Shahroud University of Medical siences Shahroud Journal of Medical Sciences 2423-6594 12 5 2026 08 29 The Effect of Technology-Enhanced Formative Assessment on Learning and Test Anxiety in Anatomy Education Among Medical Students: A Quasi-Experimental Study 50 59 eng Samira Latifi Department of Medical Education, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.. sal1400sam@gmail.com Haniye Mastour Department of Medical Education, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; School of Medical Education and Learning Technologies, Shahid Beheshti University of Medical Sciences, Tehran, Iran.. Haniye.Mastour@gmail.com Reyhaneh Shafieian Department of Anatomical Sciences and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.. shafieianr@mums.ac.ir Maliheh Dadgar Moghaddam Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.. DadgarMM@mums.ac.ir 2025 12 13 2026 05 24 Background: Anatomy is crucial in medical education, but traditional teaching methods can overload students and increase test anxiety. Technology-enhanced formative assessment (TEFA) may improve learning and reduce anxiety. This study examines the effect of TEFA on learning outcomes and test anxiety in anatomy education for medical students. Methods: This quasi-experimental study included 147 second-year medical students enrolled in a Head and Neck Anatomy course at Mashhad University of Medical Sciences, Iran. Students were allocated into intervention (n=78) and control (n=69) groups based on pre-existing class structures determined by institutional scheduling procedures. Learning outcomes were measured using midterm and final exam scores, and test anxiety was assessed using Sarason’s Test Anxiety Scale at three time points. Non-parametric statistical tests were applied for data analysis. Results: Students in the TEFA group performed significantly better in both midterm and final examinations (P-value<0.001) compared to the control group. Although the intervention group exhibited lower levels of test anxiety, the differences were not statistically significant (P-value>0.05). Conclusion: TEFA significantly improved learning outcomes in anatomy education but did not produce a statistically significant reduction in test anxiety. Integrating TEFA into medical curricula may enhance academic performance while requiring additional strategies to manage student anxiety.