formative assessment for writing

14 Examples of Formative Assessment [+FAQs]

Traditional student assessment typically comes in the form of a test, pop quiz, or more thorough final exam. But as many teachers will tell you, these rarely tell the whole story or accurately determine just how well a student has learned a concept or lesson.

That’s why many teachers are utilizing formative assessments. While formative assessment is not necessarily a new tool, it is becoming increasingly popular amongst K-12 educators across all subject levels. 

Curious? Read on to learn more about types of formative assessment and where you can access additional resources to help you incorporate this new evaluation style into your classroom.

What is Formative Assessment?

Online education glossary EdGlossary defines formative assessment as “a wide variety of methods that teachers use to conduct in-process evaluations of student comprehension, learning needs, and academic progress during a lesson, unit, or course.” They continue, “formative assessments help teachers identify concepts that students are struggling to understand, skills they are having difficulty acquiring, or learning standards they have not yet achieved so that adjustments can be made to lessons, instructional techniques, and academic support.”

The primary reason educators utilize formative assessment, and its primary goal, is to measure a student’s understanding while instruction is happening. Formative assessments allow teachers to collect lots of information about a student’s comprehension while they’re learning, which in turn allows them to make adjustments and improvements in the moment. And, the results speak for themselves — formative assessment has been proven to be highly effective in raising the level of student attainment, increasing equity of student outcomes, and improving students’ ability to learn, according to a study from the Organization for Economic Co-operation and Development (OECD). 

On the flipside of the assessment coin is summative assessments, which are what we typically use to evaluate student learning. Summative assessments are used after a specific instructional period, such as at the end of a unit, course, semester, or even school year. As learning and formative assessment expert Paul Black puts it, “when the cook tastes the soup, that’s formative assessment. When a customer tastes the soup, that’s summative assessment.”

14 Examples of Formative Assessment Tools & Strategies

There are many types of formative assessment tools and strategies available to teachers, and it’s even possible to come up with your own. However, here are some of the most popular and useful formative assessments being used today.

• Round Robin Charts

Students break out into small groups and are given a blank chart and writing utensils. In these groups, everyone answers an open-ended question about the current lesson. Beyond the question, students can also add any relevant knowledge they have about the topic to their chart. These charts then rotate from group to group, with each group adding their input. Once everyone has written on every chart, the class regroups and discusses the responses. 

• Strategic Questioning

This formative assessment style is quite flexible and can be used in many different settings. You can ask individuals, groups, or the whole class high-level, open-ended questions that start with “why” or “how.” These questions have a two-fold purpose — to gauge how well students are grasping the lesson at hand and to spark a discussion about the topic. 

• Three-Way Summaries

These written summaries of a lesson or subject ask students to complete three separate write-ups of varying lengths: short (10-15 words), medium (30-50 words), and long (75-100). These different lengths test students’ ability to condense everything they’ve learned into a concise statement, or elaborate with more detail. This will demonstrate to you, the teacher, just how much they have learned, and it will also identify any learning gaps. 

• Think-Pair-Share

Think-pair-share asks students to write down their answers to a question posed by the teacher. When they’re done, they break off into pairs and share their answers and discuss. You can then move around the room, dropping in on discussions and getting an idea of how well students are understanding.

Looking for a competitive edge? Explore our Education certificate options today! >

• 3-2-1 Countdown

This formative assessment tool can be written or oral and asks students to respond to three very simple prompts: Name three things you didn’t know before, name two things that surprised you about this topic, and name one you want to start doing with what you’ve learned. The exact questions are flexible and can be tailored to whatever unit or lesson you are teaching.

• Classroom Polls

This is a great participation tool to use mid-lesson. At any point, pose a poll question to students and ask them to respond by raising their hand. If you have the capability, you can also use online polling platforms and let students submit their answers on their Chromebooks, tablets, or other devices.

• Exit/Admission Tickets

Exit and admission tickets are quick written exercises that assess a student’s comprehension of a single day’s lesson. As the name suggests, exit tickets are short written summaries of what students learned in class that day, while admission tickets can be performed as short homework assignments that are handed in as students arrive to class.

• One-Minute Papers

This quick, formative assessment tool is most useful at the end of the day to get a complete picture of the classes’ learning that day. Put one minute on the clock and pose a question to students about the primary subject for the day. Typical questions might be:

• What was the main point?
• What questions do you still have?
• What was the most surprising thing you learned?
• What was the most confusing aspect and why?
• Creative Extension Projects

These types of assessments are likely already part of your evaluation strategy and include projects like posters and collage, skit performances, dioramas, keynote presentations, and more. Formative assessments like these allow students to use more creative parts of their skillset to demonstrate their understanding and comprehension and can be an opportunity for individual or group work.

Dipsticks — named after the quick and easy tool we use to check our car’s oil levels — refer to a number of fast, formative assessment tools. These are most effective immediately after giving students feedback and allowing them to practice said skills. Many of the assessments on this list fall into the dipstick categories, but additional options include writing a letter explaining the concepts covered or drawing a sketch to visually represent the topic. 

• Quiz-Like Games and Polls

A majority of students enjoy games of some kind, and incorporating games that test a student’s recall and subject aptitude are a great way to make formative assessment more fun. These could be Jeopardy-like games that you can tailor around a specific topic, or even an online platform that leverages your own lessons. But no matter what game you choose, these are often a big hit with students.

• Interview-Based Assessments

Interview-based assessments are a great way to get first-hand insight into student comprehension of a subject. You can break out into one-on-one sessions with students, or allow them to conduct interviews in small groups. These should be quick, casual conversations that go over the biggest takeaways from your lesson. If you want to provide structure to student conversations, let them try the TAG feedback method — tell your peer something they did well, ask a thoughtful question, and give a positive suggestion.

• Self Assessment

Allow students to take the rubric you use to perform a self assessment of their knowledge or understanding of a topic. Not only will it allow them to reflect on their own work, but it will also very clearly demonstrate the gaps they need filled in. Self assessments should also allow students to highlight where they feel their strengths are so the feedback isn’t entirely negative.

• Participation Cards

Participation cards are a great tool you can use on-the-fly in the middle of a lesson to get a quick read on the entire classes’ level of understanding. Give each student three participation cards — “I agree,” “I disagree,” and “I don’t know how to respond” — and pose questions that they can then respond to with those cards. This will give you a quick gauge of what concepts need more coverage.

5 REASONS WHY CONTINUING EDUCATION MATTERS FOR EDUCATORS

The education industry is always changing and evolving, perhaps now more than ever. Learn how you can be prepared by downloading our eBook.

List of Formative Assessment Resources

There are many, many online formative assessment resources available to teachers. Here are just a few of the most widely-used and highly recommended formative assessment sites available.

• Arizona State Dept of Education

FAQs About Formative Assessment

The following frequently asked questions were sourced from the Association for Supervision and Curriculum Development (ASCD), a leading education professional organization of more than 100,000 superintendents, principals, teachers, and advocates.  

Is formative assessment something new?

No and yes. The concept of measuring a student’s comprehension during lessons has existed for centuries. However, the concept of formative assessment as we understand it didn’t appear until approximately 40 years ago, and has progressively expanded into what it is today.

What makes something a formative assessment?

ASCD characterized formative assessment as “a way for teachers and students to gather evidence of learning, engage students in assessment, and use data to improve teaching and learning.” Their definition continues, “when you use an assessment instrument— a test, a quiz, an essay, or any other kind of classroom activity—analytically and diagnostically to measure the process of learning and then, in turn, to inform yourself or your students of progress and guide further learning, you are engaging in formative assessment. If you were to use the same instrument for the sole purpose of gathering data to report to a district or state or to determine a final grade, you would be engaging in summative assessment.”

Does formative assessment work in all content areas?

Absolutely, and it works across all grade levels. Nearly any content area — language arts, math, science, humanities, and even the arts or physical education — can utilize formative assessment in a positive way.

How can formative assessment support the curriculum?

Formative assessment supports curricula by providing real-time feedback on students’ knowledge levels and comprehension of the subject at hand. When teachers regularly utilize formative assessment tools, they can find gaps in student learning and customize lessons to fill those gaps. After term is over, teachers can use this feedback to reshape their curricula.

How can formative assessment be used to establish instructional priorities?

Because formative assessment supports curriculum development and updates, it thereby influences instructional priorities. Through student feedback and formative assessment, teachers are able to gather data about which instructional methods are most (and least) successful. This “data-driven” instruction should yield more positive learning outcomes for students.

Can formative assessment close achievement gaps?

Formative assessment is ideal because it identifies gaps in student knowledge while they’re learning. This allows teachers to make adjustments to close these gaps and help students more successfully master a new skill or topic.

How can I help my students understand formative assessment?

Formative assessment should be framed as a supportive learning tool; it’s a very different tactic than summative assessment strategies. To help students understand this new evaluation style, make sure you utilize it from the first day in the classroom. Introduce a small number of strategies and use them repeatedly so students become familiar with them. Eventually, these formative assessments will become second nature to teachers and students.

Before you tackle formative assessment, or any new teaching strategy for that matter, consider taking a continuing education course. At the University of San Diego School of Professional and Continuing Education, we offer over 500 courses for educators that can be completed entirely online, and many at your own pace. So no matter what your interests are, you can surely find a course — or even a certificate — that suits your needs.

Be Sure To Share This Article

• Share on Twitter
• Share on Facebook
• Share on LinkedIn

Your Salary

Browse over 500+ educator courses and numerous certificates to enhance your curriculum and earn credit toward salary advancement.

Related Posts

Improving Student Writing Through Formative Assessments

Making the writing connection, what is formative feedback, monitoring progress, the time is write.

Premium Resource

Is Writing in Crisis?

Writing is crucial to success in college, a career, and life in general. Despite writing's pivotal role, several indicators point to a nationwide crisis in the skill.

"Policies have been shaped by misconceptions that writing cannot be taught or assessed," says Graham. In reality, writing can be taught and assessed—but it requires a significant investment in teacher training and improved summative assessments, he notes.

Studies show that two out of three students don't write well enough to meet grade level. In classrooms, less time is spent on writing instruction, and students have fewer opportunities to write, especially writing that involves analysis and interpretation.

"The Nation's Report Card," by the National Assessment of Education Progress, reports broad trends in subject-specific achievement across the United States. In 2007, the report showed small gains in writing, but these gains may have masked the fact that only a third of 8th graders and less than a quarter of high school seniors tested at or above the proficient level, writes Gavin Tachibana in the article, "'Nation's Report Card' Shows Modest Improvement in Students' Writing Scores."

Basically, two out of three students don't write well enough to meet grade level, say the Informing Writing researchers. And, employers and college students are spending billions every year for remedial writing courses. For example, almost a third of all incoming freshmen (attending community and four-year colleges) take at least one remedial course; about a quarter of those remedial courses are in writing, according to the 2006 Alliance for Excellent Education report Paying Double: Inadequate High Schools and Community College Remediation .

<P EXCERPT="yes" ALPHABET="latin" SDAFORM="para"> <!-- Start of Brightcove Player --> <!--div style="display:none"> </div--> <!--By use of this code snippet, I agree to the Brightcove Publisher T and C found at https://accounts.brightcove.com/en/terms-and-conditions/. --> <!-- insert video here brightcove information : http://video.ascd.org/services/player/bcpid18377529001?bckey=AQ~~,AAAAAmGjiRE~,escbD3Me8-wT_coVb7sTe18vG6vv3Oyk&bctid=1377612042001--> <!-- This script tag will cause the Brightcove Players defined above it to be created as soonas the line is read by the browser. If you wish to have the player instantiated only afterthe rest of the HTML is processed and the page load is complete, remove the line.--> <!-- End of Brightcove Player -->

ASCD is a community dedicated to educators' professional growth and well-being.

Let us help you put your vision into action..

ChatGPT for Teachers

Trauma-informed practices in schools, teacher well-being, cultivating diversity, equity, & inclusion, integrating technology in the classroom, social-emotional development, covid-19 resources, invest in resilience: summer toolkit, civics & resilience, all toolkits, degree programs, trauma-informed professional development, teacher licensure & certification, how to become - career information, classroom management, instructional design, lifestyle & self-care, online higher ed teaching, current events, how to properly implement a formative writing assessment over a year.

Formative assessment can be tricky — especially for a subject like writing — but it is an essential part of any plan to ensure student success.

Tests, or assessments in the educational vernacular, come in two major varieties:

• Summative assessments, which evaluate a student’s progress at the end of a year or course.
• Formative assessments, which monitor the progress of student learning throughout the year.

Though grading students via summative assessment typically receives a lot of attention from students, parents and policymakers, formative assessments are essential because they give teachers a better idea of how to adapt their instructions to meet the needs of the students. These tips offer guidance on properly implementing formative writing assessment in the classroom.

Charting Daily Progress with In-Class Formative Writing Assessments

At the beginning of the year, teachers can give students a simple diagnostic writing test to establish a baseline of students’ writing skill, both individually and as a class. 

When handing back diagnostics with comments, teachers can ask students to write for one to three minutes in response to the feedback they received. This will open up a dialogue around their writing process that will shift the focus away from summative grades and towards the process of writing, thinking about writing, and improving writing. Using this technique on all formal writing assignments can help students practice meta-cognition, which can improve their critical-thinking skills.

Exit tickets are another great way to prompt meta-cognition. These short, simple daily assignments can measure the main objective being taught on a larger level. Teachers should give the students no more than two questions, and try to keep one question concrete and allow the other question to require more explanation. Then, the teacher can tally the results of the exit tickets each day to measure class mastery and pinpoint enduring weaknesses.

 Maximizing the Benefits of Homework, Quizzes and Tests

Traditional weekly homework assignments provide a great way to measure progress because they show how students write outside the controlled environment of a classroom. Teachers should require students to go beyond simple answers in their quizzes and tests and ask open-ended questions that require thorough explanation of their thinking. Their answers will be more revealing, and give better data to inform future instruction.

Generating Student Feedback and Reflection

It always helps to require students to give you feedback on the day’s writing practice. In examining student feedback and reflection, be on the lookout for misconceptions. Here are a few approaches to that:

• Direct refutation: Let students know their thinking is simply incorrect.
• Provide examples that point out why the misconceptions are not reasonable.
• Offer visual models that give students an alternative way of understanding.
• Engage students in thinking by teaching active-learning strategies so they get out of the habit of learning passively.

The more teachers use formative writing assessment, the better equipped they’ll be to address misconceptions and understand the progress their students are making toward the goal of improving as writers, thinkers, and students.

You may also like to read

• These 4 End-of-the-Year Writing Projects are Sure Bets for Engaging and Exciting Your Students
• 3 Types of Assessment Commonly Used in Education
• 4 Tips for Teaching 2nd Grade Writing
• How Teachers Can Increase the Impact of Essay Writing for Students
• School District Debate: Year-Round Schools
• 4 Prompts To Get Middle School Kids Writing

Categorized as: Tips for Teachers and Classroom Resources

• Math Teaching Resources | Classroom Activitie...
• PhD Programs for Education
• Master's in Education Technology & Learning D...

• MyU : For Students, Faculty, and Staff

Writing Across the Curriculum

• Research & Assessment
• Writing Plans
• WEC Liaisons
• Academic Units
• Engage with WEC
• Teaching Resources
• Teaching Consultations
• Faculty Writing Resources

Creating and Using Formative Writing Assignments

As writers, we know that writing is a process that takes place over time and is made up of different sorts of intellectual activities. As instructors, however, we often assign writing tasks as large, single assignments at the end of a semester. This can be too late for feedback to be meaningful or effective for future use and can encourage students to procrastinate until the last minute. By breaking up these large writing assignments into smaller “formative” assignments, you can not only provide more timely feedback but also better train students to approach writing as a process made up of different, equally important intellectual activities.

Formative assignments are low-stake, high-value smaller assignments that are later brought together into larger, cumulative assignments. For example, instead of assigning a single writing project all at once, you might schedule a series of small assignments that, for instance, require students to summarize the theories they’ve studied, analyze the evidence they will be using, and formulate and present the question and thesis to be addressed. After students have received feedback on each of these component parts, they bring them all together into the larger assignment.

There are many benefits to breaking up large assignments into smaller, formative assignments

• They encourage students to think of writing as an ongoing, developing process rather than as a single activity done all at once.
• They can keep students on track in terms of both time and content (by, for example, helping them avoid writing an entire assignment at the last minute on a bad or misguided idea).
• Rather than piling up all your own feedback work at once, they allow you to spread it out and give immediate, targeted feedback to the intellectual task at hand.
• They emphasize and target specific skills for the course or discipline (for example, source use, results discussion, and so on).

How to write formative assignments

Break a large writing assignment into its component pieces (e.g., introduction, conclusion, summary, methods, etc.).

• Prepare explicit directions for each piece. For example, provide specific explanations for what belongs in a successful introduction, or what a summary component requires, and so on. ( The best instructions also tell students why these things are required .)
• Prepare straightforward rubrics for evaluating the assignment according to the given directions.
• For example, if the first thing students need to do is analyze evidence, have them complete this assignment first; if the last thing they should do is write the introduction, have them complete this assignment last.

Use assignments to target potential stumbling blocks for students; if, for instance, you know students struggle with thesis development or counterargument, create assignments focused on these areas.

Formative assignments can also focus on specific writing conventions of the discipline, such as tone, voice, terminology, use of sources, and so on.

• WAC Clearinghouse, “Sequencing Writing Assignments”
• MIT Comparative Media Studies/Writing, “Sequencing Writing Assignments”
• Kate Kiefer, “Examples of Writing ­to­ Learn Activities”
• University of Minnesota Center for Writing, “Informal, In­-class Writing Activities”

Further Support

Visit us online at http://writing.umn.edu/tww. To schedule a phone, email, or face­-to-­face teaching consultation, click here.

• Log in to post comments
• African American & African Studies
• Agronomy and Plant Genetics
• Animal Science
• Anthropology
• Applied Economics
• Art History
• Carlson School of Management
• Chemical Engineering and Materials Science
• Civil, Environmental, and Geo- Engineering
• College of Biological Sciences
• Communication Studies
• Computer Science & Engineering
• Construction Management
• Curriculum and Instruction
• Dental Hygiene
• Apparel Design
• Graphic Design
• Product Design
• Retail Merchandising
• Earth Sciences
• Electrical and Computer Engineering
• Environmental Sciences, Policy and Management
• Family Social Science
• Fisheries, Wildlife, and Conservation Biology
• Food Science and Nutrition
• Geography, Environment and Society
• German, Nordic, Slavic & Dutch
• Health Services Management
• Horticultural Science
• Hubbard School of Journalism and Mass Communication
• Industrial and Systems Engineering
• Information Technology Infrastructure
• Mathematics
• Mechanical Engineering
• Medical Laboratory Sciences
• Mortuary Science
• Organizational Leadership, Policy, and Development
• Political Science
• School of Architecture
• School of Kinesiology
• School of Public Health
• Spanish and Portuguese Studies
• Speech-Language-Hearing Sciences
• Theatre Arts & Dance
• Youth Studies
• New Enrollments for Departments and Programs
• Legacy Program for Continuing Units
• Writing in Your Course Context
• Syllabus Matters
• Mid-Semester Feedback Strategies
• Designing Effective Writing Assignments
• Writing Assignment Checklist
• Scaffolding and Sequencing Writing Assignments
• Informal, Exploratory Writing Activities
• 5-Minute Revision Workshops
• Reflective Memos
• Conducting In-Class Writing Activities: Notes on Procedures
• Now what? Responding to Informal Writing
• Teaching Writing with Quantitative Data
• Commenting on Student Writing
• Supporting Multilingual Learners
• Teaching with Effective Models of Writing
• Peer Response Protocols and Procedures
• Using Reflective Writing to Deepen Student Learning
• Conferencing with Student Writers
• Designing Inclusive Writing Assigments
• Addressing a Range of Writing Abilities in Your Courses
• Effective Grading Strategies
• Designing and Using Rubrics
• Running a Grade-Norming Session
• Working with Teaching Assistants
• Managing the Paper Load
• Teaching Writing with Sources
• Preventing Plagiarism
• Grammar Matters
• What is ChatGPT and how does it work?
• Incorporating ChatGPT into Classes with Writing Assignments: Policies, Syllabus Statements, and Recommendations
• Restricting ChatGPT Use in Classes with Writing Assignments: Policies, Syllabus Statements, and Recommendations
• What do we mean by "writing"?
• How can I teach writing effectively in an online course?
• What are the attributes of a "writing-intensive" course at the University of Minnesota?
• How can I talk with students about the use of artificial intelligence tools in their writing?
• How can I support inclusive participation on team-based writing projects?
• How can I design and assess reflective writing assignments?
• How can I use prewritten comments to give timely and thorough feedback on student writing?
• How can I use online discussion forums to support and engage students?
• How can I use and integrate the university libraries and academic librarians to support writing in my courses?
• How can I support students during the writing process?
• How can I use writing to help students develop self-regulated learning habits?
• Submit your own question
• Short Course: Teaching with Writing Online
• Five-Day Faculty Seminar
• Past Summer Hunker Participants
• Resources for Scholarly Writers
• Consultation Request
• Faculty Writing Groups
• Further Writing Resources

Your browser is not supported

Sorry but it looks as if your browser is out of date. To get the best experience using our site we recommend that you upgrade or switch browsers.

Find a solution

• Skip to main content
• Skip to navigation

• Back to parent navigation item
• Collections
• Sustainability in chemistry
• Simple rules
• Teacher well-being hub
• Women in chemistry
• Global science
• Escape room activities
• Decolonising chemistry teaching
• Teaching science skills
• Get the print issue
• RSC Education

• More navigation items

Writing effective questions for formative assessment

• No comments

Taking this approach will get your students thinking about how they can improve

Source: © Andrea Ebert/Ikon Images

It’s more than doing formative assessment, it’s about ‘being’ formative

I first became interested in the importance of classroom culture to successfully implement formative assessment when I was doing my doctorate in education. So, I want to introduce how to write and use questions more formatively so that they inform teaching and learning.

For me, it’s more than ‘doing’ formative assessment, it’s about ‘being’ formative, by creating a formative culture in your classroom. Formative values underpin everything that is done and said by teachers and learners in the formative classroom, although in real classrooms there is a blend of summative and formative approaches.

The benefits of formative assessment have been seen in classrooms globally over the past two decades. In particular, formative assessment has highlighted the power of effective feedback, led to improvements in our understanding of how feedback can affect motivation, and helped to harness independence in learners through the development of self-regulation .

Download this

An audit to help you develop your formative practice as MS Word or pdf . Answer the questions to work out which practices you use and which you would like to develop.

Download all

An audit to help you develop your formative practice from the Education in Chemistry website: rsc.li/2DVRFef

Different teachers have different values with regard to assessment based on their personal pedagogy and the culture of the school in which they work. So it is useful to reflect upon your values, decide what you want to change and then make those changes in your practice. Here are three examples of formative practices in the use of written questions.

Writing closed questions

Closed questions, often in the form of knowledge tests, are a common approach to assess how well learners know a particular topic. These tests are often written as a list of recall questions that require short one- or two-word answers. In this summative approach, questions need to be closed and unambiguous. For example, what is the chemical symbol for chlorine?

