How Formative Engagement Predicts Exam Success—and How Calibrate Makes It Happen

Faculty play a central role in shaping how learners engage with formative assessments. A recent study in Family Medicine (Wingrove et al., 2025) offers compelling evidence that how learners participate in ongoing assessments—particularly those emphasizing reflection and confidence calibration—has a measurable impact on summative exam success.  

Even more importantly, tools like Aquifer’s Calibrate bring this research to life, enabling educators to translate theory into practice through structured, data-informed learning.

The Research: Engagement Predicts Outcomes

The Knowledge Self-Assessment Engagement and Family Medicine Board Examination Outcomes study examined more than 24,000 family physicians who participated in the American Board of Family Medicine’s Continuous Knowledge Self-Assessment (CKSA). The findings are clear: consistent, thoughtful engagement in formative assessments directly improves performance on high-stakes certification exams.

Key Insights for Educators:

• Consistent engagement improves results: Completing all four CKSA quarters was linked to higher exam scores across all prior performance levels.
• Timing matters: Early and steady participation predicted better outcomes than last-minute completion.
• Depth of engagement drives learning: Time spent on low-confidence and incorrect questions correlated with stronger CKSA and summative performance.
• Metacognition predicts mastery: Accurate self-assessment of strengths and weaknesses strongly correlated with exam success.
• Fatigue undermines performance: Completing questions late at night or under rushed conditions was linked to lower scores.

This evidence reinforces that how students engage matters as much as how much they study. Intentional, reflective engagement is not an optional habit—it’s a measurable determinant of success.

From Data to Design: Calibrate Brings the Evidence to Life

Calibrate transforms CKSA research insights into an automated, learner-centered assessment experience. By integrating structured reflection, early engagement, and adaptive feedback, Calibrate automatically delivers individualized learning insights—reducing manual grading and feedback demands. This intelligent automation not only reinforces evidence-based learning, but also saves faculty significant time, allowing them to focus on high-impact teaching and mentorship.

Faculty-Focused Implications: Beyond the Test Score

The Family Medicine study doesn’t just highlight learner behaviors—it demonstrates how Calibrate streamlines faculty engagement by integrating powerful analytics directly within the Aqueduct learning platform. Educators can save valuable time while enhancing learner outcomes by:     

• Coaching metacognition by reviewing discrepancies between confidence and accuracy.
• Reinforcing reflection by having students analyze missed or low-confidence questions.
• Promoting early engagement through structured deadlines and check-ins.
• Using data for targeted feedback rather than relying solely on end-of-rotation grades.
• Supporting at-risk learners proactively, identifying patterns before they affect performance.

By embedding evidence-based assessment directly into Aqueduct, Calibrate transforms evaluation from a time-consuming endpoint into an ongoing, efficient feedback process—perfectly aligned with the goals of competency-based medical education.

Building a Culture of Reflective Learning

The CKSA study highlights an essential truth: formative assessment is not just about knowledge—it’s about reflection and consistency. Faculty are uniquely positioned to model and reinforce these behaviors.

Calibrate supports this culture shift by making reflection and feedback part of the learning workflow.  When learners see their confidence tracked alongside accuracy, they begin to internalize the habit of questioning not only what they know, but how well they know it.

For programs, this means moving beyond one-time assessments toward a system of continuous, data-informed learning—one that aligns with the broader goals of competency-based medical education.

Bringing It All Together

For faculty educators, the convergence of CKSA research and Calibrate’s design offers a rare opportunity: evidence-based affirmation that how we structure formative engagement directly shapes summative outcomes.  

By integrating tools like Calibrate, programs can foster lifelong learning behaviors, identify struggling students sooner, and align local education practices with national standards for continuing certification.

Learn More and Collaborate

Want to explore how Calibrate can help your program identify at-risk learners, foster metacognition, or strengthen assessment strategies? 

👉 Request a curricular consult: aquifer.org/curricular-consult