Good formative assessments strengthen the students’ capacity to regulate their own performance. Nicol and Macfarlane-Dick [12] identified seven principles of good feedback practices. Good feedback practices 1) help to define good performance, 2) facilitate self-reflection; 3) deliver high-quality information to students about their learning, 4) encourage teacher and peer dialogue, 5) promote positive motivational beliefs and self-esteem, 6) close the gap between current and desired performance and 7) provide instructors with information that can be used to shape their teaching. Regarding formative assessment, the study showed that the students perceived the Kahoot! sessions as an effective feedback tool. It is an attractive learning tool that is a source of motivation and guidance for student learning.
Attractive learning tool
Kahoot! was perceived as being more user-friendly than eQuiz. This finding was similar to that of a previous previous study [4]. The students can benefit from formative assessment by downloading the Kahoot! application, which is available free in the Play Store (for Google’s Android operating system) and the App Store (for Apple’s iOS operating system). They can participate in the sessions with just a single tap. In contrast, participation in eQuiz involves more steps, such as browsing the e-learning portal, logging in with their user names and passwords and searching for their courses. The multiple steps might explain the students’ preference for Kahoot! as a formative assessment tool.
This study shows that student engagement in formative assessment was higher with Kahoot! than with eQuiz. This was consistent with the previous findings that fewer than 50% of students used eQuiz. After the change to Kahoot!, more than 90% participated in the formative assessment activities. An effective tool for gamifying learning, Kahoot! possesses all seven elements of the persuasive architecture of gamification (Fig. 2; [ [13]. It sets goals, offers challenges and provides feedback. It also provides reinforcement, facilitates learners’ comparisons of their own and their peers’ progress, enables social connectivity and creates a fun learning environment. Learning with Kahoot! was perceived as fun mainly because of the gamification features and the audio-visual stimuli. The platform was also perceived as providing challenging activities, such as games for large groups for which the results are available in real time. A Kahoot! session is different from and more interesting than an eQuiz session. Furthermore, Kahoot!‘s interactive features promote active learning through increased engagement.
Trumpower and Sarwar [14] asserted that user-friendliness is crucial for effective formative assessment. The specificity and accuracy of a platform are of no value if the users (students and teachers) cannot understand how to use it [15]. The current study has demonstrated that Kahoot! is user-friendly; however, a strong internet connection and the appropriate devices must be available before and during the session. For a session to be successful, the faculty members should also be familiar with the platform. However, Kahoot! has some limitations. It is suitable for multiple-choice rather than essay questions.
Medical training is considered to be intense and demanding; therefore, medical students are predisposed to psychological distress [16]. Previous studies have found the worldwide prevalence of psychological distress among medical students to be 21–56% [16]. A fun learning environment has been shown to reduce psychological distress [17]. In addition to having positive effects on education, gamification creates a fun and entertaining environment [18]. The current study shows that the Kahoot! platform is effective at changing a stressful environment into a joyous one. This finding is consistent with that of a previous quantitative study in which students perceived Kahoot! sessions as fun [4]. However, institutions that wish to adopt Kahoot! for fun learning should note that the sessions should be properly planned to ensure that the students achieve the intended outcomes and avoid the excessive fun that could create disastrous teaching environment and lead to negative consequences [19].
Sources of motivation
Formative assessment can have a significant effect on student motivation and achievement [20] if it is designed to stimulate the extrinsic aspects of student motivation [21]. Kahoot! has been shown to be an external factor in facilitating continual learning, which could improve academic performance. Its competitive environment is key [22]. Another interesting aspect that has been demonstrated in the current study is the sense of satisfaction experienced by the students. Thus, Kahoot! indirectly engenders positive feelings in students regarding their academic progress [23].
Learning guidance
As has been demonstrated in this study, formative assessment is most effective through the ‘catalytic effect’ of specific and actionable feedback to learners [2]. The sessions encouraged the participants to reflect on their strengths and weaknesses. Furthermore, unlike other formative assessment approaches, Kahoot! allows teachers to provide instant feedback. The session allows teachers to interact with their students and to clarify material related to the questions. In addition to facilitating teacher feedback, the sessions also promote self-assessment. An ‘assessment for learning’ tool [24], the Kahoot! session indirectly prepares students for summative assessment by highlighting the important topics to be reviewed. In sum, Kahoot! sessions serve as an assessment of learning.
Other advantges of Kahoot!
Kahoot! offers several other advantages. The platform: 1) is free; 2) uses multiple formats, i.e. quizzes, discussion questions or surveys; 3) is user-friendly; 4) facilitates participation through an automatically generated game pin; 5) is compatible with smartphones, tablets and computers; 6) has music and colourful illustrations that generate excitement; and 7) has a flexible and adjustable response time based on question complexity. In addition, instructors can download, review and save the students’ results to analyse student performance [4]. Therefore, it is recommended that medical schools use this free platform as a formative assessment tool to promote learning. Kahoot! can be incorporated into teaching and learning sessions, such as lectures, tutorials and problem-based learning activities, for effective formative feedback.
Limitations of the study
This qualitative study was conducted in a single institution; therefore, caution should be observed in extending the findings to other populations. The study found that students perceived Kahoot! as a useful tool for formative assessment. They indicated that participation in Kahoot! sessions can improve their academic performance. However, further study is need to determine the effects of Kahoot! on academic performance.