However, these questions can be used more formatively if these become a resource rather than a test. Learners take ownership of the process by self-testing until they feel confident before a summative test takes place.

In a formative culture, you can use questions to support self-regulation. When setting a learning activity — learn the symbols for the first 20 elements — also ask the students ‘how’ they might achieve this. For example, the question could be ‘How will you make sure that you have really remembered the first 20 elements?’ There could be a discussion about which strategies students might try: ‘look, cover, write’ method, regular retesting, mixing up the order, or making a game, such as ‘pairs’ with cards of the names and symbols.

A formative approach focuses on the self-regulation principles of planning, monitoring and evaluating. It also promotes effective ways to learn, such as retrieval practice .

Writing diagnostic questions

Diagnostic questions are intended to be used formatively; they ask a question that is often supported by a choice of answers. Depending on the choice made by a learner, a judgment and intervention can be made. Carefully construct your diagnostic questions to ascertain what a learner knows about a particular concept. The questions can take several forms:

• Multiple choice questions – these are quick to answer and mark.
• Concept cartoons – in which a problem is given alongside three or four plausible answers.
• Pinch point multiple choice questions – whereby each answer leads to a specific intervention.

These questions can be difficult to write and often take a lot of research, trials and modifications to get right.

Using diagnostic questions as a summative test is possible, but it rather defeats the object. The follow-up from diagnostic questions focuses on the intervention and the learning. In a formative culture, teachers are more likely to explain the purpose of the activity. For example, a typical introduction to an activity might be: ‘This activity is to help you find out what you know and what you need to do more work on. Once you have done the task, based on the results, you can decide which improvement activity to do. At the end of the lesson, I want you to be able to tell me how you improved and what you did to make those improvements in your learning.’

This approach gives the learners some ownership over how they will address areas for improvement, values improvement by giving it time in the lesson, and emphasises what has been learned and how it has been learned (the process of learning).

Writing open-ended questions

Open questions are written to deliberately invite extended, thoughtful, detailed answers. They encourage learners to identify what they know, what they need to improve, and how to find out and learn deficits in knowledge and understanding.

Open questions, such as ‘What happens when a candle burns?’, often have supporting guidance like ‘Explain the physical and chemical processes that occur when a candle burns’ or a rubric to support the task. Examples of open-ended questions include the use of ‘grade-ladder tasks’ or threshold concept mastery tasks .

The structure of the lesson is often crucial to encourage a formative approach. The first part of the lesson is spent drafting the answer, a middle part reflecting on how to improve and the final part making those improvements. Yet, as with all teaching resources, it’s not what you do, it’s the way that you do it.

Developing a formative culture audit

More Andy Chandler-Grevatt

Reviewing the ECF

Establish good learning behaviours in the science lab

Get support from … ASE

• Developing teaching practice
• Secondary education

Related articles

Classroom assessment skills: 6 ways to develop your assessment literacy

2021-03-16T06:43:00Z By Andy Chandler-Grevatt

Master this essential skill and develop a mental map of your subject in three easy steps

5 tips for approaching formative assessment

2021-02-18T09:43:00Z By David Read

Use these research-informed teaching tips to better uncover your classes’ core chemical thinking

6 ways to develop your assessment skills

2021-02-08T09:24:00Z By Andy Chandler-Grevatt

Master the essentials of assessment to maximise your students’ learning

No comments yet

Only registered users can comment on this article., more feature.

Enhance students’ learning and development with digital resources

2024-06-17T05:02:00Z By David Paterson

Tips and a model to improve learners’ understanding and develop vital skills using digital learning

Getting the most out of the UK Chemistry Olympiad

2024-06-05T07:00:00Z

It’s the competition with something for every learner and teacher. Discover the benefits of participation here

Your guide to the UK Chemistry Olympiad

2024-06-05T07:00:00Z By Nina Notman

Discover how your school can easily participate in the leading annual chemistry competition for secondary school learners

• Contributors
• Print issue
• Email alerts

Site powered by Webvision Cloud

• Grades 6-12
• School Leaders

Get our FREE Classroom Seating Charts 🪑

25 Formative Assessment Options Your Students Will Actually Enjoy

Get them excited to show you what they know!

Formative assessment is the piece of the teaching puzzle that allows us to quickly (and hopefully, accurately) gauge how well our students are understanding the material we’ve taught. From there, we make the important decisions about where our lesson will go next. Do we need to reteach, or are our students ready to progress? Do some students need additional practice? And which students need to be pushed to achieve the next level?

The best formative assessments will not only answer these questions but will also engage students in their own learning. With that in mind, here are 25 formative assessment techniques that will have your students looking forward to showing you what they know.

1. Doodle Notes

Have students doodle/draw a pic of their understanding instead of writing it. Studies have shown it has numerous beneficial effects on student learning.

2. Same Idea, New Situation

Ask your students to apply the concepts they’ve learned to a completely different situation. For example, students could apply the steps of the scientific method to figuring out how to beat an opposing soccer team. They observe data (the other team’s plays), form theories (they always rely on two main players), test theories while collecting more data (block those players and see what happens), and draw conclusions (see if that worked).

[contextly_auto_sidebar]

3. Tripwire

Tripwires are things that catch people off guard and mess them up. Ask your students to list what they believe are the three misunderstandings about the topic that are most likely to mess up a peer. By asking students to think about the key understandings from this angle, we can get an excellent view of how well they comprehend the topic.

4. Two Truths and a Lie

No longer just a get-to-know-you game or icebreaker, this well-known activity also makes a great formative assessment. Ask students to list two things that are true or accurate about the learning and one idea that sounds like it might be accurate, but isn’t. You’ll be able to assess each student’s understanding when they turn in their responses, and going over them with your class the following day makes an excellent review activity.

5. Popsicle Sticks

Formative assessment doesn’t need to be complicated or time-consuming to be meaningful and engaging. Have each student put their name on a popsicle stick in a jar or box on your desk. Let them know you’ll be pulling popsicle sticks to see who will be answering questions about the lesson. Knowing their name could be pulled makes students who might let peers do the talking focus on the learning. It dispels notions of favoritism and identifies learning gaps. And, most importantly, provides real-time feedback teachers can use in their lesson planning.

6. Explain it to a Famous Person

Ask the student to explain the day’s lesson to someone famous in an analogy that would make sense to that person. For example, the Revolutionary War was fought between the colonies and Great Britain. The colonies wanted to be independent and, after winning the war, renamed themselves the United States of America, just like when Prince left his record label and had to change his name to an unpronounceable symbol in order to break contractual obligations (I’m dating myself with this example, aren’t I?).

7. Traffic Light

Printing on post-it notes is actually pretty simple and fun! Slap a clip-art picture of a traffic light on there and you have a perfect formative assessment tool that students can complete when time is short at the end of class.

8. 30-Second Share

Challenge students to explain what the lesson they learned was all about to a peer, a small group, or the entire class in 30 seconds. At first, you might want to start at 15-seconds and build their stamina. But by encouraging students to explain everything they can for a set and relatively short amount of time, you’ll be building their confidence and public speaking skills at the same time as you get a good grasp on how much they’ve remembered about the lesson.

9. Venn Diagrams

An oldie but a goodie. Have your student compare the topic you just introduced to a tangential topic you taught in the past. This way, you’re getting a formative assessment on how well they understand the new topic and they’re getting a review of an older topic as well!

10. Poll Them

Polls are a great way to quickly assess student understanding. You can do this in person, or you can use apps like Poll Everywhere , Socrative , or Mentimeter to make free polls students can answer using their phones or computers.

11. S.O.S. Summaries

A great, quick formative assessment idea that can be used at any point throughout a lesson is the S.O.S. summary. The teacher presents the students with a statement (S). Then, asks the students to give their opinion (O) about the statement. Finally, the students are asked to support (S) their opinion with evidence from the lesson. For example, a teacher might say to the students, “Complete an S.O.S. on this statement: The Industrial Revolution produced only positive effects on society.”

S.O.S. can be used at the start of a lesson to assess prior knowledge or at the end of a unit or lesson to determine if students’ opinions have changed or if their support has grown stronger with the new information they’ve learned.

12. FOUR-Corners

This activity can be used with questions or opinions. Before asking the question/making the statement, establish each corner of the room as a different potential opinion or answer. After giving the prompt, each student goes to the corner that best represents their answer. Based on classroom discussion, students can then move from corner to corner, adjusting their answer or opinion.

13. Jigsaw Learning

Perfect when teaching complicated subjects or topics with many different parts. In this formative assessment, teachers break a large body of information into smaller sections. Each section is then assigned to a different small group. That small group is in charge of learning about their section and becoming the class experts. Then, one by one, each section teaches the others about their part of the whole. As the teacher listens to each section being taught, they can use the lesson as a method of formative assessment.

14. Anonymous Pop-Quiz

All the formative assessment power of a pop-quiz with none of the unnecessary pressure or embarrassment. To use this tool, simply quiz your students on the essential information you want to ensure they understand. Instruct each student NOT to put their name on their paper.

Once the assessment is complete, redistribute the quizzes in a way that ensures no one knows whose quiz they have in front of them. Have the students correct the quizzes and share out which answers most students got wrong and which answers everyone seemed to understand the most. You’ll know right away how well the class as a whole understands the topic without embarrassing any students individually.

15. One-Minute Write-Up

At the end of a lesson, give students one minute to write as much as they can about what they learned through the lesson or unit. If needed, provide some guiding questions to get them started.

• What was the most important learning from today, and why?
• Did anything surprise you? If so, what?
• What was the most confusing part of the lesson, and why?
• What is something that will likely appear on a test or quiz, and why?

Challenge them to write as much as they can and to write for all of the 60-seconds. To make it a bit more engaging, consider letting students do this with a partner.

16. EdPuzzle

Students love to watch videos and, because of this, we end up showing a lot of short video clips. While they’re engaging, it’s often tough to determine if our students are getting the information we hoped they would get out of watching them. EdPuzzle solves this problem. The free app allows you to link to a video and add questions that stop the video at times you determine. So you can show your students the video of the Dust Bowl, but stop at various points to ask them what they think life might have been like during this time. You can ask them to make comparisons between what they watch and the characters they’re reading about in class. All of this information is then available for you to view and use for formative assessment.

17. Historical Post Cards

Ask students to take on the role of one historical figure you’ve been learning about in class. Have them write a postcard/email/tweet (as long as it’s short) to another historical figure discussing and describing a political event.

18. 3x Summaries

Have students write a 75-100 word summary of a lesson independently. Then, in pairs, have them rewrite it using only 35-50 words. Finally, have them work with a small group to rewrite it one last time. This time, they may use only 10-15 words. Discuss what different groups decided was the most essential information and why they chose to omit certain information. The conversation about what they left out is just as useful as seeing what they left in.

19. Roses and Thorns

Ask students to write or share out two things they really liked/understood about a topic (the roses) and something they didn’t like/didn’t understand (the thorn).

20. Thumbs Up, Down, or in the Middle

Sometimes things stick around because they just work. Asking students to give you a thumbs up if they understand, thumbs down if they don’t, or thumbs somewhere in the middle if they are so-so about it, is probably one of the fastest formative assessments around. It’s also very easy to keep track of if you’re the teacher standing in the front of the room. Just make sure that you follow up with the thumbs down or thumbs in the middle folks to help them with any confusion.

21. Word Clouds

Ask your students to provide you with the three most essential words or ideas from a lesson and plug them into a word cloud generator . You’ll quickly have an excellent formative assessment that shows you what they thought was most worthy of remembering. If it doesn’t line up with what you think was most important, you know what you need to reteach.

22. Curation

Ask students to gather a bunch of examples that correctly demonstrate the concept you taught. So if you’re studying rhetorical strategies, have students send you screenshots of ads that demonstrate them. Not only will you be able to tell immediately who understood the lesson and who didn’t, but you’ll also have a bunch of great examples and non-examples ready to go for those students who need additional practice.

23. Dry Erase Boards

Another time-tested method of formative assessment that teachers often overlook is individual dry erase boards. They really are an awesome and fast way to see where each student’s level of understanding is at any given point.

24. Think-Pair-Shares

Like so many teacher tools, this one can get stale if overused. But, if used as a method to encourage all students to find their voice and share their learning, it’s perfect for formative assessment. To ensure its effectiveness, ask a question of the class. Have every student write down their own answer. Pair students up with a classmate and give them time to share and discuss their answers. After pairs have had a chance to discuss, have them share out with a larger group or the class as a whole. Circulate, listening to groups who have students you know might be more likely to struggle with the current topic. Collect the papers for extra accountability.

25. Self-Directed

This one can intimidate some students at first, but it can be incredibly powerful to let students themselves choose how they want to demonstrate learning. You can support students by giving them managed choice, but let them decide if they want to show you they understood the essential parts of your lesson by drawing a picture, writing a paragraph, creating a pop quiz, or even writing song lyrics. This shows you’re putting them in charge of their own learning.

What’s your go-to method of formative assessment? Tell us in the comments.

Get more teaching tips and ideas when you sign up for our free newsletters .

You Might Also Like

25 Alternative Assessment Ideas

Test outside the box. Continue Reading

Copyright © 2024. All rights reserved. 5335 Gate Parkway, Jacksonville, FL 32256

You are using an outdated browser. Upgrade your browser today or install Google Chrome Frame to better experience this site.

• Professional learning

Teach. Learn. Grow.

Teach. learn. grow. the education blog.

27 easy formative assessment strategies for gathering evidence of student learning

• New Clothes
• Dos and Don’ts
• Three Common Misunderstandings
• Yes/No Chart
• Three Questions
• Explain What Matters
• Big Picture
• Venn Diagram
• Self-Directed Response

Combining these 10 with 10 others we’ve blogged about in the past gives teachers 20 great formative assessment strategies for checking on student learning. Be sure to click through to learn more about these formative assessment strategies.

• The Popsicle Stick
• The Exit Ticket
• The Whiteboard
• Think-Pair-Share
• Two Stars and a Wish
• Carousel Brainstorming
• Basketball Discussions

Want more? Here are seven more strategies you can use to elicit evidence of student learning.

• Entrance Tickets. We’ve blogged about and explained the Exit Ticket, so why not have an Entrance Ticket? Here, the teacher asks a question at the start of a lesson, and students write their responses on index cards or strips of paper. Answers are used to assess initial understanding of something to be discussed in that day’s lesson or as a short summary of understanding of the previous day’s lesson. The teacher designs the lesson around the fact that information on student learning will be coming in at the start of the lesson and can be used to improve the teaching and learning in that lesson. Be sure to write the question so it is easily interpreted and analyzed, allows time for you and/or the students to analyze the responses, and leaves space for you to adjust the lesson, if needed.
• Keep the Question Going. With this formative assessment strategy, you’ll ask one student a question and then ask another student if that answer seems reasonable or correct. Then, ask a third student for an explanation of why there is an agreement or not. This helps keep all the students engaged because they must be prepared to either agree or disagree with the answers given and provide explanations.
• 30-Second Share. With this strategy, students take a turn to report something learned in a lesson for up to 30 seconds each. Connections to the learning targets or success criteria are what you’ll be looking for in the language used by the student. Make this a routine at the end of a lesson so all students have the opportunity to participate, share insights, and clarify what was learned.
• Parking Lot. This is an underused strategy for students and one that can surface questions before learning, as well as during and after. This tool also offers an anonymous place for questions that may be directly related to the content or tangential to the current topic and provide insight into student thinking. Simply save a spot on your whiteboard to write down ideas or questions that aren’t completely relevant in the moment but should be revisited later.
• One-Minute Paper. This might be considered a type of exit ticket as it is typically done near the end of the day. Ask your students, either individually or with a partner, to respond in writing to a single prompt. Typical prompts include:
• Most important learning from the day and why
• Most surprising concept and why
• Most confusing topic and why
• Something I think might appear on a test or quiz and why
• 3-2-1. At the end of the learning, this strategy provides students a way to summarize or even question what they just learned. Three prompts are provided for students to respond to:
• 3 things you didn’t know before
• 2 things that surprised you about the topic
• 1 thing you want to start doing with what you’ve learned
• Assessment Reflection. This strategy is a post-assessment reflection completed individually first and then shared in a small group. After an assessment, the teacher provides a list of questions so learners can reflect on their assessment experience. During group discussion, ideas are collected as new information to support students to better prepare for and engage in future assessments. Consider the following or similar questions. You might also use strategies such as Plus, Minus, Interesting, or Plus/Delta.
• How engaged were you with this assessment? Why?
• What did you feel most confident about? Why?
• What did you do that led to your success or confidence?
• What was the most difficult part of this assessment? Why?
• What would you do differently next time?
• What was the most confusing? Why?
• What do you know about the topic that the assessment didn’t allow you to show?

All 27 of these formative assessment strategies are simple to administer and free or inexpensive to use. They’ll provide you with the evidence of student learning you need to make lesson plan adjustments and keep learning on target and moving forward. They’ll also give your students valuable information so they can adjust their learning tactics and know where to focus their energies.

If you’re not quite sure where to get started, the following discussion questions can help.

Questions for teachers

• How do you use formative assessment data to inform instructional decisions?
• How can formative assessment strategies foster a learning environment of collaboration and engagement?
• How do formative assessment strategies elicit evidence of student learning?
• What is one strategy you could try tomorrow and why?

Questions for leaders

• How do you use formative assessment data to drive school-wide instructional academic decisions?
• How can you model formative assessment strategies in staff meetings, PLCs, and meetings with teachers?
• What are three formative assessment strategies you could bring to your teachers and staff? Why do you feel these would be most effective at your school?

Get more formative assessment tips and tricks in our e-book “Making it work: How formative assessment can supercharge your practice.”

Recommended for you

Norm- vs. criterion-referenced in assessment: What you need to know

MAP Reading Fluency with Coach provides targeted interventions grounded in the science of reading 

K–12 data leadership: Be the change for your school community

Making it work: How formative assessment can supercharge your practice

Formative assessment isn’t new. But as our education system changes, our approaches to any instructional strategy must evolve. Learn how to put formative assessment to work in your classroom.

View the eBook

STAY CURRENT by subscribing to our newsletter

You are now signed up to receive our newsletter containing the latest news, blogs, and resources from nwea..

Formative assessments: the ultimate guide for teachers

• Categories Blog
• Date February 14, 2024

K-12 education is a construction process where students’ skills and knowledge are gradually built up, with every preceding “block” essential to keep on building.

As a teacher, it’s your job to ensure that your students have the core knowledge they need to keep advancing through their education. You need a daily understanding of their current skills and knowledge so that you can accurately gauge their progression, and decide what to teach them next.

One of the most effective, proven ways to do this is with formative assessments (OECD, 2008). 1 They’re a crucial tool in your teaching kit, helping you to provide quality education to students.

Table of contents

• What are formative assessments?
• Evidence that formative assessment works
• Formative assessment examples / types
• Formative assessment strategies for your school and classroom

1. What are formative assessments?

Formative assessments are regular low-stakes tests that help you gauge students’ understanding. They are “dipsticks” where you can quickly check learning as you might quickly check the oil in your car, allowing you to adapt your teaching and fill knowledge gaps while learning is still taking place.

Quizzes are a common example of formative assessments. They’re quick to create, complete, and mark, and give you a good impression of students’ understanding of the content and their progress for the unit. You can see which questions and topics they are struggling with, re-teach them, and then re-test – a rapid feedback and improvement cycle that boosts student outcomes and moves them along their learning journeys.

You can see how this differs from summative assessments like end-of-year exams. These are one-off tests used to evaluate student understanding after learning has finished, with no opportunity to improve. Their purpose is to grade. But with formative assessments, getting the right answers isn’t important because that isn’t the objective. Instead, the purpose is to provide you with continuous, fast “readings” of student progress which you use to adapt your teaching and advance their learning. Summative assessments are to grade, and formative assessments are to direct .

As you can imagine, this sets entirely different tones for the two types of assessment. Summative tests can be high-stakes with real consequences that shape students’ future opportunities. This makes them understandably anxious, which can significantly affect their performance (Embse et al., 2018). 2 Formative assessments, on the other hand, are low-stakes, light-touch tests that are (ideally) designed to be fun and engaging, and to boost learning outcomes (OECD, 2008). 5 Formative assessments help to improve summative assessment scores/grades (and more importantly, their education), but this doesn’t work the other way around.

To make our position clear: both types of assessment have an important place in education. They just have different purposes and effects on students. If you’d like a more detailed comparison of these two types of assessment, please check out our article here .

How formative assessments help your teaching

“Formative assessment – while not a “silver bullet” that can solve all educational challenges – offers a powerful means for meeting goals for high-performance, high-equity of student outcomes, and for providing students with knowledge and skills for lifelong learning.” 1

– OECD

In essence, formative assessments help you answer three key questions:

• Are students learning what they need to learn?
• Are students learning at a steady pace?
• What should be taught next?

The answers to these questions form an objective appraisal of your current teaching strategies and lesson plans, providing clues on what needs to change. This may include the following and more:

• Change of content – formative assessments reveal student understanding, which includes any learning gaps or misconceptions they may have. With this information, you can adjust the content being taught to ensure they are learning what they need.
• Refine learning intentions – when you have a strong understanding of your students’ knowledge and skills, you’re able to write more precise learning intentions in your lesson plans, and by extension, better plans overall that accurately address students’ needs.
• Group students based on ability – formative assessments are usually given to entire classes, which reveals students’ both individually, and as a whole. If assessment results reveal distinct groupings of students based on their knowledge and skill, and you have the capacity to group them in your class and set unique work, that’s a much more inclusive way to teach and likely to result in better learning outcomes. More broadly, this information also helps you form separate support classes or Gifted and Talented classes.
• Change frequency of assessment – if you’ve previously identified knowledge gaps, you’ll want to re-assess after learning to ensure they’re filled. While formative assessment should be a regular occurrence in your class, the frequency should change depending on the results and other feedback you get from students.

Formative assessments in action – a quick example

“Assessment is the bridge between teaching and learning. It’s only by assessment that you know what has been taught, has been learned.” 3

– Dylan Wiliam, formative assessment expert

To give you an example of formative assessments in action, let’s say you’re a Year 8 Science teacher starting a new term with students, and before proceeding with the content assigned to this term, you want to check their understanding to ensure they’ve mastered the prerequisite content, allowing you to correctly build on their knowledge.

As part of this term, students are extending their knowledge of biological sciences. So you ask them to take five minutes to create individual mind maps of everything they remember about cells – a brain dump of the content they have already been taught last term. Walking around the class, you can see maps that contain organelles, membranes, nuclei, and even little drawings of cell structures. Some students have filled their A4 sheet and others have barely touched it (mental note added). But overall, your students have covered the core concepts they learned last year.

To validate this information, you’d like them to elaborate on their mind maps to ensure they actually understand (rather than just remember) the concepts, so you write a few of the key ideas on the board and ask who would like to explain it. They seem to have a good grasp of membranes and nuclei, but even with plenty of hints, nobody can accurately describe what organelles do, or how the cells of plants and animals differ. You’ve identified two clear topics that need some refreshing, which you can either teach immediately or add to your next lesson plan.

