Effects Of Testing Research Articles

Effectiveness of Multiple-choice Questions (MCQS) Discussion as a Learning Enhancer in Conventional Lecture Class of Undergraduate Medical Students

Context: Multiple Choice Questions (MCQs) are one of the commonly used assessment tools in the field of medical education. A few initiatives have been made to use MCQ tests during classes as a mode of test-enhanced learning. However, there is a lack of enough scientific information regarding the use of MCQs as a learning enhancer. Aims: The present study has been undertaken to analyze the effectiveness of MCQ discussion as a learning tool. Methodology: The study was conducted in a Government Medical College in Kerala among Phase 2 MBBS students. They were divided into study and control groups of 61 students each. Online lecture classes were conducted for both groups on six topics of Pathology. For the study group, an additional MCQ discussion was done towards the end of the lecture class. Post-test was conducted on day 1 and after 2 weeks. A questionnaire was given to assess the attitude of students. Scores obtained in the post-tests were used to test the significance. Results: There was a significant difference in the mean score obtained between control and study groups in the post-test conducted on the same day suggesting that the MCQ discussion conducted at the end of the lecture class has added benefit (P value = 0.04). There was no significant improvement in academic performance when an assessment was made after 2 weeks (P value = 0.59). More than 80% of students showed a positive perception of this method. Conclusion: MCQ supplementation towards the end of the didactic lecture class is an effective teaching-learning method. Students also express a very positive attitude towards it. MCQs can be considered not only as an assessment tool but as a learning enhancer also.

Transfer of Test-Enhanced Learning.

Memory for paired-associate words is facilitated by interim testing relative to restudy. According to the mediator effectiveness hypothesis, the benefit of retrieval practice is a consequence of the activation of a mediator word linking the cue and target. Evidence for the activation of cue-related mediators stems from the finding that mediators are more effective at prompting recall of target words than are words not associated with the original cue, a pattern that is larger following testing than restudy. The benefit of testing for the unstudied cues at the final test is referred to as transfer of test-enhanced learning. One goal of the current study was to examine whether the activation of mediators leads to the recall of targets indirectly via the original cues in a process known as backward chaining. We indexed backward chaining with the probability of incorrectly recalling a trial-specific original cue in place of a target. The second goal was to explore whether testing would yield a transfer effect for cues associated with target words. In four experiments, following an initial study of weakly related word pairs (e.g., Mother-CHILD), participants either restudied the pairs or attempted to recall the target given the original cue (e.g., Mother). On a final cued-recall test, participants were presented with unstudied cues that were related to either the original cue (semantic mediators, e.g., Father) or the target (target-related cues, e.g., Baby). The type of new cue presented on the final test was varied either between subjects (Experiment 1) or mixed within a list (Experiments 2, 3, and 4). Mixing mediators and target-related cues reduced the transfer of test-enhanced learning and increased the likelihood of recalling the original cues when shown a mediator. These results challenge the assumptions of the mediator effectiveness hypothesis.

Test‐enhanced learning improves learner attendance during a laparoscopic box trainer simulation program

BackgroundLaparoscopy is the gold standard approach for many surgical procedures, but it is a complex skill to learn. Laparoscopic simulation training may help, but it is unclear how to best engage trainees in these programs. Test‐enhanced learning (TEL) uses regular, well‐defined assessments of performance throughout the training phase of learning.AimThe aim of this study was to assess the effects of TEL on a laparoscopic simulation program involving a cohort of medical student volunteers.Materials and methodsA prospective cohort study was performed with a convenience sample of 40 medical students. Students were recruited to participate in a ten‐week laparoscopic simulation program. Twenty students participated in a laparoscopic surgical program with TEL (‘TEL group’), and 20 students participated in a standard laparoscopic simulation program (‘control group’).ResultsAttendance in the TEL group was significantly higher than in the standard group (71 vs 51.5%, P = 0.03). There was no difference between groups in mean time scores. Four themes were identified in qualitative data drawn from student surveys – personal traits and motivators, training context, clear goals and feedback enabling understanding of one's own performance.ConclusionTesting laparoscopic skills throughout a learning program, in conjunction with individualised feedback and tracking of learning trajectory, increases trainee attendance. Laparoscopic simulation training programs are encouraged to reflect on the pedagogic framework in which their procedural skills training operates.

Beyond what we expect: The basics and pedagogical implications of test-enhanced learning in contemporary medical education.

Beyond what we expect: The basics and pedagogical implications of test-enhanced learning in contemporary medical education.

Does Two-Stage Testing Promote Long-Term Individual Learning?

