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1.  Prescribed Active Learning Increases Performance in Introductory Biology 
CBE— Life Sciences Education  2007;6(2):132-139.
We tested five course designs that varied in the structure of daily and weekly active-learning exercises in an attempt to lower the traditionally high failure rate in a gateway course for biology majors. Students were given daily multiple-choice questions and answered with electronic response devices (clickers) or cards. Card responses were ungraded; clicker responses were graded for right/wrong answers or participation. Weekly practice exams were done as an individual or as part of a study group. Compared with previous versions of the same course taught by the same instructor, students in the new course designs performed better: There were significantly lower failure rates, higher total exam points, and higher scores on an identical midterm. Attendance was higher in the clicker versus cards section; attendance and course grade were positively correlated. Students did better on clicker questions if they were graded for right/wrong answers versus participation, although this improvement did not translate into increased scores on exams. In this course, achievement increases when students get regular practice via prescribed (graded) active-learning exercises.
PMCID: PMC1885904  PMID: 17548875
2.  Increased Course Structure Improves Performance in Introductory Biology 
CBE Life Sciences Education  2011;10(2):175-186.
We tested the hypothesis that highly structured course designs, which implement reading quizzes and/or extensive in-class active-learning activities and weekly practice exams, can lower failure rates in an introductory biology course for majors, compared with low-structure course designs that are based on lecturing and a few high-risk assessments. We controlled for 1) instructor effects by analyzing data from quarters when the same instructor taught the course, 2) exam equivalence with new assessments called the Weighted Bloom's Index and Predicted Exam Score, and 3) student equivalence using a regression-based Predicted Grade. We also tested the hypothesis that points from reading quizzes, clicker questions, and other “practice” assessments in highly structured courses inflate grades and confound comparisons with low-structure course designs. We found no evidence that points from active-learning exercises inflate grades or reduce the impact of exams on final grades. When we controlled for variation in student ability, failure rates were lower in a moderately structured course design and were dramatically lower in a highly structured course design. This result supports the hypothesis that active-learning exercises can make students more skilled learners and help bridge the gap between poorly prepared students and their better-prepared peers.
PMCID: PMC3105924  PMID: 21633066
3.  Replacing Lecture with Peer-led Workshops Improves Student Learning 
CBE Life Sciences Education  2009;8(3):182-192.
Peer-facilitated workshops enhanced interactivity in our introductory biology course, which led to increased student engagement and learning. A majority of students preferred attending two lectures and a workshop each week over attending three weekly lectures. In the workshops, students worked in small cooperative groups as they solved challenging problems, evaluated case studies, and participated in activities designed to improve their general learning skills. Students in the workshop version of the course scored higher on exam questions recycled from preworkshop semesters. Grades were higher over three workshop semesters in comparison with the seven preworkshop semesters. Although males and females benefited from workshops, there was a larger improvement of grades and increased retention by female students; although underrepresented minority (URM) and non-URM students benefited from workshops, there was a larger improvement of grades by URM students. As well as improving student performance and retention, the addition of interactive workshops also improved the quality of student learning: Student scores on exam questions that required higher-level thinking increased from preworkshop to workshop semesters.
PMCID: PMC2736022  PMID: 19723813
4.  A Model for Self-Directed Problem-Based Learning for Renal Therapeutics 
To introduce a new approach to problem-based learning (PBL) for self-directed learning in renal therapeutics.
This 5-week course, designed for large student cohorts using minimal teaching resources, was based on a series of case studies and subsequent pharmaceutical care plans, followed by intensive and regular feedback from the instructor.
Assessment of achievement of the learning outcomes was based on weekly-graded care plans and peer review assessment, allowing each student to judge the contributions of each group member and their own, along with a written case-study based examination. The pharmaceutical care plan template, designed using a “tick-box” system, significantly reduced staff time for feedback and scoring.
The proposed instructional model achieved the desired learning outcomes with appropriate student feedback, while promoting skills that are essential for the students' future careers as health care professionals.
PMCID: PMC2996763  PMID: 21301607
renal therapeutics; problem-based learning; case study; pharmaceutical care plan
5.  How Accurate Is Peer Grading? 
CBE Life Sciences Education  2010;9(4):482-488.
