Exam Performance Research Articles

Asynchronous student-generated flip videos facilitate student learning and assessment in a large-enrollment introductory human physiology course.

Oral demonstration of knowledge is an effective learning and assessment strategy. It has been shown that generating explanations to oneself, or self-explaining, can improve student understanding of information. This can be achieved via student-generated videos. The quantitative effects of student-generated videos on learning and assessment in postsecondary education are unknown. To our knowledge, this is the first study to analyze the effects asynchronous student-generated videos have on student learning and assessment in a large-enrollment (∼400 students), undergraduate physiology course. Students were charged with making self-generated videos discussing major physiological concepts and uploading these videos to Flip for assessment. Flip is an online, social education platform for asynchronous video-based discussion. In the present study, we combined four semesters (n = 1,100 students) of Flip data and analyzed the effects it had on student examination performance. Specifically, we first analyzed how students performed on exam questions corresponding to their Flip prompts in comparison to students not assigned those prompts [25/44 (57%) were statistically significantly different]. Second, we analyzed the association between Flip prompt score and performance on corresponding exam questions [39/44 (89%) were statistically significantly different]. Third, we analyzed the association between cumulative Flip score and performance on all corresponding, and noncorresponding exam questions. Finally, we analyzed the association between cumulative Flip score and averaged exam performance. There was a positive association (r = 0.54). Taken together, our data suggest that asynchronous student-generated Flip videos can facilitate student learning and assessment in a large-enrollment, undergraduate physiology course.NEW & NOTEWORTHY Oral demonstration of knowledge is an effective learning and assessment strategy. Student-generated videos have been shown to improve learning and assessment in secondary education. To our knowledge, this is the first study to analyze the effects asynchronous student-generated Flip videos have on student learning and assessment in postsecondary education. The results of the present study suggest that asynchronous student-generated Flip videos can facilitate student learning and assessment in a large-enrollment (∼400 students), undergraduate physiology course.

Determinants of CPA exam performance

Certified Public Accountant (CPA) certification is an important measure of professional achievement and a critical element to advancement in the accounting profession. The CPA exam is rigorous, with lower pass rates relative to other professional exams, and even lower pass rates for historically disadvantaged groups. Thus, a key policy question is how to improve candidates’ performance on the CPA exam. In this paper, we examine the role that environmental (community segregation, socioeconomic status, and education and income gaps) and other factors representing opportunity play in CPA exam performance. The results of univariate analysis across various demographic and opportunity factors and those of multivariate models indicate that opportunity influences exam performance of all candidates and differently so for the disadvantaged groups. Finally, we offer recommendations for programs to help meet the profession’s need for an increasing number of qualified CPAs and its diversity and inclusion goals.

Exam Time Usage in Accounting Courses and Student Exam Performance

Exam Time Usage in Accounting Courses and Student Exam Performance

Equitable Impacts of Coaching Reports on Pre-PharmD Students Self-Directed Learning and Pharmaceutical Science Exam Performance

Equitable Impacts of Coaching Reports on Pre-PharmD Students Self-Directed Learning and Pharmaceutical Science Exam Performance

Implementation of Spaced Repetition by First-Year Medical Students: a Retrospective Comparison Based on Summative Exam Performance.

Many medical students use spaced repetition as a study strategy to improve knowledge retention, and there has been growing interest from medical students in using flashcard software, such as Anki, to implement spaced repetition. Previous studies have provided insights into the relationship between medical students' use of spaced repetition and exam performance, but most of these studies have relied on self-reports. Novel insights about how medical students use spaced repetition can be gleaned from research that takes advantage of the ability of digital interfaces to log detailed data about how students use software. This study is unique in its use of data extracted from students' digital Anki data files, and those data are used to compare study patterns over the first year of medical school. Implementation of spaced repetition was compared between two groups of students who were retrospectively grouped based on average performance on three exams throughout the first year of medical school. Results indicate that students in the higher scoring group studied more total flashcards and implemented spaced repetition via Anki earlier in the year compared to the lower scoring group. These findings raise the possibility that implementing spaced repetition as a study strategy early in medical school may be related to improved knowledge retention and exam performance. Additional research should be performed at more sites to further examine the relationship between spaced repetition implementation and exam performance.

How Learning Strategies and Academic Parameters Predict Medical Student Success.