These formative assessments may have taken no longer than 10 minutes. Of course, there needs to be a good balance between assessment and instruction, but that’s the beauty of formative assessments: they are quick and sharp and provide you with objective, real-world data that effectively directs your teaching. By incorporating formative assessments into your day-to-day teaching, you have vital feedback on student learning which you can use to identify and fill their knowledge gaps, build on their knowledge, and set them up for success.

Formative assessments help students become self-learners

Formative assessments have another effect on students that can improve their education and lives immeasurably: they help them become empowered self-learners (Clark, 2012). 3

This happens for two reasons:

They learn self-evaluation techniques

Many formative assessments have processes in which students assess their own work or the work of their peers. Rubrics are a good example. You can give students a marking rubric that allows them to assess their classmates’ abilities at reading aloud, as per below:

“By learning how to evaluate their own work, students develop the crucial meta-cognitive skills they need to progress by themselves.”

By using this rubric as a guide, they can score their classmates on volume, fluency, and clarity, and in the process, they also learn how to assess their own skills and pinpoint areas of weakness.

Informal debates are another example. You can create small groups of students and ask them to debate an issue in which they express their opinions, back them up with evidence, and listen to why their classmates agree or disagree. The conversations help them discover potential misconceptions or logical flaws, again teaching them (through modelling) how to evaluate such things by themselves.

By learning how to evaluate their own work, students develop the crucial meta-cognitive skills they need to progress by themselves. It’s giving them the proverbial fishing rod instead of a fish. They learn how to reflect, critique, review, and mark their own work, giving them a firm grip on their own learning and accelerating them to speeds far beyond what teachers can achieve by themselves. This leads to greater self-efficacy (Panadero et all., 2017) 4 and success.

They’re interactive and social

Formative assessments are highly varied, interactive tasks that students engage with during class. For most students, because the assessments are hands-on activities that require their attention, this makes them more interesting than standard instruction from the teacher. Students often become enthusiastically engaged in their learning, which creates a sense of agency and responsibility for their education. When combined with learning goals, this can be a powerful tool for improving outcomes.

Similarly, formative assessments can be co-operative social activities where students are encouraged to interact with their classmates and teachers. They might be having conversations with each other, validating their knowledge before and after learning, self-assessing using proven techniques, and many other activities (see our full list of assessment examples below) in which they are active and involved. As socially-driven creatures, this can turn your students’ learning from dull chores into genuinely fun experiences where they build friendships along the way.

2. Evidence that formative assessment works

“Teaching which incorporates formative assessment has helped to raise levels of student achievement, and has better enabled teachers to meet the needs of increasingly diverse student populations, helping to close gaps in equity of student outcomes.” 1

Formative assessments have been studied extensively, and show sweeping improvements for learning outcomes (OECD, 2008). 1

A comprehensive report on formative assessment by the Organisation for Economic Co-Operation and Development (OECD), backed up by numerous studies, found the practice to be one of the most important interventions for promoting high [student] performance ever studied (OECD, 2008). 1 It’s the equivalent of taking students’ scores in an average performing country and lifting them into the top five best performing countries (Beaton et al., 1996, Black and Wiliam, 1998) 5,6 .

The OECD report shows that formative assessments:

• Make education more equitable . They lift the performance of every single student, including those who are underachieving.
• Improve school attendance . Formative assessments tend to be fun and engaging for students, which makes school much more enjoyable and reduces absence rates.
• Help students retain what they’ve learned. Assessments tap into the “testing effect” – a phenomenon in which the act of testing also boosts learning. Trying to recall information from memory is a highly effective way to learn (Brown et al., 2014). 9
• Help students become self-learners . They are more involved and engaged in the learning process itself, discovering the mechanics behind learning and self-evaluation and how they can do it themselves.
• Help to clarify misconceptions. These can be immediately corrected during learning, before they are consolidated into long-term memories during sleep (Klinzing, Niethard and Born, 2019). 11

Aside from the OECD report, there are numerous studies where formative assessment has proven its worth. A 2021 meta-analysis of 32 studies found that formative assessments boosted learning outcomes considerably (Karaman, 2021). 11 For the core foundational skill of Writing, another meta-analysis of formative assessment experiments found feedback to be a crucial part of the process. When teachers and peers gave feedback, and students self-evaluated their own work, writing quality was enhanced (Graham et al., 2015). 7

Another study found formative assessment to have a positive influence on literacy as well as maths and the arts. Helping students to self-assess provided one of the biggest benefits, as did providing written feedback on quizzes (Lee et al., 2020). 8 Feedback has proven to be a crucial part of effective formative assessment, and we cover this in more detail below. For Science, high school biology teachers who completed a professional development program on formative assessment saw their abilities increase for key areas such as interpreting student ideas, eliciting questions and providing feedback (Furtak, et all., 2016). 7

Finally, in a random sample of 22 Swedish Year 4 Mathematics teachers, researchers asked them to participate in a professional development program on formative assessment. After implementing their knowledge in their respective classes, their students significantly outperformed others (Andersson, Palm, 2016). 10

We could go on. There’s so much evidence of the efficacy of formative assessment. It’s amazing to think that such drastic improvements can be made by introducing effective formative assessments into your classrooms (we talk more about effective strategies below).

3. Formative assessment examples / types and how they work

Formative assessments are extremely diverse. They range from generic to subject/content-specific, allowing you to assess knowledge and skills in a variety of ways, and cover the full breadth of K-12. You can pick and choose which formative assessments suit your students based on their age and the covered content.

Their variety and spontaneity can make learning much more fun for students of all ages. These are some of the more common formative assessment examples you’ll find in schools across the world.

Age group: all

Quizzes are one of the most popular types of formative assessment, and for good reason: they’re fun, quick to create and mark, and give you a great indication of students’ general knowledge, learning gaps and possible misconceptions for a topic. They can be given as:

• Diagnostic pre-tests before starting a new unit
• Mid-unit checkups to determine whether learning is going according to plan
• Evaluative tests that check learning before the next unit starts
• Start or end of lesson check-ups to quickly assess learning

Quizzes typically contain multiple-choice questions , which make them nice and quick to mark. But they can take other forms if needed. You can also incorporate directive feedback into each quiz’s results to show students what they might do to improve.

Discussion boards

With discussion boards, students write what they know about a topic on the whiteboard. This could be as a mind map, graffiti wall, or another format, with students writing short words or phrases, full sentences, or even drawing pictures. It’s a brain-dump of sorts that helps you understand students’ depth of knowledge for a topic, and any potential learning gaps or misconceptions you need to address.

Brain dumps are the same as discussion boards but are completed on paper or screens, either individually or in small groups. Students write everything they know about a topic in the format they prefer, which gives you an idea of their knowledge for the topic.

Traffic light system

With the traffic light system, each student is given three coloured cards – one red, one orange and one green – which they need to hold up in response to a statement. Red is disagree, orange is unsure, and green is agree. You might ask them whether 10 times 10 is 200, whether day and night is created by the moon, or whether the word “running” is a verb.

When students hold their cards up, you get a visual gauge of how many students answered correctly. It’s another super-quick, fun formative assessment for younger students.

Questions / surveys

These are the simplest formative test of all: you ask questions to the class and assess their answers on the spot. They’re a staple of teaching around the world because they give you an ultra-fast idea of what your students know about the content already taught, so that you can refresh their memories if needed. You’ll be able to gauge their knowledge from the numbers of hands raised and the quality of answers (keeping in mind the general shyness of that particular class).

Rubrics / self-evaluation

Age group: Years 3 to 10

When students learn how to assess their own work, they’re on the road to becoming self-learners who can develop a fully-fledged love of learning. Rubrics are a formative assessment that helps them on this path. They’re a simple marking criteria that students can apply to their own (or their classmates’) work to judge their performance, and what improvements they might need to make.

As already touched on previously, an example is the reading rubric shown below. Students can listen to their classmates read aloud, give them a score for each skill, and then discuss why they gave them afterwards. The rubric is one of many tools that students can use to self-evaluate and become enthusiastic independent learners.

KWL charts are a formative assessment that prepare your students for what they’re going to learn, get them invested in their own learning, and help them evaluate whether learning was successful.

Three columns are drawn on the board in class, from left to right:

• What I know
• What I want to know
• What I learned

For the content being taught in today’s class, students are invited to write about what they know about it, and what they want to know about it. They complete the “what I learned” third column at the end of class, showing them whether they achieved their desires/objectives. This is another simple, effective way for students to assess their own learning.

You can include an additional section if you wish – how will you learn it (which makes it KWHL). This encourages students to think about how to research and discover the information.

Think-Pair-Share

Age group: Years 1 to 9

With Think-Pair-Share, students write down their responses to a question and then discuss their answers with a partner. You walk around the room and listen to their discussions, to gauge their level of understanding of the topic. Finally, they share their answers with the class, which encourages them to reflect on the accuracy and logic of their own.

See, Think, Wonder

Age group: Years 1 to 5

See, Think, Wonder is a formative assessment that stimulates students’ curiosities and really gets them thinking about an image. They are given a photograph or picture and sheets with three columns that must be filled out:

• See – they describe what they see using descriptive language
• Think – they describe what they think is going on with the image
• Wonder – they write anything they’re wondering about the image

The task shows you the quality of their writing, their interpretation skills, their creativity, the accuracy of their observations, and more. Once done they can discuss their answers with students at their table, which encourages teamwork, or read them to the entire class.

Thumbs up or down

This is another quick and easy assessment that reveals general misconceptions. You offer a statement and ask them to give a thumbs up if they agree, and a thumbs down if they disagree. By judging the accuracy of their answers, you’ll know whether common misconceptions are present and resolve them if so.

For the statements, it can be a good idea to use any that your prior students have struggled with in the past.

Hot seat questioning

Hot seat questioning is an assessment that makes questions a little more fun. Anonymous questions are placed on a selection of seats, typically in front of class, and students are invited to select a seat, read the question aloud, and then try to answer. The rest of the class are encouraged to discuss the students’ answer and provide their own if appropriate.

The questions can vary in difficulty depending on the subject and year level. It can be an engaging, fun way to assess student learning and stimulate discussion.

Entry & exit slips

Age group: Years 1 to 6

Entry and exit slips are a simple form of pre- and post-tests, helping you understand whether content was successfully learned. Students fill out an entry slip with a question like “How does heat transfer?” and then an exit slip with the same question. This helps them to compare their knowledge before and after the lesson, which can be extremely satisfying and motivating. You can also check their answers for accuracy once the lesson is over and discover learning gaps or misconceptions that need to be addressed.

One-minute papers

At the end of the lesson, students are given a minute to answer a question that summarises what has been learned. For example: how does hardware and software allow people to interact with computers?

After quickly reviewing their papers, you’ll have a sense of how well they’ve remembered and understood the content, and whether you need to go over it again in the next lesson.

The limited time given to complete this task can make it stressful for some students, which impairs its accuracy. You can relax every student by telling them they have a minute, but that they can also take some extra time if they need.

Muddiest point

With the muddiest point assessment, students are asked to write down what they were most confused about after a lecture or other activity. You can select random students to discuss their answers with the class, have them talk about their answers between themselves, or review their answers once the class is over. If you notice common confusions/misunderstandings, you’ll want to address them in a future lesson.

Informal debates

Age group: Years 5 to 12

Informal debates between groups of two or more students can be a great way to gauge their understanding of a topic. You can assign each group member a position in the debate, ask them to present evidence of their viewpoints to each other, and have them respond in turn. It works best for more “subjective” subjects that can lack concrete explanations or viewpoints, like literature, the arts, or social sciences.

This assessment tool really taps into students higher-order thinking skills, with each side bringing their arguments, supportive reasoning and passion to the conversation.  

Anticipation guides

Age group: Years 3 to 9

Anticipation guides are a tool that help you discover misconceptions for students. You present them with a statement like “Products have minimal impact on the earth’s environment,” and ask them write down whether they agree with the statement before the lesson begins. Once the lesson is over, you ask them to respond to the same question.

Their answers will tell you whether they have absorbed your instruction, and can also vividly demonstrate the value of teaching to them – “in the past hour I’ve learned something new and important!”

Kids love moving their bodies, and you can use this to your advantage by asking them to “act out” certain processes in class. For example, if you want to know whether they’ve understood how gas, liquids, and solids behave differently, you can clear a space and ask them to (safely) demonstrate how they might move if they were transformed into one of these states. Or you can ask them to form expressions for how a character might feel in a story.

This exercise is not only great fun (especially for younger children), it also communicates their understanding to you.

4. Formative assessment strategies for your school and classroom

Now that we’ve covered the what and why of formative assessment, it’s time to talk about some actual strategies that you can use to implement them at your school and execute them to a high standard.

Set up a formative assessment framework

“A framework will make your formative assessments structured, purposeful, frequent, and at less risk of being dropped in favour of ‘teaching to the tests’.”

Some teachers are pressured to achieve good grades on high-visibility summative assessments, and this can come at the cost of fewer formative assessments that actually improve student outcomes (OECD, 2008). 1

So it’s crucial to create a formative assessment framework that prioritises the tests, especially if they are regularly dropped in favour of summative testing. A framework will make your formative assessments structured, purposeful, frequent, and at less risk of being dropped in favour of “teaching to the tests,” especially if they are endorsed by the school leaders.

Thankfully, the OECD has completed extensive research on formative assessments , with real case studies on teachers who have successfully made them a part of their teaching and achieved strong learning outcomes for their students. These are some of their suggestions that can form the basis of your framework, adapted and summarised:

Establish a classroom culture that encourages interaction through formative assessments

Interaction is a big part of formative assessment. Students may find themselves thrusting their thumbs in the air, holding up coloured paper, drawing mind maps, having debates and more. These hands-on, collaborative types of assessment are not only more engaging for students, but it’s showing them that learning can (and should) be fun – even for the teenagers!

Make formative assessments an integral part of your classroom culture. Factor them into your lesson plans and get every student involved. Demonstrate that the tasks themselves are important because they teach them to become more self-aware, more empathetic and cooperative with their classmates, more able to make decisions, and better equipped to assess their own work. Show them, over and over, that formative assessments are not necessarily about getting a top score or beating their classmates. They’re about carving out a path for your teaching while giving them the tools they need to become fully-fledged, self-learners. Get parents involved too and try to convince them of the value of formative assessment – it should be an easy sale!

There is no such thing as “failure” with formative assessments, and with every new one completed, students will start to realise this and become more confident and happier to take risks.

Create challenging learning goals for students and track their progress, together

Goal-setting is a long proven technique for achieving better outcomes, both inside and outside the classroom. Setting challenging goals has shown to improve task performance, boost work output, and regulate choices in favour of completing the goal (Locke et al., 1968). 12

In the context of formative assessments, goals should relate to mastery, not marks. Your students may create learning goals to improve their reading comprehension, to master their multiplication tables, or to run simple science experiments with clear predictions, conclusions and evaluations. With clear goals that have explicit, easy-to-understand success criteria, lessons can become more meaningful and students may find themselves more engaged in their learning – there’s a purpose and objective to what they’re doing. Rather than achieving an A+, it’s about becoming a more capable person. This can lead to greater intrinsic motivation, improved self-esteem, and a number of other benefits (OECD, 2008). 1

Work with your students to set learning goals that are personally meaningful to them. Have them print them off and stick them to their workbooks. For related lessons where learning goals are shared among students, ask them to quickly read their goals at the start of the lesson, and then when the lesson is over, get them to spend 30 seconds reflecting on their progress. Did they move a little closer? What might they do better next time? This is self-learning in action, and gives them the confidence and autonomy to become lifelong learners.

Use varied formative assessment methods to meet diverse student needs

Your students are all fantastically unique. Some thrive when asked to complete quizzes. Others enjoy reflecting on what they’ve learned. Some love going up to the board and writing or drawing what they know about something.

To cater to the various needs and preferences of your students, it pays to incorporate a variety of formative assessment methods into your day-to-day teaching. This not only makes things more fun for your students, it provides you with a broader, more accurate assessment of their skills and knowledge.

Involve students in the learning process

As previously discussed, one of the most incredible things about formative assessments is that they encourage students to become actively involved in their own education, teaching them self-learning strategies they can use to grow all by themselves. These “metacognitive” strategies are a fundamental soft skill that can make a big difference to their success at school and beyond.

Try to incorporate a good portion of formative assessments that teach students the value of learning and show them how to assess their own work. These include rubrics, KWL charts, entry/exit tickets and more.

Give feedback rather than marks

Marks are important to summative tests like exams, but when it comes to formative assessments, feedback is the name of the game. It’s essential for helping students self-learn. A mark is a solitary number that tells them almost nothing; high-quality feedback is rich, specific information that tells them where to go next. It can help students to feel more motivated, better equipped, and more confident, which can almost double their growth over the course of a year (Hattie and Temperley, 2007) 13 .

When offering feedback for formative assessments, try to ensure that it is:

• Timely – imagine if a driving instructor only provided suggestions after you’d got out of the car? They’d be nowhere near as effective. Our short-term memories are exactly that – short – and we are much more capable of actioning feedback if it’s delivered immediately when the tasks are still fresh in our minds. Work with your students’ short-term memories, not against them.
• Specific and constructive – what specifically did the student fail at, and how can they remedy the problem themselves? That’s what your feedback should focus on. Students need to know what they did wrong and what actionable steps they can take to fix it: key ingredients for self-learning. It may be that they can’t do this by themselves because they don’t know the content well enough, in which case it needs to be re-taught.
• Motivational – starting feedback by acknowledging students’ correct answers can make them more receptive to fixing their mistakes / filling their learning gaps. By telling them they’ve done well for certain questions, it can motivate them to do well for every A pat on the back can do wonders! You can also highlight what they’ve improved on since their last assessment, helping them to see that they’re progressing towards their learning goals.
• Where am I going?
• How am I going?
• Where to next?

When providing formative assessment feedback to students, it can be based on four different things:

• The activity – how well the task was understood or performed.
• The learning process – what the student needs to do to complete the task.
• Managing their learning – how the student might need to plan or self-monitor.
• Qualities – personal qualities that the student shows, like an aptitude for arithmetic.

And finally, if providing praise as part of your feedback, it goes without saying that you should never focus on their intelligence or natural abilities. It creates a fixed mindset that can really hinder their learning. 14 Instead, try to praise their effort.

Teach students how to assess their own work

Self-assessment is a key part of self-learning – a process that can work like high-powered fertiliser for students’ growth. When students are taught how to self-assess, they better understand how their answers are related to their learning goals, they’re invited to reflect on their efforts, and most importantly, they can identify what they need to do to produce better quality work.

As their teacher, you use pre-defined success criteria to assess the accuracy of their work, and they can use the very same criteria to assess themselves and their peers. As you complete the different types of formative assessment, demonstrate how you use the templates, checklists, or rubrics to mark their work, and how it shapes the judgment of what is considered high-quality. Give them samples of exemplary work and explain why it’s so good. Show them, again and again, how you use the criteria to discover potential gaps in their learning and the actions that might be taken to fill them. By modelling your own assessment and feedback processes, you help them become their own teachers.

When they get better at this important skill, students can spend time marking, discussing, critiquing and demystifying their assessment results, blossoming into self-directed learners who can take ownership of their education. You’re showing them that self-assessment is a vital part of the learning process and providing them with the tools they need to achieve great things.

The NSW Government provide some more extensive examples of how to teach students self-assessment techniques , which we highly recommend reading.

Vary formative assessments to meet students’ diverse needs

Student diversity is one of the biggest challenges to providing great education, and this extends to formative assessment. With so many different learning styles, preferences, levels of progress and subject matter, you’ll need to select a variety of assessment types to suit their needs. A quiz might make sense for one subject and group of students, an informal debate for another, KWL charts for younger children, etc. It all comes down to what you think might work best for the group and the content, which takes time and patience to figure out.

Practice and experimentation is key. In time, you’ll be a formative assessment master.

Always test for misconceptions before starting a new unit

Education is a series of building blocks, and if one of those blocks is the wrong size, it compromises the entire structure. Knowledge cannot be built upon if incorrect. If students have misunderstood how basic fractions work, they’re not going to be able to understand equivalent fractions later on.

Thankfully, formative assessments are ideal for diagnosing these kinds of misconceptions . Pretty much any formative assessment can be diagnostic. Whether you’re using surveys, hot seat questioning, or another type of assessment, you’ll quickly discover common misconceptions and remedy them before they can hamper students’ learning later on. And the best time to do this is before starting a new unit, when they’re about to learn fresh content. It’s the perfect time to repair those misshapen blocks of knowledge from the previous unit so you can confidently keep building.

Make students feel safe

Formative assessment can be engaging and highly interactive, so students need to participate for it to work. But this won’t happen unless they feel safe.

Creating a safe learning environment is a big topic, but here are some effective tips you can use to make students feel secure in your classroom, and coax each of them out of their shells:

• Lay down ground rules – make it absolutely clear that there will be no laughing, teasing, or name calling in class, and that transgressions will be punished. These kinds of hurtful interactions can be burned into students’ memories and really hold them back. Make your class a judgment-free zone and enforce a strict zero-bullying policy.
• Be trustworthy – consistently treat your students with kindness, respect and a “fair but firm” attitude, and you’ll quickly win their trust. They’ll feel much safer to participate when they know the authority in the room has their back. This is especially important for the students who are particularly withdrawn or emotional, and may have a turbulent life at home. Your classroom could become their precious safe place.
• Explain the importance of mistakes – every mistake is an opportunity for the student to recognise the error, figure out where they went wrong, and do it right next time. There’s no growth without mistakes – they’re a sign that your students are pushing themselves!
• Incorporate brief social-emotional activities – brief activities like daily greetings, checking in with emotions and gratitude lists can help your students express their emotions to their peers, build stronger empathy skills, and feel emotionally safe in your class.
• Post their work around the class – most of us love to be celebrated for our achievements, and you can do this for your students by posting their great work on the classroom’s walls. It’s a visual reminder that they are skilled and capable.
• Explain why you’re giving an assessment – for formative assessments that can feel high-stakes, like quizzes or one-minute papers, briefly explain why it’s important, and remind them that there are no consequences for wrong answers.
• OECD/CERI, Assessment for Learning Formative Assessment , OECD
• Nathaniel von der Embse, Dane Jester, Devlina Roy, James Post, 2018, Test anxiety effects, predictors, and correlates: A 30-year meta-analytic review , Journal of Affective Disorders
• Ian Clark, 2012, Formative Assessment: Assessment Is for Self-regulated Learning , Educational Psychology Review
• Ernesto Panadero, Anders Jonsson, Juan Botella, 2017, Effects of self-assessment on self-regulated learning and self-efficacy: Four meta-analyses , Educational Research Review
• Beaton, A.E. et al. (1996), Mathematics Achievement in the Middle School Years, Boston College, Boston, MA.
• Black P. and D. Wiliam (1998), Assessment and Classroom Learning, Assessment in Education: Principles, Policy and Practice
• Steve Graham, Michael Hebert, and Karen R. Harris, Formative Assessment and Writing , The Elementary School Journal
• Hansol Lee, Huy Q.Chung, Yu Zhang, Jamal Abedi, Mark Warschauer, 2020, The Effectiveness and Features of Formative Assessment in US K-12 Education: A Systematic Review , Applied Measurement in Education
• Brown et al. (2014), Make It Stick, Belknap Press
• Catarina Andersson, Torulf Palm, 2017, The impact of formative assessment on student achievement: A study of the effects of changes to classroom practice after a comprehensive professional development programme , Learning and Instruction , 49
• Jens G. Klinzing, Niels Niethard, Jan Born, 2019, Mechanisms of systems memory consolidation during sleep , Nature Neuroscience
• Edwin A. Locke, 1968, Toward a theory of task motivation and incentives , Organisational Behaviour and Human Performance
• Hattie, J & Timperley, H, 2007, The Power of Feedback , Review of educational Research Vol. 77
• Carol Dweck, 2006, Mindset: The New Psychology of Success, Random House

Nardin is a former primary school teacher of 10 years. During her time as a teacher, she served as Head of Years for K-2, was a trained NAPLAN marker, and was part of the team that wrote the 2021 NSW English Syllabus 3-6. She is currently an assessment consultant for ICAS and Reach.