Previously we showed that weekly, written, timed, and peer-graded practice exams help increase student performance on written exams and decrease failure rates in an introductory biology course. Here we analyze the accuracy of peer grading, based on a comparison of student scores to those assigned by a professional grader. When students graded practice exams by themselves, they were significantly easier graders than a professional; overall, students awarded ≈25% more points than the professional did. This difference represented ≈1.33 points on a 10-point exercise, or 0.27 points on each of the five 2-point questions posed. When students graded practice exams as a group of four, the same student-expert difference occurred. The student-professional gap was wider for questions that demanded higher-order versus lower-order cognitive skills. Thus, students not only have a harder time answering questions on the upper levels of Bloom's taxonomy, they have a harder time grading them. Our results suggest that peer grading may be accurate enough for low-risk assessments in introductory biology. Peer grading can help relieve the burden on instructional staff posed by grading written answers—making it possible to add practice opportunities that increase student performance on actual exams.
PMCID: PMC2995766  PMID: 21123695
6.  Temporal Structure of First-year Courses and Success at Course Exams: Comparison of Traditional Continual and Block Delivery of Anatomy and Chemistry Courses 
Croatian Medical Journal  2009;50(1):61-68.
To evaluate students’ academic success at the Anatomy and Chemistry courses delivered in a traditional continual course, spread over the two semesters, or in alternating course blocks, in which 1 group of students attended first the Anatomy and then the Chemistry course and vice versa.
We analyzed the data on exam grades for Anatomy and Chemistry courses in the first year of the curriculum for academic year 2001/02, with the traditional continual delivery of the courses (n = 253 for chemistry and n = 243 for anatomy course), and academic year 2003/04, with block delivery of the courses (n = 255 for chemistry and n = 260 for anatomy course). The content of the courses and the teachers were similar in both academic years. Grades from the final examination were analyzed only for students who sat the exam at the first available exam term and passed the course. For the Anatomy block course, grades at 2 interim written tests and 2 parts of the final exam (practical stage exam and oral exam) in each block were analyzed for students who passed all interim tests and the final exam.
There were no differences between the two types of course delivery in the number of students passing the final examination at first attempt. There was a decrease in passing percentage for the two Anatomy block course student groups in 2003/04 (56% passing students in block 1 vs 40% in block 2, P = 0.014). There were no differences in the final examination grade between the 2 blocks for both the Anatomy and Chemistry course, but there was an increase in the average grades from 2001/02 to 2003/04 academic year due to an increase in Chemistry grades (F1,399 = 18.4, P < 0.001, 2 × 2 ANOVA). Grades in Chemistry were significantly lower than grades in Anatomy when courses were delivered in a continual but not in a block format (F1,399 = 35.1, P < 0.001, 2 × 2 ANOVA). When both courses were delivered in a block format there was no effect of the sequence of their delivery (F1,206 = 1.8, P = 0.182, 2 × 2 ANOVA). There was also a significant difference in grades on interim assessments of Anatomy when it was delivered in the block format (F3,85 = 28.8, P < 0.001, between-within subjects 2 × 4 ANOVA) with grades from practical test and oral exam being significantly lower than grades on 2 interim tests that came at the beginning of the block (P < 0.001 for all pair-wise comparisons).
The type of course delivery was not associated with significant differences in student academic success in Anatomy and Chemistry courses in the medical curriculum. Students can successfully pass these courses when they are delivered either in a continual, whole year format or in a condensed time format of a course block, regardless of the number and type of courses preceding the block course.
PMCID: PMC2657569  PMID: 19260146
7.  Daily Online Testing in Large Classes: Boosting College Performance while Reducing Achievement Gaps 
PLoS ONE  2013;8(11):e79774.
An in-class computer-based system, that included daily online testing, was introduced to two large university classes. We examined subsequent improvements in academic performance and reductions in the achievement gaps between lower- and upper-middle class students in academic performance. Students (N = 901) brought laptop computers to classes and took daily quizzes that provided immediate and personalized feedback. Student performance was compared with the same data for traditional classes taught previously by the same instructors (N = 935). Exam performance was approximately half a letter grade above previous semesters, based on comparisons of identical questions asked from earlier years. Students in the experimental classes performed better in other classes, both in the semester they took the course and in subsequent semester classes. The new system resulted in a 50% reduction in the achievement gap as measured by grades among students of different social classes. These findings suggest that frequent consequential quizzing should be used routinely in large lecture courses to improve performance in class and in other concurrent and subsequent courses.
