Using collaborative two-stage examinations to address test anxiety in a large enrollment gateway course

Learning in context: Undergraduate students' knowledge and the content retention of anatomy between discipline-specific and integrated course approaches

Undergraduate introductory human anatomy and human physiology courses are either taught as discipline-specific or integrated anatomy and physiology (A&P) sequences. An institution underwent a curricular revision to change the course approach from discipline-specific Human Anatomy and Human Physiology to an integrated A&P I and II sequence, allowing the unique opportunity to explore the potential role of contextual learning in academic achievement and content retention. Mediation and moderation analysis was used to evaluate lecture examinations, laboratory practical examinations, and anatomical content retention between the different course approaches. Undergraduate students in the integrated A&P I course approach performed significantly better on lecture assessments and had a higher anatomy content retention rate at the end of the year than students enrolled in the standalone Human Anatomy course. The lecture examination averages between Human Physiology and A&P II (the second course in the sequence), as well as the anatomy laboratory practical examinations, were not significantly different between discipline-specific and integrated course approaches. The results suggest contextual learning-providing physiological context to anatomical structures-increases the anatomical content retention and academic achievement overall.

Collaborative Assessment in the Gross Anatomy Lab

Purpose

In 2018, the Michigan State University College of Human Medicine incorporated two-stage examinations into the gross anatomy curriculum. Multiple studies have investigated two-stage examinations and have largely reported positive findings. Here, we used a mixed-methods approach to further investigate the feasibility and student perceptions of the two-stage examination in the context of a medical school curriculum that emphasizes longitudinal group-based learning and formative assessments.

Methods

Three student cohorts were assessed with a formative two-stage examination at the end of their first-year anatomy experience. Data for the quantitative analysis included examination scores from the individual and group portions of the two-stage examination. For the qualitative stage of this project, we utilized a constructivist grounded theory methodology in which data, including both post-examination survey results and one-on-one semi-structured student interviews, were transcribed (interviews), coded, inductively and iteratively reviewed, and thematically interpreted.

Results

Survey and interview results revealed an overwhelmingly positive perception of the collaborative assessment experience. Student comments demonstrated educational value in the immediate feedback provided by this examination format and suggested that collaboration during the examination transformed the assessment into a learning experience.

Conclusions

While two-stage examinations have the potential to positively transform an assessment into a learning experience, we also identified complex relationships between content knowledge and anxiety that may affect student perceptions. In addition, examination logistics (e.g., curricular timing) have the potential to negatively affect student perceptions, indicating that faculty should consider these factors when implementing collaborative assessments into their curriculum.

The Russian version of the Abbreviated Math Anxiety Scale: psychometric properties in adolescents aged 13-16 years

This study is the first to assess the internal consistency and factor validity of the Abbreviated Math Anxiety Scale (AMAS) in a sample of Russian adolescents as well as gender differences and gender invariance. The study included 4,218 adolescents in grades 7-9 (M = 14.23, SD = 0.92). Internal consistency, measured with Cronbach's alpha, was high. Analysis of the factor structure revealed the best correspondence of the second-order factor model, which included two scales (learning math anxiety and math evaluation anxiety) and the general scale of math anxiety. There were greater gender differences in the all three scales. Analysis of gender invariance demonstrated that the mathematics anxiety construct was uniform in boys and girls. These findings confirm the reliable psychometric properties and validity of the AMAS, enabling its use in adolescents.

Why Did Students Report Lower Test Anxiety during the COVID-19 Pandemic?

Test anxiety is a common experience shared by college students and is typically investigated in the context of traditional, face-to-face courses. However, the onset of the COVID-19 pandemic resulted in the closure of universities, and many students had to rapidly shift to and balance the challenges of online learning. We investigated how the shift to online learning during the pandemic impacted trait (habitual) and state (momentary) test anxiety and whether there was variation across different demographic groups already vulnerable to performance gaps in science, technology, engineering, and mathematics (STEM) courses. Quantitative analyses revealed that trait and state test anxiety were lower in Spring 2020 (COVID semester) than in Spring 2019 and were higher overall in women than men. We did not find a difference in either trait or state anxiety in first-generation students or among persons excluded because of ethnicity or race. Qualitative analyses revealed that student priorities shifted away from coursework during Spring 2020. While students initially perceived the shift to online learning as beneficial, 1 month after the shift, students reported more difficulties studying and completing their coursework. Taken together, these results are the first to compare reports of test anxiety during a traditional, undisrupted semester to the semester where COVID-19 forced a sudden transition online.

Two-stage collaborative group testing does not improve retention of anatomy among students studying medical radiation technology

INTRODUCTION

Two-stage collaborative group testing is an assessment format where students first complete a summative assessment independently, and then immediately convene in a small group to complete the same assessment again. Research on two-stage collaborative group testing has shown that it increases immediate learning, improves communication and teamwork, and can lead to enhanced retention of course material; the latter of which is especially important for basic anatomical concepts among health care professionals such as medical radiation technologists. However, such previous research has often employed quasi-experimental designs that may limit both internal and external validity.

