3.0: Introduction
In the academic year 2021–2022, a total of 61 midwifery third-year students were enrolled in a communicable disease control course as part of their semester courses. All of them were females (n = 61 (100%)) and were all asked to participate in this study after explaining the objective of the study before the data collection. From the total of 61 students enrolled in the class, only 42 students participated in the study (response rate: 69%). Group differences show that those who participated in the study scored significantly higher (78.9%) compared to non-participants (68.3%) in their final grades, with a medium-sized effect (d = 47). The below results demonstrate the perception of midwifery students about the use of continuous graded assessments in a course and its relation to students’ intrinsic motivation to study and the results (grades) they obtain from the continuous assessment.
Since the question items that have been used in the questionnaire were designed according to the 5-point Likert scale to determine the minimum and the maximum length of the 5-point Likert type scale, the range is calculated by (5-1=4) and then divided by five as it is the greatest value of the scale (4/5 = 0.80). Afterwards, number one, which is the least value on the scale, was added in order to identify the maximum value of the first cell, and a similar procedure for the afterward cells. The length of the cells is determined below:
Table 3: Scoring range of Likert scale of the survey
|
Value
|
Mean
|
Interpretation
|
Strong disagree
|
1
|
1-1.80
|
Very low
|
Disagree
|
2
|
1.81-2.60
|
Low
|
Neutral
|
3
|
2.61-3.40
|
Neutral
|
Agree
|
4
|
3.41-4.20
|
High
|
Strongly agree
|
5
|
4.21-5.00
|
Very high
|
3.1. Perceptions of students about continuous graded assessment
The perception of students about continuous graded assessment has been evaluated by 13 questions in the questionnaire, which was further classified into three factors using factor analysis by PCA varimax rotation. The 13 questions were divided into three major factors, namely "Usefulness", "Beneficial effects" and "Adverse effects", of continuous graded assessment.
Factor 1: Usefulness of continuous graded assessment:
The question item in this factor was assessing how useful or important the use of continuous graded assessment was in this course. Students may see it as either a useful approach to enhance students' learning capacities and improve their interest and motivation towards studying the course, while other students may see it as a boring and useless approach where the teaching and learning system will be effective without the use of continuous graded assessment.
Table 4 demonstrates the finding from this factor, which indicates that a majority of students, about 92%, believe that use of continuous graded assessment helps them study regularly. Another 97% and 95% said that this approach to assessing students was very interesting and that they were happy to get their results of the assessment immediately after each quiz. 54% of students mention that they would have studied less without the continuous graded assessment, but on the other hand, about 33% of students suggest that they would prefer to get only feedback for the continuous assessment instead of grading it and including it in the final exam. Overall, this factor received a high rating (Mean: 4; SD:.53), indicating that the majority of students, roughly 75%, believe that continuous graded assessment is important and useful in a course to stimulate students and improve the teaching learning system.
Factor 2: Beneficial effects of continuous graded assessment
Another four items also assessed the beneficial or desired effects of continuous graded assessment. Three of the question items are the direct opposites of the ones in the adverse effects section, including decreased stress, improved self-confidence, and improved studying time as a result of the continuous assessment. The fourth question in this factor assessed whether this approach of assessment has helped students identify aspects of the course they are good at and where they need to improve, which can be related to the formative impacts of the assessment to enhance further studying.
This factor's findings on the beneficial or desired effects of continuous graded assessment were very high (Mean: 4.33; SD:.59) (Table 4). This shows that the majority of the students in the study found the use of this approach to be beneficial and advantageous to be used in terms of reducing students' stress levels by 37 (88%) towards the final exam. Since this approach has a formative element where students can learn from their mistakes and make the necessary improvements based on the results they obtain from their continuous assessments, approximately 39 (92%) of students mention that this approach of assessment helped them identify aspects of the course that they were good at and where they needed to improve.
Factor 3: Adverse effects of continuous graded assessment
Four items in the questionnaire have assessed the adverse unwanted effects of continuous graded assessment in the course, including whether use of this approach has dropped students' self-confidence or increased the level of stress during the final exam and whether the use of this approach has decreased students' studying time, which can be as a result of students' obtaining marks from the assessment, which can lead them to feel a sense of inability to study more and pass the exams.