PMCID: PMC3835925  PMID: 24278176
8.  A Self-paced Course in Pharmaceutical Mathematics Using Web-based Databases 
To transform a pharmaceutical mathematics course to a self-paced instructional format using Web-accessed databases for student practice and examination preparation.
The existing pharmaceutical mathematics course was modified from a lecture style with midsemester and final examinations to a self-paced format in which students had multiple opportunities to complete online, nongraded self-assessments as well as in-class module examinations.
Grades and course evaluations were compared between students taking the class in lecture format with midsemester and final examinations and students taking the class in the self-paced instructional format. The number of times it took students to pass examinations was also analyzed.
Based on instructor assessment and student feedback, the course succeeded in giving students who were proficient in pharmaceutical mathematics a chance to progress quickly and students who were less skillful the opportunity to receive instruction at their own pace and develop mathematical competence.
PMCID: PMC1637015  PMID: 17149445
mathematics; Web-based instruction; self-paced; distance education; assessment
9.  Portfolio: A Comprehensive Method of Assessment for Postgraduates in Oral and Maxillofacial Surgery 
Post graduate learning and assessment is an important responsibility of an academic oral and maxillofacial surgeon. The current method of assessment for post graduate training include formative evaluation in the form of seminars, case presentations, log books and infrequently conducted end of year theory exams. End of the course theory and practical examination is a summative evaluation which awards the degree to the student based on grades obtained. Oral and maxillofacial surgery is mainly a skill based specialty and deliberate practice enhances skill. But the traditional system of assessment of post graduates emphasizes their performance on the summative exam which fails to evaluate the integral picture of the student throughout the course. Emphasis on competency and holistic growth of the post graduate student during training in recent years has lead to research and evaluation of assessment methods to quantify students’ progress during training. Portfolio method of assessment has been proposed as a potentially functional method for post graduate evaluation. It is defined as a collection of papers and other forms of evidence that learning has taken place. It allows the collation and integration of evidence on competence and performance from different sources to gain a comprehensive picture of everyday practice. The benefits of portfolio assessment in health professions education are twofold: it’s potential to assess performance and its potential to assess outcomes, such as attitudes and professionalism that are difficult to assess using traditional instruments. This paper is an endeavor for the development of portfolio method of assessment for post graduate student in oral and maxillofacial surgery.
Electronic supplementary material
The online version of this article (doi:10.1007/s12663-012-0381-7) contains supplementary material, which is available to authorized users.
PMCID: PMC3589504  PMID: 24431818
Oral and maxillofacial surgery; Post graduate; Assessment; Portfolio
10.  Creation of a Graduate Oral/Written Communication Skills Course 
To convert a traditional graduate seminar course into a class that emphasizes written as well as oral communication skills.
Graduate pharmacology/toxicology students presented formal and informal seminars on their research progress and on recent peer-reviewed literature from the field. Students in the audience wrote critiques of the research project or article, as well as of the presentations themselves.
Students were evaluated based on oral presentations, class participation, and a scientific writing component. All faculty members provided constructive written comments and a grade. The course master provided the presenter with a formal written review and returned a “red pen” revision of each student critique.
This novel seminar/writing course introduces intensive focus on writing skills, which are especially essential today given the large number of graduate students for whom English is not a first language.
PMCID: PMC1636900  PMID: 17136148
research; seminar; communication skills; graduate education
11.  Assessment of the Effectiveness of the Studio Format in Introductory Undergraduate Biology 
CBE Life Sciences Education  2008;7(2):234-242.
Kansas State University converted its introductory biology course, previously taught as an audio-tutorial (A-T), to a studio format in 1997. We share with others information about the process involved and present assessment data for the studio format course that address 1) student exam performance in A-T and studio; 2) student course grades in A-T and studio; 3) student and instructor perceptions and attitudes for A-T and studio; 4) student performance in subsequent biology courses for A-T and studio; and 5) gains in student learning for the studio course and other traditional lecture/lab courses. Collectively, these measures demonstrate that the studio format is as effective as or more effective (for some measures) than the A-T approach and traditional approaches in providing an effective learning environment. We discuss the issues involved in comparing course formats.
