsory in the sense that if students who choose not to do it, there is no penalty involved. Inconsistency in staff perceptions of formative assessment is shown in an earlier study by Maclellan (2001) whereby staff declare a commitment to the formative purposes of assessment but engaged in practices which militate against formative assessment being fully realised. Maclellan’s study also reveals that although staff maintain that
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the full range of learning is frequently assessed formatively, the dominant mode of assessment is the traditional written assignment, thereby weakening the idea that students are engaging in assessment which can enhance learning. A variety of perceptions about feedback practice is also identified in a study by Clegg (2004). The study highlights staff diversity of expectations and practice of giving feedback. It concludes that the development of an underlying pedagogic rationale in the delivery of formative feedback is paramount if teachers are to transform their assessment practice. It is assumed that student learning from formative assessment is to some extent dependent on the teacher engagement in the process. Samuelowicz and Bain (2002) suggest that teachers’ approaches to assessment are influenced by their views on teaching and learning and that teachers are unlikely to engage with different assessment methods if they do not accord with their own views on learning and teaching. The suggestion here is that there is a direct link between perspectives on learning and feedback practice. Although feedback is central to formative assessment, evidence suggests that students do not understand the feedback given by teachers and are therefore unable to take action to close the knowledge gap (Channock, 2000; Higgins et al., 2001). Understanding can be further distorted by illegibility and use of unfamiliar words. A study by Duers and Brown (2009) reveals that nursing students prefer oral feedback to written feedback which can, at times, be illegible and utilise unfamiliar vocabulary. Moreover, there is a mismatch of understanding between teachers and students arising from lack of clarity in the feedback (Higgins et al., 2001). Differences of understanding of feedback can also be influenced by the view held by students of teachers as experts. Hyatt (2005) suggests that it is possible to see the operation of power through the discourse of feedback, the power of the academic discourse in privileging certain truths. Consequently, students tend to adopt teachers’ values, and take strategic approaches to learning (Samuelowicz and Bain, 2002). If students are to become autonomous and interdependent learners then the relationship between students and teachers must be critically examined. Nicol and Macfarlane-Dick (2004) emphasize the need for students to be empowered as self-regulated learners and suggest that self and peer evaluation is beneficial to student learning. Although peer assessment has been found to have a positive impact on learning (Elliot and Higgins, 2005), nursing students are unprepared for the critical feedback from their peers (Duers and Brown, 2009). Whilst it is recognized that students have much to offer through peer assessment processes, they may not have the skill to achieve their learning potentials and require teachers to make it effective (Boud et al., 2001; Sluijsmans et al., 2004). Research design A qualitative approach was adopted, drawing upon the principles of phenomenological investigation as suggested by Koch (1999). A great strength of qualitative research is its attention to detail and context and is particularly appropriate when little is known about the topic or a particular phenomenon (Morse and Field, 1996). This approach, based on interpretive traditions, placed emphasis on individual choice and allowed for participants to make sense of their own experiences and perceptions of formative assessment. Ethical considerations The study was approved by the university research ethics committee. The participants were invited personally to participate. They were given written information of the research before informed consents were obtained. The option of non-participation
or withdrawal at any stage was explained and a guarantee of anonymity and confidentiality was given. Samples Convenience sampling was used to represent teachers of preand post-registration nurse education. An email was sent to each of the twenty participants, inviting them to participate in the research. The email provided information regarding the purpose of the study, the questions to be asked, and the amount of time each interview was likely to take. The only pre-defined criterion for the recruitment of the participants consisted of a minimum of two years experience as a teacher involved in assessment practice. Data collection and analysis Twenty semi-structured interviews were conducted in the participants’ workplace and were tape-recorded. All participants were interviewed once with each interview lasting approximately 45 min. Open-ended questions were used with attention paid on listening and following the direction of the participant along with reflective questioning. The interview data were transcribed verbatim. A modification of the phenomenological framework of thematic analysis by Colaizzi (1978) was used. The process involved reading each transcript a number of times to extract and identify significant statements. Preliminary categories were established, reviewed and clustered into specific themes. The themes were then compared to the identified significant statements for consistency of information. To maintain the trustworthiness of the study, the transcriptions were returned to the participants for review of accuracy of the interview content which was confirmed. However, the trustworthiness could be strengthened if the participants were also involved in validating the identified themes. Results The findings were derived from the data analysis, with quotations taken from the interviews. The common themes identified revolved around purposes of formative assessment, involvement of peers in the assessment process, ambivalence of timing of formative assessment, types of formative assessment and quality of good feedback. Purposes of formative assessment The participants shared the opinion that a primary purpose of formative assessment was to give students feedback on their progress in preparation for the summative assessment. Formative assessment was also considered important in providing information for teachers in making judgment of students’ strengths and weaknesses and the support that students might need: When you are thinking about formative assessment, you are trying to judge learning as it goes on, leading up to the summative assessment. . . .It’s a valuable way of finding out which students are likely to need additional support. However, the participants recognized that there was an assumption by teachers that students understood the purposes of formative assessment, when often they might not. They added that the purposes of formative assessment might not be fully understood by some teachers themselves: But we don’t make it explicit to them the purpose of formative assessment. The problem is that we are not clear in our minds the purpose of formative assessment.
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The participants perceived that some students, particularly the pre-registration nursing students, did not appear to value formative assessment. A possible reason given was that students tended to be driven by summative assessment. Another likely reason was that some students might not understand the link between formative assessment and summative assessment. Consequently, many saw it as unnecessary additional work: For many, formative assessment is another chore, another burden. Given the choice, most students would not have formative assessment.