According to the findings for this factor, the overall negative unwanted effects of the continuous graded assessment were very low (Mean: 1.67; SD:.55) (Table 4). Six (14% of students) reported that the use of continuous graded assessment increased their stress and anxiety about the final exam. Another 3 (7%) and 1 (2.3%) reported that they lost their confidence and decreased their study time as a result of the continuous graded assessment used in the course, respectively.
Table 4: Students’ perception of continuous graded assessment
Factor
|
Category
|
Question items
|
N
|
Mean
|
Standard deviation
|
1
|
Usefulness of Continuous graded assessment
|
1. The use of continuous assessment in this course helped me study regularly
2. I found studying for this course was interesting due to the use of continuous assessment
3. Without frequent assessments, I would have studied less in this course
4. I liked getting results of the continuous quizzes immediately after each quiz
5. I would rather prefer getting only feedback for the continuous assessments and not graded
|
42
42
42
42
42
|
4.45
4.59
3.69
4.57
2.73
|
0.70
0.54
1.05
0.66
1.43
|
2
|
Beneficial effects continuous graded assessment
|
1. In response to my grades of the continuous assessment in this course, I started studying more
2. The continuous quizzes applied in this course have decreased my stress and tension level for the final exam
3. The grades that I received for the continuous assessment of this course provided me with a feeling of self-confidence
4. The continuous assessment which has been used in this course helped me find out aspects of the course that I did well and where I need to improve
|
42
42
42
42
|
4.28
4.19
4.47
4.38
|
1.06
1.13
0.70
0.69
|
3
|
Adverse effects of continuous graded assessment
|
1. The continuous quizzes applied in this course have increased my stress and tension level for the final exam
2. Due to the grades, I received for my continuous assessment in this course, I lost my self-confidence
3. In response to my grades of the continuous assessment in this course, I started studying less
4. Due to the continuous graded assessment. Studying for this course was boring
|
42
42
42
42
|
1.38
2.04
1.64
1.69
|
0.53
1.32
0.93
0.64
|
Table 5: Over all mean and standard deviation of student’s perceptions about continuous graded assessment
Factor
|
N
|
Mean (SD)
|
Min
|
Max
|
Usefulness of CA
|
42
|
4.00 (0.53)
|
3.2
|
5
|
Beneficial effects
|
42
|
4.33 (0.59)
|
2.5
|
5
|
Adverse effects
|
42
|
1.67 (0.55)
|
1
|
3
|
Table 6 shows the correlations between the assessed factors in the perception of students towards the continuous graded assessment and results show that the usefulness of the continuous assessment showed a moderately negative association (r= -.37) with the adverse effects of the CA and a moderate positive association (r= .28) with the beneficial desired effects of CA, while there was a moderately negative correlation (r = -.59) between the beneficial effects and adverse effects of CA. where all the associations between the factors were statistically significant (P <0.05).
Table 6: Correlations of factors related to student perceptions of continuous assessment
No
|
Factor
|
Usefulness
|
Adverse effects
|
1
|
Usefulness
|
|
|
2
|
Adverse effects
|
-0.375**
|
|
3
|
Beneficial effects
|
0.285*
|
-0.590*
|
Note: n= 42 *= p <0.05 **= p <0.01
3.2. Students’ motivation as a result of CA
Tables 7 and 8 summarize the descriptive results on the motivation of students, which were evaluated as general intrinsic motivation, which assesses whether students have their own intrinsic motivation to study in general, and intrinsic motivation for the course, which assesses whether students develop intrinsic motivation as a result of the continuous graded assessment that has been used in the class.
Results show that the mean score for the general intrinsic motivation (IM general) of students was (2.55 SD:.71) (table 8), which is below the neutral level. This indicates that the general intrinsic motivation of the students is low. Only 2 (4.7%) of the students have the initiative of learning new things instead of waiting for their teachers to teach them, and 3 (7.4%) of students mention that they continue learning even after they finish a course.
