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

Christopher J. Harrison* (Corresponding Author), Karen D. Könings, Lambert Schuwirth, Valerie Wass, Cees van der Vleuten

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

86 Citations (Scopus)


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

Original languageEnglish
Pages (from-to)229-245
Number of pages17
JournalAdvances in Health Sciences Education
Issue number1
Early online date7 Jun 2014
Publication statusPublished - Mar 2015

Bibliographical note

We are grateful to Sarah Yardley for independently coding some of the interviews, to Adrian Molyneux for setting up the feedback website and to Kirsty Hartley for helping to recruit students for the interviews. Finally, we are most grateful to all the students who took part in the interviews.


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


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