Involvement of peers in the assessment process Teachers were clearly stated as the key persons to facilitate formative assessment. Peers were sometimes seen to be involved in the process although it appeared to be more successful with the post-registration nursing students. In contrast, the pre-registration nursing students did not see it as an important part of learning: I think the pre-registration students don’t necessary see the point of peer assessment. They just want to hand in their assignment and get a mark. It was deemed that peer assessment was done in a superficial way with limited interaction and minimal discussion. It was also felt that some students found it difficult to assess and give feedback to their peers, probably because of lack of practice and confidence. Moreover, students appeared to view the feedback from their peers as not credible when compared with that from teachers: For whatever reasons, they (students) put more importance on the teacher’s feedback. The participants believed that there was an assumption that students would have the skill to peer assess and give feedback. Despite knowing that peer assessment was a complex task and that most students were unprepared for this role, the participants acknowledged that they had not considered peer assessment as a skill that students would need to develop: This task is actually very complex. . . It is something that I have not considered carefully enough. I have never consciously thought that I can enable them to do that better. On reflection, the participants agreed that development of skills of peer assessment and feedback was necessary and should start at an early stage of the course. They added that teachers needed professional development themselves if they were to guide students effectively. Ambivalence of timing of formative assessment It was reported that formative assessment was identified in the module study guide and specifically written down as such in the timetable. Some modules had a midpoint formative assessment and others had formative assessment at various stages depending on the nature of the module assessment. Although there tended to be a formal point for formative assessment, the participants considered that learning should be an ongoing process. However, they were unclear as to whether the ongoing process was reflected as formative assessment: It’s getting back to what we mean by formative assessment. Is it this actual event that happens or are we talking about the ongoing development that the student goes through? The participants concluded that formative assessment was identified as formal and informal. They described formal formative
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assessment as formative assessment specified in the timetable and aimed at preparing students for the summative assessment, whereas informal formative assessment involved ongoing learning activities aimed at enhancing student learning. Types of formative assessment The participants outlined a variety of formal and informal formative assessment used in both classroom and online activities. Some common examples given were MCQ, individual and group presentations, personal development plans, tutorials on essay plans and online discussion. MCQ were identified as a type of formative assessment, mainly in the form of paper exercise done in the classroom. Online MCQ were reported to be underused due to lack of availability of online questions and feedback although they were seen as a useful means of giving students more control of their learning. Individual and group presentations were given as another example of formative assessment. By students presenting findings, they could provide opportunities for teachers to be informed of students’ application of knowledge and use of evidence: Presentations and discussion were crucial and worthwhile. You can assess the quality of the information they brought, the way they presented it and the evidence used to support and justify their assertions. Personal development plans (PDP) were mentioned as a typical example of formative assessment which aimed at guiding students to identify their personal learning needs, set their own personal goals and develop their personal performance. Tutorials were referred to as a common formative assessment used in preparing students for their summative assessment. Online discussion was considered as a potentially useful formative assessment. However, the participants felt that, if student engagement in this process was to be motivated, it needed to be facilitated with its purpose explained and its clear link to the summative assessment understood by students. Quality of good feedback Constructive comments were recognized to be important when giving feedback, as students’ confidence could be undermined with the use of wrong words or phrases with subsequent student disengagement from learning. The relevance of the feedback to the assessment guidelines and marking criteria was deemed to be critical if students were to be helped to develop their understanding of what was required of them and the standard to be achieved. The participants added that an advantage of this approach was that it enabled teachers and students to follow a consistent structure which aimed at clarifying standards of the assessment: The advantage of using a marking grid to give feedback is that it structures the feedback. It also highlights for students exactly what they are to focus on. Everybody knows what is expected of them to produce. Although the participants said that feedback should be easily understood, they reported that students sometimes didn’t understand the feedback given while teachers assumed that students understood what it meant. Words like ‘analysis’ and ‘synthesis’ were exemplified as terms which students found difficult to understand. Some participants captured the opportunity to say that some teachers themselves might have difficulty of explaining the words:
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Words like ‘analysis’ and ‘synthesis’ need to be explained. But I don’t think we have. I have fallen into that trap as well. We go through this but we don’t understand the words and the difference between the different academic levels. On reflection, the participants acknowledged that terms, including words with difficult concepts, could be made explicit and reinforced to students through feedback of formative assessment. Timing was considered to be important when giving feedback, with plenty of time for students to take action and improve on their work. Feedback given soon after an assessment was felt to be more immediate and meaningful for students, as their assessment experiences and discussion were still fresh in their minds. The participants compared this to the feedback given for the summative assessment which appeared less relevant because it often came too late for students to act on. Discussion Formative assessment and its purposes were discussed by Boud (1995) and some of the issues identified then were similar to the themes presented in this study. Nicol and Macfarlane-Dick (2004) suggest that the purposes of formative assessment are to motivate students to learn, diagnose learning and evaluate teaching. The participants were clear that the purposes of formative assessment were to assess and provide feedback on students’ strengths and weaknesses and make judgment of students’ progress, with the aim of guiding students in the preparation of their summative assessment. However, they were less clear about the consistency of the approach adopted by teachers in explaining the term and purposes of formative assessment. This reflects a finding by Duers and Brown (2009) that teachers do not use the term ‘‘formative assessment” in their communication with nursing students. Rust et al. (2005) point out the importance of involving students in the rationale behind assessment practices. This infers that a primary aim of assessment practice is to build students’ knowledge of how and why formative assessment takes the form it does and raise awareness of ongoing as well as final processes. The participants’ perception was that students undervalued formative assessment and that they were only interested in their summative assessment. Duers and Brown (2009) report that nursing student preparation and effort is greater when assessment is for summative purposes. Primacy attached by students to assessment that counts is to be expected (Hodgson and Bermingham, 2004). However, the participants acknowledged that the link