The mean score for the intrinsic motivation for the course (IM Course) was neutral (Mean: 3.19 SD:.38) (table 8), which indicates that the use of continuous graded assessment has made a minimal improvement in the intrinsic motivation of students towards a course compared to their general intrinsic motivation to study. About 41 (97%) of students used the CA as their study motivator, while another 38 (90%) mentioned that they wouldn’t participate in the assessment if it were not included in their final grade. This indicates that the driving force of students' motivation was the marks allocated for each assessment and not the assessment itself, which can lead to superficial learning due to the stimulated extrinsic motivation resulting from the summative element of the assessments used in the course.
The correlation between the IM general and IM course was found to be moderately positive (r =.45), which is statistically significant (P-value = 0.002).
Table 7: Means and standard deviation results of motivation factors
Factor
|
Category
|
Question items
|
N
|
Mean
|
Standard deviation
|
1
|
IM General
|
1. During my study I take the initiative for learning new things, instead of waiting for my teacher to encourage me
2. Even when a course has ended, I continue to learn about the subject
|
42
42
|
2.52
2.59
|
0.74
0.82
|
2
|
IM for Course
|
1. The use of continuous assessment in this course helped me to stay motivated
2. I didn’t like those continuous assessments, because I want to decide when to study for my self
3. I think the continuous assessments used in this course were a waste of time
4. I think I would study more efficiently for this course without continuous assessments
5. If the continuous assessments in this course did not count towards the final grade, I would not participate in these assessments
|
42
42
42
42
42
|
4.69
2.30
2.19
2.35
4.40
|
0.46
0.78
0.80
0.82
0.73
|
Table 8: Overall Mean and standard deviation scores for IM general and IM course
Factor
|
N
|
Mean (SD)
|
Min
|
Max
|
Intrinsic motivation in general (IM general)
|
42
|
2.55 (0.71)
|
1.5
|
5
|
Intrinsic motivation for the course (IM course)
|
42
|
3.19 (0.38)
|
2.6
|
4.4
|
3.3: Student’s achievement (Grades) as a result of CA
Each student’s achievement was assessed in terms of their achieved grade from each assessment activity that has been applied while in the course. Table 9 demonstrates the descriptive results of the student grades from all the assessed activities in the course and compares the average continuous assessment with that of the final exam.
The results of the continuous assessment demonstrate an improvement in students' grades from the first quiz (Mean: 6.22; SD: 1.91) to the last quiz (Mean: 7.46; SD: 1.72) out of ten. This improvement in student achievement can be explained by their increased self-confidence and decreased stress and tension due to the students’ familiarity with the type and format of questioning during the continuous quizzes, which helped them score higher in the late quizzes, or might be due to the increased effort students make as they get near to the final examination.
Table 9: Overall students grade score for the continuous assessment and final exam
Continuous assessment and final exam results
|
|
No
|
Assessment name
|
N
|
Minimum
|
Maximum
|
Mean
|
Standard deviation
|
Standard error
|
1
|
Quiz 1
|
42
|
1
|
10
|
6.22
|
1.91
|
0.29
|
2
|
Quiz 2
|
42
|
4
|
10
|
6.76
|
1.37
|
0.21
|
3
|
Mid exam
|
42
|
5
|
10
|
7.87
|
1.22
|
0.18
|
4
|
Quiz 3
|
42
|
2
|
10
|
7.10
|
2.12
|
0.32
|
5
|
Quiz 4
|
42
|
3
|
10
|
7.46
|
1.72
|
0.26
|
6
|
Group assignment
|
42
|
5
|
10
|
7.60
|
1.23
|
0.19
|
7
|
Over all CA
|
|
|
|
7.5
|
1.07
|
|
8
|
Final exam
|
42
|
5.6
|
10
|
7.65
|
1.07
|
0.16
|
Table 10 shows the correlations between all the activities in the continuous assessments used in the course, which shows that there was a small to moderate positive correlation between all the four quizzes, the midterm exam, and the student’s group work assignment with a good level of significance (see Table 10).
The overall summary mean score of the continuous assessment was (M: 7.5; SD: 1.07), which was below that of the final exam (M: 7.65; SD: 1.07) out of ten. The correlation between the grade of CA and that of the final exam was a strong positive association (r =.79), which was not statistically significant (P > 0.05). This can also be explained by the chance students obtain from having multiple quizzes and assessments before the final exam, which helps them, adapt to the exam structures and improve their confidence and preparation for the final exam.
