Impact of a change from A-F grading to honors/pass/fail grading on academic performance at Yonsei University College of Medicine in Korea: a cross-sectional serial mediation analysis

This study aimed to explore how the grading system affected medical students’ academic performance based on their perceptions of the learning environment and intrinsic motivation in the context of changing from norm-referenced A-F grading to criterion-referenced honors/pass/fail grading. The study involved 238 second-year medical students from 2014 (n = 127, A-F grading) and 2015 (n = 111, honors/pass/fail grading) at Yonsei University College of Medicine in Korea. Scores on the Dundee Ready Educational Environment Measure, the Academic Motivation Scale, and the Basic Medical Science Examination were used to measure overall learning environment perceptions, intrinsic motivation, and academic performance, respectively. Serial mediation analysis was conducted to examine the pathways between the grading system and academic performance, focusing on the mediating roles of student perceptions and intrinsic motivation.