Tag: formative assessments

Previous post

How ICAS boosts Ryan's love of learning

8 fun ways to improve literacy and numeracy at home, you may also like.

How ICAS is helping Rebekah with her career aspirations

ICAS vs NAPLAN – key differences for parents to know

How DEEP is helping the Central West Leadership Academy improve their students’ literacy and numeracy skills

Home Blog Inspiring Educators A teacher’s guide to different types of assessments

July 5th, 2024 by Ashlee Taylor

A teacher’s guide to different types of assessments

Table of Contents

Exploring different assessment types

Assessments are an essential part of education. While many people have a misconception that an assessment is always the final goal, different types of assessments can – and should – take place throughout the academic year. 

The right type of assessment helps teachers understand what their students have learned and the areas they need to improve on. They also enable students to better recognize their strengths and weaknesses, too.

Three of the most common assessment types are diagnostic, formative, and summative .

Diagnostic assessment

Also known as a pre-test, a diagnostic assessment establishes what knowledge a student possesses before formal learning begins. Teachers can then use this information to alter their lessons accordingly and tailor the amount of attention each pupil receives. 

Because a diagnostic assessment aims to understand students’ existing knowledge, strengths, and weaknesses, it will not count toward grades. The goal is to improve teaching by recognizing areas that need improvement; it’s never to judge students for what they do not know.

Types of diagnostic assessment

Educators can use different methods to assess their students’ pre-existing knowledge. Types of diagnostic assessments include:

• Quizzes – these can be a speedy way to assess knowledge without the pressure of a test.
• Mock exam – teachers may prefer to set a formal test for a more robust assessment.
• Class surveys – asking students to share what they know can help teachers gauge knowledge levels in their classrooms.
• Discussion boards – rather than teachers asking students to put their hands up, educators can request that their pupils write down what they know. Students can do this collaboratively on an Explain Everything online whiteboard when paired with an interactive display, such as an ActivPanel .
• Debates and discussions – Teachers can ask their students to discuss what they know in smaller groups, sometimes forming arguments. To understand what is being discussed, teachers need to spend time with each group or ask students to present back to the class.
• Mind maps – students can write down everything they know. Teachers can then review these for any obvious gaps or mistakes.
• K-W-L chart – students can note down what they know (K), want to know (W), and what they’ve already learned about a topic (L). These may not work if the topic is new (as the student hasn’t learned anything about the subject so far). However, teachers can set these at the end of an introductory lesson to establish what basic information is new for their class.

The assessment a teacher chooses to use will depend on their aim. For example, if the goal is to assess individual needs, a teacher must use independent assessments (e.g. quizzes). This is because a group activity can result in more experienced (or more vocal) students masking their peers’ knowledge gaps. However, a group assessment would work well if a teacher wants to understand the general subject familiarity in their classroom. 

When to use diagnostic assessment

A diagnostic assessment should take place at a starting point. This could be the beginning of a specific study area (such as a topic on the syllabus) or time-based (such as the first day of term or school year).

Teachers can use diagnostic assessments to inform their future lesson plans. For example, if the diagnostic assessments show a common knowledge gap, teachers can address this in future sessions.

Educators can also use diagnostic assessments to adjust learning on an individual level. These assessments can help teachers identify which students need more help and which students already have a lot of knowledge and will need more challenging material. To ensure each pupil is benefitting from their education, teachers may want to introduce differentiation .

Educators can also use diagnostic assessments to inform classroom groupings. For example, a school may use diagnostic assessments to work out the academic abilities of new students. This may determine whether pupils should be taught in different groups.

Formative assessment

A formative assessment enables teachers to check in on their pupils’ progress. Teachers can use the information from these assessments to inform future instruction, recognizing the areas that they may need to repeat. Teachers can also use formative assessments to glean insights into their teaching (i.e. what methods have worked and what ones haven’t).

Because formative assessments are a check-in point, they will not affect students’ grades. Instead, educators use these to tweak future lessons, which will help pupils excel at formal exams. 

Types of formative assessment

There are many ways to conduct a formative assessment, and not all involve a teacher assigning new work.

Formative assessment examples include:

• Assessing students’ work so far – Teachers can conduct formative assessments without their students’ knowledge. By examining homework and classroom activities, educators can analyze their pupils’ abilities and identify areas for improvement.
• One-minute papers – teachers can assess how much a student has learned in each lesson with a quick one-question assessment as each lesson wraps up. They can then review this and see if the lesson met its learning goals.
• Exit slips – Teachers can ask students for feedback at the end of each lesson on small pieces of paper, known as exit slips or exit tickets. Alternatively, they can conduct this digitally using Explain Everything Whiteboard technology. Whatever the method, teachers can use this feedback to tweak future lessons. 
• Quizzes – Low-stakes quizzes can be a quick and objective way of assessing students’ knowledge levels. These can be multiple-choice. 
• Problem pairs – This method can help educators understand if their students have grasped a skill. It works by the teacher writing down two very similar examples (or problems), completing one themselves, and then asking a student to complete the other. This activity can be carried out using Explain Everything software, with the teacher writing their example on the board for pupils to see easily. Educators can invite a student (or students) to complete the other problem on the online whiteboard.

When to use formative assessment

Formative assessments inform future lessons and should take place during a learning period. Some learning needs to have come before them, so they cannot take place at the beginning. They will also not be as useful at the end of a topic because the teacher cannot implement any findings for the current cohort of students.

Formative assessments, such as regular exit slips, can be continuous or serve as mid-term or mid-topic check-in points. As this type of assessment doesn’t contribute to students’ grades, it’s up to teachers how often they take place. Some educators may want to constantly conduct assessments to inform future lessons. Others may prefer to give pupils longer to learn information before checking their progress. 

Used well, formative assessments benefit teachers and their students. Educators can use them to improve their teaching and develop professionally. Students can reap the rewards of future lessons that will better match how they learn best and address any areas of missing knowledge.

Teachers can use Explain Everything Advanced’s built-in apps to carry out formative assessments. With the Spinner app , teachers can randomize information. They can input exit slip questions and then spin to randomly decide which student gets each question. Alternatively, teachers can use the Polling feature to create multiple choice, text, or creative polls (where students can draw on the canvas) about whatever they need to assess.

Summative assessment

A summative assessment measures what a student has learned at the end of a course, topic, or timeframe (e.g. academic year).

Finals and formal exams are summative assessments which contribute to students’ grades. However, some teachers may use informal summative assessments to review performance outside moderated exams.

Types of summative assessment

The aim of all summative assessments is the same: to review what has been achieved at the end of a unit or time period. However, teachers can measure pupils’ overall learning in different ways beyond exam papers.

Examples of summative assessments include:

• Exams – Tests are the most common summative assessments, with students formally quizzed on everything they’ve learned across a unit. These could take place throughout the semester after each topic (usually called term papers) or encompass all learnings (such as finals).
• Essays or dissertations – Educators may assign essays or dissertations as final assignments for summative assessments that take place in students’ own time. 
• Presentations – Teachers may give their students the option of presenting back their learnings via presentations. Pupils could present their findings in groups or independently.
• Projects – Depending on the nature of the subject, a project may be the most appropriate way to assess what students have learned. For example, building something with coding for a computing course could be a summative assessment.

When to use summative assessment

Summative assessments measure students’ learning at the end of a topic, term, or academic year. 

Summative assessments are often formal assessments that determine students’ grades. They can also take the form of mock exams. For example, children too young to be formally assessed may still take summative assessments. Educators can still use this information to understand their pupils’ progress.

The subject often determines the timing and type of a summative assessment. For example, in English, a summative assessment may take place after completing a piece of literature. It may be unrealistic (and not particularly useful) for students to retain analyses of books and poems for months. Because of this, teachers may assess their students via multiple summative assessments in the form of essays. However, for math, teachers may choose to have one summative exam to determine whether students have retained taught skills at the end of the year. 

Assessment templates

Explain Everything’s digital whiteboard has various customizable templates that teachers can use for assessments.

Explain Everything’s free assessment templates include:

What ‘stuck’ with you? exit slip template

Instead of giving students physical exit tickets, teachers can use the Explain Everything Whiteboard to record feedback.

Teachers can digitize this formative assessment by asking students to respond to the question ‘What ‘stuck’ with you?’ with online sticky notes . Each pupil can write (or draw) their answer. As teachers can save the completed whiteboard work, they can keep a digital copy.

Open the What ‘stuck’ with you? template.

3-2-1 Reflection exit ticket template

Another Explain Everything template that can serve as an exit pass is the 3-2-1 Reflection template. This breaks down the feedback into three areas: one with three points, another with two, and one with a single point.

Teachers can adapt the questions as they see fit. For example, students could answer three things they’ve learned, two questions they still have, and one thing they found challenging.

Besides using this template as a formative check-in assessment, teachers can adapt this to suit diagnostic K-W-L assessments . To use it in this way, teachers can ask their students to identify three things they already know (K), two things they want to know (W), and one thing they’ve learned so far (L).

Open the 3-2-1 Reflection template.

Learning target tracker template

Teachers can use the Explain Everything learning target tracker as a diagnostic tool (for pre-assessment) and a formative assessment to check their students’ progress.

This template invites pupils to self-assess their understanding of a topic or a skill. The learning tracker is pre-filled with four statements relating to knowledge: 

• “1. I don’t get it! I need help!”
• “2. I get some of it! I might need help!”
• “3. I’ve almost got it! I can do it by myself.”
• “4. I’ve got it! And I can teach it to a friend.” 

The aim is to move as many students as possible to the fourth category. If many pupils still answer in 1 or 2, teachers know they must spend longer on this subject. Teachers can use this information to differentiate lessons if only a smaller number are struggling.

Open the learning target tracker template.

Using Explain Everything for different types of assessments

Explain Everything’s templates can help teachers make assessments more interactive. The easier it is for teachers to assess pupils, the quicker they can adapt lessons to help students meet their learning goals.

To try out these templates in your classroom, sign up for your free Explain Everything account .

Recommended articles:

• How to master the “I Do, We Do, You Do” model approach to teaching
• Create engaging whiteboard assignments in best LMSs
• The whole story matters – providing effective feedback

In order to continue enjoying our site, we ask that you confirm your identity as a human. Thank you very much for your cooperation.

Study: Formative Assessment Improves Writing Skills

• Share article

Student writing skills can be improved in the classroom by having teachers provide students regular feedback, track their progress, and encourage them to evaluate their own skills, finds a new report from the Carnegie Corporation of New York released today.

“Informing Writing: The Benefits of Formative Assessment” examines whether formative assessment can improve students’ writing skills and what techniques are best to help them improve. The research was published by the Alliance for Excellent Education , an advocacy group based in Washington that supports college readiness for high school students.

The report draws on earlier findings from “Writing Next” and “Writing to Read” , previous reports from Carnegie and the alliance that also assess how to improve students’ reading and writing skills. Even with the growing research, the report encourages more, given the lagging high school writing skills that leave many students unprepared for college or the workplace. These writing assessments should be closely aligned to the Common Core Standards Initiative , researchers say.

“Formative writing assessment makes a difference in how well students convey thoughts and ideas through text,” the researchers write. “However, the trustworthiness of formative writing assessments can be compromised if careful attention is not directed at what is assessed, how it is assessed, and how it is scored.”

While the report says that regular in-class assessment can help students improve, it also stresses that the best practices must be employed in student assessment, particularly having teachers anonymously grade student papers, randomly order papers, collect multiple samples of work, and score papers as fairly as possible, among other strategies.

“Helping young people learn to write clearly, coherently, and logically will expand their access to higher education, give them the skills needed to be successful at work, and increase the likelihood that they will actively participate as citizens of a literate society,” the report concludes.

A version of this news article first appeared in the Curriculum Matters blog.

Sign Up for EdWeek Update

• About Michelle Waters
• Curriculum Vitae
• Tools I Use
• Podcast Episodes
• How To Be Our Podcast Guest
• Member Login
• Member Helpdesk
• Support Portal
• Resource Partners
• Writing Partners
• Certificate Verification
• How To Contribute

by Michelle Boyd Waters, M.Ed.  

6 Formative Assessment Strategies to Boost Student Learning and Engagement in English Class

January 17, 2023 in  Pedagogy

Formative assessment strategies are key components of effective teaching and learning in any subject, but especially English Language Arts (ELA). If you've ever paused in the middle of a lecture and wondered if any of the faces staring back at you (or out the window, or snoring on their desktops) heard a word you were saying, you know what I'm talking about. These assessments, which are typically ongoing and informal, are designed to help teachers track student progress and adjust their instruction accordingly. They also provide students with regular feedback on their learning, which can help them stay motivated and engaged.

There are many different formative assessment strategies that English Language Arts teachers can use to gauge student understanding and provide meaningful feedback. Here are some of my favorites:

Quickwrites

Quickwrites are short, timed writing exercises that allow students to demonstrate their understanding of a topic. Teachers can ask students to write for a set amount of time (e.g., five minutes) on a specific topic or prompt. Quickwrites can be used to assess student comprehension, writing skills, and critical thinking skills. They can also be used to help students start longer writing projects. In my classroom, I often provided several prompts during the first few days of a unit that could lead to the type of writing I wanted students to engage in. For example, if we were going to write an narrative essay, I'd provide students with several prompts to help them choose and write about specific moments of their lives. Then students would choose which quickwrite they wanted to continue drafting and revise to create the longer text.

You can learn more about how this works and access several of our writing prompts, divided by writing genre with the  five first days of school quickwrite prompts or in our 180+ Days of Quickwrites unit.

Think Pair Share

In this strategy, students are asked to think about a question or topic individually, and then pair up with a classmate to discuss their thoughts. This strategy is particularly respectful of introverted students who may need time to write their thoughts down and try them out with a partner before sharing with the class. Additionally,  the pairs can then decide which partner speaks in front of the rest of the class to share their ideas. This strategy allows teachers to see how well students are able to explain their ideas and listen to others, as well as to identify any misconceptions or gaps in understanding. It also helps teachers see who may need help with developing their social skills in a safe place.

At the end of a lesson, teachers can ask students to write a brief reflection on what they learned or what questions they still have. This can help teachers gauge student understanding and identify areas that may need further clarification or review. I've done this with index cards or a Google form and asked students to complete a 3-2-1 response, such as three things each student learned from the lesson, two connections students made to their schema or prior knowledge, and one question they still have. You could also ask students to write their thoughts on a sticky note and attach them to a bulletin board related to the lesson. Or just hand their notes to you on their way out of the door.

Oral Presentations

Requiring students to give oral presentations on a topic can be an effective way to assess their understanding and public speaking skills. Teachers can provide students with guidelines for their presentations and assess them based on factors such as organization, clarity, and use of supporting evidence. This strategy can be authentically embedded in argumentative writing units to give students the opportunity to present their side of the argument while other groups present another side. Also, I say groups because it's important to provide your introvert, shy, or socially anxious students with a peer support group for any public speaking activities you assign. Additionally, for groups or individuals who are truly terrified, I provide the option to present via pre-recorded video or in my room with only myself (and a student teacher, if I have one) as the audience.

Peer Review

Encouraging students to review and provide feedback on each other's work can be a valuable formative assessment tool. This can help students develop their editing and critical thinking skills, and it can also provide teachers with insight into areas where students may need additional support. Of course, we've probably all had that situation where we ask students to review each others work for clarity, conciseness, organization -- and they responded by correcting the writing for capitalization and punctuation. So prior to asking for peer reviews, it's important to choose just one or two writing features to review for, such as use of metaphors or finding unnecessary words and model what that process looks like so they can duplicate in while reviewing their peers' work.

TQE ( Thoughts, Questions, and Epiphanies ) is a method students use to record their own thoughts about what they’re reading instead of the teacher telling them what to look for and discuss. It provides them with a framework to drive their own learning as they read any kind of text.  When students are reading an online PDF, I have them use tools to annotate the text on screen. If we have a printed copy of a short story or article, I'll ask students to write in the margins. When we're reading novels, I'll have them use sticky notes (just make sure the notes are too sticky...). I also realize some students may not have the fine motor or writing skills to write their thoughts in small spaces, so there is also the option of recording their thoughts in Flipgrid, making sure to note the page or paragraph number. (For the record, I also have students who use sticky notes write their name and the page or paragraph number in case the note falls off the text.)

You can listen to our podcast episode with Marisa Thompson, the creator of TQEs , on our website.

While formative assessment is an important way for English Language Arts teachers to track student progress and adjust their instruction accordingly, it's equally important to use strategies that encourage critical thinking, reflection, and communication. As you try these methods with your students, you'll note that strategies work better than others and some work better with some lessons and some students than others. But as you try the strategies, keep adjusting until you find what works in that setting, with those students, and in that context. By using a variety of authentic strategies and adjusting as they receive feedback from students, teachers can get a well-rounded view of student understanding and provide meaningful feedback that helps students learn and grow.

Related topics: Formative Assessment Strategies , Marisa Thompson , Student Engagement

About the author 

Michelle Boyd Waters, M.Ed.

I am a secondary English Language Arts teacher, a University of Oklahoma student working on my doctorate in Instructional Leadership and Academic Curriculum with an concentration in English Education and co-Editor of the Oklahoma English Journal. I am constantly seeking ways to amplify students' voices and choices.

75 Formative Assessment Examples

Chris Drew (PhD)

Dr. Chris Drew is the founder of the Helpful Professor. He holds a PhD in education and has published over 20 articles in scholarly journals. He is the former editor of the Journal of Learning Development in Higher Education. [Image Descriptor: Photo of Chris]

Learn about our Editorial Process

• Video Overview
• Key Characteristics

Formative assessment is a type of assessment that takes place in the middle of a unit of work. It is usually compared to summative assessment which takes place at the end of the learning experience.

The key characteristic of formative assessment is that learning will take place before and after the assessment. The assessment is designed to help students:

• Stay on track
• Pivot if they are off track
• Deepen their knowledge based on an assessment of what they currently know
• Receive feedback on their progress

Similarly, it helps teachers:

• Change their teaching strategies based on student needs
• Assess students’ current knowledge to inform future instruction
• Reflect on their own teaching practice for continual improvement
• A) To give a final grade at the end of the course
• B) To help students understand what they need to improve
• C) To pass or fail students based on their knowledge
• D) To memorize information for tests
• A) It allows teachers to give less homework
• B) It provides insights into students’ understanding to tailor future lessons
• C) It reduces the need for teaching different topics
• D) It enables teachers to focus only on high-performing students

Formative Assessment Examples

1. 1-Minute Check In – Check in with every student in the class for one minute throughout the day to see how they are feeling about their tasks. Use the class roll to keep track.

2. 1-Minute Paper – Students get one minute to write a rapid-fire paper on the topic to try to show their depth of knowledge as fast as possible.

3. 3 Things – Students are asked to quickly list 3 things they want to know more about in regards to their topic, or 3 things they don’t currently understand.

4. 3-2-1 Reflection (aka Exit Slip) – Have students write down 3 big ideas from what they learned, 2 insights (reflective comments), and 1 question they still have.

5. 3x Summarization – Have students summarize the topic in three ways: in 10-15 words, 30-50 words, and 75-100 words. As they step up in word count, they will need to add some more depth and detail to demonstrate deeper knowledge.

6. 5 W’s and H – The 5W’s and H method gets students to write down their knowledge of what, when, where, who, why, and how to demonstrate their depth of knowledge about a topic.

7. Anonymous Feedback Box – Have students place anonymous comments about what they’re struggling with into a feedback box. This will allow students to share their concerns with the safety of anonymity. It helps gather crowd-sourced formative assessment but isn’t good for individual formative feedback.

8. Brainstorming – Have the students come together in groups and write down the key question in the middle of a piece of paper. Then, have them brainstorm ways to answer the question around the central question.

9. Check for Transfer – Have the students transfer the current concept from class to a new context. For example, if students are learning a math problem, check if they can apply it in a supermarket context.

10. Cold Calling – Let students know that you will not ask them to put their hands up to answer questions. Instead, you will call on one student randomly and all students by the end of class. This keeps everyone engaged and allows you to do spot checks of knowledge.

11. Comments on Drafts – Have students submit drafts of their essays to provide formative comments at least two weeks before submission.

12. Compare and Contrast – Have students compare two components of what is being learned to help them demonstrate their current knowledge. For example, in a biology class, you could have the students compare reptiles to mammals based on several key criteria.

13. Concept Map – Have students complete a concept map demonstrating their understanding of how concepts connect to one another in visual form.

14. Corner Quiz – Place letters A, B, C, and D on four separate corners of the room. Students are given a multiple choice quiz on what they are learning. Students have to run to the corner that they think has the right answer, e.g. if the answer is D, they run to the corner with the D on it. The teacher can look to see which students are consistently getting the wrong answer (or following others!).

15. Doodle It (Visualization) – Have students draw a representation of what they have learned in a visual format. This is a great formative assessment task for visual learners .

16. Elevator Pitch – Students give a 2-minute ‘elevator pitch’ speech about how much they know about the topic. In two minutes or less, they need to show you the depth of their knowledge.

17. Extension Project – Give students an extension project to see how well they apply the information in a new and less structured context. An example might be getting them to make a diagram about the topic.

18. Five Whys – Have students to ask ‘why’ five times to see if they can get to the root of their knowledge and understanding on a topic. This helps you understand how deeply they know the topic. For example, if the student says “Shakespeare is the best writer in history” ask why, then they say “because his poetry tells the best stories”, then ask why several more times, until they have fleshed out their knowledge to the best of their ability.

19. Flashcards – Have students answer flashcard questions mid-way through the unit of work to check for understanding.

20. Flip Chart Check In – Students get into groups and write anything and everything they know about the topic onto a flip chart. They then present their flip chart to the rest of the class.

21. Formative Presentation – Have the students give a presentation on what they have learned so far. This can be great for a mid-term check-in so you can help students stay on track and go deeper for their end-of-term assessment on the same topic.

22. Hand in, pass out – Students are assessed on a pop quiz. They do not write their own name on the paper. They then hand in their answers and the teacher passes out the answer sheets randomly to the class. The class then grades the anonymous work they are given. The students are given a chance to grade others’ work. The teacher can take the answer in afterward to see the questions that were most commonly incorrect to see what to focus on.

23. Homework Task – Homework is perhaps the most extensively used example of formative assessment. When you grade your students’ homework you can get a good idea of their level of understanding of content explored in class.