Background Student scores on the Learning and Study Strategies Inventory (LASSI), an assessment of academic skills, have been shown in previous studies to be significantly different between U.S. medical students based on their scores in various examinations during the pre-clerkship curriculum. This study aimed to evaluate LASSI and other early academic performance markers for predicting the likelihood of shelf exam underperformance in third-year medical students. Methods A retrospective analysis of student-specific demographic information and medical school exam performance from 220 medical students from the University of Texas Southwestern was performed. Students were then categorized based on underperformance (score in <25th percentile) on each NBME shelf exam and statistical analysis was performed to identify predictors of shelf underperformance. Results For predicting Surgery shelf underperformance, pre-clerkship final exam average (PCA), STEP 1, and LASSI Time Management (TMT) were statistically significant in univariate analysis. Internal Medicine: PCA, STEP 1, LASSI Attitude (ATT), Test Strategies (TST), and TMT. Pediatrics: PCA and STEP 1 quartile. Obstetrics-Gynecology: PCA, STEP 1, and LASSI Anxiety (ANX), with ANX an independent predictor on multivariate analysis. Neurology: PCA, STEP 1, LASSI ANX, Information Processing (INP), TST, and average LASSI, with PCA, LASSI Concentration (CON), TMT, and ANX independent predictors on multivariate analysis. Family Medicine: PCA, STEP 1, LASSI ANX, TST, and Using Academic Resources (UAR), with PCA an independent predictor on multivariate analysis. Psychiatry: only STEP 1 was significant. Conclusion In contrast to previous studies, no single LASSI scale was significantly associated with underperformance on all 7 NBME shelf exams. Univariate analysis identified several LASSI scales that correlated with NBME underperformance, but the drastic inter-clerkship heterogeneity makes use of these scales in early academic intervention impractical. Conversely, PCA was found to be strongly associated with shelf exam underperformance.

Quality Metrics and Indicators for Surgical Training: A Scoping Review

Surgical training quality is critical to ensure that trainees receive adequate preparation to perform surgical procedures independently and that patients receive safe, effective, and high-quality care. Numerous surgical training quality indicators have been proposed, investigated and implemented. However, the existing evidence base for these indicators is limited, with most studies originating from English-speaking, high-income countries. This scoping review aimed to identify the range of quality indicators that have been proposed and evaluated in the literature, and to critically evaluate the existing evidence base for these indicators. A systematic literature search was conducted using MEDLINE and Embase databases to identify studies reporting on surgical training quality indicators. A total of 68 articles were included in the review. Operative volume is the most commonly cited indicator and has been investigated for its effects on trainee exam performance and career progression. Other indicators include operative diversity, workplace-based assessments, regular evaluation and feedback, academic achievements, formal teaching, and learning agreements, and direct observation of procedural skills. However, these indicators are largely based on qualitative analyses and expert opinions and have not been validated quantitatively using clear outcome measures for trainees and patients. Future research is necessary to establish evidence-based indicators of high-quality surgical training, including in low-resource settings. Quantitative and qualitative studies are required to validate existing indicators and to identify new indicators that are relevant to diverse surgical training environments. Lastly, any approach to surgical training quality must prioritize the benefit to both trainees and patients, ensuring training success, career progression, and patient safety.

How Does the Sequence of the American Board of Surgery Examinations Impact Pass/Fail Outcomes?

Historically, the American Board of Surgery required surgeons to pass the qualifying examination (QE) before taking the certifying examination (CE). However, in the 2020-2021 academic year, with mitigating circumstances related to COVID-19, the ABS removed this sequencing requirement to facilitate the certification process for those candidates who were negatively impacted by a QE delivery failure. This decoupling of the traditional order of exam delivery has provided a natural comparator to the traditional route and an analysis of the impact of examination sequencing on candidate performance. All candidates who applied for the canceled July 2020 QE were allowed to take the CE before passing the QE. The sample was then reduced to include only first-time candidates to ensure comparable groups for performance outcomes. Logistic regression was used to analyze the relationship between the order of taking the QE and the CE, controlling for other examination performance, international medical graduate status, and gender. Only first-time candidates who took both examinations were compared (n=947). Examination sequence was not a significant predictor of QE pass/fail outcomes, OR=0.54; 95% CI, 0.19-1.61, P =0.26. However, examination sequence was a significant predictor of CE pass/fail outcomes, OR=2.54; 95% CI, 1.46-4.68, P =0.002. This important study suggests that preparation for the QE increases the probability of passing the CE and provides evidence that knowledge may be foundational for clinical judgment. The ABS will consider these findings for examination sequencing moving forward.

