[Online quizzes for practice and assessment of pharmacotherapeutic knowledge during clinical courses in medical school - a pilot study in the psychiatry and neurology courses].

In this study, we developed auto-graded quizzes for practice and for summative assessment, covering drugs of relevance in the undergraduate clinical psychiatry and neurology courses in medical school. The underlying intention was to combine repetition of theoretical aspects and promoting progression to the clinical context. The quizzes were implemented in two steps. After the courses in question were completed, before and after the first as well as the second step of quiz implementation, the students' achieved level of knowledge was investigated by a voluntary formative test/questionnaire including 20 patient-based single best answer questions. In the first step, voluntary practice quizzes and a summative assessment test were introduced. In the second step, a clinical context was provided to the quizzes, using the structure of the practical manual to good prescribing issued by the World Health Organization in 1994. Furthermore, the summative test was expanded for improved constructive alignment, exposing the students to the drug-related course content to a greater extent. In all, 274 students out of 404 participated in the study (response rate: 68%; 56% women; 66% ≤24 years). Compared with before the quiz implementation (median number of correct answers: 10 [interquartile range: 9-13]), no difference was seen after the first step (11 [8-13]; P=0.88) but a clear improvement appeared after the second step (14 [12-16]; P<0.0001). After the second step, the students reported having used all (17%), most (22%), some (32%), or no (29%) practice quizzes. The extent of use was positively correlated with the number of correct answers in the formative test (r=0.33; P=0.002). After the second step, the student-reported number of attempts at the assessment quiz was in median 6 times (interquartile range: 3-9). There was a negative correlation between the number of quiz attempts and the extent of use of practice quizzes (r=-0.22; P=0.034) as well as the number of correct answers in the formative test (r=-0.44; P<0.0001). In conclusion, practice and assessment quizzes about drugs, elaborated with clinical context and constructive alignment, may increase pharmacotherapeutic knowledge in medical students.