Barriers to the uptake and use of feedback in the context of summative assessment

Christopher Harrison, Karen Könings, Lambertus Schuwirth, Valerie Wass, Cees Van der Vleuten

    Research output: Contribution to journalArticlepeer-review

    86 Citations (Scopus)


    Despite calls for feedback to be incorporated in all assessments, a dichotomy exists between formative and summative assessments. When feedback is provided in a summative context, it is not always used effectively by learners. In this study we explored the reasons for this. We conducted individual interviews with 17 students who had recently received web based feedback following a summative assessment. Constant comparative analysis was conducted for recurring themes. The summative assessment culture, with a focus on avoiding failure, was a dominant and negative influence on the use of feedback. Strong emotions were prevalent throughout the period of assessment and feedback, which reinforced the focus on the need to pass, rather than excel. These affective factors were heightened by interactions with others. The influence of prior learning experiences affected expectations about achievement and the need to use feedback. The summative assessment and subsequent feedback appeared disconnected from future clinical workplace learning. Socio-cultural influences and barriers to feedback need to be understood before attempting to provide feedback after all assessments. A move away from the summative assessment culture may be needed in order to maximise the learning potential of assessments.

    Original languageEnglish
    Pages (from-to)229-245
    Number of pages17
    JournalAdvances in Health Sciences Education
    Issue number1
    Publication statusPublished - Mar 2015


    • Assessment for learning
    • Feedback
    • OSCE
    • Summative assessment
    • Undergraduate medical education


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