between the formative assessment and the summative assessment was not always made clear to students. The connection between formative assessment and summative assessment may be obvious or second nature to teachers. But if the link between these two forms of assessment is not explained and consistently applied by teachers, students may struggle to make the connection by themselves. The assumption is that student engagement in formative assessment is not a student responsibility alone and does not relate simply to factors such as self motivation. Teachers’ approaches to assessment practice maybe as significant as those of their students in engaging with assessment and feedback processes. Teachers and peers were reported to be involved in formative assessment, although there was greater emphasis placed on the process being teacher-led. The participants expressed some support for the use of peer assessment as a method that was formative. Peer assessment is an important form of learning in nurse education (Elliot and Higgins, 2005). It fosters interdependent learning (Morris, 2001), and when combined with a culture of reflective dialogues within discussion groups, promotes critical thinking (Cooper, 2000). However, the participants believed that learning from peers was limited due to minimal interaction and
discussion by students. Students were also perceived to place lower value on peer feedback compared to the greater value placed on feedback from teachers. To increase the value of peer feedback and student engagement in dialogues with their peers, peer assessment needs to be embedded as a formative assessment. The participants recognized that peer assessment involved complex skills and that there was an assumption that students had these skills. An experienced teacher will possess knowledge, awareness of standards and expertise in evaluative skills that have contributed to their tacit professional knowledge (Sadler, 1998). But students may not have such knowledge or skills. Nursing students need help with the development of peer assessment skills if they are to engage with this form of learning (Welsh, 2007; Duers and Brown, 2009). The need for appropriate development of both students and inexperienced teachers should not be under estimated when introducing peer assessment. Timing of formative assessment and feedback was considered important if students were to benefit from it. However, it appeared that there was a degree of ambivalence about when formative assessment should occur. The participants concluded that formative assessment involved formal formative assessment and informal formative assessment. Feedback on performance whether by formal or informal ways can help students to evaluate their learning (Nicol and Macfarlane-Dick, 2004). The participants outlined a few examples of formative assessment such as MCQ, individual and group presentations, personal development plans, tutorials and online discussion. Black and Wiliam (1998) point out that an assessment is not formative unless it follows through with feedback for the development of learning. Feedback is thus a central component of effective formative assessment. The participants were clear that feedback should be constructive, aimed at guiding students to improve their performance. Ways of communicating feedback are likely to be critical if students are to benefit from it through fostering of selfesteem. These can involve learning in the form of dialogues between teachers and students as a normal part of assessment practice where there is the opportunity for meaningful information to be exchanged that is helpful for both parties. The participants believed that feedback should reflect the assessment guidelines and marking criteria. However, they acknowledged that feedback might have the propensity for a mismatch of understanding between teachers and students. It is easy to assume that students and teachers have similar understanding of feedback and assessment criteria. Such assumption must be taken with caution as evidence has suggested that there is a substantial gap between student understanding and teacher usage of assessment criteria (Rust et al., 2003; Williams, 2005). In order to increase the positive impact of feedback, it is worth considering that students may need help to develop a clear understanding of teacher expectations regarding the criteria against which work is to be judged. Duers and Brown (2009) highlight that a reason for students’ choice of oral feedback is that sometimes written feedback utilise unfamiliar vocabulary. The participants reported that words like ‘analysis’ and ‘synthesis’ were common examples where students had difficulty of understanding what they meant. They perceived that some teachers themselves found these words difficult to conceptualise. If teachers do not fully understand assessment terms and are not clear what it is they are supposed to be helping students to develop, this can distort the potential for learning. It thus means that engagement in the discourse of assessment terms for teachers and students may require deliberate exposure to the language through examples used in every-day assessment practice. The problem with assessment is that everyone has been through it and has picked up approaches to it, by observing what colleagues do. It is fair to assume that appropriate knowledge
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and skills with a firm grounding in the theory of assessment and learning are necessary requisites to undertaking assessment practice. If this knowledge and skills are developed and better understood, theoretical understanding of formative assessment can be transformed into pragmatic classroom actions. However, it must be recognized that actualizing assessment practice at the classroom level can be a long-term process. For teachers to become proficient in classroom assessment, they need ongoing quality professional development (Munn et al., 2004). To begin with, assessment practice can be reviewed to identify whether formative assessment is aligned with summative assessment and learning outcomes; how formative assessment is carried out and how feedback is given. Based on the outcome of the review, developmental programmes for teachers can then be facilitated. Finally, even if teachers have the required knowledge and skills for assessment practice, Heritage (2007) asserts that, without the appropriate attitudes towards the role that formative assessment can play in teaching and learning, their knowledge and skills will lie dormant. Thus, changes to the practice of formative assessment must go hand in hand with concomitant changes in fundamental beliefs about the purposes of the assessment. Until teachers believe that learning is central to the purposes of formative assessment, the potential of benefits may not be fully exploited nor realised. Limitations of the study should be acknowledged. The themes presented in this study are only tentative perceptions held by a small sample of academic staff from a single institution. Although the findings cannot be generalised, they offer added knowledge on formative assessment in nurse education. Conclusions Whilst the issues presented in the study are not new, the findings add a new perspective to an old problem. These issues are explored with the aim of improving assessment practice, particularly in the development of formative assessment in nursing curricula. If teachers believe that formative assessment is central to learning, they can transform their theoretical understanding into day to day assessment activities. Also, if students are going to be successfully involved in assessing their own and their peers’ learning, then they need to be regarded by their teachers as partners in learning. However, quality formative assessment and feedback can only be put into practice when staff development and support are provided. Teachers must view formative assessment as a worthwhile process that is inseparable from the learning process. Acknowledgments The author would like to thank the academic staff who participated in the research. References Black, P., Wiliam, D., 1998. Assessment and classroom learning. Assessment in Education 5 (1), 7–73. Bone, A., 2006. The impact of formative assessment on student learning. UKCLE Project, HE Academy. University of Warwick, Coventry. Available from: (accessed 02.07.07). Boud, D., 1995. Assessment and learning: contradictory or complementary? In: Knight, P. (Ed.), Assessment for Learning in Higher Education. Kogan Page, London, pp. 35–48.