Two-stage testing (TST) involves individual testing followed by taking the same test in teams. Previously, Vogler and Robinson (The Journal of Experimental Education, 84(4), 787–803, 2016) found that TST facilitated individual performance. The present study addressed methodological limitations in the Vogler and Robinson study in two replications along with isolating the components of TST in a laboratory study. In Experiments 1 and 2, where undergraduates remained in testing conditions (individual or TST) for the entire semester, no TST advantages were found. Experiment 3 controlled for the effects of initial test format [short answer (SA) versus multiple choice (MC)], mode (individual vs. group), and repetition (once vs. twice) on new and old (appeared on previous tests) MC and SA items. Two weeks after watching a lecture and being tested once or twice individually or in teams, students were tested once more individually. Results revealed effects for repetition (taking an initial test twice was better than once—confirming test-enhanced learning) and format (taking an initial SA test was better than MC—confirming the superiority of supply over recognition tests). However, taking an initial team test was no better than taking an individual test. TST alone may not lead to individual learning gains.

A Case Study of Using Test-Enhanced Learning as a Formative Assessment in High School Mathematics

Retrieving information from memory can—under many circumstances—strengthen one’s memory of the retrieved information itself. The strategic use of retrieval to enhance memory and help long-term retention is known as retrieval practice. However, it is unclear whether its effect also holds true in the case of learning mathematics. This research is an exploratory case study, where we test a method— using test-enhanced learning as formative assessment—in a high-needs vocational school. Since the literature on how this method works in classroom settings in mathematics is limited, the purpose of our case study was to get a better view and to lay the groundwork for further experiments. The experimental group and one of the control groups were from the vocational school, while the other control group was from an elite grammar school. On the final test members of the experimental group outscored their schoolmates and reached statistically the same scores as the control group from the elite grammar school. By means of the method, we were able to reduce the performance gap in long-term retention between students from the elite grammar school and students from the urban high-needs school.

Small group learning/assessment sessions: A method using test enhanced learning to increase engagement in a basic medical science neuroanatomy course.

Previous research has shown that test‐enhanced learning with structured feedback facilitates durable learning. We describe a small group learning/assessment activity using these approaches intended to increase engagement and engagement with the course material. We divided our class into six groups of seven students each that worked together in the activity. During each weekly session, course related multiple choice questions were projected and each group instructed to work independently to arrive at a consensus answer for each question. After each question is considered, a faculty facilitator then randomly selects one group to share their choice with the other groups and provide and rationale for their choice. A different group or groups are then called upon to share their choice. When differences emerge, the instructor then facilitates discussion among the groups in an effort to resolve confusion or incomplete or incorrect understanding that becomes evident. We found that attendance for these sessions was greater than for the more traditional lecture based session also included in the course and that students were actively engaged in this learning activity. The success of the small group learning/assessment session is dependent on several factors including the difficulty of the questions and their relatedness to the course objectives, the timing and placement of the session or sessions within the course and the skill of the faculty facilitator in encouraging active participation while ensuring a safe environment in which students can openly share their sometimes incomplete or incorrect understanding of the material.

The Importance of Sociocultural Factors in Moderating the Applicability of Test-Enhanced Learning to Continuing Professional Development.

Many studies have shown that repeated testing promotes learning, an effect known as test-enhanced learning. Although test-enhanced learning has been well-established within health care trainees, there are mixed findings of whether testing facilitates learning within continuing professional development (CPD) contexts. This piece argues that for testing to support learning in CPD, there is need to understand the various social, cultural, and structural factors that influence clinicians' willingness to participate in regular testing activities. The solution to this problem is conceptual in nature, whereby CPD programs must consider how learning cultures shape practicing clinicians' perspectives toward testing.

Prior episodic learning and the efficacy of retrieval practice

In three experiments we investigated how the level of study-based, episodic knowledge influences the efficacy of subsequent retrieval practice (testing) as a learning event. Possibilities are that the efficacy of a test, relative to a restudy control, decreases, increases, or is independent of the degree of prior study-based learning. The degree of study-based learning was manipulated by varying the number of item repetitions in the initial study phase between one and eight. Predictions of the dual-memory model of test-enhanced learning for the case of one study-phase repetition were used as a reference. Results support the hypothesis that the advantage of testing over restudy is independent of the degree of prior episodic learning, and they suggest that educators can apply cued-recall testing with the expectation that its efficacy is similar across varying levels of prior content learning. Implications for testing effect theory are discussed.

Pretesting versus posttesting: Comparing the pedagogical benefits of errorful generation and retrieval practice.

