Formative self-assessment using multiple true-false questions on the Internet: feedback according to confidence about correct knowledge

In undergraduate clinical courses, students are often dispersed over severa l teaching sites. Traditional curricula do not have mechanisms that allow m onitoring of an individual student's educational progress or that of a smal l group of students at a teaching site relative to that of the whole group. To address these issues, we have developed a web-based formative assessmen t system that consists of knowledge tests based on multiple true-false ques tions. During the test, in addition to marking true or false against each q uestion, students indicate their level of confidence (doubt or certainty) a bout each answer. The feedback consists of whether the answer is correct or incorrect and the confidence with which the student had responded. Feedbac k to students assesses their own performance in relation to that of their p eers. Feedback to tutors provides anonymized information about the level of achievement of students at their teaching site relative to that of student s at other sites. This systems has the tools that students can use to direc t their learning and tutors can use to tailor their teaching in the light o f the instantaneously available comparative feedback.