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Boud, D., Cohen, R., Sampson, J., 2001. Learning From and With Each Other. Kogan Page, London. Brown, S., 2004–2005. Assessment for learning. Learning and teaching in higher education (1). Available from: (accessed 03.07.09). Channock, K., 2000. Comments on essays: do students understand what tutors write? Teaching in Higher Education 5 (1), 95–105. Clegg, K., 2004. Playing safe: learning and teaching in undergraduate law. UK Centre for Legal Education, Warwick University. Available from: (accessed 08.08. 07). Colaizzi, P.F., 1978. Psychological research as the phenomenologist views it. In: Valle, R., King, M. (Eds.), Existential Phenomenological Alternatives for Psychology. Oxford University Press, Oxford, pp. 48–71. Cooper, N.J., 2000. Facilitating learning from formative feedback in level 3 assessment. Assessment and Evaluation in Higher Education 25 (3), 279–291. Duers, L.E., Brown, N., 2009. An exploration of student nurses’ experiences of formative assessment. Nurse Education Today 29 (6), 654–659. Elliot, N., Higgins, A., 2005. Self and peer assessment – does it make a difference to student group work? Nurse Education in Practice 5, 40–48. Heritage, M., 2007. Formative Assessment: What do teachers need to know and do? Phi Delta Kappan 89 (2), 140-145. Available from: (accessed 18 Nov 2007). Higgins, R., Hartley, P., Skelton, A., 2001. Getting the message across: the problem of communicating assessment feedback. Teaching in higher education 6 (2), 269– 274. Available from: (accessed 01.06.07). Hodgson, J., Bermingham, V., 2004. Feedback on assessment: can a better student experience be achieved by working smarter rather than working harder? UK Centre for Legal Education, Warwick University. Available from: (accessed 09.07). Hyatt, D., 2005. ‘Yes, a very good point!’: a critical genre analysis of a corpus of feedback commentaries on Master of Education assignments. Teaching in Higher Education 10 (3), 339–353. Koch, T., 1999. An interpretative research process: revisiting phenomenological and hermeneutical approaches. Nurse Research 6 (3), 20–34. Maclellan, E., 2001. Assessment for learning: the differing perceptions of tutors and students. Assessment and Evaluation in Higher Education 26 (4), 307–318. Morris, J., 2001. Peer assessment: a missing link between teaching and learning? A review of the literature. Nurse Education Today 21 (7), 507–515. Morse, J.M., Field, P.A., 1996. Nursing Research: The Application of Qualitative Approaches. Chapman & Hall, London. Munn, N., McColskey, W., Butler, S., 2004. Building teacher capacity in classroom assessment to improve student learning. International Journal of Educational Policy, Research & Practice 4 (4), 25–48. Nicol, D., Macfarlane-Dick, D., 2004. Rethinking formative assessment in HE: a theoretical model and seven principles of good feedback. Available from: (accessed 28.10. 07). Quality Assurance Agency for Higher Education, 2006. Code of Practice for the Assurance of Academic Quality and Standards in Higher Education, second ed. QAA, Gloucester. Available from: (accessed 29.05.07). Ramsden, P., 2003. Learning to Teach in Higher Education, second ed. Routledge, London. Rust, C., Price, M., O’Donovan, B., 2003. Improving students’ learning by developing their understanding of assessment criteria and processes. Assessment and Evaluation in Higher Education 28 (2), 147–164. Rust, C., O’Donovan, B., Price, M., 2005. A social constructivist assessment process model: how the research literature shows us this could be best practice. Assessment and Evaluation in Higher Education 30 (3), 231–240. Sadler, D.R., 1998. Formative assessment: revisiting the territory. Assessment in education: principles. Policy and Practice 5 (1), 77–85. Samuelowicz, K., Bain, J., 2002. Identifying academics’ orientations to assessment practice. Higher Education 43 (2), 173–201. Santy, J., Mackintosh, C., 2000. Assessment and learning in post-registration nurse education. Nursing Standard 14 (18), 38–41. Sluijsmans, D.M.A., Brand-Gruwel, S., van Merrienboer, J.J.G., Marterns, R.L., 2004. Training teachers in peer-assessment skills: effects on performance and perceptions. Innovations in Education & Teaching International 41 (1), 60–78. Welsh, M.M., 2007. Engaging with peer assessment in post-registration nurse education. Nurse Education in Practice 7 (2), 75–81. Williams, K., 2005. Lecturer and first year student (mis)understandings of assessment task verbs: ‘‘mind the gap”. Teaching in Higher Education 10, 157–173. Yorke, M., Thomas, L., 2003. Improving the retention of students from lower socioeconomic groups. Journal of Higher Education Policy and Management 25 (1), 63–74.
