EA-3304 Formative Assessment and Feedback

1.0       Purpose

The Liaison Committee on Medical Education (LCME) requires that formative feedback be provided to medical students in all courses and clerkships of four or more weeks in duration (LCME Standard 9, Element 7). Feedback must be delivered early enough to allow students to address identified deficiencies, typically no later than the midpoint of each course or clerkship. For shorter courses or clerkships, alternative mechanisms must be available for students to assess their progress. In alignment with these requirements, the Virginia Tech Carilion School of Medicine (VTCSOM) has established processes for administering and reviewing assessments to ensure programmatic alignment across institutional, course, and clerkship learning objectives and activities. These processes are designed to promote consistency, transparency, and fairness in the assessment of student performance.

2.0       Policy

• All courses, regardless of length, must incorporate formative assessment(s) to identify each student’s strengths and areas for improvement.
• Formative assessments provide students with feedback on their learning progress and support their ongoing development.
• Course and Clerkship Directors must ensure that one or more faculty provide formative feedback during educational experiences, as it is essential for student professional development.
• Students must have opportunities to seek and receive formative feedback prior to the assignment of a final grade.

Phase 1 (Pre-Clerkship)

• Formative feedback (verbal and written, self-assessment questions, etc.) within each course and the longitudinal pedagogies (e.g., PBL, clinical skills, clinical experiences).
• Students receive formative feedback by the mid-point of the course and also at a frequency no less than every six weeks.
• Mid-course feedback may be delivered through a structured evaluation form (e.g., SPIRAL, Harmonized Milestones Assessment), a required face-to-face or virtual meeting, or documented results from formative exams or assignments with faculty comments.

Phase 2-3 (Clerkship and Post-Clerkship)

• All clerkships must provide formative feedback to students no later than the midpoint of the rotation using the designated mid-clerkship feedback form.
• Supervising clinicians provide additional formative feedback throughout the rotation, either verbally or through formal documentation methods (e.g., clinical assessment forms, mini-CEX).
• In the post-clerkship phase, students must receive verbal formative feedback at least once by the midpoint of each course.
• Supervising clinicians are encouraged to provide ongoing verbal feedback throughout shorter post-clerkship rotations (2–4 weeks in duration).

3.0       Procedures

All feedback must be specific, constructive, and actionable, addressing student performance in relation to the VTCSOM Educational Program Objectives.

In the pre-clerkship curriculum, course directors have discretion in selecting the methods of formative feedback, which must be clearly described in the course syllabus and aligned with the course learning objectives. Students are required to receive formative feedback at least once at the midpoint of each course. Acceptable methods may include, but are not limited to, self-assessment questions, practice tests, audience response questions, homework assignments, informal verbal feedback, written narrative feedback, class discussions, quizzes, and formative OSCEs.

In clinical clerkships, the mid-clerkship feedback process involves the clerkship director providing mid-clerkship feedback with all students on the clerkship. The clerkship director and student review available data/feedback, student strengths, areas of improvement, and discuss progress on the requirements on the Digital Passport.  After the feedback meeting, the student attests to receiving mid-clerkship feedback on the end-of-clerkship evaluation. Clerkship director submits mid-clerkship feedback into One45, which is managed by the Office of Educational Affairs. For clerkships shorter than four weeks, alternative methods are provided to help students assess their progress, such as informal verbal discussions, completion of EPA assessments, or use of clinical evaluation tools.

Compliance Monitoring

Course and clerkship directors are responsible for ensuring timely completion of all formative feedback requirements. Any issues that could prevent compliance must be promptly reported to the Office of Educational Affairs and/or the corresponding Phase Director to ensure appropriate follow-up and resolution.

Central Monitoring

The Medical Curriculum Committee holds final authority and oversight for monitoring compliance with formative feedback requirements. Students are surveyed at multiple points throughout the curriculum to confirm receipt of formative feedback, including through End of Course/Clerkship Evaluations, the Institutional End-of-Year Survey, and the AAMC Graduate Questionnaire. The Committee reviews course- and clerkship-level compliance data from these surveys at least twice per year, with additional reviews conducted as requested by the Chair of the Committee.

4.0       Definitions

Formative Assessment: Formative assessment is the process of monitoring students’ acquisition and development of knowledge, skills, and behaviors throughout a course or clerkship using assessment methods that enable students to identify their individual strengths and areas for improvement.

Formative Feedback: Formative feedback is information provided to a student about their strengths, weaknesses, and opportunities for improvement, delivered in a timely manner that enables the student to adjust their behavior or deepen their understanding before final evaluation.

5.0       References

• VTCSOM Education Program Objectives 
• Office of Educational Affairs

6.0       Approval and Revisions

Approved by the Medical Curriculum Committee on November 20, 2025