24. Hot Seat – A student sits in a seat in front of their peers and gets rapid-fire questions from their peers to test their quick responses. Great for math quizzes.

25. Hot Topics – Students choose one aspect of what they are learning and present in front of the class for 5 minutes about their knowledge, then take 5 minutes of questions.

26. Identify the Misconception – Give students a common misconception about their topic and ask them to explain what the misconception is and how to improve upon it.

27. Intentional Mistake – Intentionally embed an error into the students’ work or instructions and see whether they can identify it part-way through the lesson.

28. KWL Chart – A KWL chart asks students to write down what they know, what they want to know, and what they learned in the lesson. Have students complete this chart at the end of a lesson as a quick formative assessment that can help you structure your follow-up lessons based on student feedback.

29. Lunch Pass – Ask every student a question. If they can get their question right, they can go to lunch.

30. Metacognition – Have the students reflect on what they did, what they learned, why they learned it, how they can apply it, and what they still are unsure about it.

31. More Knowledgeable Other – Have students sit beside a student who is one step ahead of them and learn from the more knowledgeable student. The more knowledgeable student gives them feedback and assesses their progress, giving formative corrections to help them progress. Often, students who are at a similar level to one another are better at explaining concepts than teachers.

32. Open-Ended Questioning – Ask students questions that cannot be answered with a Yes/No answer so you can gather their depth of knowledge in the answer.

33. Paraphrasing – Give students a piece of information then ask them to repeat the information back to you in their own words to see if they understand it.

34. Peer Assessment – Have students grade each other’s work. This allows students to see other students’ work to gather whether they’re on track and how to improve.

35. Photo Assessment – Have students take photos of things they think best represent their current level of knowledge. Students might take photos of their current projects. Then, have them write descriptions underneath that explain what they currently know about the topic.

36. Pop Quiz – Give the students a quiz at the beginning, middle, or end of a lesson that involves just 5 to 10 questions that can allow you to see how much they know.

37. Postcard – The students write a postcard or letter from one historical figure to another describing something. For example, psychology students might write a letter from Bronfenbrenner to his wife explaining his Ecological Systems Theory .

38. Prediction and Hypothesis – Halfway through the lesson, have students make a prediction or hypothesis about what will happen by the end of the lesson. This will help the teacher know if the students are starting to understand what is being taught.

39. Prior Knowledge Onboarding Task – Have students write down what they already know about a topic before the first lesson. This will help you know what level you need to start your teaching at and help prevent redundancy in re-teaching things students already know.

40. RSQC2 – RSQC2 stands for Recall, Summarize, Question, Connect, Comment. Students start with recall which involves listing words or phrases that they recall from class. They then summarize the words by putting them all into a sentence that explains the topic. For Question, they list any questions they have that are unanswered. For connect, students write about connections between the lesson and the overall goals of the unit of work. For Comment, students provide a feedback comment to the teacher evaluating their teaching. 

41. Run an Opinion Poll – Poll the students on their opinion of the topic and examine the responses. The teacher can gauge students’ knowledge based on their answers in the poll.

42. Running Records – Have students take notes throughout the class on questions they have and things they don’t understand. As you come around to check on the student, ask them to show their running records notecard.

43. Spaced Repetition Testing – Students are given pop quizzes at strategically placed intervals to help students remember information they may be forgetting. For example, you might give students a quiz after 1 day, then 3, then 8, then 15. The answers from the quiz can help you assess student retention of knowledge learned in class.

44. Sticky Notes – Have students leave a sticky note on their desk with a comment about what they would like to know more about.

45. Student Becomes Teacher – Have the student teach the concept they are learning to a small group of peers.

46. Students Create a Test – Have each student create a 20-question test that they would use to test someone on the topic. Students write the answers to the test on a separate paper. Then, have the students swap mock-up tests with each other and fill out the answers.

47. Submit a Research Proposal – Have students submit a mock (or real!) research proposal stating what they would want to research further into the topic they have been discussing ( use my research proposal examples ). Get them to discuss what they would research, why they are curious about that aspect, and how they would go about it. This can reveal a great deal of new information about the student’s current level of knowledge.

48. Submit an Essay Plan – For students writing an essay, get them to submit their essay plan for approval. Using this method, you can catch if a student is off track and correct the course so they submit a high-quality essay.

49. TAG Feedback – Have students assess one another by getting them to tell a peer what they did well, ask them a question about their knowledge, then give feedback to their peer.

50. Text Rendering – Students take one quote that they think is the most important or illuminating from an article and explain why they think it’s the best quote.

51. Think-Pair-Share – Students spend one minute individually writing down key points from what they learned. They then pair up with a partner and compare notes. Finally, the pair share what they learned with the class. The class can ask questions and the teacher can assess the pair’s knowledge from their presentation and responses.

52. Timeline (Historical) – Students create a historical timeline demonstrating their knowledge of the sequence of events from a historical process or series of events.

53. Timeline (Lesson Reflection) – A lesson reflection timeline gets students to reflect on their lesson by writing down 

54. Ungraded Essay – Have students submit an essay or essay draft that is not graded. Students submit the essay only for feedback, which will inform their final submission.

55. Venn Diagram – Students use a Venn Diagram to compare and contrast two elements of what they are learning. The outer sides of the Venn diagram show unique features of each element. The overlap shows the similarities.

Instant Formative Assessment for Teachers

56. Fingers Up – Have students show their level of knowledge by showing a certain number of fingers. One finger means uncertainty and discomfort while five fingers means strong confidence with the content.

57. Hand Thermometer – Students put their hand up only a distance they think they are comfortable with the knowledge. A low hand up shows mild comfort, a medium shows moderate understanding, and a stretched hand shows high confidence in the content.

58. Quick Nod – Ask students to nod if they understand. This can be great as a very fast way to check for comprehension in the middle of a task.

59. Red / Green Cards – Provide students with red and green cards. They can hold up the green card if they are ready to move on to the next part of the lesson or the red card if they’re still confused.

60. Thumbs Up, Middle, Thumbs Down – Have students quickly respond with their thumbs to show levels of understanding or enthusiasm.

61. Traffic Lights – An extension of red/green cards, the traffic lights system also have an amber color for students who are feeling tentative about their progress. For this one, you can pair students who held up green lights with those who held up amber lights to teach each other while the teacher works with students who held up red lights.

62. Two Roses and a Thorn – Have students present two things they are happy or knowledgeable about, and one thing they are still finding “prickly”.

63. Watch Body Language – Students who misunderstand may be crossing their legs, looking away, or frowning.

Self-Evaluative Formative Assessment

64. Self-Evaluation on Marking Rubric – Provide students the criteria you will be using to grade their work (also known as a marking rubric) and get them to self-assess what grade they think they will get.

65. Self-Sort – Have students choose which level they are at in a task: beginner, intermediate, or advanced, and have them select the next piece of work based on their self-evaluated level.

66. SMART Goals Self-Evaluation – Have the students complete a personal SMART Goal template demonstrating what their goals are and whether they think they are on track for achieving it.

67. SWOT Analysis – Have students complete a SWOT analysis that demonstrates what their strengths are in relation to what they are learning, what their weaknesses are, opportunities for improvement for the rest of the unit of work, and threats that they could avoid. This will make sure they stay on track.

Technology Enhanced Formative Assessment

68. Blog About It – Have students write weekly 200-word blog posts about what they learned and comment on each student’s blog comment assessing what they did well and what they need to focus on in the next week.

69. Clickers – Use clickers (instant Yes/No responses – technology required) to provide instant feedback to the teacher on their level of understanding.

70. Forum Comments – Have students submit one forum comment per week to their online discussion board for the teacher to provide a formative assessment and comment on what they did well and how to improve.

71. Padlet – Have students use the Padlet app to contribute their ideas to a virtual notice board to show their thoughts and knowledge to the group.

72. Text the Answer – Have students text an answer to you in 50 words or less once they have completed the task.

73. Twitter Comment – Have students tweet what they learned in class today and tweet a reply to a friend’s comment.

74. Write 1 if you Understand, 2 if you Don’t – This is a task for online lessons. Have students simply write a 1 or 2 in the chatbox. This can also get quiet groups to start contributing in a small no-risk step.

75. YouTube Communities Poll – Have students complete a YouTube poll using the YouTube communities tab.

Related Articles:

• Constructive Feedback Examples
• Achievement test examples

Formative assessment are usually informal evaluations that give students an opportunity to pivot and improve based on the teacher’s feedback. A the same time, it’s valuable for the teacher who needs to assess students’ current knowledge and pain points in order to adjust their teaching practices and maximize students’ chances of passing the summative assessment that will occur at the end of the unit of work.

• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd-2/ 21 Cozy Classroom Reading Corners
• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd-2/ 25 Math Center Ideas for Teachers
• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd-2/ 25 Student-Centered Learning Activity Ideas
• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd-2/ 25 Game-Based Learning Activities for the Classroom

1 thought on “75 Formative Assessment Examples”

appreciate reading this information

Leave a Comment Cancel Reply

Your email address will not be published. Required fields are marked *

• Teaching Tips

20 Formative Assessment Examples To Use In Your College Classroom

Informal assessments are an easy way to stay connected with your students and understand their progress in your course

Top Hat Staff

Formative assessments are where students are quizzed periodically throughout a learning unit. Unlike traditional assessments, these insights provide you with regular and reliable feedback on student progress. Whether it’s polls , discussions , debates or reflections, frequent, low-stakes assessments let students apply what they have learned thus far. At a time when students place increased value on frequent feedback from their educators, facilitating regular assessments is essential. Below, we share:

• What formative assessments are
• What the differences are between formative and summative assessments
• How to engage students with formative and summative assessments
• The tools you’ll need to run formative assessments
• The benefits of formative assessments

20 formative assessment examples for any course or discipline

What are formative assessments.

Formative assessments involve monitoring student progress regularly throughout a course so that educators can better gauge students’ learning gaps and address those early on. Basic formative assessment strategies may include concept maps, responses posted to a discussion board and an ungraded quiz or poll.

Watch the video below to learn how formative assessments in the classroom can benefit both educators and students. You’ll also get assessment ideas that Leslie Sprunger, Associate Dean for Professional Programs in the Faculty of Integrative Physiology and Neuroscience at Washington State University, uses in her own courses.

How to engage students with formative assessments

Well-designed assessments encourage students to prioritize intellectual growth, while equipping them with marketable skills for their future careers. There are three main types of assessments instructors can incorporate into their higher educations courses.

• Assessments as learning opportunities: The best assessments are educational opportunities in which students can practice different methods of synthesizing, analyzing, and communicating what they have learned. There are many ways students can demonstrate mastery of the course content that go beyond traditional papers, quizzes and examinations. Giving students choice in how they express their knowledge, such as unessays, short films, collaborative blogs and field work also enables students to build their personal portfolios and resumes.
• Assessments that are self-reflective: Rather than objective assessments, instructors can create opportunities for students to reflect on their own progress. Consider asking students to students keep a journal throughout the class is a great way to create a record of their semester-long evolution. You can also ask students to evaluate their own work, as well as their peers. This way, instructors empower students to take ownership of the assessment process.
• Assessments that happen over time: One popular method is incorporating “scaffolding” into assessments. Instead of a paper worth a large proportion of the final grade, students submit several smaller assignments throughout the course of writing their paper, each worth a fraction of the overall grade and building towards the final product. For instance, they might first submit a topic and thesis statement, followed by their outline, then a rough draft, and then the final paper. This method provides students with feedback at various points, prioritizes the process of writing, and lowers the stakes for each graded piece of work.

Formative vs. summative assessment: The difference

Formative and summative assessments can easily be confused.  Summative assessment remains an essential part of every single college course being offered today. Despite its widespread use, however, an over-reliance upon it can turn the benefits into drawbacks:

• Every summative assessment is a high-pressure situation for students.
• Poor performance on an early assessment only increases the pressure on subsequent assessments. If a student earned a C on the midterm, they’ll feel the need to ace the final just to end up with a B.
• Poor performance on an early assessment undermines students’ confidence in their ability to perform better in the latter stages of the course. This creates an incentive to cheat: if they need to ace the final, they’ll find a way.

The best way to design any summative assessment is to make it an integral part of course planning.

Formative vs summative assessment: A structured approach

While formative assessment can take place informally through classroom discussion, it also benefits from a planned approach to its use. The challenge, for educators, is to strike the right balance between checking in on the progress of student learning and putting that learning to the test.

Choosing between formative and summative assessment for a particular course isn’t an either-or proposition. Formative assessment can’t substitute for traditional summative assessment, since exams and assignments remain essential as the best way to definitively measure student proficiency and assign a grade.

Some faculty who have embraced formative assessment choose to make the final exam worth 100 percent of their students’ grades, conducting formative evaluations throughout the semester to the point where come exam day, they and their students are confident of success. This formula probably wouldn’t work for every professor or every course, but it is a testament to the effectiveness of formative assessment, and to the value of making thoughtful use of both assessment types in every course you teach.

We share the key differences between formative and summative assessments in the table below.

Tools you can use to run formative assessments

Depending on what type of assessment you’re looking to run—whether a quiz or group discussion—the technology required will vary. Different disciplines, such as STEM or Humanities courses, may also require different formative assessment tools in order to run simulations or lab activities. 

That said, plenty of the 20 formative assessment strategies we share later in this post can also be facilitated with pen and paper or simple tech tools. If you’re looking to use ed tech to run your formative assessments, here are some platforms you may want to consider.

• Quizzes : Kahoot! , Quizlet , Socrative , Top Hat
• Video-based assessment : Animoto , Flipgrid , PlayPosit
• Discussions : Backchannel Chat , Discord , Top Hat (with anonymous discussion capabilities)
• Whiteboard or note taking tools : Dotstorming , Padlet , Limnu  
• Tools for STEM classes : BeyondLabz , Labster , Top Hat Labs
• Tools for Humanities classes : Annotation Studio , Audacity , Canva , Top Hat

Assessing course-related skills and knowledge

These formative assessment examples help evaluate learning of a given subject’s content by assessing student understanding and information recall from previous courses. Assessing this knowledge is especially important for instructors at the beginning of the term, in order to provide a clearer understanding of how to proceed with course material.

1. Exit tickets/exit slips:

Rather than a formal assessment, students use exit tickets to answer one or more assessment questions at the end of a class period or online course module to demonstrate how well they’ve absorbed that particular lesson. Each question should focus on a single concept or skill taught in that lesson. Download your free exit ticket formative assessment template for your next course.

2. One-minute paper:

In this informal assessment example, students are prompted to write a short response answering two questions related to a given week’s course content. Responses to one-minute papers can also be posted in online discussion forums to spur conversation between students. Questions can be as simple as: What was the most valuable, important or useful thing you learned in the lesson? What key questions, problems or issues remain unresolved?

Are you looking to further assess students in and out of your classroom? Top Hat’s formative assessment capabilities can help. Facilitate the one-minute paper exercise in-app using an interactive discussion board. Platforms like Kahoot! and Socrative can also be used for running polls and discussions as a quick formative assessment example.

Developing critical thinking and analysis skills

Consider structuring formative assessment examples around the development of higher-order thinking skills that rely on metacognition. Various modes of analysis, including the ability to break down information, problems and questions help develop students’ critical thinking skills. Students who think critically become instinctual problem solvers in class, engineering creative solutions to solve complex real-world case studies.

3. Think-pair-share :

Students work together in pairs or small groups to answer a question or solve a problem related to an assigned reading. These groups can use dedicated chat channels built into active learning platforms to communicate and discuss their ideas. First, the instructor asks an assessment question regarding the text for students to think about. Next, students pair up with one or more fellow students to discuss the question and their thoughts on the possible answers. Finally, each pair or group shares their conclusions with the rest of the class.

4. Defining features matrix:

Students categorize concepts based on whether or not they contain certain defining features. This is particularly useful for assessing how fully students understand certain factors distinguishing various concepts from one another and how well they can analyze whether a particular concept fits a certain category.

5. Socratic seminar:

Students help one another apply the ideas, issues and values reflected in a course text through a group discussion. Ask students to annotate the text in advance of class in order to familiarize themselves with the key themes and ideas discussed. Pose a general question and encourage students to share their responses with the group. Another student then responds to the last thought that was shared.

Encouraging students to think creatively

Quick formative assessments can involve creative expression. The following examples of formative assessments are used to understand student abilities when synthesizing information. By instructing students to express themselves creatively, students have the opportunity to think outside the box.

6. Word journal:

This assessment is conducted in two parts. In the first part, the student summarizes an entire lesson in a single word. In the second part, the student composes a short statement of one or two paragraphs explaining why they chose that particular word to summarize the lesson. These can then be submitted to the instructor for feedback directly through content delivery platforms or your learning management system (LMS).

7. Invented dialogue:

This strategy is particularly useful for demonstrating how well students have synthesized various historical or literary personalities, settings or themes. In this assessment, students compose a fictional dialogue between two real or fictitious personalities that demonstrate the students’ understanding of the topic. Teachers can opt to instruct students to incorporate actual quotes from primary sources into the dialogue or to simply invent plausible quotes of their own based on their comprehension of the content.

Enhancing problem-solving skills

These formative assessment examples assess students’ problem-solving abilities, including their ability to recognize the various types of problems and any causes and appropriate techniques to solve them. Learners can also use the time to draw similarities between various features of different problems, reflect upon them and adjust strategies for solving them accordingly. They are an important component for every educator to have on their formative assessment checklist.

8. Documented problem solutions:

Similar to a show-and-tell exercise or a how-to article, students write down each step they went through in solving a particular problem. This helps instructors understand how a student goes about thinking through problems and may highlight student obstacles when efficiently solving different types of problems. A variation of this is to document the student’s problem-solving process through an audio-video recording of the student demonstrating their process.

9. Problem-and-solution type recognition:

Effectively solving any problem requires the ability to identify the type of problem and, subsequently, the most appropriate methods of solving it. Students are given a problem and must identify its type, such as routine or non-routine, well-defined or ill-defined, and the most likely type of solution to apply to it, such as algorithm, heuristics or trial and error. Students can answer these problems through a short-answer question and the results can be shown to the class using a word cloud display.

Assessing student performance and application abilities

These formative assessment examples assess students’ understanding of how to apply the knowledge they’ve learned to specific situations. These informal assessment examples can stand alone as “temperature checks” or can be a part of a longer assessment, such as a scheduled test or quiz .

10. Directed paraphrasing:

Students take a lesson and paraphrase it with a particular audience in mind. This not only helps to assess a student’s understanding of the topic, it also helps to assess their ability to reframe it in a way that people in a different context and setting can likewise understand and apply it.

11. Student-generated test questions:

As a form of role-reversal, students devise test questions and sample appropriate answers that demonstrate their ability to comprehend concepts that underlie assigned readings. Rather than simply requiring students to recall what they’ve read, it asks them to hone in on the key elements that would indicate to them another person’s full comprehension of the concepts.

Understanding student self-awareness, attitudes and values

These formative assessment examples engage students and motivate them to develop their own attitudes, values, opinions and self-awareness through course-related activities. The three quick formative assessments below can be used as an exercise to generate discussion amongst students and ensure learning continues once class is over.

12. Opinion polls:

Students indicate how much they agree or disagree with a particular prompt or statement. This assessment data can help educators see how comfortable students are with regard to key objectives of learning activities and with specific course content in particular.

13. Profiles of admirable individuals:

This assessment in the classroom involves asking students to write a brief biography of a real person involved in a relevant field that highlights the admirable characteristics making them a role model. Instructors can use polling features for students to vote on which expert in the field they would like to research.

14. Everyday ethical dilemma: Students answer how they would go about solving a common everyday ethical dilemma related to the course or their discipline.

Activities that help develop individual awareness of self as a learner

These formative assessment examples help students clarify and express their self-concept and personal goals in ways that connect to the course content.

15. Focused autobiographical sketch:

Students write a brief memoir-style essay describing a moment or episode of their lives during the course in which they felt like they successfully reached a learning outcome.

16. Goal-ranking:

Students list three to five goals of their own that serve as their learning goals of the course, then rank them in order of priority. At the end of the course, instructors can go back to this exercise and have students evaluate their rankings and/or assess how well they did achieving each goal they set. Using Top Hat’s heat map question functionality, instructors can show how the class performed as a group.

Understanding student learning behaviors, strategies and skills

These formative assessment examples help instructors assess students’ learning habits. They can help create a more tailored learning experience.

17. Productive study-time log:

Students keep a log of all the time they spent learning and studying for a given course and, alongside each entry, the quality of that time. This acts as a form of self-assessment because it helps both students and educators see how effectively students are making use of their study time.

18. Punctuated lectures:

After listening to a lecture, students reflect (in writing) on how well they were concentrating on the material and, by contrast, how often they became distracted. They may also note how they brought their attention back to the material, if at all, so they can arm themselves with these tools in future lectures. They can even add how the lecture met their expectations and how they connected the lecture to knowledge they already possess. This can be submitted through the class’s live chat while lectures are occurring, so students are able to view their peers’ thoughts and opinions.

Assessing student reactions to learning

These formative assessment examples help instructors assess how well students can identify the key points and learning outcomes of a given lesson. These formative assessment ideas will let students thoughtfully reflect on a given reading or artifact.

19. Feedback forms:

There are several ways to solicit weekly feedback from students after a lesson. Educators can pose a series of questions, or even a single question, about the lesson’s effectiveness. These can be multiple-choice, true/false, yes/no or open-ended questions.

Students compose a brief statement regarding a particular lesson written in the following format: Recall, Summarize, Question, Connect, Comment. This can also take place in a discussion forum, so students can comment on each other’s questions and ideas.

Formative and Summative Assessments. (n.d.). Yale Poorvu Center for Teaching and Learning. https://poorvucenter.yale.edu/Formative-Summative-Assessments  

What is the difference between formative and summative assessment? (n.d.). Eberly Center at Carnegie Mellon University. https://www.cmu.edu/teaching/assessment/basics/formative-summative.html

50 CATS by Angelo and Cross. (n.d.). University of California, San Diego. https://vcsa.ucsd.edu/_files/assessment/resources/50_cats.pdf

Recommended Readings

25 Effective Instructional Strategies For Educators

The Complete Guide to Effective Online Teaching

Subscribe to the top hat blog.

Join more than 10,000 educators. Get articles with higher ed trends, teaching tips and expert advice delivered straight to your inbox.

Formative Assessment and Writing: A Meta-Analysis

• The Elementary School Journal 115(4):000-000
• 115(4):000-000

• Arizona State University

• University of Nebraska at Lincoln

Abstract and Figures

Discover the world's research

• 25+ million members
• 160+ million publication pages
• 2.3+ billion citations

• LEARN INSTR

• Érick Falardeau

• Pascale Dubois

• Adam I. Attwood

• Timothy Paustian
• Betty Slinger

• Laura K. Allen
• Matthew E Jacovina

• FOCUS EXCEPT CHILD

• Michael Hebert
• EDUC PSYCHOL-US

• Carol L. Hamlett
• Rose M. Allinder
• V.L.B. Olson
• Pietro Boscolo
• Katia Ascorti

• Chen-Lin C. Kulik
• James A. Kulik
• M.T. Morgan
• Tanya Santangelo
• Recruit researchers
• Join for free
• Login Email Tip: Most researchers use their institutional email address as their ResearchGate login Password Forgot password? Keep me logged in Log in or Continue with Google Welcome back! Please log in. Email · Hint Tip: Most researchers use their institutional email address as their ResearchGate login Password Forgot password? Keep me logged in Log in or Continue with Google No account? Sign up

• Our Mission

13 Formative Assessments That Inspire Creativity

Sometimes mixing in formative assessments that go a step beyond exit slips and low-stakes quizzes can inject some fun—and creativity—into learning.