Contents lists available at ScienceDirect
Nurse Education in Practice journal homepage: www.elsevier.com/nepr
Academic staff perspectives of formative assessment in nurse education Lai Chan Koh * Thames Valley University, Faculty of Health and Human Sciences, Paragon House, Boston Manor Road, Brentford, Middx TW8 9GA, UK
a r t i c l e
i n f o
Article history: Accepted 30 August 2009
Keywords: Formative assessment Formative assessment and nurse education Formative assessment and academic staff perspectives Formative feedback and teacher perceptions
s u m m a r y High quality formative assessment has been linked to positive benefits on learning while good feedback can make a considerable difference to the quality of learning. It is proposed that formative assessment and feedback is intricately linked to enhancement of learning and has to be interactive. Underlying this proposition is the recognition of the importance of staff perspectives of formative assessment and their influence on assessment practice. However, there appears to be a paucity of literature exploring this area relevant to nurse education. The aim of the research was to explore the perspectives of twenty teachers of nurse education on formative assessment and feedback of theoretical assessment. A qualitative approach using semi-structured interviews was adopted. The interview data were analysed and the following themes identified: purposes of formative assessment, involvement of peers in the assessment process, ambivalence of timing of assessment, types of formative assessment and quality of good feedback. The findings offer suggestions which may be of value to teachers facilitating formative assessment. The conclusion is that teachers require changes to the practice of formative assessment and feedback by believing that learning is central to the purposes of formative assessment and regarding students as partners in this process. Ó 2009 Elsevier Ltd. All rights reserved.
Introduction Success in higher education for students from lower socio-economic groups and from disadvantaged backgrounds is an important policy goal in the UK and abroad (Yorke and Thomas, 2003). In response to the widening participation, Brown (2004–2005) suggests the need to change the nature of assessment to facilitate the learning of a more diverse student population. The Quality Assurance Agency, an independent body which safeguards quality and standards in UK higher education, states that formative assessment provides students with feedback on progress but does not contribute to the overall assessment, whereas summative assessment measures achievement or failure of a student’s performance (QAA, 2006). Boud (1995) cautions that the two assessments should not be seen separately and that both must be considered together to have a beneficial influence on the learning process. Whilst summative assessment remains central in measuring students’ achievement, there is considerable evidence supporting the importance of formative assessment and feedback on learning, as highlighted in the comprehensive review by Black and Wiliam (1998). Good formative assessment and feedback represents one of the key characteristics of quality teaching in higher education (Ramsden, 2003) and plays a decisive role in learning in nurse education (Santy and Mackintosh, 2000). * Tel.: +44 020 8209 4214; fax: +44 020 8209 4137. E-mail address: [email protected] 1471-5953/$ - see front matter Ó 2009 Elsevier Ltd. All rights reserved. doi:10.1016/j.nepr.2009.08.007
Whilst the potential benefits of formative assessment in the enhancement of learning have been widely acclaimed and much has been written in this area, academic staff perspectives of formative assessment in nurse education are under-researched. The overall aim of this research was to explore how academic staff experience, understand and interpret the process of formative assessment and feedback of theoretical assessment. The findings of the paper offer an insight for teachers of nurse education on issues relevant to the practice of formative assessment and feedback and may provide new evidence for future assessment practice. Literature review Formative assessment is not a new issue. Its nature and purposes have been extensively discussed by Boud (1995) and many teachers would consider formative assessment and feedback important for learning. However, different perceptions about the nature of formative assessment are identified in a study by Bone (2006). The findings show that although formative assessment is reported to be a course requirement, staff are unclear as to whether this is compulsory in the sense that if students who choose not to do it, there is no penalty involved. Inconsistency in staff perceptions of formative assessment is shown in an earlier study by Maclellan (2001) whereby staff declare a commitment to the formative purposes of assessment but engaged in practices which militate against formative assessment being fully realised. Maclellan’s study also reveals that although staff maintain that
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the full range of learning is frequently assessed formatively, the dominant mode of assessment is the traditional written assignment, thereby weakening the idea that students are engaging in assessment which can enhance learning. A variety of perceptions about feedback practice is also identified in a study by Clegg (2004). The study highlights staff diversity of expectations and practice of giving feedback. It concludes that the development of an underlying pedagogic rationale in the delivery of formative feedback is paramount if teachers are to transform their assessment practice. It is assumed that student learning from formative assessment is to some extent dependent on the teacher engagement in the process. Samuelowicz and Bain (2002) suggest that teachers’ approaches to assessment are influenced by their views on teaching and learning and that teachers are unlikely to engage with different assessment methods if they do not accord with their own views on learning and teaching. The suggestion here is that there is a direct link between perspectives on learning and feedback practice. Although feedback is central to formative assessment, evidence suggests that students