Table 10: Correlations (Pearson’s) between all the continuous assessment grades
No
|
|
Quiz 1
|
Quiz 2
|
Mid exam
|
Quiz 3
|
Quiz 4
|
1
|
Quiz 1
|
|
|
|
|
|
2
|
Quiz 2
|
0.14
|
|
|
|
|
3
|
Mid exam
|
0.54
|
0.21*
|
|
|
|
4
|
Quiz 3
|
0.45**
|
0.09
|
0.54
|
|
|
5
|
Quiz 4
|
0.37**
|
0.21*
|
0.38**
|
0.38**
|
|
6
|
Group work assignment
|
0.31**
|
0.03
|
0.28*
|
0.24*
|
0.10
|
Note: n= 42
*= p <0.05
**= p <0.01
3.4. Correlations between students’ perception on CA their intrinsic motivation for the specific course and their grades from the CA
Table 11 demonstrates the overall correlations between all the major assessed variables in the study, namely the students’ perception of the CA, their intrinsic motivation for the specific course, and the grade they obtain from the CA. Thus, the study found that the usefulness of the CA had a moderate negative association with the adverse effects and a small to moderate positive association with the beneficial effects of CA, which was statistically significant (P<0.05). Also, there was a small to moderate positive association between the usefulness of CA and the intrinsic motivation for the specific course and the marks students obtained from the CA, which wasn’t statistically significant (P>0.05).
The adverse unwanted effects of the CA had a strong to moderate negative correlation with the beneficial effects of CA and the intrinsic motivation for the specific course, which was statistically significant (P<0.05). Similarly, the study also found a moderate positive correlation between the beneficial effects and the intrinsic motivation for the course and the marks obtained from the CA, which was statistically significant (P<0.05). This suggests that the constant use of CA in a course improves the beneficial effects, the students’ intrinsic motivation for the course, and the grades of CA while it decreases the unwanted adverse effects of assessments.
Table 11: Correlations between students’ perception on the continuous graded assessment their intrinsic motivation for the specific course and their grades from the continuous assessment
Factor
|
|
Usefulness
|
Adverse effects
|
Beneficial effects
|
IM course
|
1
|
Usefulness
|
|
|
|
|
2
|
Adverse effects
|
-0.37**
|
|
|
|
3
|
Beneficial effects
|
0.28*
|
-0.59*
|
|
|
4
|
IM course
|
0.21
|
-0.41**
|
0.50**
|
|
5
|
CA result
|
0.16
|
-0.15
|
0.27*
|
0.11
|
Note: n= 42
* = p <0.05
** = p <0.01
3.5. Qualitative data analysis
During this study, qualitative data has been collected using two focus group discussions, one for each class, where seven purposefully sampled students participated in each FGD. Each focus group lasted for a duration of about an hour, and students were asked about their general view of using continuous assessment in the course, the benefits and challenges associated with CA, and whether students would participate in the same type and form of assessment if it was not graded to see how it related to the intrinsic motivation of the students to study for the course.
The data was collected by a mobile recording application using the local language (Somali) and moderated by the principal investigator. It was then transcribed after translating the students’ answers using the most relevant terms. Then similar answers were coded together to form themes. The present study found 3 major themes and 10 subthemes, which are presented and explained below.
Theme 1: Advantages of Continuous Graded Assessment
From this point of view, many students who participated in the FGD suggested that the use of continuous graded assessment has many benefits for students during the teaching and learning process. Some of the benefits include: improved studying time; high marks obtained; covering all the topics in the content of the course; improved punctuality and self-confidence of students. Below are the descriptions of some of the major beneficial effects of continuous graded assessment.
A. Regular study
Almost all students who participated in both FGDs agreed that the use of continuous graded assessment was very useful and advantageous because this approach of assessment helped them study regularly throughout the semester, which decreased the load that many students feel during the final examination days. Some other students also mention that CA has helped them increase their study time since they need to prepare themselves for the continuous assessment, which improves the time students devote to reading and studying course materials while they are even away from the university.