PMCID: PMC2424303  PMID: 18519615
12.  Multiple Rubric-based Assessments of Student Case Presentations 
To evaluate a rubric-based method of assessing pharmacy students' case presentations in the recitation component of a therapeutics course.
A rubric was developed to assess knowledge, skills, and professional behavior. The rubric was used for instructor, student peer, and student self-assessment of case presentations. Rubric-based composite scores were compared to the previous dichotomous checklist-based scores.
Rubric-based instructor scores were significantly lower and had a broader score distribution than those resulting from the checklist method. Spring 2007 rubric-based composite scores from instructors and peers were significantly lower than those from the pilot study results, but self-assessment composite scores were not significantly different.
Successful development and implementation of a grading rubric facilitated evaluation of knowledge, skills, and professional behavior from the viewpoints of instructor, peer, and self in a didactic course.
PMCID: PMC2508736  PMID: 18698367
rubric; pharmacy; peer assessment; self-assessment; assessment
13.  Collaborative Testing Improves Performance but Not Content Retention in a Large-Enrollment Introductory Biology Class 
CBE Life Sciences Education  2012;11(4):392-401.
Collaborative testing has been shown to improve performance but not always content retention. In this study, we investigated whether collaborative testing could improve both performance and content retention in a large, introductory biology course. Students were semirandomly divided into two groups based on their performances on exam 1. Each group contained equal numbers of students scoring in each grade category (“A”–“F”) on exam 1. All students completed each of the four exams of the semester as individuals. For exam 2, one group took the exam a second time in small groups immediately following the individually administered test. The other group followed this same format for exam 3. Individual and group exam scores were compared to determine differences in performance. All but exam 1 contained a subset of cumulative questions from the previous exam. Performances on the cumulative questions for exams 3 and 4 were compared for the two groups to determine whether there were significant differences in content retention. Even though group test scores were significantly higher than individual test scores, students who participated in collaborative testing performed no differently on cumulative questions than students who took the previous exam as individuals.
PMCID: PMC3516795  PMID: 23222835
14.  Redesign and Evaluation of a Patient Assessment Course 
To redesign a patient assessment course using a structured instructional design process and evaluate student learning.
Course coordinators collaborated with an instructional design and development expert to incorporate new pedagogical approaches (eg, Web-based self-tests), create new learning activities (eg, peer collaboration on worksheets, SOAP note writing), and develop grading rubrics.
Formative and summative surveys were administered for student self-assessment and course evaluation. Seventy-six students (78%) completed the summative survey. The mean course grade was 91.8% ± 3.6%, with more than 75% of students reporting achievement of primary course learning objectives. All of the additional learning activities helped students meet the learning objectives with the exception of the written drug information response.
The use of a structured instructional design process to redesign a patient assessment course was successful in creating a curriculum that succeeded in teaching students the specified learning objectives. Other colleges and schools are encouraged to collaborate with an instructional design and development expert to improve the pharmacy curriculum.
PMCID: PMC2779648  PMID: 19960090
curriculum design; patient assessment; physical assessment
15.  Evaluation of validity of midwifery special courses in Isfahan University of Medical Sciences 
The aim of training midwifery student is to increase scientific and practical abilities in trainees in order to present caring health services. Then, the evaluation tools of these abilities have great importance. This study tried to evaluate the content validity, criterion validity and base validity of academic exams.
This cross-sectional research was an evaluated type that has been done on 18 special theoretical courses of midwifery in 2 semesters in 2007-2008. The data gathered by checklists. The data about questionnaire and the result of analyzing exam questions (final and midterm) were compiled by 2 educating experts of medical education and 2 experts for each course. The data analyzed by SPSS software. For determining the base validity, spearman correlation test and for presenting descriptive results, distribution tables were applied.
The evaluation of 1013 questions showed that in 18 courses, in 61.18% of exams, more than 90% of questions had content validity and in 28.27% of exams, in more than 90% of questions, criterion validity had been considered. The results showed that in 92.38% of questions, content validity and in 80.45% of questions, criterion validity was considered. 11 courses out of 18 courses had base validity.
This survey showed that content validity of the exam questions in midwifery special theoretical courses was in favorable levels. But, the criterion validity of exam questions was far away from the ideal level. Then, education in each session can help the teachers achieve their exam purposes.