Making confident and competent readers of Cell, Nature and Science papers using a flipped classroom approach to introduce protein detection techniques

IntroductionIt is beneficial for all biomedical track courses to train students early in their educational career in reading biomedical literature. A shortcoming of many biomed track courses during undergraduate education is that laboratory techniques necessary for fully understanding further reading of biomedical articles are not part of courses early in the curriculum. To bridge this gap, an educational investment is needed that will create confident and competent readers of scientific biomedical literature. All consecutive courses in the biomedical track may benefit from such an investment. Probably, the nescience of techniques needed for protein detection, which are part of virtually all composite figures in cell biological articles, forms the basis of such a gap. Activating forms of education were shown to be effective and are increasingly implemented in higher education.MethodsHere, the implementation of a flipped classroom approach for explaining ELISA, Immunohistochemistry, Western Blotting and flow cytometry as four common basic protein detection methods is described. The successfulness of the educational approach was assessed in the exam, where a comparison was made between the experts’ and receivers’ grades. Students gave feedback on whether this method made them more confident and competent readers of biomedical literature.ResultsExperts on the four techniques were successful in conveying their field of expertise since exam performances on the specific techniques were equally good between experts and receivers. The flipped classroom activity made students more confident (65% agreed vs. 18% disagreed) and more competent (79% agreed vs. 12% disagreed).ConclusionA simple and time-efficient intervention early in their educational career, using a flipped classroom approach has resulted in self-reported confident and competent readers of scientific cell biological literature.

COVID-19 Crisis, Economic Hardships, and Schooling Outcomes

AbstractWe combine phone-survey data from 2,200 students collected in July–August of 2020 with student-level administrative data from 54 schools in four northwestern provinces of Cambodia to investigate the implications of the COVID-19 pandemic for grade 9 students. These students were particularly vulnerable to dropping out of school prematurely due to the crisis. We find that most students kept studying during the crisis, returned to school to participate in the lower-secondary graduation exam after schools reopened, and transitioned to high school thereafter. However, we also find that students' exposure to the economic downturn had substantial implications: The likelihood that the father experienced income losses due to the crisis is negatively associated with a student's propensity to study during school closure, participation and performance in the final exam, and with the likelihood to transition to high school. In contrast, the likelihood that the mother experienced income losses is positively associated with student studying during the crisis, with participation in the final exam, and with transition to high school—potentially because mothers used the time at home to encourage their children to study.

Intangible rewards versus tangible rewards in gamified online learning: Which promotes student intrinsic motivation, behavioural engagement, cognitive engagement and learning performance?

AbstractGamification has often been used to stimulate learner engagement via intangible rewards, such as virtual points and virtual badges, rather than material goods or benefits. However, not all learners value such intangible rewards; some express their desire to redeem intangible rewards for utilitarian resources or benefits. Although tangible rewards have long been considered a key gamification mechanism in commercial loyalty programs, few studies have explicitly explored its effectiveness in the context of gamified education. To address this gap, the present study used a randomized controlled trial approach to examine the effects of tangible rewards that are redeemed through intangible rewards on students' intrinsic motivation, behavioural and cognitive engagement, and learning performance in a fully online gamified flipped class. Each student was randomly assigned either to the tangible rewards group (EG = 28) or the intangible rewards group (CG = 29). The students in EG significantly outperformed those in CG in terms of intrinsic motivation, behavioural engagement, cognitive engagement and learning performance in the final exam. The results provided practical implications for instructors who plan to use tangible rewards in their gamified classes. Practitioner notesWhat is already known about this topic Fully online learning often suffers from a lack of student engagement. Gamification is often used to stimulate learner engagement via intangible rewards (eg, virtual points and badges) that do not contain any utilitarian benefits outside the gamified system. Not all learners value intangible rewards over time—instead, they desire to convert the intangible badges or points into more utilitarian benefits/resources. What this paper adds This study conducted a randomized controlled experiment to compare the effects of redeemable tangible rewards and intangible rewards on student intrinsic motivation, behavioural engagement, cognitive engagement and learning performance. The tangible rewards group significantly outperformed the intangible rewards group in all aspects. Implications for practice Using tangible rewards is better than merely using intangible rewards in gamified learning. Practitioners should link tangible rewards to a standard of performance. Practitioners should also set a specific and moderately challenging redemption goal.