"Before this course, I used to read and study any course materials just 1 or 2 days prior to the final exam, but on this course, because of the continuous assessment, I found myself studying course materials on a regular basis because there was an assessment every other week." This helped me decrease the load that I used to feel on the final examination days “. (Participant 8)
"The use of the continuous assessment method in this course forced me to increase my time of study throughout the course, and I remember I used to read the course material whenever I got the time, even while I was on the bus when coming or leaving the class." (Participant 10)
"To study for this course, I needed to memorize the characteristics of different communicable diseases, which needs a lot of time to do so. Therefore, the use of continuous assessment helped me to study a lot and dedicate a lot of time to studying and memorizing those characters for the sake of fear of losing marks or failing in those continuous assessments."(Participant 12)
B. Formative function
More than two thirds of the students, about 11 out of the 14 who participated in both FGDs, mentioned that this approach to assessment helped them identify which parts of the lesson/course they were good at and where they really needed to improve to obtain good marks in the coming assessments. After they receive their results from every assessment immediately after the quiz, this clearly identifies the formative element of the continuous graded assessment because each assessment gives students the chance to identify aspects that they are good at and where they need to improve.
"The use of continuous graded assessment in this course helped me to study and read course materials continuously, and because of the immediate feedback, this approach helped me identify aspects of the chapter/lesson that I covered well and where I needed to improve before the final exam." (Participant 2)
C. High grades
About two-thirds of students who participated in the study said that the use of continuous graded assessment helped them achieve higher marks in the total course marks. This was explained because each assessment was given with smaller marks, which always gave them a chance to recover even if they were scoreless in one of the quizzes. Apart from that, the students' level of confidence was increasing time by time as they got exposure to the type and structure of the assessment, which could lead them to attend any assessment with less fear and more comfort, resulting in improved achievement and high grades.
"When it comes to the course marks, I always prefer the use of the continuous graded assessment method instead of waiting for a high-stakes final exam where you lose high marks by missing a small number of questions. But during the continuous graded assessment, the regular study and the earning of small marks in multiple assessment activities results in better course marks and even in the final exam, you can score better when you have had multiple assessment activities prior to the final exam because you adapt to the type and structure of the exam beforehand." (Participant 4)
D. Cover all the topics
Almost all students (14, 100%) in both FGDs agreed that the use of continuous graded assessment helped students and the instructor to cover the course content on time and make sure that students had at least one quiz in every aspect of the course, which let students cover the whole course and test their understanding of the major course objectives before the final exam. Similarly, before the use of CA in this course, the majority of the students claimed that they used to study and read course materials in the final few days before the final exam. This habit imposes huge pressure on students to the extent that they only read and study part of the course material and leave the rest, which results in less course coverage and a decreased ability to cover course objectives in time.
"The CA in this course helped me read and cover all the aspects of the course in the course outline before the final exam, which is really a habit that I never practiced before because I used to read the course materials in the final days of the course, where I would make some priority for the aspects of the course that I should read so that I could pass the course and the aspects that I could leave to read since I don’t have adequate time to cover them all." (Participant 3)
"It was really a pleasure for me to cover the whole course content and be assessed on all of it before the final exam; it really relieved some pressure to prepare for the final exam." (Participant 12)
E. Punctuality
One major benefit that happens as a result of continuous graded assessment is the improvement in student punctuality throughout the course. Students tend to miss classes when there are no obligatory assessments, assuming that they can recover and read the course material that they have missed, but they attend more when there are frequent assessments throughout the course.
"I personally like to attend all my classes, but if something happens to me, I always urge to get permission from my instructor to miss that class. But on this course, I never missed even a single session because either there was an assessment that I would not get back or a lesson that I would be assessed a week after, so I was always present in the class and managed to solve all my problems before the class so that I wouldn’t miss the session." (Participant 14)
"To study for this course, I needed to memorize the characteristics of different communicable diseases, which needs a lot of time to do so. Therefore, the use of continuous assessment helped me to study a lot and dedicate a lot of time to studying and memorizing those characters for the sake of fear of losing marks or failing in those continuous assessments." (Participant 12)
F. Self-confidence
Almost all the 14 (100%) students who have participated in both focus groups agreed that their confidence in attending numerous assessments, including exams like the final exam, has greatly improved. This indicates that use of continuous assessments can help students adapt to the associated conditions of the assessment, including adapting to the format and type of questioning that the instructor uses in assessments, which can therefore reduce students’ tension and fear of exams and at the same time improve their confidence in attending numerous assessments.
