Impact Factor 1.0
Volume 34, 12 Issues, 2024
  Letter to the Editor     April 2024  

Identifying Medical Students in Difficulty Using Integration of Programmatic Assessment and Real-Time Evaluation Framework

By Khadija Farrukh Warraich, Shehla Baqai


  1. Department of Medical Education, Bahria University Health Sciences, Karachi, Pakistan
doi: 10.29271/jcpsp.2024.04.504


Medical students are prone to stress due to the demanding and extensive medical education curriculum. Common stress factors are immediate change of environment, extensive curriculum, work overload, and fear of failure. However, it is seen that they do not reach out for help due to the prevailing social stigma that weak personalities seek emotional or psychological help.1-3 Therefore, medical colleges should formulate a framework to identify students facing difficulties. Early identification of such students would facilitate procedures to support such students accordingly. Early identification of such students can be done using the integration of programmatic assessment and real-time evaluation framework; and data for this purpose can be collected through portfolios. Programmatic assessment advocates continue data collection and longitudinal evaluation through immediate feedback. It is an approach which continuously collects required information about the learner and analyses it to give immediate feedback for continuous improvement.4 Real-time evaluation features real-time data collection and real-time reporting. It also has multiple cycles of evaluative activities for single-loop, double-loop, and triple-loop learning.5 Both programmatic assessment and real-time evaluation emphasise continuous data collection for evaluation of student progress and engaging stakeholders in formulating action plans. Students are the main stakeholders in medical education, therefore students’ reflections along with faculty feedback should be incorporated while identifying difficulty areas as well as planning a supportive action plan for them. A way forward is to record student academic and personal information in a portfolio designed using integration of programmatic assessment and real-time evaluation framework. Faculty and mentors’ feedback and cyclic student reflection will cause early identification of students in difficulties which will prevent academic failure and stress.


The authors declared no conflict of interest.

SB: Main idea, concept, and proofreading.
KF: Manuscript write-up and framework.
All authors approved the final version of the manuscript to be published.


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  2. Ye WQW, Rietze BA, McQueen S, Zhang K, Quilty LC, Wickens CM. Barriers to accessing mental health support services in undergraduate medical training: A multicenter, qualitative study. Acad Med 2023; 98(4):491-6. doi: 10. 1097/ACM.0000000000004966.
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