PMCID: PMC3249765  PMID: 22224099
Content validity; criterion validity; midwifery special exams; reliability
16.  Peer-Led Team Learning in an Online Course on Controversial Medication Issues and the US Healthcare System 
Objective. To implement peer-led team learning in an online course on controversial issues surrounding medications and the US healthcare system.
Design. The course was delivered completely online using a learning management system. Students participated in weekly small-group discussions in online forums, completed 3 reflective writing assignments, and collaborated on a peer-reviewed grant proposal project.
Assessment. In a post-course survey, students reported that the course was challenging but meaningful. Final projects and peer-reviewed assignments demonstrated that primary learning goals for the course were achieved and students were empowered to engage in the healthcare debate.
Conclusions. A peer-led team-learning is an effective strategy for an online course offered to a wide variety of student learners. By shifting some of the learning and grading responsibility to students, the instructor workload for the course was rendered more manageable.
PMCID: PMC3776904  PMID: 24052653
peer-led team learning; online learning; interprofessional education; healthcare system
17.  Transition from Longitudinal to Block Structure of Preclinical Courses: Outcomes and Experiences 
Croatian Medical Journal  2009;50(5):492-506.
To evaluate the transition from a longitudinal to block/modular structure of preclinical courses in a medical school adapting to the process of higher education harmonization in Europe.
Average grades and the exam pass rates were compared for 11 preclinical courses before and after the transition from the longitudinal (academic years 1999/2000 to 2001/2002) to block/modular curriculum (academic years 2002/2003 to 2004/2005) at Zagreb University School of Medicine, Croatia. Attitudes of teachers toward the 2 curriculum structures were assessed by a semantic differential scale, and the experiences during the transition were explored in focus groups of students and teachers.
With the introduction of the block/modular curriculum, average grades mostly increased, except in 3 major courses: Anatomy, Physiology, and Pathology. The proportion of students who passed the exams at first attempt decreased in most courses, but the proportion of students who successfully passed the exam by the end of the summer exam period increased. Teachers generally had more positive attitudes toward the longitudinal (median [C]±intequartile range [Q], 24 ± 16) than block/modular curriculum (C±Q, 38 ± 26) (P = 0.001, Wilcoxon signed rank test). The qualitative inquiry indicated that the dissatisfaction of students and teachers with the block/modular preclinical curriculum was caused by perceived hasty introduction of the reform under pressure and without much adaptation of the teaching program and materials, which reflected negatively on the learning processes and outcomes.
Any significant alteration in the temporal structure of preclinical courses should be paralleled by a change in the content and teaching methodology, and carefully planned and executed in order to achieve better academic outcomes.
PMCID: PMC2765745  PMID: 19839073
18.  Intergroup Peer Assessment in Problem-Based Learning Tutorials for Undergraduate Pharmacy Students 
To develop, implement, and evaluate a process of intergroup peer assessment and feedback using problem-based learning (PBL) tutorials.
A peer-assessment process was used in a PBL tutorial setting for an integrated pharmacy practice course in which small groups of students graded each others’ PBL case presentations and provided feedback in conjunction with facilitator assessment.
Students' quantitative and qualitative perceptions of the peer assessment process were triangulated with facilitator feedback. Students became more engaged, confident, and motivated, and developed a range of self-directed, life-long learning skills. Students had mixed views regarding the fairness of the process and grade descriptors. Facilitators strongly supported the peer assessment process.
Peer assessment is an appropriate method to assess PBL skills and is endorsed by students as appropriate and useful.
PMCID: PMC3138352  PMID: 21769149
pharmacy students; peer assessment; problem-based learning
19.  Assessment of scientific thinking in basic science in the Iranian second national Olympiad 
BMC Research Notes  2012;5:61.
To evaluate the scientific reasoning in basic science among undergraduate medical students, we established the National Medical Science Olympiad in Iran. In this Olympiad, the drawing of a concept map was used to evaluate a student's knowledge framework; students' ability in hypothesis generation and testing were also evaluated in four different steps. All medical students were invited to participate in this program. Finally, 133 undergraduate medical students with average grades ≥ 16/20 from 45 different medical schools in Iran were selected. The program took the form of four exams: drawing a concept map (Exam I), hypothesis generation (Exam II), choosing variables based on the hypothesis (Exam III), measuring scientific thought (Exam IV). The examinees were asked to complete all examination items in their own time without using textbooks, websites, or personal consultations. Data were presented as mean ± SE of each parameter. The correlation coefficient between students' scores in each exam with the total final score and average grade was calculated using the Spearman test.