METHODS

Using a randomized crossover design with both quantitative and qualitative data analyses including robust intra-individual statistical comparisons, this research compared the educational impact of the two-stage collaborative group testing format (the COL condition) to traditional independent testing (the IND condition). Students (n=196) from two successive renditions of an introductory anatomy course were randomly assigned into groups of 3-5 students. Groups worked together throughout the term on various course elements, including three in-class, non-cumulative term tests (TTs). After practicing the collaborative format during TT1, during TT2 half the groups were assigned to the COL condition while the other half were assigned to the IND condition. Groups crossed over for TT3. All students completed a cumulative final examination independently, with performance data from that examination coded and extracted according to previous TT condition. Educational impact was evaluated as both immediate learning (by comparing IND and COL performance on the associated TT) as well as retention (by comparing final examination performance for topics previously IND tested versus previously COL tested). Students' qualitative reflections were coded into categories and juxtaposed against quantitative Likert-style feedback to comprehensively explore students' perception of the testing format for evidence of enjoyment, acceptability, and influence on relevant CAMRT professional competencies.

RESULTS

167 students (85%) consented to data inclusion, with a final course grade of 75.5 ± 10.0%. On average, TT performance was 13.6 ± 11.6% greater on the COL test (90.4 ± 7.6%) than the IND test (76.7 ± 14.3%) (p<0.01, r = 0.76), results that support immediate learning. Contrary to expectations, final examination performance specific to the two experimental conditions was similar, with students earning an average of 69.6 ± 18.3% on questions that pertained to material they were previously IND tested on, and 67.4 ± 19.1% on questions they were previously COL tested on (ns). Students' overall perceptions of the two-stage collaborative group testing format were overwhelmingly positive, with 84% indicating a belief that the format was a constructive learning opportunity and 74% recommending continued use. Written reflections revealed that students believed that collaborative testing enhanced their learning by both clarifying previous mistakes and reinforcing correct knowledge. Relevant CAMRT professional competencies included oral communication and interprofessional skills, capacity for productive teamwork, and collaborative practice.

SIGNIFICANCE

Although the results of this study do not support the use of two-stage collaborative group testing for retention of course material, they simultaneously reveal how the testing structure may be uniquely beneficial to students studying within the field of medical radiation sciences while also presenting a pragmatic example of how to implement this unique testing format.

Team-Based Ultrasound Objective Structured Practice Examination (OSPE) in the Anatomy Course

The clinical use of ultrasound has dramatically increased, necessitating early ultrasound education and the development of new tools in ultrasound training and assessment. The goal of this study was to devise a novel low-resource examination that tested the anatomical knowledge and technical skill of early undergraduate medical students in a gross anatomy course. The team-based ultrasound objective structured practice examination (OSPE) was created as a method for assessing practical ultrasound competencies, anatomical knowledge, and non-technical skills such as teamwork and professionalism. The examination utilized a rotation of students through four team roles as they scanned different areas of the body. This station-based examination required four models and four instructors, and tested ultrasound skills in the heart, abdominal vessels, abdominal organs, and neck regions. A Likert scale survey assessed student attitudes toward the examination. Survey data from participants (n = 46) were examined along with OSPE examination grades (n = 52). Mean and standard deviations were calculated for examination items and survey responses. Student grades were high in both technical (96.5%). and professional (96.5%) competencies with structure identification scoring the lowest (93.8%). There were no statistical differences between performances in each of the body regions being scanned. The survey showed that students deemed the examination to be fair and effective. In addition, students agreed that the examination motivated them to practice ultrasound. The team-based OSPE was found to be an efficient and student-favored method for evaluating integrated ultrasound competencies, anatomical knowledge, team-work, and professional attributes.

A collaborative two-stage examination in biomedical sciences: Positive impact on feedback and peer collaboration

Examinations present an intensely focused opportunity for student learning yet opportunities for collaboration, communication, and feedbacks are often wasted. Two-stage examinations where students first take examinations individually and then repeat the examination in small groups hold promise to address this issue. Here, we pilot and evaluate a two-stage examination within an advanced undergraduate biomedical sciences course. We evaluated this innovation by triangulation of data from a questionnaire, semi-structured student interviews, as well as, comparison of student grades between stages of examination across higher- and lower-performing student groups. Quantitative data from the structured questionnaire showed that a majority of students perceived the collaborative stage of two-stage examinations successful in promoting peer collaboration and communication. Furthermore, there was deepened conceptual understanding and provision of immediate feedback. The two-stage examination did not, however, ameliorate students' test anxiety. Qualitative data from semi-structured student interviews were consistent with quantitative data to show that a two-stage examination provides positive impact particularly on immediate feedback, peer collaboration and communication but contributed to sustained test anxiety possibly due to negative experiences during group interactions. Both lower- and higher-performing students showed improvement in the collaborative stage as compared to the preceding individual stage of two-stage examination. This would suggest possible benefits of two-stage examination for learning for all student abilities. This study discusses the advantages and pitfalls of two-stage examinations for biomedical sciences and will guide informed recommendations for subsequent implementation elsewhere.