Although progress testing (PT) is well established in several medical schools, it is new to dentistry. Peninsula College of Medicine and Dentistry has recently established a Bachelor of Dental Surgery programme and has been one of the first schools to use PT in a dental setting. Issues associated with its development and of its adaption to the specific needs of the dental curriculum are considered.

BACKGROUND: Progress testing is used at Peninsula Medical School to test applied medical knowledge four times a year using a 125-item multiple choice test. Items within each test are classified and matched to the curriculum blueprint. AIM: to examine the use of item classifications as part of a quality assurance process and to examine the range of available feedback provided after each test or group of tests. METHODS: the questions were classified using a single best classification method. These were placed into a simplified version of the progress test assessment blueprint. Average item facilities for individuals and cohorts were used to provide feedback to individual students and curriculum designers. RESULTS: the analysis shows that feedback can be provided at a number of levels, and inferences about various groups can be made. It demonstrates that learning mostly occurs in the early years of the course, but when examined longitudinally, it shows how different patterns of learning exist in different curriculum areas. It also shows that the effect of changes in the curriculum may be monitored through these data. CONCLUSIONS: Used appropriately, progress testing can provide a wide range of feedback to every individual or group of individuals in a medical school.

BACKGROUND: to use progress testing, a large bank of questions is required, particularly when planning to deliver tests over a long period of time. The questions need not only to be of good quality but also balanced in subject coverage across the curriculum to allow appropriate sampling. Hence as well as creating its own questions, an institution could share questions. Both methods allow ownership and structuring of the test appropriate to the educational requirements of the institution. METHOD: Peninsula Medical School (PMS) has developed a mechanism to validate questions written in house. That mechanism can be adapted to utilise questions from an International question bank International Digital Electronic Access Library (IDEAL) and another UK-based question bank Universities Medical Assessment Partnership (UMAP). These questions have been used in our progress tests and analysed for relative performance. RESULTS: Data are presented to show that questions from differing sources can have comparable performance in a progress testing format. CONCLUSION: There are difficulties in transferring questions from one institution to another. These include problems of curricula and cultural differences. Whilst many of these difficulties exist, our experience suggests that it only requires a relatively small amount of work to adapt questions from external question banks for effective use. The longitudinal aspect of progress testing (albeit summatively) may allow more flexibility in question usage than single high stakes exams.

This article is primarily an opinion piece which aims to encourage debate and future research. There is little theoretical or practical research on how best to design progress tests. We propose that progress test designers should be clear about the primary purpose of their assessment. We provide some empirical evidence about reliability and cost based upon generalisability theory. We suggest that the future research is needed in the areas of educational impact and acceptability.

Peninsula Medical School, UK, employed six students to write MCQ items for a formative applied medical knowledge item bank. The students successfully generated 260 quality MCQs in their six-week contracted period. Informal feedback from students and two staff mentors suggests that the exercise provided a very effective learning environment and that students felt they were 'being paid to learn'. Further research is under way to track the progress of the students involved in the exercise, and to formally evaluate the impact on learning.