Shadow Education in Hong Kong: the Effects of Backwash on Hong Kong Secondary Students

Shadow education is a widely discussed topic in Asian countries since this is a popular way of learning for students. In Asian society, parents have invested a lot of money into shadow education, and they hope that their children can stay competitive or climb up the social ladder by getting good grades in public exams. Shadow education becomes a method that some people believe can help students to perform well in the exam, but is this true? In this paper, the focus is on the backwash effects of shadow education, and whether shadow education can help students to perform well in the exam. 12 secondary school students in this study expressed that shadow education can help them in their public exams and it has some positive effects on their overall exam grades. However, there are only a few studies focused on the effects of shadow education on students’ exam performance, and it seems that this area has not been completely discussed in the field of shadow education. As a result, this study hopes to contribute to backwash in shadow education, and whether it can help students to improve their grades in the public exam.

Paying Attention in Class: Using In-Class Quizzes to Incentivize Student Attention

Background: Methods are needed to incentivize student attention to class material. Objective: The purpose of this study was to examine the effects of in-class quizzing to incentivize student attention to class material to boost exam performance. Method: A randomized, alternating treatments design embedded in an introductory psychology class compared learning benefits of two types of quiz-based engagement activities, mastery quizzes, and concepts checks, as compared to a no-engagement activity control. Results: Students performed significantly better on exam content linked to classes with quiz-based engagement activities. Learning benefits of engagement activities extended across levels of cognitive complexity indexed to Bloom levels, although were stronger for low-level items. The effects of engagement activities were also stronger for content directly discussed in class. There were no significant differences in learning outcomes between the two engagement activities. Conclusion: Students performed better on exam content linked to class sessions with quiz-based engagement activities that incentivized attention to class material compared to those that did not. Teaching Implications: Using in-class quizzes as attentional cues offers instructors a means of incentivizing student attention to class material with minimal disruption of class time and lecture flow, while also improving exam scores.

An Exploratory Study of Dental Students’ Use of Whiteboard Animated Videos as Supplementary Learning Resources in Basic Sciences

AbstractAnimated videos are being increasingly incorporated into health professions education, but evidence is limited and mixed regarding their educational impact. We have been providing dental students with complimentary access to whiteboard animated videos on a web-based and mobile learning platform. This exploratory study evaluated first-year predoctoral dental students’ (n = 143) adoption, perceived value, and impact of the videos as supplementary learning resources in basic sciences. Students were surveyed about their perceived value of the videos, while the host website platform analytics captured video watching patterns. Regression analyses examined the correlation between video watching and students’ exam performance. Results showed that the mean score of students’ perceived value of the videos was 3.2 on a 4-point scale. The class watched a total of 10, 919 videos throughout the academic year. The number of videos watched by individual students ranged from 0 to 627. Video watching was positively correlated with students’ exam performance in biochemistry and nutrition. These findings suggested that students had a favorable attitude towards the animated videos. They frequently used the videos to supplement their learning in basic sciences, but usage varied among individual students. Factors impacting the effectiveness of animated videos such as the complexity of cognitive processing, students’ personal differences, and video watching strategies were discussed and future directions were proposed. The study contributed to the literature of whiteboard animated videos in the understudied context of dental education. Experience from our school could help other institutions identify and implement animated videos to augment student learning.

Open-Topic Project-Based Learning and Its Gender-Related Effect on Students’ Exam Performance in Engineering Mechanics

Open-Topic Project-Based Learning and Its Gender-Related Effect on Students’ Exam Performance in Engineering Mechanics

Data Mining Approach to Detect Student's Exams Performance Factors.

Data Mining Approach to Detect Student's Exams Performance Factors.

The relationship between exam anxiety, academic performance and peer support among 9th grade students in Shenzhen, China

In recent years, with the incentive of competition, various industries have introduced many exams to assess and screen the overall level of personnel. Faced with exams, especially those that carry significant weight, most students experience some degree of anxiety. Moderate exam anxiety can stimulate the excitement of the cerebral cortex, which has a positive effect on active thinking, concentration, information extraction, and so on. However, excessive exam anxiety can cause cognitive impairments for students, such as blocked thinking, memory lapses, restless emotions, low learning efficiency, and other adverse reactions. This can also affect students' exam performance and even their mental and physical health, keeping them in a state of anxiety for a long time. This study aimed to investigate the relationship between exam anxiety, academic performance, and the moderating effect of peer support on student learning and development among 9th grade students in Shenzhen, China. The study used a questionnaire survey to collect data from 300 valid respondents and conducted data analysis. The results showed that: There was a significant gender difference in academic performance, with 9th grade male students performing better than female students; The greater the exam anxiety, the lower the academic performance of 9th grade students; Peer support can positively predict the academic performance of 9th grade students.

