Purpose
Exit Tickets are a strategy outlined in K-12 Education that promote active learning. Exit tickets assess content comprehension formatively and summatively in real time and solidify the learning objectives in a low-stakes environment. By comparison, high-stakes, summative multiple choice exams do not provide performance feedback until after the opportunities for relearning have closed, leading to additional stress for students. This abstract describes various ways exit tickets have been delivered at one medical school.

Methods
For one academic year, exit tickets were designed with the following goals: motivate students to attend a session, provide timely feedback to students about their understanding of the content, allow students to immediately apply what they learned, and earn non-exam points. Modalities include free text reflection prompts, multiple choice questions (pre or post), Likert scales, and attestations.

Results
Over 8 courses within the core preclinical curriculum have delivered exit tickets to 485 students over two campuses. Student satisfaction has grown as they completed more exit tickets. For example, in one course in Fall 2024 92% of students agreed or strongly agreed that exit tickets supported learning objectives (N=212).

Conclusion
Overall, exit tickets were found to be effective tools for expanded interactive learning and teaching. Having a real-time measure of comprehension allowed instructors to assess misconceptions or incomplete understanding prior to higher stakes multiple choice exams. Exit tickets also provided an opportunity for reflection on more sensitive material such as DEI topics where multiple-choice questions may not effectively assess competency. Exit tickets provided holistic assessment opportunities in a lower-stress environment that was welcomed by most students, and offered faculty additional tools for both formative and summative assessment that engaged students in new ways.