The use of practice tests to enhance learning, or test-enhanced learning, ranks among the most effective of all pedagogical techniques. We investigated the relative efficacy of pretesting (i.e., errorful generation) and posttesting (i.e., retrieval practice), two of the most prominent practice test types in the literature to date. Pretesting involves taking tests before to-be-learned information is studied, whereas posttesting involves taking tests after information is studied. In five experiments (combined n = 1,573), participants studied expository text passages, each paired with a pretest or a posttest. The tests involved multiple-choice (Experiments 1-5) or cued recall format (Experiments 2-4) and were administered with or without correct answer feedback (Experiments 3-4). On a criterial test administered 5 min or 48 hr later, both test types enhanced memory relative to a no-test control, but pretesting yielded higher overall scores. That advantage held across test formats, in the presence or absence of feedback, at different retention intervals, and appeared to stem from enhanced processing of text passage content (Experiment 5). Thus, although the benefits of posttesting are more well-established in the literature, pretesting is highly competitive with posttesting and can yield similar, if not greater, pedagogical benefits. These findings have important implications for the incorporation of practice tests in education and training contexts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Testing (quizzing) boosts classroom learning: A systematic and meta-analytic review.

Over the last century hundreds of studies have demonstrated that testing is an effective intervention to enhance long-term retention of studied knowledge and facilitate mastery of new information, compared with restudying and many other learning strategies (e.g., concept mapping), a phenomenon termed the testing effect. How robust is this effect in applied settings beyond the laboratory? The current review integrated 48,478 students' data, extracted from 222 independent studies, to investigate the magnitude, boundary conditions, and psychological underpinnings of test-enhanced learning in the classroom. The results show that overall testing (quizzing) raises student academic achievement to a medium extent (g = 0.499). The magnitude of the effect is modulated by a variety of factors, including learning strategy in the control condition, test format consistency, material matching, provision of corrective feedback, number of test repetitions, test administration location and timepoint, treatment duration, and experimental design. The documented findings support 3 theories to account for the classroom testing effect: additional exposure, transfer-appropriate processing, and motivation. In addition to their implications for theory development, these results have practical significance for enhancing teaching practice and guiding education policy and highlight important directions for future research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Strategies From 11 U.S. Medical Schools for Integrating Basic Science Into Core Clerkships.

Calls for curricular reform in medical schools and enhanced integration of basic and clinical science have resulted in a shift toward preclerkship curricula that enhance the clinical relevance of foundational science instruction and provide students with earlier immersion in the clinical environment. These reforms have resulted in shortened preclerkship curricula, yet the promise of integrated basic science education into clerkships has not been sufficiently realized because of barriers such as the nature of clinical practice, time constraints, and limited faculty knowledge. As personalized medicine requires that physicians have a more nuanced understanding of basic science, this is cause for alarm. To address this problem, several schools have developed instructional and assessment strategies to better integrate basic science into the clinical curriculum. In this article, faculty and deans from 11 U.S. medical schools discuss the strategies they implemented and the lessons they learned to provide guidance to other schools seeking to enhance basic science education during clerkships. The strategies include program-level interventions (e.g., longitudinal sessions dedicated to basic science during clerkships, weeks of lessons dedicated to basic science interspersed in clerkships), clerkship-level interventions (e.g., case-based learning with online modules, multidisciplinary clerkship dedicated to applied science), bedside-level interventions (e.g., basic science teaching scripts, self-directed learning), and changes to formative and summative assessments (e.g., spaced repetition/leveraging test-enhanced learning, developing customized examinations). The authors discovered that: interventions were more successful when buy-in from faculty and students was considered, central oversight by curricular committees collaborating with faculty was key, and some integration efforts may require schools to provide significant resources. All schools administered the United States Medical Licensing Examination Step 1 exam to students after clerkship, with positive outcomes. The authors have demonstrated that it is feasible to incorporate basic science into clinical clerkships, but certain challenges remain.

