Laura Thorp
Department of Physical Therapy
Laura Thorp
Laura Thorp
Laura Thorp, MPT, PhD, is a Clinical Associate Professor in the Department of Physical Therapy. She currently teaches human gross anatomy and neuroanatomy to first-year students in the Doctor of Physical Therapy program and conducts yearly clinical anatomy continuing education courses for clinicians and anatomy educators. Her primary research interests are curricular innovation and formative assessment in anatomy education. She was a participant in Scholars for Teaching Excellence Faculty Fellowship (STEFF) (Applied Instruction in Health Professions Education) in the fall of 2022 and STEFF (Applied Curriculum Development and Evaluation) in the spring of 2023. During her tenure at UIC she has received the Department of Physical Therapy Susan K Campbell Award for Academic Teaching Excellence and the AHS Excalibur Award for Teaching Excellence. She was also the recipient of Teaching Recognition Program (TRP) award in 2019-2020.
Thorp is a 2024-25 Action Research Scholar.
Laura Thorp
Laura Thorp
Formative Assessment as an Instructional Tool in Anatomy Education
Abstract
1
Formative assessment (FA), when employed consistently and paired with feedback, can promote student success and engagement by giving students information about their current knowledge/performance in a course and where knowledge/performance gaps exist. While faculty may believe in the benefits of FA, getting student buy-in can be a challenge and may be impacted by students’ mindsets (growth or fixed) (Sigmundsson & Haga, 2024) as they pertain to specific coursework. Another question regarding FA is whether, in graduate education, FA benefits students in a cohort differently.
2
Specifically, do students who require additional academic support, benefit from formative assessment as a teaching tool in similar ways to their peers. We investigated the use of FA paired with feedback as an instructional tool in Neuroanatomy, a course where students are known to enter with anxiety about performance and where students may struggle with the rigors of the content. We examined the relationship between FA and summative assessment performance as well as what factors motivate students to use FA and how a growth or fixed mindset affects this motivation.
Project Information
Background and Rationale
1
Formative assessment (FA) paired with feedback is one tool known to benefit student success (Black & Wiliam, 1998; Choudhury & Freemont, 2017; Jensen et al., 2014; Krasne et al., 2006; McMillan & Moore, 2020). Providing students tools to assess their progress in course and opportunities to reflect on and change study strategies can foster success while helping students actively engage in their education regardless of the subject matter.
While there is agreement on the benefits of formative assessments and feedback in education, application of formative assessments to anatomical sciences education warrants continued investigation. Specific questions that arose included: What is the benefit of formative assessment employed as a teaching tool on summative assessment. Assuming there is a benefit, does formative assessment benefit all students in a cohort equally, specifically does it benefit those who are struggling in a course and/or who have had academic challenges in the past? How do we get student buy-in to use formative assessment as a teaching tool?
2
Students may struggle, particularly in math or science courses, or in our case, neuroanatomy, when they enter a course already anxious about the content (Javaid et al., 2018; Lyons & Beilock, 2012) and may have a fixed mindset about future performance. A fixed mindset could relate to preconceived notions about the difficulty of the course itself or could be based on past academic performance. Motivating students to utilize FA can be a challenge depending on a student’s mindset. Resistance to feedback and focus on outcome rather than process are characteristics of a fixed mindset that may limit the benefit of FA for some students. General education literature would suggest that lower performing students may actually benefit more from formative assessment (Black & Wiliam, 1998; Krasne et al., 2006), but this is a question that requires further examination at the graduate level and when specifically applied to the anatomical sciences.
In our course, we employed FA to motivate student’s engagement in their learning process through continued assessment of content knowledge throughout the semester. Simultaneously we introduced the concept of growth mindset, acknowledging that the course work is challenging but with effort, success is achievable. FA included weekly at-home and in-class quizzes, paired with immediate feedback. Students were encouraged to make notes as they reviewed their performance. For in-class quizzes, students earned one point to add to their lowest summative exam score for every ten points earned on the FAs. Students completed questionnaires at specific timepoints that assessed growth mindset and prompted reflection on study strategies and use of resources including the FAs. Through these measures we sought to support student success but also investigated how growth mindset and use of FA changes across the duration of a semester-long course and how they relate to each other.
Questions Investigated
What is the relationship between performance on regularly administered formative assessments and performance on summative assessments. Does a students’ prior academic performance impact the relationship between formative and summative assessments?
How do current and prior academic performance relate to presence of a growth or fixed mindset across a semester-long Neuroanatomy course?
How does presence of a growth or fixed mindset relate to use of formative assessment with feedback as a teaching/study tool?
Findings/Insights
My project ended up being divided into two parts. Analysis of the data collected in the spring semester of 2025 is in process and some results/conclusions are pending.