Correlation between average sleep duration among medical students and their performance in physiology final exam

Sleep is a restful state of mind that plays a crucial and significant role in consolidation of memory. Several studies have reported that better and proper sleep is associated with superior cognitive functions including better learning and memory which is critical for successful academic performance. The present study was set to determine whether a correlation exists between the average sleep duration in medical students and their performance in physiology final examination score. This study was conducted in a Caribbean Medical School after approval from the Institutional Review Board. 40 medical students (23 male, 17 female) from first year of MD program were selected based on the inclusion criteria after informed written consent. The participants reported their average sleep duration in hours based on the records in their smart phones and wearable sleep/activity tracker devices. The data of their age, gender, body mass index, average sleep duration, and physiology final examination scores were tabulated in Microsoft Excel and descriptive analysis was done. The correlation of their average sleep duration in hours to physiology final examination scores in percent was determined by a Pearson correlation coefficient and regression analysis. The correlation coefficient (adjusted r2) of our study was 0.028 and significance P was 0.154. The average sleep duration of medical students was not significantly correlated with the physiology final examination score % (r (38) = 0.229, p = 0.154). The regression model predicted only 5.3% (R2 = 0.053) of the physiology final examination score of medical students. Medical students with an average sleep duration of more than 6 hours performed better in their physiology final exam. Our study concludes that there is no significant correlation between the average sleep duration in medical students and their performance in physiology final exam. However, medical students with an average sleep duration of 6 hrs. or more scored better in their physiology final exam. Therefore, our study aligns with the findings of the other studies, and we conclude that the longer duration of sleep for more than 6 hours is associated with better academic performance. So, correlations of the sleep duration and quality in medical students with their performance in other subjects and examinations need to be assessed in further studies.

The Impact of Periodic Formative Assessments on Learning Through the Lens of the Complex Adaptive System and Social Sustainability Principles.

Medical institutions in India have employed different periodic formative assessment (FA) methods with variable impact. The formative evaluation must incorporate feedback to improve learning. Formative assessment has helped inexperienced students apprehend their weaknesses, make choices, prepare for summative exams, and allow teachers to identify regions wherein students may also need aid. This study attempts to quantify the impact of the weekly, monthly, and semesterformative assessments and view it retrospectively through the lens of complex adaptive systems and social sustainability principles. We used a post-exam survey and statistical analysis to compare the students' performance between the timely periodic formative assessments in a competency-based curriculum. The cohort consisted of 2018 (semester), 2019 (weekly), and 2020 (monthly) first-year medical students. Cronbach alpha, spearman's correlation coefficient, descriptive statistics, and repeated measure analysis of variance were used to explore the reliability and relationship between formative assessment and summative scores of each cohort and find any significant difference. The authors also analyzed the accordance between the FA exam performance and students' perceptions, deduced broad themes, and discussed the appropriateness and feasibility of students' suggestions for changes. A significant correlation was found only between the weekly formative assessment and summative scores (r=0.74, p=0.01). Theanalysis of variance established significant differences betweenall summative scores of respective periodic formative assessments. The weekly formative assessment showed the highest mean summative examination scores. This study helped comprehend preclinical students' apprehension after the intervention of periodic formative assessments. The students found this intervention helpful in driving and detecting gaps in learning but preferred focused feedback, clinically oriented practices, and countered mental health issues. The continuous periodic formative assessment model had a valid educational impact but was not sustainable according to social sustainability principles. A complex adaptive framework can be utilized to make it sustainable.

Can online discussions benefit students’ learning in online courses? Evidence From teaching introduction to microeconomics

In this research, we investigated whether online discussions can significantly benefit students’ learning in online courses. We designed an experiment by dividing 129 students who enrolled in four fully online “Introduction to Microeconomics” courses taught by the same instructor into four groups (one control group and three experimental groups). We adopted econometric analysis to investigate the issue. Our empirical evidence demonstrated that online discussions can significantly benefit students’ exam performance in online courses only when instructors are effectively engaged in discussions. Instructors who do not effectively engage in online discussions had a less than significant effect on students’ exam performance even when peer-responses were required. On the other hand, the effect was positive and significant when instructors effectively engaged but the level of significance was weak (at the 10% level of significance) and began with a later exam (Exam 4, out of a total of five exams) rather than the first exam or earlier. Detailed discussions about these phenomena are offered as are several possible reasons for these findings. We recommend significantly increasing weights for online discussions in the final course grade and including exam questions that directly reflect online discussion questions (including serious participation in discussions and requiring that students provide answers to instructors’ follow-up questions). These additions would significantly benefit students’ learning in online courses.