It’s always better to know if a student is struggling before a big test is in the rearview mirror. But students often lack the self-awareness to monitor their own learning, and may struggle to work up the courage to ask for help . Others may overestimate their mastery of important ideas and concepts, tricking their brains into thinking they’re prepared for a test when they’re not. 

So when it comes to student learning, how can you tell what's sticking—and where additional instruction or review could make a difference?

Formative assessments are typically short, gradeless ways to evaluate what students know while they’re still in the process of learning it. When used early and often, they can shine a light on individual student progress, serve as general indicators of how the class is doing as a whole, and inform subsequent instruction. This process of actively checking in with students on their journey toward mastery is “especially effective when students are given tactical feedback, immediately followed by time to practice the skill,” says Todd Finley , a tenured professor of English education at East Carolina University.

Quick checks for understanding aren’t new, of course, but when time allows, occasionally injecting an element of creativity into formative assessments can deliver unexpected benefits. For example—regardless of a student's artistic talent—research suggests that drawing the information they’re learning can increase student recall by nearly double . And when kids are encouraged to tap into their imagination to show what they know, they tend to ask more innovative questions of themselves, brainstorm fresh solutions to problems, and synthesize material in original and surprising ways. 

Here are 13 formative assessment strategies that lean into creativity—inspired by the work of several Edutopia contributors, and from Finley’s handy list of quick checks for understanding . 

Simple Symbols: Sketchnoting—simple, hand-drawn renderings of things like facts, dates, or abstract concepts—can be a great way to help students process vocabulary. Educator Wendi Pillars has her students co-create a symbolic language library , working together to visually represent important terms from a unit. After choosing 10 terms, students develop an icon or character to correspond with each one. For example, a drawing of a sun can represent energy or a tree can represent life.

Write a Letter: On a sheet of paper or an index card, ask students to explain a new concept they've learned in the form of a short letter to a friend or family member, pretending the other person is new to the information. This process of explanation can open students' eyes to what they know and what they don't, explains Woo-Kyoung Ahn , a psychology professor at Yale University who uses a similar strategy with college students before exams.

Tweet Like a Historian: Challenge students to enter the minds of popular historical figures, tweeting about major events in the figure’s life as that person would have, suggests former educator Matthew Lynch . To get a firm grasp on how well students understand their chosen figure, ask who their figure might be following on social media, as well as topics that would be “trending” on their feed at the time. Educator Jill Fletcher prefers to use a paper template so that students can engage in the exercise without going online.

Playful Pamphlets: An effective brochure is easy and engaging to read, and offers eye-catching design. Ask students to create their own brochures that describe the key features of a concept, or to explain a historical event or scientific discovery. This can be done using paper and art materials, or digitally using applications like Canva or Google Slides.

Do It Yourself TED Talks: Most students are familiar with TED Talks , this strategy provides them with the opportunity to give their own. Educator Katy Farber describes them as "one person’s short presentation of an idea worth spreading." After showing an example that students can model, ask them to find an idea worthy of spreading from the day's lesson and create their own speeches to present the information. Those who feel comfortable can share with the class.

Comic Creators: Using digital creation tools like Canva , kids can create their own comic strips to connect new material and information from past units. The comics shouldn’t be a "regurgitation of knowledge," explains Andrew Miller , director of teaching and learning at the Singapore American School. Instead, they should have an authentic purpose, making it a fulfilling exercise where students create products that are informative and useful to peers. After a lesson on nutrition, for example, students could make comics that explain the major nutrients—as well as the role they play in how bodies function—that could be displayed in hallways for classmates to learn from.

Build-a-Billboard: Have small groups work together to create an advertisement, with visuals and text, to highlight a newly learned concept like Manifest Destiny or the scientific method. Students in San Francisco Unified School District health classrooms learn about tools advertisers use to convince people to buy their products, then create their own billboards. "If you were going to make an ad for your favorite fruit or vegetable, what techniques would you use?” asks health ed content specialist Christopher Pepper .

Sing It Out: Asking students to sing or rap about a lesson can be a fun change of pace—and rack up a few giggles. First, students identify the main concept of a lesson and list related keywords. In a rap about the order of operations, for example, educator Alex Kajitani lists “operations, order, parenthesis, exponent, multiply, divide, add, and subtract.” Using the website RhymeZone.com helps identify what words rhyme with each key term, then students can begin writing their rap, song, or even spoken word poem.

Illustrate Connections: “A student who draws as they learn considers the following: How should I represent the relationship between these parts? How large/small should I draw these parts? What shape should they be? Where do I place each part?,” explains instructional leader Shveta Miller . Invite students to draw a picture that illustrates a relationship between terms from the lesson or recreates a scene from their reading. Providing reflection questions like "How well did I recall the material after having represented it in my drawings?" or “When would drawing as I learn be useful? When is it not useful?” can be a useful add-on to the exercise. 

60 Minutes: Students pair up and pretend they're a guest expert on the television program 60 Minutes or their local news broadcast. During their segment, they'll need to answer a few of their partner's interview-style questions—"What is the purpose of feudalism in a society?," for example. 

Laughable Lists: At the end of a lesson or once students have finished assigned reading, ask them to enumerate what they think are the top ten most important takeaways. The twist? Students will have to try to infuse humor into their list of observations. Sharing a few examples before they begin can help students who might struggle with the exercise at first.

Cut and Paste: Encourage students—on their own, in pairs, or in groups—to make either digital or paper collages to demonstrate their understanding of the lesson's major themes and concepts: anything from matter and energy, to fractions and decimals. If time allows, have a few kids present their collages to the rest of the class and explain their thinking. 3-2-1 Action!: Choose a selection of excerpts from a recently read text—like a poem, play, or a short story—for students to dramatically interpret and perform. Without the use of props, costuming, or sets, students must not only have read the text but understood it enough to convey an insightful character analysis, as well as the mood and tone of the scene. These 5-minute performances can be recorded and submitted to the teacher to review, or shared in class for peers to see.

• Open access
• Published: 03 July 2024

Flipped and Peer-Assisted teaching: a new model in virtual anatomy education

• Mohammad Afshar 1 , 2 ,
• Afagh Zarei 3 ,
• Mahdieh Rajabi Moghaddam 4 &
• Hamed Shoorei 1 , 5 , 6  

BMC Medical Education volume  24 , Article number:  722 ( 2024 ) Cite this article

119 Accesses

Metrics details

Introduction

In response to the COVID-19 crisis, this study aimed to introduce a new virtual teaching model for anatomy education that combines Peer-Assisted Learning (PAL) and flipped classrooms, aligning with constructivist principles.

The Flipped Peer Assisted (FPA) method was implemented in a virtual neuroanatomy course for second-year medical students at Birjand University of Medical Sciences via a descriptive study. The method involved small groups of PAL, with peer learning serving as educational assistants and the teacher acting as a facilitator. Educational content was uploaded to the university’s learning management system (LMS). The opinion of medical students regarding the teaching method were evaluated using a 15-item questionnaire on a five-point Likert scale.

A total of 210 students participated in the instruction using the FPA method. The analysis of students’ scores revealed an average score of 26.75 ± 3.67 on the 30-point test. According to student feedback, this teaching method effectively motivated students to study, enhanced teamwork and communication skills, transformed their perspective on the anatomy course, provided opportunities for formative assessment and feedback, and demonstrated the teacher’s dedication to education.

The FPA model demonstrates its effectiveness in transforming traditional classroom teaching and fostering teaching and learning in virtual environments, particularly during pandemics like COVID-19. This model holds promise for enhancing anatomy education in challenging circumstances.

Peer Review reports

Historically, anatomy has played a pivotal role in medical sciences education [ 1 ]. The teaching of fundamental anatomical knowledge is crucial for medical students and healthcare professionals alike [ 2 ]. Traditionally, the methods employed for teaching anatomy relied heavily on autopsies and lectures. However, advancements in educational technologies have paved the way for the integration of models, simulators, and the internet to enhance the anatomy learning experience [ 3 ]. Despite these advancements, there is still room for improvement in the field of anatomy education [ 4 ].

Furthermore, the global outbreak of Coronavirus Disease 2019 (COVID-19) has necessitated a shift from traditional to modern educational approaches [ 5 ]. Consequently, the provision of virtual anatomy education has become imperative [ 6 ]. Many active learning methods that were originally designed for face-to-face instruction have had to be adapted for virtual environments. While technologies like augmented reality, virtual reality, and 3D have shown potential in anatomy education [ 7 , 8 ], their widespread application may be limited by various factors, including subject matter and contextual constraints [ 4 ].

In addition, the importance of teamwork, communication, and higher-order thinking skills has been emphasized in medical education, highlighting the limitations of traditional teaching methods in achieving these goals. As a result, there was a need to adopt educational approaches that would provide virtual anatomy education while enabling students to practice these skills and learn through effective feedback [ 9 ]. In this context, teachers play a crucial role. Good teachers expedite the learning process by offering relevant information, assessments, guidance, and examples. They motivate and guide learners, foster interactive discussions, and leverage their experience and skills to facilitate the learning process in a positive environment [ 10 ]. In the realm of electronic learning (e-learning), effective integration of existing technology-based methods becomes essential since there is no single, comprehensive e-learning model currently available [ 11 , 12 , 13 , 14 ].

Numerous educational techniques and approaches rooted in constructivism have been proposed, including flipped classrooms (FC) and peer-assisted learning (PAL). The term “flipped classroom” was first coined by American educators Jonathan Bergman and Aaron Sams in 2000 [ 15 ]. The FC Model presents a departure from the conventional teaching approach. Instead of the traditional method where teachers give lectures during class and assign homework, the FC Model delivers lectures outside of class and emphasizes in-class practice, which can be considered similar to homework. Another well-recognized framework, the FC, encompasses a set of teaching strategies that (1) move most of the direct instruction outside the classroom; (2) utilize classroom time for interactive and engaging learning activities; and (3) require students to participate in activities before and/or after class to fully leverage the benefits of classroom sessions [ 16 ]. This model involves inverting student activities with the support of new technologies, allowing students to engage more meaningfully with their teachers and enhancing face-to-face learning experiences [ 17 ]. Indeed, the FC, which holds great potential in e-learning for healthcare, is supported by active learning theory and promotes critical thinking, problem-solving, and experimentation [ 18 ]. Furthermore, the FC aligns with the Theory of Educational Differentiation, which emphasizes personalized teaching to cater to the diverse needs of learners. Differentiated instruction involves adapting teaching methods based on students’ needs, interests, and abilities to enhance their learning and academic achievement [ 19 ].

Despite its numerous advantages, the FC also faces certain challenges. One significant hurdle is ensuring that all students arrive prepared for class, having actively engaged with the pre-class material. Without this preparation, the planned active learning strategies for class time may not yield the desired results. Additionally, some students may perceive the FC as an unfair or unreasonable approach. On the other hand, teachers may find FCs demanding due to the time-consuming nature of the process, difficulties in task planning and management, and the associated increase in workload [ 20 ]. As a potential solution to these issues, we hypothesize that peer-assisted learning could be a suitable approach.

PAL, in contrast, is defined as the process of actively assisting and supporting one another among peers of equal status or matched companions. It involves individuals from similar social groups who are not professional educators, helping each other learn and, in turn, enhancing their own learning [ 21 ]. Therefore, PAL is an approach in which students provide assistance to their peers in the learning process. It encompasses different forms, including peer tutoring, peer consulting, peer education, peer modeling, peer assessment, and peer monitoring [ 21 ].

Against this backdrop, in this study, we present a novel virtual teaching model that combines PAL and FCs. This model was implemented and evaluated during the crisis era.

Materials and methods

Participants and study design.

This descriptive study aimed to examine the impacts of the FPA (Flipped Peer-Assisted) method, a novel educational model, on the neuroanatomy course at Birjand University of Medical Sciences (BUMS) over three consecutive semesters from 2020 to 2021.

In this study, a total of 210 fourth-semester medical students (female students: n  = 120, with an average age of 20.7 years, and male students: n  = 90, with an average age of 20.9 years) were selected as participants. The inclusion criteria for this study were individuals who had successfully completed the third semester and entered the fourth semester of the medical program, as well as those who had not previously failed the neuroanatomy course. The FPA method was implemented, drawing inspiration from the flipped classroom approach, where small groups of students engaged in peer-assisted learning. Additionally, the model incorporated feedback sessions to foster reflection and learning, with the teacher assuming the role of a facilitator as needed. The implementation of the FPA method consisted of three steps. In the first step, instructional design was carried out, and electronic content was produced. The second step involved the actual implementation, which commenced with an online orientation class. Students were divided into groups of 10, and within each group, one student was chosen as the peer learning based on their educational level and communication skills. Given that each semester had 70 students, a total of 10 groups and seven peer learning were selected. The mean scores of students in different groups were equated. The educational content for each lesson was uploaded to the university’s learning management system (LMS) for one week. Three days after the content was uploaded, an online meeting was held between the teacher and the pre-teachers to ensure their understanding of the material and emphasize key points. Two days later, the remaining students who had studied the uploaded content had an online class with their respective peer learning, which focused on questions and answers and highlighting important concepts. Finally, an online session was conducted with all the groups, evaluating students’ learning through questions and providing additional explanations if necessary. The peer learning’s ‘s performance in delivering the educational content and interacting with students was also evaluated, and feedback was provided to improve their performance. This process was repeated every week, and students received feedback from both the professor.

Evaluation of the study

To collect students’ opinions about the teaching method, a 15-item questionnaire was administered. The questionnaire utilized a five-point Likert scale, ranging from “very high” to “very low.” The content validity of the questionnaire was established through the confirmation of ten medical educationists, and its reliability was assessed using Cronbach’s alpha, which yielded acceptable results. Additionally, an open-ended question was included in the LMS to gather students’ overall feedback and opinions regarding their learning experience with this teaching model.

Instruments

At the end of the semester, students’ learning was assessed using a 30 multiple choice question test designed according to the test blueprint which was a representative test of all course objectives and was approved in the anatomy department. These tests were different from each other in each semester. However, it was designed according to the blueprint of the exam, and by checking it in the anatomy department, it was ensured that the educational goals of the course were covered.

The results of the study indicate several important findings regarding the implementation of the educational model. A total of 210 medical students experienced instruction through this method over three consecutive semesters. Table  1 presents the students’ opinions about the teaching method.

Five categories were identified based on the students’ feedback

Study techniques.

Students mentioned that this method compelled them to utilize effective study techniques such as repetition, review, and peer review. They also emphasized the need for accurate and timely studying.

Teamwork and communication skills

Students reported an increase in group companionship and cooperation, as well as a sense of responsibility. They mentioned that this method allowed for task assignment among students and improved their verbal communication skills. Additionally, all students made efforts to promote the group’s success.

Transformation

According to the students, this teaching method successfully changed their perspective towards the anatomy course. They expressed gratitude for shifting their negative opinions to a more positive outlook, particularly regarding the fetal anatomy component.

Formative assessment and feedback

Students appreciated the opportunities provided by this teaching model for peer questioning and answering, evaluation by peers, interaction with the teacher through questioning and answering, and problem-solving to achieve a deep understanding of the material. They also mentioned that this method alleviated concerns about the final exam. Group evaluation was implemented, fostering a sense of competition among students.

Teacher role

Although the educational model was designed to be student-centered, students still recognized and appreciated the role of the teacher in its implementation. They considered the adoption of this method as a sign of respect for the student, viewing the teacher as a role model who is duty-oriented, concerned, and attentive to education. The analysis of students’ scores on the 30-point test revealed an average score of 26.75 ± 3.67.

The COVID-19 pandemic has necessitated a shift to online learning and assessment methods. Distance learning content focusing on active learning has been a significant concern for teachers. It is crucial for educators to transition from a traditional approach of acquiring knowledge to one that emphasizes knowledge construction. In response to the COVID-19 outbreak, various studies have indicated a widespread move towards virtual education to support student learning [ 6 , 11 ].

The flipped classroom has gained traction as a pedagogical approach in higher education, with several studies highlighting positive student outcomes [ 22 , 23 ].

The flipped classroom model transforms anatomy teaching by replacing large-scale lectures with interactive, team-based classes. The incorporation of multimodal digital resources and multimedia group assignments in the flipped classroom model fosters digital literacy and enables students to engage in authentic learning experiences, contributing to pedagogical innovation [ 24 ]. So, the FPA model as an active learning approach helps learners dedicate part of their time to receiving feedback, engaging in reflection, and taking action based on that feedback. The primary purpose of feedback in this model is to provide an opportunity for setting learning goals and reinforcing learning [ 15 , 17 , 21 , 25 , 26 ]. A systematic review conducted by Kazeminia et al. in 2022 highlighted the positive impact of the FC method on teaching anatomy; the review revealed numerous advantages associated with this approach, including increased satisfaction, academic achievement, self-confidence, and overall outcomes in anatomy curricular [ 27 ]. A study conducted in China demonstrated an increase in the adoption of active learning methods, such as FCs, individualized tutoring, and small group discussions, during the COVID-19 pandemic [ 28 ]. Interactions in these active learning sessions primarily took place through real-time voice, text, or teaching management platforms like Rain Classroom, Xuexitong, or Blackboard. In the context of English classroom teaching, a study introduced the SPOC-based (Small Private Online Course) FC model as an effective learning approach [ 29 ]. Consistent with our findings, one research revealed that the students exhibited a notable level of enthusiasm towards the pre-class activities, which effectively fostered their active participation and attentiveness during the in-class sessions [ 30 ].

On the one hand, studies conducted in India comparing e-learning methods during the COVID-19 crisis have found that learners generally express agreement with online discussions facilitated through virtual classrooms [ 6 ]. From the learners’ perspective, e-learning is seen as a complement to traditional education, forming integrated educational methods [ 31 ]. Constructive alignment of integrated methods in an e-learning model can contribute to effective educational design. Research has shown that learners’ satisfaction is influenced by factors such as teachers’ attitudes towards e-learning, course flexibility, course quality, course utility, perceived ease of use, and variety of assessments [ 32 ]. According to a study carried out at The College of Health-Care Professions in Bolzano, Italy, it was suggested that incorporating online learning activities can enhance the effectiveness of didactic lectures. This approach not only requires teachers to create well-structured courses but also encourages early student engagement with the course material, thereby preventing a passive role during in-class sessions [ 33 ]. Furthermore, in a study conducted by Telford and Senior in 2017, healthcare students who experienced a combination of e-learning and flipped classroom instructional approaches reported positive outcomes and a favorable learning experience [ 18 ].

Advancements in concurrent distance learning and shared technologies, such as blogs, bulletin boards, chats, emails, and distance conferencing, have made it easier to access shared learning experiences. Quantitative and qualitative studies in collaborative medical education have demonstrated higher levels of learner satisfaction, knowledge progression, self-awareness, understanding of concepts, achievement of course goals, and changes in practice.

It is important to recognize that in “e-learning,” the e-learner plays a central role. The use of information and communication technology by the new generation of digital natives distinguishes them from previous generations of learners and teachers. Therefore, effective e-medicine learning requires a balance between real-world practice and providing adequate learning opportunities. However, it is crucial to note that many challenges related to the use of technology in medical education are not solely attributable to the technology itself but to the educational approaches employed.

A significant limitation of this study was the absence of a control group for comparing the effects of the FPA model with other models. However, the application of this model over three consecutive semesters and the high satisfaction rate among students were notable strengths. Future high-quality studies are recommended to compare the effects of this method with other approaches. Additionally, exploring the applicability of this model in other fields and subjects is suggested.

The FPA model is a student-centered approach that encourages students to employ diverse learning techniques. It recognizes the important mentoring role of teachers in the learning process. The FPA model demonstrates remarkable effectiveness in deconstructing traditional classroom teaching and reconstructing teaching and learning methods through the profound integration of classroom instruction and modern educational technologies. This model is particularly valuable during times of crisis, such as the ongoing pandemic.

Data availability

All data generated and/or analyzed during the current study are available from the corresponding authors on responsible request.

Saverino D. Teaching anatomy at the time of COVID-19. Clin Anat (New York Ny). 2020;34(8):1128–1128.

Article   Google Scholar  

Fives C, Lone M, Nolan YM. Motivation and learning methods of anatomy: associations with mental well-being. Clin Anat. 2022;35(1):26–39.

Sugand K, Abrahams P, Khurana A. The anatomy of anatomy: a review for its modernization. Anat Sci Educ. 2010;3(2):83–93.

Dunleavy M, Dede C, Mitchell R. Affordances and limitations of immersive participatory augmented reality simulations for teaching and learning. J Sci Edu Technol. 2009;18:7–22.

Triepels CP, et al. Does three-dimensional anatomy improve student understanding? Clin Anat. 2020;33(1):25–33.

Singal A, et al. Anatomy education of medical and dental students during COVID-19 pandemic: a reality check. Surg Radiol Anat. 2021;43:515–21.

Keller J, von der Gracht HA. The influence of information and communication technology (ICT) on future foresight processes—results from a Delphi survey. Technol Forecast Soc Chang. 2014;85:81–92.

Quinton S, Smallbone T. Feeding forward: using feedback to promote student reflection and learning–a teaching model. Innovations Educ Teach Int. 2010;47(1):125–35.

Iwanaga J, et al. A review of anatomy education during and after the COVID-19 pandemic: revisiting traditional and modern methods to achieve future innovation. Clin Anat. 2021;34(1):108–14.

Mimirinis M. ‘Constructive alignment’and learning technologies: some implications for the quality of teaching and learning in higher education . in Seventh IEEE International Conference on Advanced Learning Technologies (ICALT 2007). 2007. IEEE.

Entezari M, Javdan M. Active learning and flipped Classroom, Hand in Hand Approach to improve students learning in human anatomy and physiology. Int J High Educ. 2016;5(4):222–31.

Google Scholar  

Hughes KS. Peer-assisted learning strategies in human anatomy & physiology. Am Biology Teacher. 2011;73(3):144–7.

Uijl S, Filius R, Ten O, Cate. Student interaction in small private online courses. Med Sci Educ. 2017;27:237–42.

Barr RB, Tagg J. From teaching to learning—A new paradigm for undergraduate education. Change: Magazine High Learn. 1995;27(6):12–26.

Bergmann J, Sams A. Flip your classroom: Reach every student in every class every day. International society for technology in education; 2012.

Abeysekera L, Dawson P. Motivation and cognitive load in the flipped classroom: definition, rationale and a call for research. Volume 34. Higher education research & development; 2015. pp. 1–14. 1.

Aidinopoulou V, Sampson DG. An action research study from implementing the flipped classroom model in primary school history teaching and learning. J Educational Technol Soc. 2017;20(1):237–47.

