Purpose
Educational curricula increasingly emphasize the importance of self-directed learning. Students have many study resources, encompassing online and school generated learning materials including formative assessments. We studied the usage and impact of our school’s weekly formative assessments in the second semester of a preclinical medical curriculum.

Methods
We developed 606 multiple choice questions, with 13 to 53 used per quiz, and 18 formative quizzes to cover all topic areas of study in four curricular modules, each with a mid-module and an end-of-module summative exam. The quizzes, posted to the online learning management system with anonymous access, could be taken multiple times, with the highest score recorded. Pearson correlation coefficients and two-sample t-tests were used to analyze collated metrics, including student participation, quiz scores, quiz length, and total engagement time to assess usage patterns and performance trends.

Results
The quizzes had scores mod
erately correlated with mid-module summative examination performance (r = 0.51), but showed a weak relationship with end-of-module examinations (r = 0.29). Quiz length negatively correlated with both average score (r = -0.60) and number of zero scores (r = -0.55). Comparison of the short versus long quizzes revealed a statistically significant difference in the number of zero scores (p < 0.05). Shorter quizzes were more likely to have a high amount of zero scores.

Conclusion
We found that weekly formative quizzes are not predictive of exam performance. Students’ scores decreased as assessment length increased. However longer quizzes were associated with improved engagement, as evidenced by fewer zero scores. Shorter quizzes may be skipped more often, whereas longer quizzes are associated with lower scores, but more engagement. The statistically significant differences in participation based on quiz length highlights the importance of quiz design in fostering student engagement.