In vitro and in vivo synergistic anti-tumor effect of LIN28 inhibitor and metformin in oral squamous cell carcinoma

Cancer stem cell therapy is becoming a focal point for oral squamous cell carcinoma (OSCC). They can be regulated by tumor glucose metabolism, whereas the regulation is not fully investigated in OSCC. Herein, we studied the synergistic anti-tumor effect of a LIN28 inhibitor C1632 and hypoglycemic medication metformin in OSCC. In this study, OSCC cell lines SCC9 and CAL27 were treated with C1632 and metformin respectively or synergistically. First, western blotting was performed to detect the expression level of LIN28 and its downstream molecule HMGA2. Second, MTT assay was conducted to assess cell proliferation. Next, wound healing assay and transwell assay were applied to evaluate cell migration. Then, xenograft mouse experiment was done to explore anti-tumor effect in vivo. Finally, western blotting was used to investigate the pharmacological mechanisms of the synergistic effect oft he two medication. Results showed that LIN28 and HMGA2 expression decreased significantly in SCC9 and CAL27 cells under 240 μM C1632 treatment for 72 h. These effects were synergized under combined treatment for 24 h. Cell proliferation ability and migration ability of both cell lines decreased significantly under respective and combined treatment. In xenograft mouse experiment, tumor weights decreased by 48% under 40 mg/kg/3d C1632 treatment, 53% under 250 mg/kg/d metformin treatment and 91% under combined treatment for 18 days. Tumor volumes decreased by 32%, 57% and 47% under C1632, metformin and combined treatment respectively. These results indicated that C1632 and metformin exerts synergistic anti-tumor effects in OSCC cell lines SCC9 and CAL27, and also inhibits xenograft tumor growth in vivo.

THE BENEFITS OF RETRIEVAL-ENHANCED LEARNING

The aim of the article is to develop, scientifically substantiate and experimentally test the technology of application of the method of generation (recollection) (testing) in comparison with traditional methods of studying mathematics. To determine the effectiveness of learning and learning processes, the following tools and methods were used: observations, test sheets-tasks, tests with delay, statistical and mathematical research, descriptive analysis of comparison-comparison of results, etc. In this article, we compared the efficiency of mathematics learning and teaching with the retrieval-enhanced (test-enhanced) learning and the traditional, repetitive (re-learning) method. We examined how the retrieval-enhanced learning method can be incorporated into the daily work schedule during mathematics teaching and its effect at a primary school with the Hungarian language of instruction in Transcarpathian region of Ukraine. The educational experiment took place as a part of formal school lessons with content that fit the class curriculum. The same curriculum was used in two parallel classes. In the experimental class, education was conducted in a retrieval-enhanced way while traditionally performed in the control class. During the study in school conditions it was confirmed that retrieval-enhanced (test-enhanced) method (at the end of the lesson, corrective questions, short-, medium- and long-term applications) effectively improves the quantitative and qualitative indicators of the process of acquiring knowledge. In the experimental class, a much larger number of students mastered the requirements of the programme material at a better level than in the control group, i.e. the use of retrieval-enhanced (test-enhanced) method improved their results.

Metacognition About Practice Testing: a Review of Learners’ Beliefs, Monitoring, and Control of Test-Enhanced Learning

Over a century of research has established practice testing as a highly robust learning strategy that promotes long-term retention. However, learners do not always appreciate the benefits of testing for memory and do not use it as effectively as they could during their own self-regulated learning. The goal of this review is to identify common themes from research focused on learners’ metacognition about practice testing using the three components of metacognition (i.e., beliefs, monitoring, and control) as an organizational guide. To foreshadow the key findings from this research: (1) Without support, learners lack metacognitive awareness of testing as a tool to enhance memory but do recognize that testing can be used as a monitoring tool. (2) Learners can accurately monitor their learning while using practice testing when judgments are made in contexts that are representative of those encountered during a criterion test. (3) In educational contexts, learners report using less effective strategies equally or more often than practice testing. (4) Learners tend to test themselves only under conditions that encourage retrieval success, and rarely use a strategy involving repeated successful retrieval even when it would lead to improved retention. After reviewing research findings, I discuss various interventions that lead to learners using testing more often and more effectively in their own learning and offer recommendations for future research.

Twelve tips on guiding preparation for both high-stakes exams and long-term learning

High-stakes exams including admissions, licensing, and maintenance of certification examinations are commonplace in health professions education. Although exam scores and performance can often serve gate-keeping purposes, the broader goal of health professions education is to foster deep, self-directed, meaningful, motivated learning. Establishing strong support structures that emphasize deep learning and understanding rather than exam scores can be beneficial to preparing learners who have the knowledge base to be excellent practitioners. This article offers guidance that can be used by academic support centres, medical educators, learning specialists, and faculty advisors, or even test-takers, to help learners to balance score achievement and knowledge development, while simultaneously cultivating more efficient and motivated studying and increasingly self-regulated learning. This series of tips details considerations for building academic success supports, fostering a growth mindset, planning efficient and effective studying efforts, utilizing test-enhanced learning strategies, exam-taking skills practice, and other support structures that can help strengthen learning experiences overall.

Test-Enhanced Learning and Incentives in Biology Education.

