by Gary L. Beck Dallaghan, Ph.D. | August 2, 2021 Article Citation: Bullock JL, Seligman L, Lai CJ, O’Sullivan PS, Hauer KE. (2021) Moving toward Mastery: Changes in Student Perceptions of Clerkship Assessment with Pass/Fail Grading and Enhanced Feedback. Teach Learn Med 2022; 34(2):198-208. DOI: 10.1080/10401334.2021.1922285 What is this article about? Clerkship grading is an amorphous process, especially from a medical student’s perspective. It becomes even more nebulous when a combination of clinical performance evaluations, subject exams and other assignments are somehow transformed into a tiered grade of Honors, High Pass, etc. Because of concerns related to tiered grading contributing to performance approach-oriented learning, a pass/fail framework augmented by feedback with required workplace-based assessments was initiated at UCSF. The purpose of this study was to examine if a pass/fail framework resulted in enhanced formative feedback and if student perceptions of fairness and accuracy of clerkship grades improved. Why should you read the article? This was a single-institution, before-after cross-sectional survey study. Prior to the new grading framework, students’ perceptions of the tiered grading system were collected. The cohort of students in the new grading framework were assessed upon completion of the clerkships. Analysis involved descriptive statistics and thematic analysis to analyze open-ended comments. Student perception of fairness and accuracy of clerkship assessment improved with an effect size of .80. Students also perceived grading to be fair and transparent in the new framework. They also found that the learning environment was more mastery-oriented than in a tiered system. Narrative comments corroborated findings, but also highlighted areas that could be improved with the workplace-based feedback process. How can you use this article? In a tiered-grading structure, students often spend more time trying to figure out how to get top grades. This goal can drive some to avoid trying new skills that they may not look good doing. This study demonstrated that a change to pass/fail on the clerkships resulted in students engaging more in learning. Knowing that if they put in effort and are motivated to learn, they can receive a passing grade and focus on mastering material. Review Author: Gary L. Beck Dallaghan, Ph.D., Research Associate Professor of Pediatrics, Director of Educational Scholarship, UNC School of Medicine, Chapel Hill, NC. Organization: Council on Medical Student Education in PediatricsStudent Perceptions of Clerkship Assessment with Pass/Fail Grading and Enhanced Feedback