Introduction: The aim of this study was to design and development of learning environment model based on real-time electronic formative assessment in medical education and investigating its content validity. Methods: In this study, a mixed method research was used. Qualitative content analysis with inductive design was first performed and based on the results, the initial model was developed. In the quantitative section, content validity of the model was done by a questionnaire survey by experts. In order to select articles in relation to the identification the elements of real-time electronic formative assessment model, valid scientific documents are indexed and relevant in international databases such as Scopus, ProQuest, Eric, Web of Science, Wiley Online Library, PubMed and Science Direct during the period 2000 to 2018 using the PRISMA protocol were selected and 67 documents were analyzed finally. To validate the content of the proposed model, 37 experts from the fields of educational technology, assessment and measurement, medical education and medical informatics were selected as a sample. Results: According to the content analysis, 8 classes were obtained as follows: Learning outcomes, Processes/Learning activities/Strategies, Academic Engagement, Interaction, Motivation, Assessment and evaluation of learner progress, Immediate feedback, Interventions and Support that resulted in designing of the desired model. The findings in the quantitative section also indicated that the proposed model had the necessary validity and effectiveness in the medical education. Conclusions: The learning environment based on real-time electronic formative assessment has a good impact on medical education.