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. 2025 Nov 1;23(11):2301-2306.
doi: 10.11124/JBIES-24-00525. Epub 2025 Nov 6.

Alternative grading approaches in health professions education: a scoping review protocol

Elena Wong Espiritu  1 , Aine O'Connor  2 , Sara Blass  3 , Kathryn L Dambrino  4 , Angela Shelton Clauson  5
Affiliations

Alternative grading approaches in health professions education: a scoping review protocol

Elena Wong Espiritu et al. JBI Evid Synth. .

Abstract

Objective: The objective of this scoping review is to map the existing literature on alternative grading approaches in health professions education and how these approaches are implemented.

Introduction: Although traditional alphanumerical tiered grading methods are widely used in health professions education, this approach is typically insufficient in providing descriptive feedback, allowing formative assessment, and promoting deeper learning and clinical application. Alternative grading approaches, including competency-based assessment, pass-fail grading, ungrading, specifications grading, and others, are increasingly being implemented, but there is a gap in understanding which approaches are being used in which health professions programs and how the approaches are being implemented.

Eligibility criteria: This scoping review will focus on literature discussing alternative grading approaches, which are any formative, summative, or cumulative assessments that have been built outside the traditional alphanumerical tiered grading systems. The population will include health professions students, such as nurses, pharmacists, physician assistants, physicians, and allied health professionals.

Methods: The proposed scoping review will be conducted in accordance with JBI methodology for scoping reviews. Both published and unpublished literature will be located through a search strategy across PubMed, CINAHL (EBSCOhost), Embase.com, ERIC (EBSCOhost), Scopus, and gray literature sources. Information sources will be searched from inception to the search date. Two reviewers will independently screen potential sources of evidence against the prespecified eligibility criteria. No date limits will be applied, and only articles published in English or with a published English translation will be included. Data will be extracted, and the results will be synthesized and presented in a tabular format.

Review registration: OSF https://osf.io/2czq8.

Keywords: alternative grading; competency-based; health professions education; pass/fail; ungrading.

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Conflict of interest statement

The authors declare no conflict of interest.

References

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MeSH terms