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    Impact of pass/fail grading on medical students' well-being and academic outcomes

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    Authors
    Spring, Laura M.
    Robillard, Diana
    Gehlbach, Lorrie
    Moore Simas, Tiffany A.
    UMass Chan Affiliations
    Office of Educational Affairs
    Department of Obstetrics and Gynecology
    Document Type
    Journal Article
    Publication Date
    2011-09-01
    Keywords
    Anxiety
    Clinical Competence
    Depression
    Depressive Disorder
    Education, Medical, Undergraduate
    Educational Measurement
    Humans
    *Internship and Residency
    Motivation
    Quality of Life
    Schools, Medical
    Students, Medical
    United States
    Medical Education
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    Link to Full Text
    http://dx.doi.org/10.1111/j.1365-2923.2011.03989.x
    Abstract
    OBJECTIVES: Many medical schools are currently undergoing curriculum reform. When considering the means by which students will be evaluated in a revised curriculum, the need to reduce the prevalences of depression and anxiety associated with academic stress must be weighed against the importance of academic outcomes. Pass/fail evaluation, as compared with tiered grading, is commonly presented as a means to adequately assess student performance while minimising stress and anxiety. The purpose of this literature review was to determine the impact of pass/fail grading on medical student well-being and academic outcomes. METHODS: A systematic search was performed of the available literature published between January 1980 and August 2010, using the PubMed, Ovid Medline, Ovid PsycINFO and ERIC databases. Eligible papers assessed the impact of pass/fail grading on medical student well-being, academic outcomes or both. Academic outcomes included but were not limited to objective measures, such as performance on the US Medical Licensing Examination, and subjective measures, such as student desirability by residency programmes. Reference lists in identified papers were searched and all identified papers were run through a citation index. RESULTS: Four papers met the inclusion criteria for both well-being and academic outcomes. An additional five papers met the inclusion criteria for academic outcomes only. The four papers that focused on well-being reported improvement in specified areas. No significant difference was identified in any of the five papers examining objective academic outcomes or in those papers that examined the quality of residency programmes attained. Results from two studies suggested that some programme directors believe pass/fail grading creates disadvantages for students in attaining a residency, whereas a third study yielded mixed results about its impact on residency attainment. CONCLUSIONS: Student well-being is enhanced and objective academic performance is not adversely affected by a pass/fail evaluation system, but students' ability to obtain a desired residency programme may be hindered by individual programme directors' preferences for tiered grading systems. There is an overall paucity of literature on this topic and additional study is needed.
    Source
    Med Educ. 2011 Sep;45(9):867-77. doi: 10.1111/j.1365-2923.2011.03989.x.
    DOI
    10.1111/j.1365-2923.2011.03989.x
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/49208
    PubMed ID
    21848714
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1111/j.1365-2923.2011.03989.x
    Scopus Count
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    T.H. Chan School of Medicine Student Publications
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