Telford M, Senior E. Healthcare students’ experiences when integrating e-learning and flipped classroom instructional approaches. Br J Nurs. 2017;26(11):617–22.

Ettien A, Touré YÉJ. Theoretical foundations of the flipped Classroom. Eur J Educ Pedagogy. 2023;4(6):53–7.

Akçayır G, Akçayır M. The flipped classroom: a review of its advantages and challenges. Comput Educ. 2018;126:334–45.

Topping KJ. Trends in peer learning. Developments Educational Psychol, 2013: p. 53–68.

Arima S, Yasui M, Okawa K. Re-design classroom into MOOC-like content with remote face-to-face sessions during the COVID-19 pandemic: a case study in graduate school . in Proceedings of the Eighth ACM Conference on Learning@ Scale . 2021.

Gleason BL, et al. An active-learning strategies primer for achieving ability-based educational outcomes. Am J Pharm Educ. 2011;75(9):186.

Xiao J, Adnan S. Flipped anatomy classroom integrating multimodal digital resources shows positive influence upon students’ experience and learning performance. Anat Sci Educ. 2022;15(6):1086–102.

Fox A. From moocs to spocs. Commun ACM. 2013;56(12):38–40.

Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.

Kazeminia M, et al. Investigation flipped classroom effectiveness in teaching anatomy: a systematic review. J Prof Nurs. 2022;42:15–25.

Youssef S. Different approaches for teaching and learning anatomy and future directions. Indian J Clin Anat Physiol. 2021;8(1):1–6.

Cheng X, et al. Gross anatomy education in China during the Covid-19 pandemic: a national survey. Anat Sci Educ. 2021;14(1):8–18.

El Sadik A, Abdulmonem WA. Improvement in student performance and perceptions through a flipped anatomy classroom: shifting from passive traditional to active blended learning. Anat Sci Educ. 2021;14(4):482–90.

Zhang E, Zhang W, Jin C. SPOC-based flipped classroom of college English: construction of an effective learning model. Int J Emerg Technol Learn (iJET). 2018;13(1):37–45.

Jochems W, Koper R, Van Merrienboer J. Integrated e-learning: implications for pedagogy, technology and organization. Routledge; 2004.

Lochner L, et al. Combining traditional anatomy lectures with e-learning activities: how do students perceive their learning experience? Int J Med Educ. 2016;7:69.

Download references

Acknowledgements

The author thanks anatomy department faculty members for implementing the course for medical students.

There is no funding to report.

Author information

Authors and affiliations.

Department of Anatomical Sciences, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran

Mohammad Afshar & Hamed Shoorei

Medical Toxicology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Mohammad Afshar

Education Development Center, Birjand University of Medical Sciences, Birjand, Iran

Afagh Zarei

Pathology Department, Medical College, Birjand University of Medical Sciences, Birjand, Iran

Mahdieh Rajabi Moghaddam

Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran

Hamed Shoorei

Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran

You can also search for this author in PubMed   Google Scholar

Contributions

This study was conducted by all authors of the study and they contributed to all steps of the study including data collection and analysis, result interpretation and writing the final manuscript.

Corresponding authors

Correspondence to Mahdieh Rajabi Moghaddam or Hamed Shoorei .

Ethics declarations

Ethics approval and consent to participate.

The study procedures adhered to the prescribed guidelines and regulations. Voluntary participation was emphasized, granting participants the freedom to withdraw at any research stage without providing reasons. Informed consent, encompassing study details, objectives, and benefits, was secured from all participants. This study was conducted under surveillance of ethical committee of Birjand University of Medical Sciences, Birjand, Iran.

Consent for publication

Not applicable.

Competing interests

The author declares that he has no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Afshar, M., Zarei, A., Moghaddam, M.R. et al. Flipped and Peer-Assisted teaching: a new model in virtual anatomy education. BMC Med Educ 24 , 722 (2024). https://doi.org/10.1186/s12909-024-05697-4

Download citation

Received : 01 March 2024

Accepted : 23 June 2024

Published : 03 July 2024

DOI : https://doi.org/10.1186/s12909-024-05697-4

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Educational model
• Active learning
• Interactive tutorial
• Flipped classroom
• Peer-Assisted learning
• Peer learning
• Virtual learning

BMC Medical Education

ISSN: 1472-6920

• Submission enquiries: [email protected]
• General enquiries: [email protected]

• Open access
• Published: 05 July 2024

Evaluating diabetes care in primary healthcare centers in Abuja, Nigeria: a cross-sectional formative assessment

• Ikechukwu A. Orji   ORCID: orcid.org/0000-0001-5028-5428 1 ,
• Abigail S. Baldridge 2 ,
• Mercy U. Ikechukwu-Orji 1 ,
• Bolanle Banigbe 3 ,
• Nelson C. Eze 4 ,
• Aashima Chopra 2 ,
• Kasarachi Omitiran 1 ,
• Guhan Iyer 5 ,
• Deborah Odoh 4 ,
• Morenike Alex-Okoh 4 ,
• Rifkatu Reng 8 ,
• Lisa R. Hirschhorn 2   na1 ,
• Mark D. Huffman 5 , 6 , 7   na1 &
• Dike B. Ojji 1 , 8  

BMC Primary Care volume  25 , Article number:  243 ( 2024 ) Cite this article

11 Accesses

Metrics details

Introduction

Noncommunicable diseases (NCDs) are associated with high and rising burden of morbidity and mortality in sub-Saharan Africa, including Nigeria. Diabetes mellitus (DM) is among the leading causes of NCD-related deaths worldwide and is a foremost public health problem in Nigeria. As part of National policy, Nigeria has committed to implement the World Health Organization (WHO) Package of Essential Non-communicable Disease interventions for primary care. Implementing the intervention requires the availability of essential elements, including guidelines, trained staff, health management information systems (HMIS), equipment, and medications, in primary healthcare centers (PHCs). This study assessed the availability of the DM component of the WHO package, and the readiness of the health workers in these PHCs to implement a DM screening, evaluation, and management program to inform future adoption and implementation.

This cross-sectional formative assessment adapted the WHO Service Availability and Readiness Assessment (SARA) tool to survey 30 PHCs selected by multistage sampling for readiness to deliver DM diagnosis and care in Abuja, Nigeria, between August and October 2021. The SARA tool was adapted to focus on DM services and the availability and readiness indicator scores were calculated based on the proportion of PHCs with available DM care services, minimum staff requirement, diagnostic tests, equipment, medications, and national guidelines/protocols for DM care within the defined SARA domain.

All 30 PHCs reported the availability of at least two full-time staff (median [interquartile range] = 5 [4–9]), which were mostly community health extension workers (median [interquartile range]) = 3 [1–4]. At least one staff member was recently trained in DM care in 11 PHCs (36%). The study also reported high availability of paper-based HMIS (100%), and DM screening services using a glucometer (87%), but low availability of DM job aids (27%), treatment (23%), and national guidelines/protocols (0%).

This formative assessment of PHCs’ readiness to implement a DM screening, evaluation, and management program in Abuja demonstrated readiness to integrate DM care into PHCs regarding equipment, paper-based HMIS, and nonphysician health workers' availability. However, strategies are needed to promote DM health workforce training, provide DM management guidelines, and supply essential DM medications.

Peer Review reports

Noncommunicable diseases (NCDs, including diabetes mellitus (DM), are collectively responsible for almost three-quarters (75%) of global deaths, and most of these deaths (86%) occur in low- and middle-income countries [ 1 ]. Moreover, cardiovascular diseases, cancers, chronic respiratory disease, and DM account for more than 80% of the global premature NCD mortality (i.e., deaths between 30 and 69 years) [ 2 ]. In Nigeria, nearly 30% of all deaths and 22% of premature mortality are due collectively to NCDs, which include DM [ 1 ]. An estimated 3.6 million adults in Nigeria were affected by DM in 2021, [ 3 ] and a recent study reported a progressive increase in the prevalence of DM in Nigeria over the past three decades [ 4 ]. This figure is projected to increase if a concerted effort does not stem the tide. Therefore, as part of the national response to the increasing NCD burden, including DM, the Federal Ministry of Health has planned to implement the World Health Organization (WHO)-recommended package of essential NCD interventions, [ 5 ] at all primary healthcare centers (PHCs) as part of the National Multi-Sectorial Action Plan (NMSAP) for the prevention and control of NCDs [ 6 ].

This package of essential NCD interventions includes cost-effective activities aimed at the prevention, early detection, treatment, and control of DM and other NCDs to prevent life-threatening complications [ 5 ]. However, the effective implementation of these interventions requires that health facilities have the necessary inputs, including guidelines, trained staff, equipment, and medications [ 7 , 8 ]. Additionally, facilities must have functional health management information systems (HMIS) to document patient information and track disease control status and retention in care. There is a dearth of information on the availability of these inputs at PHCs in Nigeria, which is a prerequisite for any meaningful implementation, sustainment, or scale-up.

This study, therefore, aims to contribute to fill this gap by assessing readiness and service availability for integrating DM screening, evaluation, and management services into PHCs in Abuja, Nigeria, leveraging the existing program infrastructure of the ongoing Hypertension Treatment in Nigeria (HTN) Program (NCT0415815411) [ 9 ]. The ultimate goal is to contextualize, implement, and evaluate strategies to address gaps and improve the delivery of an evidence-based intervention known to reduce DM-related morbidity and mortality by improving screening, diagnosis, treatment, and control of DM. Thereby strengthening and positioning the PHCs toward achieving the objectives of the NMSAP for NCD prevention and control [ 6 ].

The study aimed to evaluate the capacity and readiness of health facilities for DM screening, diagnosis, and treatment at PHCs participating in the HTN Program. The team assessed (1) DM service availability at the PHC level, (2) specific service readiness for DM diagnosis and treatment, and (3) the availability of staff, job aids for DM care, HMIS, equipment, and medications for DM screening and treatment.

Study design

The study was a cross-sectional, formative assessment.

Three researchers collected the survey data from August 2021 to October 2021 in 30 PHCs in Abuja, the Federal Capital Territory (FCT), Nigeria. These sites were selected from the 60 PHCs participating in the Hypertension Treatment in Nigeria (HTN) Program. The HTN Program PHCs were originally sampled through a multistage sampling technique and achieved an even spread across the FCT [ 10 ]. Abuja the study location, is the administrative capital of Nigeria and is located in the north-central geo-political zone of Nigeria [ 11 ]. It has six area councils (the equivalent of local government areas) with 62 political wards and more than 243 PHCs [ 10 ]. The HTN Program is an ongoing National Heart, Lung, and Blood Institute-funded type II hybrid implementation-effectiveness study of 60 selected PHCs in Abuja. The HTN Program began recruiting patients in January 2020 and aimed to improve awareness, diagnosis, treatment, and control of hypertension in Abuja, the Federal Capital Territory of Nigeria [ 9 ].

Site selection

The 30 PHCs were selected by random sampling using a computer-based statistical program across the six area councils. The process of sampling included the following steps: (1) identifying HTN Program PHCs ( n  = 60); (2) excluding the security-challenged sites ( n  = 14); and (3) sampling 50% of the original number of HTN PHCs in each area council to achieve the target sample size ( n  = 30). A team of three researchers contacted each selected PHC to ascertain their willingness to participate in this formative survey and received a positive affirmation from all eligible PHCs. The study team visited each PHC facility, obtained informed consent, and conducted the survey on the appointed days.

Survey adaptation

The study team adapted the WHO Service Availability & Readiness Assessment (SARA) tool [ 12 ] and used it to assess the availability and readiness for diabetes care in the selected PHCs (Appendix A: additional file 1). The WHO defines service readiness as the capability of health facilities to offer a specific service, as measured through selected indicators, including trained staff, printed guidelines, essential equipment, diagnostic capacity, and required medications and commodities [ 12 ]. This study assessed the presence or absence of each of the following SARA indicators: (1) staffing and training, which refers to at least one staff member being trained in diabetes care within the last 24 months. (2) DM service availability, (3) job aid for DM care service delivery, including national guidelines for the prevention, diagnosis, and management of DM and other guidelines, (4) health management information system, (5) DM screening equipment and supplies, and (6) essential DM medications. The team completed the survey using the adapted SARA tool (Appendix A; additional file 1) and the observation checklist (Appendix B; additional file 2).

These indicators are described below:

Staffing and training

Staffing refers to the availability or otherwise of two or more full-time health workers as adequate, the benchmark used in the HTN Program, [ 10 ] and includes the category of nonphysician health workers (community health extension workers and nursing professionals cadres) who are qualified to prescribe diabetes medications under the Nigerian National Task-shifting and Task-sharing (NTSTS) policy for the Prevention and Control of NCDs in Nigeria, recently approved for use by the Federal Ministry of Health and Social Welfare to adopt [ 13 , 14 ]. The training component was measured by the proportion of PHCs with at least one staff member trained in DM care within the last 24 months.

DM service availability

DM service availability was defined as the availability of DM treatment and/or diagnostic services at the PHC facility during the time of the survey.

Job aid for DM care service delivery, including national guidelines and others for the prevention, diagnosis, and management of DM

This indicator refers to the availability or otherwise at the PHC of job aids for DM care, such as the national guidelines and other related guidelines for the Prevention, Diagnosis, and Management of DM; printed checklists for screening patients for risk of diabetes; printed checklists for interventions for patients with risk factors for cardiovascular diseases (CVDs) and DM; and cardiovascular risk assessment charts.

Health management information system

The health management information system refers to the availability or otherwise of electronic and/or paper-based medical records for all patients, and patients with NCDs. These data comprised records of patient visits, patient record files, and individual records for patients with NCDs, including DM, with usability for longitudinal monitoring of patient care.

DM screening equipment and supplies

DM screening equipment and supplies were defined as the availability or otherwise of a functional point-of-care glucometer and valid glucometer strip, according to the recommendations of the Nigerian NTSTS policy for the prevention and control of NCDs at the primary healthcare level in the country [ 13 , 14 ].

Essential DM medications

Essential DM medications describe the availability of at least a 30-day stock of 500 mg metformin and 5 mg glibenclamide. These two medications are among those approved for use in the Nigerian national guidelines on the prevention, control, and management of DM [ 15 ].

DM Service Readiness reflects the availability of the essential indicators for DM care at the PHCs, including the availability of two or more full-time staff approved to prescribe DM medications, treatment, and/or provide diagnostic services; a functional glucometer and valid test strip; DM medications of at least a 30-day dose of glibenclamide and metformin; the availability of national guidelines on the prevention, diagnosis, and management of DM; and the availability of health management information systems that can be used for longitudinal monitoring of patients.

Data collection process

The research team completed the SARA surveys by interviewing the four most senior clinical staff members available at each PHC on the day of the visit after providing written informed consent. These staff members included facility managers and heads of units from maternity, laboratory, and pharmacy units. The team visited the various units to observe the availability of self-reported materials, including the pharmacy and the laboratory sections, to confirm the availability of DM medications and diagnostic equipment, respectively. On the day of the visit, the study team used a checklist (Appendix B; Additional file 2) to document the presence of a functional glucometer, test strips, and selected DM medications, namely, metformin and glibenclamide, which are among the medications approved for use in the national guideline, [ 15 ] and listed in the Nigeria Essential Medicine List 2020, 7th Edition for the management of DM [ 16 ].

Statistical analyses

The results of the facility-based formative evaluation of DM care service availability and readiness were tabulated. Continuous variables were summarized as the mean and standard deviation, and nonparametrically distributed variables were summarized as the median and interquartile range. Categorical results were reported as frequencies. The domains of interest to the research team were based on the availability and readiness of the PHCs to deliver DM care, including staffing and training, DM service delivery, health management information systems, equipment for DM screening, and medications for DM treatment. The service availability and readiness indicator scores were calculated based on the proportion of PHCs with available DM care services, minimum personnel requirement, diagnostic tests, equipment, medications, and national guidelines/protocols for DM care within the defined SARA domain question bank. The study team used R version 3.5.1 (R Foundation, Vienna, Austria) and Microsoft Excel version 2016 (Microsoft, Redmond, Washington) for statistical analysis.

Participants

The flowchart of the assessed sites is shown in Fig.  1 below. The SARA assessment was completed for all 30 selected PHCs, by three members of the research team.

Site selection flow chart.  AMAC Abuja Municipal Area Council, FCT Federal Capital Territory, PHCs primary healthcare centers

Definitions of the key indicators

Table 1 below, provides definitions of the key indicators.

Table 2 summarizes the service availability and readiness assessment for DM care integration across the included domains. Among all ( n  = 30, 100%) participating PHCs, there were at least two full-time staff at the time of survey administration. The median [interquartile range] number of full-time staff was 5 [4-9]; most were community health extension workers, with a median [interquartile range] = 3 [1-4], followed by nurses (median [interquartile range] = 1 [0–2]). In terms of personnel training, 11 (37%) of the sites reported at least one staff member trained in the diagnosis and management of DM within the last two years.

DM service and job aid availability

Among the 30 PHCs surveyed, 26 (87%) could provide on-site DM diagnosis, while 6 (20%) sites reported on-site capacity for DM treatment. The national guidelines or protocols for the diagnosis and management of DM at primary health centers and cardiovascular risk assessment were absent in all the surveyed facilities ( n  = 0; 0%). There was also a low availability of other job aids, such as job aids for screening patients for risk of DM ( n  = 8; 27%), job aids for interventions for patients with risk factors for CVDs and DM ( n  = 7; 23%), and other guidelines/protocols for the diagnosis and management of DM ( n  = 8; 27%), Table  2 .

Health management information systems

No ( n  = 0; 0%) PHCs reported having an electronic medical records system; however, all ( n  = 30; 100%) PHCs reported the availability of a paper-based health management information system, including records of patient visits, maintaining patient files for all their patients, and individual records for patients with NCDs Table  2 .

DM service readiness

Table 3 presents diabetes service readiness indicators for the surveyed PHCs in the six area councils of Abuja. DM service readiness reflects the composite availability of the essential indicators for DM care at the PHCs presented according to the area councils' performance. The staffing indicator revealed adequate staff for DM service in all the area councils in the FCT, Abuja (100%). This indicator refers to the proportion of facilities with two or more full-time nonphysician health workers approved to prescribe DM medication according to the recommendations of the Nigerian NCD TSTS policy guideline. The equipment indicator, defined as the proportion of facilities with available functional glucometers and valid test strips for point-of-care screening for DM, varied from 60 to 100% across the area councils and an average of 87% for FCT, Abuja. The medication availability indicator refers to the proportion of PHCs across the area councils with at least a 30-day dose of 500 mg metformin and 5 mg glibenclamide found in the PHC pharmacy inventory and drug shelf or cabinet on the day of the assessment. This indicator was a 3% score as just one PHC in the Bwari area council had the requisite DM medication. The National guideline indicator score which refers to the proportion of facilities with available national guidelines/protocols for diagnosing and treating DM was 0% across the area council. The paper-based HMIS, defined as the proportion of PHCs with paper-based medical records for all patients, including patients with NCDs, and usable for longitudinal patient monitoring, is 100% in all the 30 PHCs assessed.

In line with the WHO's target to reduce premature death from NCDs, including DM, by 30% by 2030, Nigeria launched the National Multi-Sectorial Action Plan for the Prevention and Control of NCDs in 2019, with the plan to implement the WHO Package of Essential NCD interventions at all PHCs [ 17 , 18 ]. Although there are ongoing system-level hypertension control programs at the primary health care level, such as the HTN Program in 60 PHCs in Abuja [ 19 ], no such wide-scale programs have yet been implemented for DM. Across the surveyed 30 PHCs in the HTN Program, DM care service availability and readiness were high in the health workforce and paper-based health management information systems. The current study also revealed variability in equipment availability and low scores in the availability of DM medicines and national guidelines or protocols. The survey demonstrated the readiness to integrate DM care into these PHCs in terms of the availability of paper-based health management information systems, equipment, and personnel (nonphysician health workers; nurses, and community health extension workers). However, the strategy to use nonphysician health workers requires an investment in DM care training and longitudinal retraining in alignment with the provisions of the NTSTS policy for the prevention and control of NCDs in Nigeria [ 13 , 14 ]. The findings also revealed the need to provide access to DM guidelines and protocols and supply chain strengthening to ensure a reliable supply of quality DM medications and equipment.

On the staffing and training domain, the study reported adequate full-time staff among all PHCs surveyed in terms of nonphysician health workers (nurses and community health extension workers), with a cut-off of two or more full-time staff used to define adequacy for DM service delivery, the same criterion used in the HTN Program [ 12 ]. The staffing component is focused on the category of nonphysician health workers (community health extension workers (CHEWs) and nursing professional cadres), approved to prescribe DM medications according to the recommendation of the National Task-Shifting/Task Sharing policy for the prevention and control of NCDs [ 13 , 14 ]. The findings showed a median of three full-time CHEWs across the surveyed sites, which aligns with the minimum number of three CHEWs recommended for PHC by the Nigerian National Primary Health Care Development Agency [ 20 ]. This finding is similar to that of a recent PHC facility assessment survey in different states in Nigeria, which revealed that CHEWs were the most common cadres of staff across the PHCs surveyed, [ 21 , 22 ] and a 2017 WHO publication which reported the CHEWs as the largest cadre of health workforce in PHCs across Nigeria [ 23 ]. This pattern may be partly attributed to the high availability of schools of health technology responsible for their training and the shorter duration of training, which has enabled a high turnover of CHEWs in Nigeria [ 24 ]. In addition, the CHEW cadre was created to fill the health workforce gap in PHCs when it was established as the basic health unit in Nigeria in the late 1970s [ 25 ]. Furthermore, there is a seeming preference for the hiring of CHEWs in the primary health care system over nurses/midwives by local government authorities in Nigeria as this appears more economically viable due lower salaries of the former [ 26 ]. Our result demonstrates the high rating of staff availability for a nonphysician-led DM care service delivery. On the contrary, a significant gap in staff training for diagnosing and treating DM across the sites was identified, similar to the findings of a previous survey in Nigeria in which inadequate staff training was reported for managing Human Immunodeficiency Virus (HIV) and tuberculosis coinfections, including multidrug-resistant tuberculosis; [ 27 ] and for CVD and hypertension management. [ 11 ] Findings from other sub-Saharan African country reports also showed that the availability of trained staff was the poorest performing domain of DM service readiness [ 28 , 29 , 30 ]. On the other hand, a 2020 Nigerian study revealed the high availability of trained staff in the management of HIV and malaria, as well as immunization and family planning services [ 21 ]. The low availability of staff trained in DM can be attributable to the previous task-shifting policy for essential services in Nigeria which focused on the management of HIV, malaria, tuberculosis, reproductive health, and maternal and newborn health and not on CVD [ 26 ]. However, with the Nigeria National Task-Shifting/Task Sharing policy document of November 2023 now including treatment of CVD risk factors like DM and hypertension [ 13 , 14 ] the availability of trained staff is likely to improve over time. The need for such improvement cannot be over-emphasized as the availability of qualified and trained staff remains an essential component in implementing the task-shifting/task-sharing strategy for NCD treatment, including DM care [ 31 ]. Therefore, bridging the training gap for these nonphysician health workers before initiating DM care integration, as well as longitudinal retraining, continuing medical education, and supportive supervision and mentoring, is required for successful DM care integration in PHCs in Nigeria [ 32 , 33 , 34 ].