Part 1: Through retrospective analysis, we investigated the relationship between formative assessment (FA) and summative assessment (SA) scores in Neuroanatomy for doctor of physical therapy (DPT) students (n=121). Additionally, we examined if previous academic difficulty impacted the relationship between FA and SA by grouping students with no history of academic challenges into Group 1 (n=80) and students who experienced previous academic difficulty in coursework into Group 2 (n=41). The distinction for academic difficulty was defined by programmatic guidelines. Eleven multiple-choice FAs were administered to support preparation for three separate unit SAs. A 1X2 multivariate analysis of covariance (MANCOVA) explored the relationship among student groups, FAs, and SAs for Units 2 and 3. No significant interaction of student grouping on the relationship between formative and summative assessment scores was observed, thus no differentiated impact of FA scores on SA outcomes between the groups existed. Significant relationships were observed between both formative assessment covariates and related summative assessment scores for all students in both units. On average, a one-point increase on FA scores was associated with a 2.41 percentage point increase on SA scores in Unit 2 and a one-point increase on FA scores was associated with a 2.54 percentage point increase on SA scores In Unit 3. We found FA can benefit all students, positively impacting SA scores and contributing to a narrowing of the performance gap between higher and lower performing students. Thus, FA can be a useful study tool in Neuroanatomy for students who have previously demonstrated academic challenges.
The aforementioned work has been submitted for publication to Anatomical Sciences Education. This manuscript submission was reviewed by the journal and is currently under revision.
Regarding my work with student mindset, data from 54 students enrolled in Neuroanatomy was collected during the spring of 2025 and analyses are ongoing. We sought to examine how students view/utilize formative assessment and how perceptions about formative assessment might relate to growth mindset throughout the duration of the Neuroanatomy course. Preliminary results based on student completion of exam wrappers and growth mindset questionnaires suggest that students who viewed formative assessment as a “mandatory assignment” rather than a study tool were more likely to report elements of a fixed mindset when asked to respond to the statements, “I see learning as my goal” and “ I have faith in my own skills and possibilities”. Specifically these students responded that they felt either neutral about these statements or felt the statements were not like them as compared to the cohort as a whole. These students also were more likely to report that they re-read notes as a study strategy and less likely to report that they used active retrieval practice in their studying when compared to the cohort as a whole. We presented these results at the Kennesaw State SOTL conference in September 2025 and are currently working on further analysis of this data to submit a manuscript for publication. We believe student mindset may impact their ability to engage with the feedback that formative assessments provide and therefore further exploration of this relationship is an important area of research to promote student engagement and overall success.
Dissemination and Impact
- At the individual level (e.g., to students and colleagues): I believe my students have benefitted from the addition of more reflective teaching practices such as the exam wrappers I created and the use of reflections about growth mindset.
- At the department/program or college/school level (e.g., dissemination at department meetings, impact on any courses or programs): At our departmental retreat in May 2025, I discussed the use of my exam wrappers as part of my exam reviews. I intend to share these with my colleagues with the goal that others can adapt the wrappers for their courses should they wish, leading to more consistency with exam reviews and more opportunities for students to reflect on their performance.
- At the state, national, and/or international levels (e.g., presenting at conferences or in publications beyond UIC; impact on discipline):
- I presented my work at the Kennesaw State SOTL Summit in September 2025 “Formative Assessment as a Teaching and Learning Tool, and its Relationship to Growth Mindset”
- Submitted manuscript entitled, “Formative Assessment Benefits Summative Assessment Performance in Neuroanatomy Regardless of Prior Academic Performance” to Anatomical Sciences Education in February 2025
Implications
- Have you changed anything (or plan to change anything) in your teaching because of your experiences implementing your action research project?
- Yes, first I will continue to begin my courses with a more deliberate explanation about why we use formative assessments and what the potential benefits can be based on the literature. Also, I implemented the use of exam wrappers in my classes and will continue this practice next fall and beyond. These have allowed me to gain insight not only into student opinions about formative assessment and how students utilize formative assessments, but also to gain information about student study strategies. Finally, I introduced the concept of growth mindset with my students at the start of the spring semester and collected data about student growth mindset throughout the semester. I developed a study and sought IRB approval in the summer of 2025 to continue to investigate student mindset in my students as it relates to the anatomy lab.
- In the fall of 2025, during my Human Anatomy Course, I completed another IRB approved investigation of the relationship between student mindset, study strategies, and student experiences in the dissection laboratory. Data collection for this work ended in the fall 2025 and analyses are pending.
- Have you become involved in other activities or projects (e.g., departmental committees, curriculum projects, other grant projects) because of conducting this work? I am hopeful to create a workshop for our first-year students in the future that centers on study strategies and the benefit of growth mindset.
- Have you made connections with people from different departments, colleges, and disciplines about teaching and learning because of this program? Yes, first my collaborator on my project is from the College of Medicine. Second I feel that meeting the faculty from CATE has been an invaluable part of this experience. I feel these connections will continue and will allow me to further develop my scholarly agenda as it pertains to my courses and the science of teaching and learning.
References
- Al-Sheikh, M., Albaker, W., & Ayub, M. (2022). Do mock medical licensure exams improve performance of graduates? Experience from a Saudi medical college. Saudi Journal of Medicine & Medical Sciences, 10(2), 157–161.