Cognitive scientists have recommended the use of test-enhanced learning in science classrooms. Test-enhanced learning includes the testing effect, in which learners’ recall of information encountered in testing exceeds that of information not tested. The influence of incentives (e.g., points received) on learners who experience the testing effect in classrooms is less understood. The objective of our study was to examine the effects of incentives in a postsecondary biology course. We administered exams in the course using a quasi-experimental design with low and high point incentives and measured student learning. Although exposure to exams predicted better learning, incentive level did not moderate this effect, an outcome that contradicted recent laboratory findings that higher incentives decreased student recall. We discuss possible explanations of the disparate outcomes as well as the implications for further research on the testing effect in postsecondary biology classrooms.

Introducing multiple-choice questions to promote learning for medical students: effect on exam performance in obstetrics and gynecology

PurposeTesting is required in medical education. The large number of exams that students face requires effective learning strategies. Various methods of improving knowledge retention and recall have been discussed, two of the most widely evaluated of which are test-enhanced learning and pause procedures. This study investigated the effect of voluntary multiple-choice questions on students’ performance.MethodsIn a prospective study from April 2013 to March 2015, 721 students were randomly assigned to receive supplementary online material only (control group) or additional multiple-choice questions (investigative group) accompanying lectures. Their performance in the final exam was evaluated.ResultsA total of 675 students were ultimately included, with 299 randomly assigned to the investigative group and 376 to the control group. Students in the investigative group scored significantly better in relation to grades and points (2.11 vs. 2.49; 33 vs 31.31; p < 0.05). The effect declined over time.ConclusionThis is the first study of the use of voluntary multiple-choice questions to improve medical students’ performance. The results support test-enhanced learning and the feasibility of implementing multiple-choice questions in lectures.

Effectiveness of “OralDETECT”: a Repetitive Test-enhanced, Corrective Feedback Method Competency Assessment Tool for Early Detection of Oral Cancer

Early diagnosis of oral cancer results in less aggressive treatment and improves the quality of life and overall 5-year survival rate. Well-trained dental professionals can play a crucial role in the early detection of oral cancers. The present study aims to determine the effectiveness of the training program "OralDETECT", a spaced repetitive, test-enhanced learning tool with a corrective feedback mechanism for early detection of oral cancer. Thirty-two dentists and 259 dental students from three Malaysian dental schools were involved in this study. All participants were trained and calibrated to recognize oral potentially malignant disorders (OPMD) and oral cancer using "OralDETECT", which is comprised of a series of pre-test, lecture, post-tests and review sessions. The percentage of correct answers (scores) for each test given by the participants was calculated and analysed using a paired t test. It was found that the overall percentage of diagnostic accuracy for both dental professionals and student groups increased to above 80% from the pre-tests to the final post-tests. There was a significant improvement in overall scores between the pre-tests and all three post-tests for the dental professional groups and the student groups. The diagnostic accuracy for individual OPMD and lesions suspicious of oral cancer also increased to above 80% for both groups. The results of our study demonstrate that the "OralDETECT" is an efficient and effective competency tool which can be used to train dental professionals and students for the early detection of OPMD and oral cancer.

Beyond right or wrong: More effective feedback for formative multiple-choice tests.

IntroductionThe role of feedback in test-enhanced learning is an understudied area that has the potential to improve student learning. This study investigates the influence of different forms of post-test feedback on retention and transfer of biomedical knowledge within a test-enhanced learning framework.Methods64 participants from a Canadian and an Australian medical school sat two single-best-answer formative multiple choice tests one week apart. We compared the effects of conceptually focused, response-oriented, and simple right/wrong feedback on a learner’s ability to correctly answer new (transfer) questions. On the first test occasion, participants received parent items with feedback, and then attempted items closely related (near transfer) to and more distant (far transfer) from parent items. In a repeat test at 1 week, participants were given different near and far transfer versions of parent items. Feedback type, and near and far transfer items were randomized within and across participants.ResultsAnalysis demonstrated that response-oriented and conceptually focused feedback were superior to traditional right/wrong feedback for both types of transfer tasks and in both immediate and final retention test performance. However, there was no statistically significant difference between response-orientated and conceptually focused groups on near or far transfer problems, nor any differences in performance between our initial test occasion and the retention test 1 week later. As with most studies of transfer, participants’ far transfer scores were lower than for near transfer.DiscussionRight/wrong feedback appears to have limited potential to augment test-enhanced learning. Our work suggests that item-level feedback and feedback that identifies and elaborates on key conceptual knowledge are two important areas for future research on learning, retention and transfer.