Formative assessment (FA) is widely recognised for its role in supporting
student learning and professional development. While international research
has demonstrated its benefits, little is known about how FA is implemented
and experienced in Saudi undergraduate medical education, where
assessment remains strongly summative-oriented. This study explored FA
implementation in two Saudi medical schools, examining its perceived
benefits, challenges, and the institutional and cultural factors shaping its use.
A qualitative, interpretivist design was adopted to explore participants’
experiences in depth. Data were collected through ten semi-structured
interviews with academic leaders (n = 4) and faculty members (n = 6), and six
focus groups with students across pre-clinical and clinical phases. Reflexive
Thematic Analysis was conducted, with rigour strengthened by reflexivity,
triangulation, and strategies to enhance credibility and transparency.
The findings indicate considerable variation in how FA was understood and
practised, though little difference was observed between the two institutions.
Participants reported benefits such as helping students recognise their
strengths and areas for improvement, providing feedback to inform teaching,
and improving preparedness for summative assessments. However,
implementation was constrained by unclear policies, time pressures, limited
faculty capacity, and varying student motivation. Technology-supported FA
was evident but inconsistently integrated, influenced by digital readiness and
infrastructure.
The study concludes that coherent and sustainable FA requires multi-level
alignment between institutional policy, faculty practice, and student
engagement. Its effectiveness depends on timely, actionable, and wellunderstood
feedback. Moreover, FA strategies need to be adapted to the
assessment culture, institutional structures, and regulatory frameworks of
Saudi medical education, while offering transferable insights for other
summative-driven systems internationally. To support this, the study proposes
a context-sensitive framework as a guiding structure, emphasising policy
alignment, faculty development, feedback literacy, and the integration of digital
tools.