do not understand the feedback given by teachers and are therefore unable to take action to close the knowledge gap (Channock, 2000; Higgins et al., 2001). Understanding can be further distorted by illegibility and use of unfamiliar words. A study by Duers and Brown (2009) reveals that nursing students prefer oral feedback to written feedback which can, at times, be illegible and utilise unfamiliar vocabulary. Moreover, there is a mismatch of understanding between teachers and students arising from lack of clarity in the feedback (Higgins et al., 2001). Differences of understanding of feedback can also be influenced by the view held by students of teachers as experts. Hyatt (2005) suggests that it is possible to see the operation of power through the discourse of feedback, the power of the academic discourse in privileging certain truths. Consequently, students tend to adopt teachers’ values, and take strategic approaches to learning (Samuelowicz and Bain, 2002). If students are to become autonomous and interdependent learners then the relationship between students and teachers must be critically examined. Nicol and Macfarlane-Dick (2004) emphasize the need for students to be empowered as self-regulated learners and suggest that self and peer evaluation is beneficial to student learning. Although peer assessment has been found to have a positive impact on learning (Elliot and Higgins, 2005), nursing students are unprepared for the critical feedback from their peers (Duers and Brown, 2009). Whilst it is recognized that students have much to offer through peer assessment processes, they may not have the skill to achieve their learning potentials and require teachers to make it effective (Boud et al., 2001; Sluijsmans et al., 2004). Research design A qualitative approach was adopted, drawing upon the principles of phenomenological investigation as suggested by Koch (1999). A great strength of qualitative research is its attention to detail and context and is particularly appropriate when little is known about the topic or a particular phenomenon (Morse and Field, 1996). This approach, based on interpretive traditions, placed emphasis on individual choice and allowed for participants to make sense of their own experiences and perceptions of formative assessment. Ethical considerations The study was approved by the university research ethics committee. The participants were invited personally to participate. They were given written information of the research before informed consents were obtained. The option of non-participation
or withdrawal at any stage was explained and a guarantee of anonymity and confidentiality was given. Samples Convenience sampling was used to represent teachers of preand post-registration nurse education. An email was sent to each of the twenty participants, inviting them to participate in the research. The email provided information regarding the purpose of the study, the questions to be asked, and the amount of time each interview was likely to take. The only pre-defined criterion for the recruitment of the participants consisted of a minimum of two years experience as a teacher involved in assessment practice. Data collection and analysis Twenty semi-structured interviews were conducted in the participants’ workplace and were tape-recorded. All participants were interviewed once with each interview lasting approximately 45 min. Open-ended questions were used with attention paid on listening and following the direction of the participant along with reflective questioning. The interview data were transcribed verbatim. A modification of the phenomenological framework of thematic analysis by Colaizzi (1978) was used. The process involved reading each transcript a number of times to extract and identify significant statements. Preliminary categories were established, reviewed and clustered into specific themes. The themes were then compared to the identified significant statements for consistency of information. To maintain the trustworthiness of the study, the transcriptions were returned to the participants for review of accuracy of the interview content which was confirmed. However, the trustworthiness could be strengthened if the participants were also involved in validating the identified themes. Results The findings were derived from the data analysis, with quotations taken from the interviews. The common themes identified revolved around purposes of formative assessment, involvement of peers in the assessment process, ambivalence of timing of formative assessment, types of formative assessment and quality of good feedback. Purposes of formative assessment The participants shared the opinion that a primary purpose of formative assessment was to give students feedback on their progress in preparation for the summative assessment. Formative assessment was also considered important in providing information for teachers in making judgment of students’ strengths and weaknesses and the support that students might need: When you are thinking about formative assessment, you are trying to judge learning as it goes on, leading up to the summative assessment. . . .It’s a valuable way of finding out which students are likely to need additional support. However, the participants recognized that there was an assumption by teachers that students understood the purposes of formative assessment, when often they might not. They added that the purposes of formative assessment might not be fully understood by some teachers themselves: But we don’t make it explicit to them the purpose of formative assessment. The problem is that we are not clear in our minds the purpose of formative assessment.
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The participants perceived that some students, particularly the pre-registration nursing students, did not appear to value formative assessment. A possible reason given was that students tended to be driven by summative assessment. Another likely reason was that some students might not understand the link between formative assessment and summative assessment. Consequently, many saw it as unnecessary additional work: For many, formative assessment is another chore, another burden. Given the choice, most students would not have formative assessment.
