{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:49:29Z","timestamp":1782452969656,"version":"3.54.5"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Traditional assessment (TA) model in medical education, especially in practice-intensive disciplines such as manual therapy, frequently intensify student stress and neglect psychological wellbeing, underscoring the necessity for creative evaluation strategies. Formative assessment (FA) provides a process-oriented methodology, although its psychological advantages are still insufficiently examined. The study aimed to investigate synergistic effects of FA on students\u2019 psychological wellbeing, academic performance, and learning experience in manual therapy courses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included a total of 88 third-year physical therapy (PT) students. Groups B, C, and D constituted the prospective arms, while group A served as a historical control. Using standardized instruments (PHQ-9, GAD-7, CEQ), we assessed the impact of FA on psychological wellbeing, academic performance, and course satisfaction in comparison to TA across four groups. FA encompassed high-frequency, low-stakes tests and clinically focused evaluation criteria, characterized by variations in time and complexity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      FA significantly decreased anxiety socres (\n                      <jats:italic>F<\/jats:italic>\n                      = 2.965,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.037) and improved course satisfaction scores (\n                      <jats:italic>F<\/jats:italic>\n                      = 11.306,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), with the group D attaining the maximum satisfaction (95.30 \u00b1 6.91) owing to prolonged preparation time and refined assessment schedule. The experimental groups exhibited diminished practical performance scores (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), which can be ascribed to a paradigm shift toward stringent, clinically oriented rubrics rather than a decline in skill mastery. No notable variations were detected in depression levels (\n                      <jats:italic>F<\/jats:italic>\n                      = 1.565,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.204) or overall academic performance (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>FA facilitated the establishment of supportive, process-oriented learning environments in manual therapy education, correlating with reduced anxiety and improved course satisfaction while mitigating the limits of TA. The convergence of strategic task design and psychological support appears essential for maximizing the potential benefits of FA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1823631","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:44:29Z","timestamp":1782452669000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal formative assessment reforms in manual therapy education: impacts on psychological wellbeing and course satisfaction"],"prefix":"10.3389","volume":"13","author":[{"given":"Ruike","family":"Zhang","sequence":"first","affiliation":[{"name":"Key Laboratory of Biological Targeting Diagnosis, Department of Rehabilitation Medicine, Therapy and Rehabilitation of Guangdong Higher Education Institutes, The Fifth Affiliated Hospital of Guangzhou Medical University","place":["Guangzhou, China"]},{"name":"The Fifth Clinical College of 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