By: Michael A. Gisondi (@MikeGisondi)
Meet Amy, Diego, and Lana.
Amy attends a medical school that uses a traditional letter grading system. She received a B on her final exam in microbiology. Amy spent many hours memorizing key facts that her professor emphasized in class and that were summarized in an online review book. She wanted an A in microbiology to keep her GPA high, as class rank determines induction in the honor society at her medical school. She is devastated by her exam grade.
Diego attends a medical school across town that converted to a pass/fail assessment system several years ago. Diego passed his microbiology final exam. Though the score was reported simply as ‘pass,’ the numeric grade he earned was equivalent to a B; the exact grade was not shared with him. Diego was confident that he could score well enough to pass the exam and spent far fewer hours studying than Amy. He used his free time to lead a student organization and work with his research mentor.
Finally, Lana attends a medical school where contract grading was recently adopted. She earned a B in the course, which was her goal at the beginning of the term. To earn a B, Lana needed to attend 90% of class sessions, complete all assigned readings, consistently score 85% or higher on weekly take-home question sets, look up the answers to the questions she missed, and discuss those questions with her professor during scheduled small group review sessions. There was no final exam. To earn an A, Lana would have had to attend extra evening review sessions conducted by the teaching assistant and submit a high-quality term paper. Lana was concerned that this extra work would have reduced her study time for biochemistry, a course she was excited to take given her research interests. Overall, she spent less time on microbiology than Amy and more time than Diego.
Which student learned the most?
The Assessment Dilemma
Many health professions schools have abandoned traditional grading systems in favor of assessment methods that better align with the needs of students. For instance, the pass/fail model aims to reduce stress, foster collaboration, and promote a holistic approach to learning. However, there are some potential drawbacks of pass/fail, namely how to motivate students to engage deeply with the curriculum and demonstrate excellence in essential skills.
Enter Contract Grading
Contract grading emerges as a viable, competency-based alternative to traditional and pass/fail assessment systems. In this method, students and educators collaboratively negotiate a learning contract upfront. This contract outlines specific learning objectives, deliverables, and assessment methods, all mapped to desired grade levels.
Contract grading is thought to foster deeper learning, reduce stress, and promote student autonomy. Students take ownership of their learning, choosing tasks and activities that best suit their strengths and goals. They receive formative feedback throughout the process, allowing them to adjust their effort and fill any identified knowledge gaps along the way. Contract grading allows for a personalized learning experience tailored to individual student needs and learning styles.
Contract grading can be designed using negotiation or a pre-determined grading rubric.
Negotiation: In this method, students negotiate the criteria for assessment with their instructors at the beginning of the course based on their learning goals. Grades reflect the degree to which students meet the agreed upon assessment criteria.
Rubrics: In this method, professors explain the predetermined standards associated with higher or lower grades. Students have a clear understanding of the work required to earn a specific grade and create a study plan based on their goals.
Benefits of Contract Grading in Medical Education:
- Competency-based: Focuses on mastery of essential skills and knowledge
- Reduces stress and anxiety: Eliminates the constant pressure of testing
- Promotes deeper learning: Encourages students to engage actively with the material
- Develops self-directed learners: Helps students cultivate autonomy and critical thinking
- Individualizes the learning experience: Allows students to tailor their learning goals
Challenges and considerations:
- Time commitment: Designing and negotiating contracts can be time-consuming
- Faculty development: Requires a shift in mindset from traditional grading practices
- Potential for subjectivity: Clear assessment criteria and consistent feedback are needed
Ready to give contract grading a try?
- Start small: Introduce contract grading for specific assignments or a single course
- Collaborate with your students: Develop contracts jointly through open communication
- Focus on learning outcomes: Emphasize mastery of essential skills and knowledge
- Provide clear expectations: Define assessment criteria and monitor achievements
- Iterate as needed: Don’t be afraid to refine your contracts and grading processes
Contract grading may not be a magic bullet, but it offers a promising alternative to traditional grading in medical education. By fostering deeper learning, reducing stress, and promoting student autonomy, contract grading can empower trainees to become lifelong learners.
About the author: Michael A. Gisondi, MD is an emergency physician and medical education researcher living in Palo Alto, CA, USA. He is Professor and Vice Chair of Education in the Department of Emergency Medicine at Stanford University, and an Assistant Dean for Academic Advising at Stanford School of Medicine. X: @MikeGisondi Threads: mikegisondi
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