This article offers evidence on ways in which assessment of student learning outcomes made a difference for some academic institutions in the United States. It offers perspectives on the internal changes that took place, especially within academic programmes. Even after the capacity for assessment was developed, challenges remained in evaluating evidence and deciding what changes will lead to improved outcomes for students. In response to assessment results, many programmes improved course content, pedagogy and the sequencing of courses. Advising was also strengthened to give greater clarity on requirements and deadlines that students found confusing. Some academic institutions introduced new reviews of student progress at significant mid-points in their studies.