Out of a possible score of 200, the mean ± SE of each exam were as follows: 183.88 ± 5.590 for Exam I; 78.68 ± 9.168 for Exam II; 92.04 ± 2.503 for exam III; 106.13 ± 2.345 for Exam IV. The correlation of each exam score with the total final score was calculated, and there was a significant correlation between them (p < 0.001). The scatter plot of the data showed a linear correlation between the score for each exam and the total final score. This meant that students with a higher final score were able to perform better in each exam through having drawn up a meaningful concept map.
The average grade was significantly correlated with the total final score (R = 0.770), (p < 0.001). There was also a significant correlation between each exam score and the average grade (p < 0.001). The highest correlation was observed between Exam I (R = 0.7708) and the average grade. This means students with higher average grades had better grades in each exam, especially in drawing the concept map.
We hope that this competition will encourage medical schools to integrate theory and practice, analyze data, and read research articles. Our findings relate to a selected population, and our data may not be applicable to all medical students. Therefore, further studies are required to validate our results.
PMCID: PMC3292993  PMID: 22270104
20.  Effectiveness of Human Anatomy Education for Pharmacy Students via the Internet 
To evaluate the overall effectiveness of a human anatomy course taught to distance-based and campus-based pharmacy students.
A retrospective analysis of students' grades and course evaluations from 2003 through 2006 was conducted.
No significant differences in student performance by pathway were found for the 2003-2005 academic years (p > 0.05). However, distance-based students' percentage and letter grades were significantly higher in 2006 (p = 0.013 and p = 0.004 respectively). Comparison of course and instructor evaluations showed that students in the distance course held similar or more positive perceptions of the course than their campus peers.
Similar performance by campus and distance students enrolled in a human anatomy suggests that a distance-based course can be used successfully to teach human anatomy to pharmacy students.
PMCID: PMC2661160  PMID: 19325961
human anatomy; distance education; Internet
21.  Using Primary Literature to Teach Science Literacy to Introductory Biology Students 
Undergraduate students struggle to read the scientific literature and educators have suggested that this may reflect deficiencies in their science literacy skills. In this two-year study we develop and test a strategy for using the scientific literature to teach science literacy skills to novice life science majors. The first year of the project served as a preliminary investigation in which we evaluated student science literacy skills, created a set of science literacy learning objectives aligned with Bloom’s taxonomy, and developed a set of homework assignments that used peer-reviewed articles to teach science literacy. In the second year of the project the effectiveness of the assignments and the learning objectives were evaluated. Summative student learning was evaluated in the second year on a final exam. The mean score was 83.5% (±20.3%) and there were significant learning gains (p < 0.05) in seven of nine of science literacy skills. Project data indicated that even though students achieved course-targeted lower-order science literacy objectives, many were deficient in higher-order literacy skills. Results of this project suggest that building scientific literacy is a continuing process which begins in first-year science courses with a set of fundamental skills that can serve the progressive development of literacy skills throughout the undergraduate curriculum.
PMCID: PMC3706167  PMID: 23858355
22.  Use of key feature questions in summative assessment of veterinary medicine students 
Irish Veterinary Journal  2013;66(1):3.
To prove the hypothesis that procedural knowledge might be tested using Key Feature (KF) questions in written exams, the University of Veterinary Medicine Hannover Foundation (TiHo) pioneered this format in summative assessment of veterinary medicine students. Exams in veterinary medicine are either tested orally, practically, in written form or digitally in written form. The only question formats which were previously used in the written e-exams were Type A Single-choice Questions, Image Analysis and Short Answer Questions. E-exams are held at the TiHo using the electronic exam system Q [kju:] by CODIPLAN GmbH.
In order to examine less factual knowledge and more procedural knowledge and thus the decision-making skills of the students, a new question format was integrated into the exam regulations by the TiHo and some examiner used this for the first time in the computer based assessment. Following a successful pilot phase in formative e-exams for students, KF questions were also introduced in summative exams. A number of multiple choice questions were replaced by KF questions in four computer based assessment in veterinary medicine. The subjects were internal medicine, surgery, reproductive medicine and dairy science.