Involvement of peers in the assessment process Teachers were clearly stated as the key persons to facilitate formative assessment. Peers were sometimes seen to be involved in the process although it appeared to be more successful with the post-registration nursing students. In contrast, the pre-registration nursing students did not see it as an important part of learning: I think the pre-registration students don’t necessary see the point of peer assessment. They just want to hand in their assignment and get a mark. It was deemed that peer assessment was done in a superficial way with limited interaction and minimal discussion. It was also felt that some students found it difficult to assess and give feedback to their peers, probably because of lack of practice and confidence. Moreover, students appeared to view the feedback from their peers as not credible when compared with that from teachers: For whatever reasons, they (students) put more importance on the teacher’s feedback. The participants believed that there was an assumption that students would have the skill to peer assess and give feedback. Despite knowing that peer assessment was a complex task and that most students were unprepared for this role, the participants acknowledged that they had not considered peer assessment as a skill that students would need to develop: This task is actually very complex. . . It is something that I have not considered carefully enough. I have never consciously thought that I can enable them to do that better. On reflection, the participants agreed that development of skills of peer assessment and feedback was necessary and should start at an early stage of the course. They added that teachers needed professional development themselves if they were to guide students effectively. Ambivalence of timing of formative assessment It was reported that formative assessment was identified in the module study guide and specifically written down as such in the timetable. Some modules had a midpoint formative assessment and others had formative assessment at various stages depending on the nature of the module assessment. Although there tended to be a formal point for formative assessment, the participants considered that learning should be an ongoing process. However, they were unclear as to whether the ongoing process was reflected as formative assessment: It’s getting back to what we mean by formative assessment. Is it this actual event that happens or are we talking about the ongoing development that the student goes through? The participants concluded that formative assessment was identified as formal and informal. They described formal formative
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assessment as formative assessment specified in the timetable and aimed at preparing students for the summative assessment, whereas informal formative assessment involved ongoing learning activities aimed at enhancing student learning. Types of formative assessment The participants outlined a variety of formal and informal formative assessment used in both classroom and online activities. Some common examples given were MCQ, individual and group presentations, personal development plans, tutorials on essay plans and online discussion. MCQ were identified as a type of formative assessment, mainly in the form of paper exercise done in the classroom. Online MCQ were reported to be underused due to lack of availability of online questions and feedback although they were seen as a useful means of giving students more control of their learning. Individual and group presentations were given as another example of formative assessment. By students presenting findings, they could provide opportunities for teachers to be informed of students’ application of knowledge and use of evidence: Presentations and discussion were crucial and worthwhile. You can assess the quality of the information they brought, the way they presented it and the evidence used to support and justify their assertions. Personal development plans (PDP) were mentioned as a typical example of formative assessment which aimed at guiding students to identify their personal learning needs, set their own personal goals and develop their personal performance. Tutorials were referred to as a common formative assessment used in preparing students for their summative assessment. Online discussion was considered as a potentially useful formative assessment. However, the participants felt that, if student engagement in this process was to be motivated, it needed to be facilitated with its purpose explained and its clear link to the summative assessment understood by students. Quality of good feedback Constructive comments were recognized to be important when giving feedback, as students’ confidence could be undermined with the use of wrong words or phrases with subsequent student disengagement from learning. The relevance of the feedback to the assessment guidelines and marking criteria was deemed to be critical if students were to be helped to develop their understanding of what was required of them and the standard to be achieved. The participants added that an advantage of this approach was that it enabled teachers and students to follow a consistent structure which aimed at clarifying standards of the assessment: The advantage of using a marking grid to give feedback is that it structures the feedback. It also highlights for students exactly what they are to focus on. Everybody knows what is expected of them to produce. Although the participants said that feedback should be easily understood, they reported that students sometimes didn’t understand the feedback given while teachers assumed that students understood what it meant. Words like ‘analysis’ and ‘synthesis’ were exemplified as terms which students found difficult to understand. Some participants captured the opportunity to say that some teachers themselves might have difficulty of explaining the words:
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Words like ‘analysis’ and ‘synthesis’ need to be explained. But I don’t think we have. I have fallen into that trap as well. We go through this but we don’t understand the words and the difference between the different academic levels. On reflection, the participants acknowledged that terms, including words with difficult concepts, could be made explicit and reinforced to students through feedback of formative assessment. Timing was considered to be important when giving feedback, with plenty of time for students to take action and improve on their work. Feedback given soon after an assessment was felt to be more immediate and meaningful for students, as their assessment experiences and discussion were still fresh in their minds. The participants compared this to the feedback given for the summative assessment which appeared less relevant because it often came too late for students to act on. Discussion Formative assessment and its purposes were discussed by Boud (1995) and some of the issues identified then were similar to the themes presented in this study. Nicol and Macfarlane-Dick (2004) suggest that the purposes of formative assessment are to motivate students to learn, diagnose learning and evaluate teaching. The participants were clear that the purposes of formative assessment were to assess and provide feedback on students’ strengths and weaknesses and make judgment of students’ progress, with the aim of guiding students in the preparation of their summative assessment. However, they were less clear about the consistency of the approach adopted by teachers in explaining the term and purposes of formative assessment. This reflects a finding by Duers and Brown (2009) that teachers do not use the term ‘‘formative assessment” in their communication with nursing students. Rust et al. (2005) point out the importance of involving students in the rationale behind assessment practices. This infers that a primary aim of assessment practice is to build students’ knowledge of how and why formative assessment takes the form it does and raise awareness of ongoing as well as final processes. The participants’ perception was that students undervalued formative assessment and that they were only interested in their summative assessment. Duers and Brown (2009) report that nursing student preparation and effort is greater when assessment is for summative purposes. Primacy attached by students to assessment that counts is to be expected (Hodgson and Bermingham, 2004). However, the participants acknowledged that the link between the formative assessment and the summative assessment was not always made clear to students. The connection between formative assessment and summative assessment may be obvious or second nature to teachers. But if the link between these two forms of assessment is not explained and consistently applied by teachers, students may struggle to make the connection by themselves. The assumption is that student engagement in formative assessment is not a student responsibility alone and does not relate simply to factors such as self motivation. Teachers’ approaches to assessment practice maybe as significant as those of their students in engaging with assessment and feedback processes. Teachers and peers were reported to be involved in formative assessment, although there was greater emphasis placed on the process being teacher-led. The participants expressed some support for the use of peer assessment as a method that was formative. Peer assessment is an important form of learning in nurse education (Elliot and Higgins, 2005). It fosters interdependent learning (Morris, 2001), and when combined with a culture of reflective dialogues within discussion groups, promotes critical thinking (Cooper, 2000). However, the participants believed that learning from peers was limited due to minimal interaction and