Further on DM service availability and readiness, the findings revealed that screening services and equipment which are glucometers and test strips for diagnosing DM were available in most of the PHCs surveyed, similar to the findings of a previous study at primary care facilities in Nigeria in which screening services for NCDs, including DM and hypertension, were available [ 17 ]. Conversely, some studies have reported low availability of glucometers for DM screening in southwest Nigeria, at rural PHCs 33% [ 27 ] and 46% at urban PHCs. In PHCs in Tanzania, an availability of 38% [ 23 ] was reported while in Ethiopia 40% was reported [ 24 ]. The high availability of DM screening services reported in this study is a facilitator for DM integration into these primary healthcare facilities. This finding may be due, at least in part, to support from the Federal Government PHC Revitalization Initiative through the ongoing Basic Health Care Provision Fund program implemented in some of the PHCs [ 35 ]. Another reason for this finding may be due to the presence and activities of the Health Strategy and Delivery Foundation (HSDF), a nongovernmental organization that helped to implement DM screening programs in some of these PHCs in the Abuja Municipal Area Council and Bwari area councils between 2018 and 2021 [ 36 ]. Even though the availability of facilities for the screening of DM was high in these facilities, treatment services was low across all the 30 PHCs assessed, with only approximately one-fifth of sites reporting DM treatment service availability. This may be partly, due to the absence of policies and guidelines before this time which enabled non-physician healthcare workers to treat DM at the primary care level. Similarly, the medication indicator was very poor across all the 30 PHCs assessed with only one PHC having a 30-day stock of essential DM medications (i.e., metformin and glibenclamide), and this reflects low readiness for treatment. Our findings are similar to previous studies in PHCs in Nigeria that documented the absence of DM medication in all the PHCs surveyed [ 37 ] and low availability of blood pressure-lowering medications [ 12 , 38 ]. The very low score in the DM medication indicator is partly attributed to the low availability of DM treatment services found among the PHCs surveyed. This is partly attributed to the lack of policies before this time that enabled non-physician healthcare workers to initiate treatment of DM at the primary care level, and the dearth of primary care physicians in these facilities. The low availability of DM medications represents an important, potentially modifiable barrier to high-quality DM care. There is an obvious need to contextualize and implement strategies to enhance DM medication accessibility. For example, a subsidized, drug-revolving fund mechanism could be developed to ensure a reliable supply of quality DM medications at PHCs with the provision of seed stock drugs, leveraging the experience from similar programs such as the HTN Program in Nigeria, [ 39 ] and the Academic Model Providing Access To Healthcare (AMPATH) program in Kenya [ 40 ]. However, for the long-term sustainability of DM medication accessibility, a social health financial protection plan, such as community-based health insurance, is recommended to reduce out-of-pocket expenditures related to DM treatment [ 41 ]. This need was emphasized by stakeholders in a recent study that identified access to functional health insurance as a central strategy for accessing quality and affordable blood pressure-lowering medications [ 39 ]. Furthermore, the national guidelines on the prevention, control, and management of DM were unavailable for all the PHCs surveyed. This finding represents a gap that needs to be addressed for a successful DM care integration at the primary care level. Even though, the National DM management guidelines of the Federal Ministry of Health of Nigeria, [ 15 ] have been developed, they were not yet widely disseminated at the time of this survey. In addition, clinical desk guides and CHEW job aides for the management of NCDS at primary healthcare centers which are components of the newly approved policy document for the effective prevention and control of NCDs in Nigeria will be very useful in integrating DM into these primary care facilities [ 13 , 14 ].

Another important aspect of the evaluation was on the Health Management Information System (HMIS) domain, where the study found adequate paper-based HMIS across all 30 PHCs surveyed. This finding represents the availability of paper-based medical records of patients’ visits, patients’ files, and individual records for NCD patients and available for longitudinal care in other conditions. However, electronic health records were unavailable for any of the PHCs. This is similar to the work of Oluoch and de Keizer who documented the weakest evidence of the application of electronic health records (health information technology) in Low and Middle-income Countries' health systems [ 42 ]. While paper-based HMIS has been effective at the PHC level, it is challenging to use it for longitudinal follow-up and national coordination. Therefore, there is a need for a hybrid HMIS which includes a combination of paper-based and electronic-based health management information systems at the PHC level [ 43 ]. A hybrid HMIS model piloted at the PHC level in Nigeria by the Resolve To Save Lives (a nongovernmental organization) comprising a paper-based HMIS and District Health Information System version 2 (DHIS2), an electronic HMIS, is recommended. DHIS2 software which is an open-source, web-based platform developed as a global collaboration and managed by the University of Oslo’s Health Information Systems Program (HISP) Center has been proven to be reliable for use as a health management information system [ 44 ]. Such a hybrid paper-based DHIS2 electronic model piloted with Resolve To Save Lives holds great promise for improving timely reporting of quality NCD data directly from PHCs and can be used for prompt decision-making, [ 43 ] which aligns with the country’s adoption of its use for the National Health Management Information System in 2010 [ 45 ]. Although it is not currently deployed at the PHC level, DHIS2 is implemented at the local government level in the Federal Capital Territory for the management of paper-based data generated at the health facility.

This study has some strengths and limitations. The main strength of this study lies in the distribution of the facilities assessed throughout the six area councils of the Federal Capital Territory which makes generalizability throughout the FCT easy. Secondly, the use of the WHO SARA tool which is a global tool for primary health care facility assessment makes comparison of our findings with those of other studies possible. There are, however, some limitations. First, the study was a cross-sectional assessment using the adapted SARA instrument; therefore, the evaluation of temporal trends in service readiness and availability was beyond the scope of the current study. Secondly, the team limited the equipment and medication availability to a point-of-care glucometer, test strips, and a minimum supply of metformin and glibenclamide. Additional equipment such as Glycated Hemoglobin (also called Glycosylated Hemoglobin or Hemoglobin A1c or HbA1c) testing devices and other medications may be desirable for screening/diagnosing and treating people with DM to meet the needs of the population served by these PHCs. Our formative assessment was however in keeping with the recommended equipment and medications in the Nigerian national guidelines for diagnosing and treating diabetes at the PHCs.

Conclusions

This was the first formative assessment of the service availability and readiness of PHCs in the Federal Capital Territory, Abuja, Nigeria, for screening, diagnosing, and treating DM. The survey demonstrated readiness to integrate DM care into PHCs in terms of personnel in alignment with the national task-shifting policy, paper-based health management information systems, and equipment. However, strategies are needed to promote DM health workforce training, provide access to guidelines on managing DM and simplified treatment protocols, and provide a reliable supply of essential DM medications. These can be successful as PHCs continue to leverage the national task-shifting/task-sharing strategy for managing NCDs to enhance DM care integration into the PHCs. Therefore, we recommend the findings of this study to serve as a baseline for future comprehensive evaluation of work to integrate DM services in the PHCs, including sustainable financing strategies.

Furthermore, we recommend that the PHCs upgrade from paper-based HMIS to a hybrid HMIS (a combination of paper-based and electronic-based HMIS) as a precursor for the future migration to an electronic-based HMIS. This is per the WHO recommendation for countries to implement electronic health records across the broad spectrum of healthcare, which includes the primary healthcare level.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Abbreviations

Abuja Municipal Area Council

Academic Model Providing Access To Healthcare

Cardiovascular Diseases

Community Health Extension Worker

District Health Information System version 2

Diabetes Mellitus

Federal Capital Territory

Hemoglobin A1c

Health Information Systems Program

Human Immunodeficiency Virus

Health Management Information System

Hypertension Treatment in Nigeria

Inter-Quartile Range

Non-Communicable Diseases

National Task-Shifting and Task-Sharing

Primary Healthcare Center

Service Availability and Readiness Assessment

World Health Organization

World Health Organization. Noncommunicable diseases country profiles.2018. Available at: https://www.who.int/publications/i/item/9789241514620 . Accessed 01 Dec 2023.

World Health Organization. Noncommunicable diseases. 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases . Accessed 01 Dec 2023

International Diabetes Federation. Diabetes atlas. 10th ed. Brussels: International Diabetes Federation; 2021. Available at https://idf.org/our-network/regions-and-members/africa/members/nigeria/ . Accessed 01 Dec 2023

Adeleye OJ. The hazardous terrain of diabetes mellitus in Nigeria: the time for action is now. Res J Health Sci. 2021;9(1):69–76.

Google Scholar  

World Health Organization. WHO package essential noncommunicable (PEN) disease interventions for primary health care. 7 September 2020. Available at https://www.who.int/publications/i/item/9789240009226 . Accessed 01 Dec 2023.

World Health Organization. WHO and the Nigerian government move to curb cardiovascular diseases. 2019. Available at https://www.afro.who.int/news/who-and-nigerian-government-move-curb-cardiovascular-diseases . Accessed 01 Dec 2023

Aye LL, Tripathi JP, Maung Maung T, et al. Experiences from the pilot implementation of the Package of Essential Non-communicable Disease Interventions (PEN) in Myanmar, 2017–18: A mixed methods study. PLoS One. 2020;15(2):e0229081 Published 2020 Feb 18. https://doi.org/10.1371/journal.pone.0229081

Article   CAS   PubMed   PubMed Central   Google Scholar  

Mendis S, Al Bashir I, Dissanayake L, et al. Gaps in capacity in primary care in low-resource settings for implementation of essential non-communicable disease interventions. Int J Hypertens. 2012;2012:584041. https://doi.org/10.1155/2012/584041

Transforming hypertension treatment in nigeria using a Type II Hybrid, interrupted time series design. Available at https://clinicaltrials.gov/ct2/results?term=hypertension+treatment+in+Nigeria&Search=Search . Accessed 01 Dec 2023

Orji IA, Baldridge AS, Omitiran K, et al. Capacity and site readiness for hypertension control program implementation in the federal capital territory of Nigeria: a cross-sectional study. BMC Health Serv Res. 2021;21:322. https://doi.org/10.1186/s12913-021-06320-8 .

Article   PubMed   PubMed Central   Google Scholar  

Where is Abuja, Nigeria on Map Lat Long Coordinates? Available at https://www.latlong.net/place/abuja-nigeria-3321.html . Accessed 2 Dec 2023.

World Health Organization (WHO). Service availability and readiness assessment (SARA). Available at https://www.who.int/healthinfo/systems/sara_reference_manual/en/ . Accessed 01 Dec 2023

Premium Times. Agency Report. 2023. Available at: https://www.premiumtimesng.com/news/top-news/643612-nigerias-new-health-policy-will-combat-rising-non-communicable-diseases-official.html . Accessed 02 Dec 2023

Medical World Nigeria. The Federal ministry of health and social welfare received approval from the national council of health for the implementation of the non-communicable diseases (ncd) policy towards effective prevention and control of NCDs in Nigeria. Nov 30, 2023. Available at: https://medicalworldnigeria.com/post/Federal-Ministry-of-Health-and-Social-Welfare-Communique-Issued-at-the-End-of-the-64th-National-Council-of-Health-NCH-Meeting-Held-at-AB-Foundation-Civil-Centre-Ado-Ekiti-from-13th-17th-November-2023?pid=67684 . Accessed 02 Dec 2023

The Federal Ministry of Health. National guideline on the prevention, control, and management of diabetes mellitus, Abuja. Nigeria: FMoH; 2021.

Federal Ministry of Health. Nigeria Essential Medicine List 2020. 7 th Edition. \Available at: https://www.scribd.com/document/561877851/Nigeria-Essential-Medicine-List-2020 . Accessed 02 Dec 2023

Sacco RL, Roth GA, Reddy KS, et al. The heart of 25 by 25: achieving the goal of reducing global and regional premature deaths from cardiovascular diseases and stroke: a modelling study from the American Heart Association and world heart federation. Circulation. 2016;133(23):e674–90. https://doi.org/10.1161/CIR.0000000000000395 .

Article   PubMed   Google Scholar  

Federal Ministry of Health (FMoH) Nigeria. National multi-sectoral action plan for the prevention and control of non-communicable diseases (2019– 2025). 2019. https://www.iccp-portal.org/system/files/plans/NCDs_Multisectoral_Action_Plan.pdf . Accessed 02 Dec 2023

Baldridge AS, Aluka-Omitiran K, Orji IA, et al. Hypertension Treatment in Nigeria (HTN) program: rationale and design for a type 2 hybrid, effectiveness, and implementation interrupted time series trial. Implement Sci Commun. 2022;3(1):84. https://doi.org/10.1186/s43058-022-00328-9 . PMID:35918703;PMCID:PMC9344662.

NPHCDA. Minimum standard for primary health care in Nigeria. 2012. https://hrf.health.gov.ng . Accessed 02 Dec 2023.

Ekenna A, Itanyi I, Nwokoro U, Hirschhorn L, Uzochukwu B. How ready is the system to deliver primary healthcare? Results of a primary health facility assessment in Enugu State, Nigeria. Health Policy Plann. 2020;35(Supplement_1):i97–106. https://doi.org/10.1093/heapol/czaa108 .

Article   Google Scholar  

Ajisegiri WS, Abimbola S, Tesema AG, Odusanya OO, Peiris D, Joshi R. The organisation of primary health care service delivery for non-communicable diseases in Nigeria: a case study analysis. PLOS Glob Public Health. 2022;2(7):e0000566. https://doi.org/10.1371/journal.pgph.0000566

World Health Organization. Primary health care systems (PRIMASYS): case study from Nigeria. Geneva: World Health Organization; 2017. License: CC BY-NC-SA 3.0 IGO. https://apps.who.int/iris/ Accessed 07 Dec 2023.

Kress DH, Su Y, Wang H. Assessment of primary health care system performance in Nigeria: using the primary health care performance indicator conceptual framework. Health Syst Reform. 2016;2(4):302–18. https://doi.org/10.1080/23288604.2016.1234861 .

Eyitayo Lambo. Basic health services programme: The Nigerian experience. Vikalpa, 1982;7(2). Available at: https://journals.sagepub.com/doi/pdf/10.1177/0256090919820205 . Accessed 07 Dec 2023.

Federal Ministry of Health Task-shifting and task-sharing policy for essential health care services in Nigeria, 2014. Available at: https://advancefamilyplanning.org/sites/default/files/resources/Nigeria%20taskshifting%20policyAug2014%20REVISEDCLEAN%20_Approved%20October%202014.pdf . Accessed 07 Dec 2023.

Oluwasanu MM, Hassan A, Adebayo AM, et al. General and tuberculosis-specific service readiness in two states in Nigeria. BMC Health Serv Res. 2020;20:792. https://doi.org/10.1186/s12913-020-05626-3 .

Peck R, Mghamba J, Vanobberghen F, et al. Preparedness of Tanzanian health facilities for outpatient primary care of hypertension and diabetes: a cross-sectional survey. Lancet Glob Heal. 2014;2(5):e285–92.

Bekele A, Getachew T, Amenu K, et al. Service availability and readiness for diabetes care at health facilities in Ethiopia. Ethiop J Heal Dev. 2017;31(2):110–9.

Adinan J, Manongi R, Temu GA, et al. Preparedness of health facilities in managing hypertension & diabetes mellitus in Kilimanjaro, Tanzania: a cross sectional study. BMC Health Serv Res. 2019;19(1):1–9.

Joshi R, Alim M, Kengne AP, et al. Task shifting for non-communicable disease management in low and middle income countries–a systematic review. PLoS ONE. 2014;9(8):e103754. https://doi.org/10.1371/journal.pone.0103754

World Health Organization. Task shifting, global recommendations, and guidelines. 2008. Geneva: Available at: https://www.unaids.org/sites/default/files/media_asset/ttr_taskshifting_en_0 . Accessed 07 Dec 2023.

Gill GV, Price C, Shandu D, Dedicoat M, Wilkinson D. An effective system of nurse-led diabetes care in rural Africa. Diabet Med. 2008;25:606–11.

Article   CAS   PubMed   Google Scholar  

Kengne AP, Fezeu L, Sobngwi E, Awah KP, Aspray TJ, Unwin N, Mbanya JC. Type 2 diabetes management in nurse-led primary healthcare settings in urban and rural Cameroon. Prim Care Diab. 2009. https://doi.org/10.1016/j.pcd.2009.1008.1005

National Primary Health Care Development Agency. Basic health care provision fund. c2023. Available at; https://nphcda.gov.ng/bhcpf/ . Accessed 14 Dec 2023.

Health Strategy and Delivery Foundation (HSDF). c2022. Staff attrition in project facilities: lessons learned and recommendations from the Diabetes Awareness and Care (DAC) Project. 2021. Available at; https://hsdf.org.ng/staff-attrition-in-project-facilities-lessons-learned-and-recommendations-from-the-diabetes-awareness-and-care-dac-project/ . Accessed 14 Dec 2023.

Akinwumi AF, Esimai OA, Arije O, et al. Preparedness of primary health care facilities on implementation of essential non-communicable disease interventions in Osun State South-West Nigeria: a rural–urban comparative study. BMC Health Serv Res. 2023;23:154. https://doi.org/10.1186/s12913-023-09138-8 .

Adeke AS, Umeokonkwo CD, Balogun MS, Odili AN. Essential medicines and technology for hypertension in primary healthcare facilities in Ebonyi State, Nigeria. PLoS ONE. 2022;17(2):e0263394. https://doi.org/10.1371/journal.pone.0263394

Shedul G, Sanuade OA, Ugwuneji EN, et al. Stakeholder perspectives on the demandand supply factors driving substandard and falsified blood pressure loweringmedications in Nigeria: a qualitative study. BMJ Open. 2022;12: e063433. https://doi.org/10.1136/bmjopen-2022-063433 .

Manji I, Manyara SM, Jakait B, et al. The revolving fund pharmacy model: backing up the ministry of health supply chain in western Kenya. Int J Pharm Pract. 2016;24(5):358–66. https://doi.org/10.1111/ijpp.12254 .

Aregbeshola BS, Khan SM. Out-of-pocket payments, catastrophic health expenditure and poverty among households in Nigeria 2010. Int J Health Policy Manag. 2018;7(9):798–806. https://doi.org/10.15171/ijhpm.2018.19 .

Oluoch T, de Keizer NF. Evaluation of health IT in low-income countries. Stud Health Technol Inform. 2016;222:324–35 (PMID: 27198114).

PubMed   Google Scholar  

DHIS-2 Community. DHIS2 at the scale of hypertension: lessons learned so far from Nigeria. 2022. Available at https://community.dhis2.org/t/dhis2-at-the-scale-of-hypertension-lessons-learned-so-far-in-nigeria/47818 . Accessed 14 Dec 2023

University of Oslo. About DHIS2-Overview. Available at https://dhis2.org/about/ . Accessed 14 Dec 2023.

Shuaib F, Garba AB, Meribole E, et al. Implementing the routine immunization data module and dashboard of DHIS2 in Nigeria, 2014–2019. BMJ Glob Health. 2020;5:e002203.

Download references

Acknowledgements

Northwestern University Feinberg School of Medicine, Washington University in St. Louis, University of Abuja, Federal Ministry of Health, Abuja Nigeria, Federal Capital Territory (FCT) Primary Healthcare Board, Abuja, FCT Public Health Department, Abuja, FCT Area Council Primary Health Care Departments, interview respondents and health workers in the selected 30 PHCs in Abuja, and the Hypertension Treatment in Nigeria Program team.

Authors’ information

Not applicable

National Heart, Lung, and Blood Institute (R01HL144708) Northwestern Robert J. Havey Institute of Global Health, and Resolve to Save Lives, and Fogarty International Center of the National Institutes of Health (D43TW011976). The funders had no direct role in the design of the study; in the data collection, analysis, or interpretation; or in the writing of the manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Lisa R. Hirschhorn and Mark D. Huffman co-senior authors.

Authors and Affiliations

Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria

Ikechukwu A. Orji, Mercy U. Ikechukwu-Orji, Kasarachi Omitiran & Dike B. Ojji

Department of Medical Social Science, Feinberg School of Medicine, Northwestern University and Robert J Havey Institute for Global Health, Chicago, IL, USA

Abigail S. Baldridge, Aashima Chopra & Lisa R. Hirschhorn

Resolve to Save Lives, New York City, NY, USA

Bolanle Banigbe

Department of Public Health, Federal Ministry of Health, Abuja, Nigeria

Nelson C. Eze, Deborah Odoh & Morenike Alex-Okoh

Cardiovascular Division and Global Health Center, Washington University in St. Louis, St. Louis, MO, USA

Guhan Iyer & Mark D. Huffman

Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

Mark D. Huffman

The George Institute for Global Health, University of New South Wales, Sydney, Australia

Department of Internal Medicine, Faculty of Clinical Sciences, University of Abuja, Gwagwalada, Abuja, Nigeria

Rifkatu Reng & Dike B. Ojji

You can also search for this author in PubMed   Google Scholar

Contributions

IAO, MDH, LRH, DBO, and ASB, designed the study and directed the analysis. ASB, BB, and IAO adapted the study tools. MDH, DBO, and IAO secured funding for the study. IAO, MUI, and NCE implemented the study. IAO wrote the first draft of the manuscript. ASB, GI, and IAO analyzed and interpreted the data. DBO, MDH, LRH, RR, and ASB provided critical feedback on the manuscript. IAO, ASB, MUI, BB, NCE, AC, KO, GI, DO, MA, RR, LRH, MDH, and DBO read, provided feedback and edits, developed figures and tables, and approved the final manuscript.

Corresponding author

Correspondence to Ikechukwu A. Orji .

Ethics declarations

Ethics approval and consent to participate.

The study was reviewed and approved by the Ethics Committee at the University of Abuja Teaching Hospital (UATH/HREC/PR/2021/012/005) and the Institutional Review Board at Northwestern University (STU00216041). Ethical oversight of the study was provided by the University of Abuja Teaching Hospital Health Research Ethics Committee. The study was also reviewed by the Federal Capital Territory Ethics Committee. The relevant guidelines and regulations of the Declaration of Helsinki were followed in conducting the study, and all the study participants provided written informed consent.

Consent for publication

Not applicable.

Competing interests

MDH has received travel support from the American Heart Association and World Heart Federation and consulting fees from PwC Switzerland. MDH has an appointment at The George Institute for Global Health, which has a patent, license, and has received investment funding with intent to commercialize fixed-dose combination therapy through its social enterprise business, George Medicines. MDH has pending patents for heart failure polypills. All the other authors declare that they have no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Supplementary material 1., supplementary material 2., rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Orji, I.A., Baldridge, A.S., Ikechukwu-Orji, M.U. et al. Evaluating diabetes care in primary healthcare centers in Abuja, Nigeria: a cross-sectional formative assessment. BMC Prim. Care 25 , 243 (2024). https://doi.org/10.1186/s12875-024-02487-1

Download citation

Received : 15 February 2024

Accepted : 25 June 2024

Published : 05 July 2024

DOI : https://doi.org/10.1186/s12875-024-02487-1

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Service availability
• Service readiness
• Primary healthcare centers
• Diabetes care

BMC Primary Care

ISSN: 2731-4553

• General enquiries: [email protected]