The integration and linking of KF questions into the computer based assessment system Q [kju:] went without any complications. The new question format was well received both by the students and the teaching staff who formulated the questions.
The hypothesis could be proven that Key Feature questions represent a practicable addition to the existing e-exam question formats for testing procedural knowledge. The number of KF questions will be therefore further increased in examinations in veterinary medicine at the TiHo.
PMCID: PMC3599329  PMID: 23497425
Key feature questions; Written examination; Reliability; Electronic exam
23.  Teacher Preference, Peer Rejection, and Student Aggression: A Prospective Study of Transactional Influence and Independent Contributions to Emotional Adjustment and Grades 
Journal of school psychology  2008;46(06):661-685.
This study assessed the importance of teacher preference of individual students, relative to peer rejection and student aggression, as an independent predictor of children's emotional adjustment and grades. First, a longitudinal, cross-lagged path analysis was conducted to determine the patterns of influence among teacher preference, peer rejection, and student aggression. Then, parallel growth analyses were examined to test whether lower initial and declining teacher preference, beyond the influence of initial-level and change in peer rejection and student aggression, predicted change in loneliness, depression, social anxiety, and grades. Social adjustment, emotional adjustment, and academic adjustment were assessed in the fall and spring of two consecutive school years with 1,193 third-grade students via peer-, teacher-, and self-report instruments as well as school records. In the cross-lagged path analysis, reciprocal influence over time between teacher preference and peer rejection was found, and student aggression predicted lower teacher preference and higher peer rejection. In the growth analyses, initial and declining teacher preference were independent predictors of increasing loneliness and declining grades. Discussion focuses on the relevance of the results within a transactional model of school adaptation.
PMCID: PMC2598743  PMID: 19083378
24.  A Cardiovascular Pharmacotherapy Elective Course to Enhance Pharmacy Students’ Literature Evaluation Skills and Ability to Apply Clinical Evidence 
Objectives. To design and implement a cardiovascular pharmacotherapy elective course to enhance pharmacy students’ ability to evaluate medical literature and apply clinical evidence.
Design. In weekly class sessions, students were provided an overview of the important literature supporting therapeutic guidelines for the management of major cardiovascular diseases. Students worked in groups to complete outside-of-class assignments involving a patient case and then discussed the case in class. During the semester, each student also independently completed a literature search on an assigned topic, summarized the studies found in table format, and presented 1 of the studies to the class.
Assessment. Students’ grades on weekly patient case assignments steadily increased over the semester. Also, the average grade on the final examination was higher than the grade on the midterm take-home examination. On the course evaluation, students rated the course favorably in terms of improvement of confidence in evaluating the primary literature and applying it to practice.
Conclusion. Completion of the cardiovascular pharmacotherapy elective increased pharmacy students’ level of confidence in evaluating literature and applying clinical evidence in making patient care decisions.
PMCID: PMC3448475  PMID: 23049109
cardiovascular disease; pharmacotherapy; evidence-based medicine; elective course
25.  Multiple-Choice Exams: An Obstacle for Higher-Level Thinking in Introductory Science Classes 
CBE Life Sciences Education  2012;11(3):294-306.
Learning science requires higher-level (critical) thinking skills that need to be practiced in science classes. This study tested the effect of exam format on critical-thinking skills. Multiple-choice (MC) testing is common in introductory science courses, and students in these classes tend to associate memorization with MC questions and may not see the need to modify their study strategies for critical thinking, because the MC exam format has not changed. To test the effect of exam format, I used two sections of an introductory biology class. One section was assessed with exams in the traditional MC format, the other section was assessed with both MC and constructed-response (CR) questions. The mixed exam format was correlated with significantly more cognitively active study behaviors and a significantly better performance on the cumulative final exam (after accounting for grade point average and gender). There was also less gender-bias in the CR answers. This suggests that the MC-only exam format indeed hinders critical thinking in introductory science classes. Introducing CR questions encouraged students to learn more and to be better critical thinkers and reduced gender bias. However, student resistance increased as students adjusted their perceptions of their own critical-thinking abilities.
PMCID: PMC3433302  PMID: 22949426

Results 1-25 (1185632)