discussion by students. Students were also perceived to place lower value on peer feedback compared to the greater value placed on feedback from teachers. To increase the value of peer feedback and student engagement in dialogues with their peers, peer assessment needs to be embedded as a formative assessment. The participants recognized that peer assessment involved complex skills and that there was an assumption that students had these skills. An experienced teacher will possess knowledge, awareness of standards and expertise in evaluative skills that have contributed to their tacit professional knowledge (Sadler, 1998). But students may not have such knowledge or skills. Nursing students need help with the development of peer assessment skills if they are to engage with this form of learning (Welsh, 2007; Duers and Brown, 2009). The need for appropriate development of both students and inexperienced teachers should not be under estimated when introducing peer assessment. Timing of formative assessment and feedback was considered important if students were to benefit from it. However, it appeared that there was a degree of ambivalence about when formative assessment should occur. The participants concluded that formative assessment involved formal formative assessment and informal formative assessment. Feedback on performance whether by formal or informal ways can help students to evaluate their learning (Nicol and Macfarlane-Dick, 2004). The participants outlined a few examples of formative assessment such as MCQ, individual and group presentations, personal development plans, tutorials and online discussion. Black and Wiliam (1998) point out that an assessment is not formative unless it follows through with feedback for the development of learning. Feedback is thus a central component of effective formative assessment. The participants were clear that feedback should be constructive, aimed at guiding students to improve their performance. Ways of communicating feedback are likely to be critical if students are to benefit from it through fostering of selfesteem. These can involve learning in the form of dialogues between teachers and students as a normal part of assessment practice where there is the opportunity for meaningful information to be exchanged that is helpful for both parties. The participants believed that feedback should reflect the assessment guidelines and marking criteria. However, they acknowledged that feedback might have the propensity for a mismatch of understanding between teachers and students. It is easy to assume that students and teachers have similar understanding of feedback and assessment criteria. Such assumption must be taken with caution as evidence has suggested that there is a substantial gap between student understanding and teacher usage of assessment criteria (Rust et al., 2003; Williams, 2005). In order to increase the positive impact of feedback, it is worth considering that students may need help to develop a clear understanding of teacher expectations regarding the criteria against which work is to be judged. Duers and Brown (2009) highlight that a reason for students’ choice of oral feedback is that sometimes written feedback utilise unfamiliar vocabulary. The participants reported that words like ‘analysis’ and ‘synthesis’ were common examples where students had difficulty of understanding what they meant. They perceived that some teachers themselves found these words difficult to conceptualise. If teachers do not fully understand assessment terms and are not clear what it is they are supposed to be helping students to develop, this can distort the potential for learning. It thus means that engagement in the discourse of assessment terms for teachers and students may require deliberate exposure to the language through examples used in every-day assessment practice. The problem with assessment is that everyone has been through it and has picked up approaches to it, by observing what colleagues do. It is fair to assume that appropriate knowledge
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and skills with a firm grounding in the theory of assessment and learning are necessary requisites to undertaking assessment practice. If this knowledge and skills are developed and better understood, theoretical understanding of formative assessment can be transformed into pragmatic classroom actions. However, it must be recognized that actualizing assessment practice at the classroom level can be a long-term process. For teachers to become proficient in classroom assessment, they need ongoing quality professional development (Munn et al., 2004). To begin with, assessment practice can be reviewed to identify whether formative assessment is aligned with summative assessment and learning outcomes; how formative assessment is carried out and how feedback is given. Based on the outcome of the review, developmental programmes for teachers can then be facilitated. Finally, even if teachers have the required knowledge and skills for assessment practice, Heritage (2007) asserts that, without the appropriate attitudes towards the role that formative assessment can play in teaching and learning, their knowledge and skills will lie dormant. Thus, changes to the practice of formative assessment must go hand in hand with concomitant changes in fundamental beliefs about the purposes of the assessment. Until teachers believe that learning is central to the purposes of formative assessment, the potential of benefits may not be fully exploited nor realised. Limitations of the study should be acknowledged. The themes presented in this study are only tentative perceptions held by a small sample of academic staff from a single institution. Although the findings cannot be generalised, they offer added knowledge on formative assessment in nurse education. Conclusions Whilst the issues presented in the study are not new, the findings add a new perspective to an old problem. These issues are explored with the aim of improving assessment practice, particularly in the development of formative assessment in nursing curricula. If teachers believe that formative assessment is central to learning, they can transform their theoretical understanding into day to day assessment activities. Also, if students are going to be successfully involved in assessing their own and their peers’ learning, then they need to be regarded by their teachers as partners in learning. However, quality formative assessment and feedback can only be put into practice when staff development and support are provided. Teachers must view formative assessment as a worthwhile process that is inseparable from the learning process. Acknowledgments The author would like to thank the academic staff who participated in the research. References Black, P., Wiliam, D., 1998. Assessment and classroom learning. Assessment in Education 5 (1), 7–73. Bone, A., 2006. The impact of formative assessment on student learning. UKCLE Project, HE Academy. University of Warwick, Coventry. Available from:
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Boud, D., Cohen, R., Sampson, J., 2001. Learning From and With Each Other. Kogan Page, London. Brown, S., 2004–2005. Assessment for learning. Learning and teaching in higher education (1). Available from: