Background:Ascertaining student understanding can be challenging in large-enrollment and hybrid or asynchronous courses. Problem:Instructors needed an innovative instructional strategy to encourage student engagement and support learning in a large-enrollment, mixed-format pathophysiology class. Approach:A weekly, graded assignment was created by merging the formative assessment commonly referred to as the muddiest point (MP) with an asynchronous discussion board activity within the learning management system. Each week, students were required to submit a question and respond to a peer. Instructors created a remediation lecture based on the most common student questions. Outcomes:The majority of students reported they benefitted from the MP discussion boards and remediation lectures. Conclusions:The MP discussion board activity is a flexible, instructional strategy to determine areas of confusion, increase student engagement, and facilitate learning in large-enrollment classes offered in multiple formats.
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