- Azzi, A. J., Ramnanan, C. J., Smith, J., Dionne, É., & Jalali, A. (2015). To quiz or not to quiz: Formative tests help detect students at risk of failing the clinical anatomy course. Anatomical Sciences Education, 8(5), 413–420.
- Baldwin, T. F. (2021). Formative Assessment and Academic Performance as Predictors of National Physical Therapy Examination Success [ProQuest Dissertations & Theses].
- Black, P., & Wiliam, D. (1998). Inside the Black Box: Raising Standards through Classroom Assessment. Phi Delta Kappan, 80(2), 139–148.
- Choudhury, B., & Freemont, A. (2017). Assessment of anatomical knowledge: Approaches taken by higher education institutions. Clinical Anatomy (New York, N.Y.), 30(3), 290–299.
- Drake, R. L., McBride, J. M., Lachman, N., & Pawlina, W. (2009). Medical education in the anatomical sciences: The winds of change continue to blow. Anatomical Sciences Education, 2(6), 253–259.
- Evans, D. J. R., Zeun, P., & Stanier, R. A. (2014). Motivating student learning using a formative assessment journey. Journal of Anatomy, 224(3), 296–303.
- Ismail, M. A.-A., Ahmad, A., Mohammad, J. A.-M., Fakri, N. M. R. M., Nor, M. Z. M., & Pa, M. N. M. (2019). Using Kahoot! as a formative assessment tool in medical education: A phenomenological study. BMC Medical Education, 19(1), 230.
- Javaid, M. A., Chakraborty, S., Cryan, J. F., Schellekens, H., & Toulouse, A. (2018). Understanding neurophobia: Reasons behind impaired understanding and learning of neuroanatomy in cross-disciplinary healthcare students. Anatomical Sciences Education, 11(1), 81–93.
- Jensen, J. L., McDaniel, M. A., Woodard, S. M., & Kummer, T. A. (2014). Teaching to the Test…or Testing to Teach: Exams Requiring Higher Order Thinking Skills Encourage Greater Conceptual Understanding. Educational Psychology Review, 26(2), 307–329.
- Kingston, A. K., Garofalo, E. M., Cardoza, K., & Fisher, R. E. (2023). Designing Formative Assessments to Improve Anatomy Exam Performance. Anatomical Sciences Education, 16(5), 989–1003.
- Krasne, S., Wimmers, P. F., Relan, A., & Drake, T. A. (2006). Differential Effects of Two Types of Formative Assessment in Predicting Performance of First-year Medical Students. Advances in Health Sciences Education : Theory and Practice, 11(2), 155–171.
- Larsen, D. P., Butler, A. C., & Roediger III, H. L. (2009). Repeated testing improves long-term retention relative to repeated study: A randomised controlled trial. Medical Education, 43(12), 1174–1181.
- McMillan, J. H., & Moore, S. (2020). Better Being Wrong (Sometimes): Classroom Assessment that Enhances Student Learning and Motivation. The Clearing House, 93(2), 85–92.
- Prashanti, E., & Ramnarayan, K. (2019). Ten maxims of formative assessment. Advances in Physiology Education, 43(2), 99–102.
- Rolfe, I., & McPherson, J. (1995). Formative assessment: How am I doing? Lancet (London, England), 345(8953), 837–839.
- Rollins, S. P. (2014). Learning in the Fast Lane: 8 Ways to Put ALL Students on the Road to Academic Success. ASCD. Association for Supervision & Curriculum Development.
- Sotgiu, M. A., Mazzarello, V., Bandiera, P., Madeddu, R., Montella, A., & Moxham, B. (2020). Neuroanatomy, the Achille’s Heel of Medical Students. A Systematic Analysis of Educational Strategies for the Teaching of Neuroanatomy. Anatomical Sciences Education, 13(1), 107–116.
- Stiggins, R. J. (2002). Assessment Crisis: The Absence Of Assessment FOR Learning – If we wish to maximize student achievement in the U.S., we must pay far greater attention to the improvement of classroom assessment, Mr. Stiggins warns. Both assessment of learning and assessment for learning are essential. But one is currently in place, and the other is not. Phi Delta Kappan, 83(10), 758–758.
- Tabachnick, B. G. (with Fidell, L. S.). (2007). Using multivariate statistics (5th ed.). Pearson/Allyn & Bacon.
- Weston-Green, K., & Wallace, M. (2016). A method of providing engaging formative feedback to large cohort first-year physiology and anatomy students. Advances in Physiology Education, 40(3), 393–397.
- Yammine, K. (2014). The current status of anatomy knowledge: Where are we now? Where do we need to go and how do we get there? Teaching and Learning in Medicine, 26(2), 184–188.
- Lyons, I. M., & Beilock, S. L. (2012). When math hurts: Math anxiety predicts pain network activation in anticipation of doing math. PloS One, 7(10), e48076.
- Sigmundsson, H., & Haga, M. (2024). Growth Mindset Scale: Aspects of reliability and validity of a new 8-item scale assessing growth mindset. New Ideas in Psychology, 75, 101111.