session number: t219 retesting: helpful...

Session Number: T219 Retesting: Helpful Remediation or Academic Crutch?

Claire Babcock O’Connell MPH, PA-C Assistant Director, Didactic Education Rutgers University Lori Palfreyman MS, PA-C Assistant Director, Admissions and Program Assessment Rutgers University

Retesting: Remediation or Crutch?

• identify what has been learned

• identify areas of weakness

• assure minimum competence before continuing to next level of instruction

• assure fitness to practice safely

• provide a measurement of faculty effectiveness

• data for program assessment and accreditation standards

• other?


➢ Inability to master content • Mistakes in admission

➢ lack of preparation • poor attendance, incomplete assignments, poor study skills, time

management, failure to ask for help/use resources

➢ lack of motivation • inability to see importance/value of exams

➢personal stressors • family, work, “bad day”

➢ failure of faculty • delivery, organization, appropriateness of exams

Why do students fail exams?


Review of Literature:

➢Often the same students perform poorly throughout the curriculum • didactic performance ! clinical performance • (Gonnella, 2004; Hojat, 1993)

➢Poor performing students more likely to have difficulty with licensing exams • (Hojat, 1993; Challis, 1999)

➢Poor performing students tend to become poor clinicians • (Papadakis et. al , 2005; Hojat, 1993)


Exams are high stakes

▪ required level of mastery

▪ failure may jeopardize progression in program

▪ failure may jeopardize entry into profession

▪ failure may jeopardize future career


• Re-testing Policies are Exceedingly Common • Even Harvard Medical School! • Policies that govern when and how to retest are

diverse

• NCCPA allows up to 6 retakes on PANCE (within 6 years of completing PAP)

• USMLE allows 4 attempts for each step exam (within a 12 month period)

Pros of Retesting Cons of Retesting

Taking a test is part of the learning experience.

The main goal of assessment is evaluating one’s knowledge

We want students to reach their full potential

If students put in effort the first time, they meet their full potential

The goal of assessment is mastery of the material.

If we allow multiple re-tests, the grades are no longer a way to differentiate between excellent and mediocre students.

Allows students to get tutoring between the tests

Allows students to be slackers on the first test

Students can “work the system”

In the “real-world” you can look up anything. There is no reason to memorize anymore.

Testing assesses synthesis and application, not just facts. In the “real world” there is not always 2nd chances

Pros of Retesting Cons of Retesting

Allows identification of weakness of instruction (focus of responsibility on the professor)

More work for the professor to write new exams. Students need to study correctly the first time (focus of responsibility on student)

Allows more time for synthesis of current material

Takes away instruction time for new material

Everyone has an occasional bad day (illness, anxiety, personal problem)

It is the students’ responsibility to share struggles before the test

Tests are not meant to be a punishment

Rewards those who studied appropriately for the first time

Students need positive reinforcement. A really bad grade makes them feel like it’s impossible to get out of the hole.

Student who prepare properly generally do well on tests and have good self-esteem regarding knowledge.


Re-testing best practices

• Should not use the same exact test

• Same material, different questions, leads to mastery not memorization


Options for Retesting

• Allow students to research and explain the correct answers to for partial credit

• Additional written assignment or project

• Oral, short answer, or essay based exam many learners struggle with multiple choice may not adequately reflect knowledge


Breakout Topics

• Frequency and format of retesting options

• Experiences with retesting and remediation

• Impact of retesting policies on student performance


Rutgers Data on Retesting

0

10

20

30

40

remediation makeup PRE remediation

2013201420152016

NA0NA

PANCE Pass rate 2013. 96% 2014. 98% 2015. 100% 2016. NA


Retesting Not the Only Solution

• Poor performing students often progress in curriculum with little guidance or intervention

• Concerns often not recorded or addressed • Students believe their study skills are fine • Externalize reasons for their failure • Continue with same techniques or strategies to

study • Fear of asking for help • “black mark”


• More of the same knowledge, skills teaching continue until success on a required retake

VS • Cognitive and metacognitive approach

learning to learn self-regulation and reflection improve strategies for success

A Different Way of Thinking


Recommendations for Faculty

• Actively facilitate learning faculty development encouraged

• Provide constructive feedback prompt, detailed, expected, nonjudgmental

• Foster a culture where asking for help is considered positive

• Make resources known and fully available


Recommendations for Faculty

• Explore self-regulated learning processes

• Learning to Learn rather than Exam Coaching

cognitive and metacognitive processes learner-centered academic and emotional support collaborative learning reflection peer support

Retesting: Remediation or Crutch? References

Challis M, Flett A, Batstone G. An accident waiting to happen? a case for medical education. Med Teacher. 1999;21(6):582-585.

Cleland J, Arnold R, Chesser A. Failing finals is often a surprise for the student but not the teacher: identifying difficulties and supporting students with academic difficulties. Med Teacher. 2005;27(6):504-508.

Cleland J, Leggett H, Sandars J, Cost MJ, Patel R, Moffat M. The remediation challenge: theoretical and methodological insights from a systematic review. Med Educ. 2013;47:242-251.

English JB, Gordon DK. Successful student remediation following repeated failures on the HESI exam. Nurse Educator, June 2006, 31(3):62S-64S.

Guerrasio J, Garrity MJ, Aagaard EM. Learner deficits and academic outcomes of medical students, residents, fellows, and attending physicians referred to a remediation program 2006-2012. Acad Med. 2014;89(2):352-358.

Gonnella J, Erdmann J, Hojat M. An empirical study of the predictive validity of number grades in medical school using 3 decade of longitudinal data: implications for a grading system. Med Educ. 2004;38:425-434.

Hojat M, Gonnella J. Jon Veloski J, Erdman JB. Is the glass half full or half empty: A reexamination of the associations between assessment measures during medical school and clinical competence after graduation. Acad Med. 1993;68(2):569-577.

Papdakis MA, Teheran A, Banach MA, Knettler TR, Rattner SL, Stern DT, Jon Veloski J, Hodgson CS. Disciplinary action by medical boards and prior behavior in medical school. NEJM. 2005353(25):2673-2682.

Patel R, Tarrant C, Bonas S, Yates J, Sandars J. The struggling student: a thematic analysis from the self-regulated learning perspective. Med Educ. 2015;49:417=426.

Winston KA, van der Vleuten CP, Sherpbier AJA. An investigation into the design and effectiveness of a mandatory cognitive skills programme for at-risk medical students. Med Teacher. 2010;32:236-243.


Thank you!

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session number: t219 retesting: helpful...

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