“I personally feel that my self-confidence has greatly improved because in the first quiz I was very nervous and in fear that I would fail the exam, which sometimes resulted in missing some questions because of the nervousness, but as I attended many quizzes, my self-confidence has greatly improved and during the last quizzes I felt comfortable attending the assessments.” (Participant 7)
“My confidence in attending quizzes and the final exam has improved as a result of the CA. Because in the first quiz, it was difficult for me even though the question items were not that difficult, but later on, I have adapted how the questions of the assessment are formed and the type of the assessment, which helped me attend the quizzes relaxed and hoping that I can score more.” (Participant 13)
Theme 2: Disadvantages of Continuous Graded Assessment
The present study also found that the use of continuous graded assessment has its own limitations or disadvantages for students within the teaching-learning process, the main disadvantages found in this focus group discussion include: more pressure; lack of freedom to study; lack of resources; and lack of practicality in the assessment. These limitations have been discussed below.
A. More pressure
Nearly one third of the students mention that the CA used in the course has added more pressure on them and that they were thinking about the course and how they planned their reading time the whole week before the quiz, and they suggest that a lower number of assessments might be preferable.
“Even though CA had many advantages, it also added a lot of pressure to our studies, and we used to think the whole week planning on how to cover the contents that we were going to be assessed on the next week, which cost us a lot, resulting in us forgetting to read and study for the other courses. I personally suggest and prefer having 2 quizzes only during the course so that we can have time to study for the other courses as well.” (Participant 11)
B. Lack of freedom:
Small number of students agreed that CA has affected their freedom to plan their time of study and many of them argue that it was the CA which was forcing them to study for this specific course and that there was no alternative option if they missed the assessment. They missed the allocated marks for that specific assessment since the CA was graded and included in their final marks.
"I lost my personal freedom to study for this course since there was a CA which was graded." I thought that it was always compulsory for me to study for the course continuously; otherwise, I would miss marks, which could cost me the failure of the course “. (Participant 3)
C. Less resource
Almost half of the participating students mentioned that there was a challenge of resources since the format of CA was usually online quizzes, which needed every student to at least have a smart phone and the internet. Some students complain of having an issue with the accessibility and affordability of the internet, which seems like a challenge that adds additional pressure in terms of family financial condition, while others complain about the connectivity of the internet. Some other students also complained of problems related to electricity, which affected their ability to charge their mobiles the night before the assessment or quiz. Therefore, the above issues might result in challenges for the future application of the approach.
"I used to always prepare some money for my mobile internet a couple of days before the day of the assessment, which wasn’t always easy for me, and even when I prepared that, there were also internet connectivity issues where I sometimes lost internet while we were on the quiz, which cost us some additional time in order to finalize the quiz." (Participant 5)
“I always used to think about my mobile battery the night before the assessment or quiz, and sometimes we had electricity problems where I came to the university having a mobile with a dead battery, which makes it compulsory to carry my charger with me to the university and look for an area to charge my phone before the quiz. " (Participant 9)
D. Less practicality
About 4 out of the 14 students in the focus groups mentioned that the types of assessments used in the course were only objective type questions. Since all the quizzes were only made up of multiple-choice questions, it didn’t allow students to practice their critical thinking and writing skills, and they suggested that it would be better if some of the quizzes had some subjective questions that could help them develop more in their thinking and writing capabilities.
"I think it would be better if some of the quizzes were done on paper and used some open questions, which could increase our understanding of the course and practice our critical problem-solving and writing skills instead of having only online based multiple-choice questions." (Participant 6)
Theme 3: Intrinsic vs. Extrinsic Motivation
In this focus group discussion, the study found that continuous graded assessment can significantly improve extrinsic motivation rather than the intrinsic one. Almost all students who participated in the study mentioned that they wouldn’t participate in the CA if it were not graded and taken as a formative assessment only. This result indicates that the driving force for the students' motivation was the marks allocated for each quiz and that they would not participate if it was only formative and not graded.
"I will not participate in the CA used in this course if it is not graded and included in the final marks of the course." (Participant 1)
"I am not interested in participating in any assessments if they are not graded or allocated with fewer marks." I always work hard for the assessments that have high marks allocated, like the mid and final exams ". (Participant 10)