Skip to main content

Advertisement

SpringerLink
Log in

Post-exam feedback with question rationales improves re-test performance of medical students on a multiple-choice exam

  • Published:
Advances in Health Sciences Education Aims and scope Submit manuscript

Abstract

This study compared the effects of two types of delayed feedback (correct response or correct response + rationale) provided to students by a computer-based testing system following an exam. The preclinical medical curriculum at the University of Kansas Medical Center uses a two-exam system for summative assessments in which students test, revisit material, and then re-test (same content, different questions), with the higher score used to determine the students’ grades. Using a quasi-experimental design and data collected during the normal course of instruction, test and re-test scores from midterm multiple choice examinations were compared between academic year (AY) 2015–2016, which provided delayed feedback with the correct answer only, and AY 2016–2017, where delayed feedback consisted of the correct answer plus a rationale. The average increase in score on the re-test was 2.29 ± 6.83% (n = 192) with correct answer only and 3.92 ± 7.12% (n = 197) with rationales (p < 0.05). The effect of the rationales was not different in students of differing academic abilities based on entering composite MCAT scores or Year 1 GPA. Thus, delayed feedback with exam question rationales resulted in a greater increase in exam score between the test and re-test than feedback with correct response only. This finding suggests that delayed elaborative feedback on a summative exam produced a small, but significant, improvement in learning, in medical students.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Balch, W. R. (1998). Pratice versus review exams and final exam performance. Teaching of Psychology, 25(3), 181–185.

    Article  Google Scholar 

  • Bangert-Drowns, R. L., Kulik, C.-L. L., Kulik, J. A., & Morgan, M. T. (1991). The instructional effect of feedback in test-like events. Review of Educational Research, 61(2), 213–238.

    Article  Google Scholar 

  • Butler, A. D., Karpicke, J. D., & Roediger, H. L., III. (2007). The effect and type and timing of feedback on learning from mulitple-choice tests. Journal of Experimental Psychology, 13(4), 273–281.

    Google Scholar 

  • Clariana, R. B., Ross, S. M., & Morrison, G. R. (1991). The effects of different feedback strategies using computer-administered multiple-choice questions as instruction. Educational Technology Research and Development, 39(2), 5–17.

    Article  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences. New Jersey: Lawrence Erlbaum Associates.

    Google Scholar 

  • DiBattista, D., Mitterrer, J. O., & Gosse, L. (2004). Acceptance by undergraduates of the immediate feedback assessment technique mfor mulitple-choic testing. Teaching in Higher Education, 9(1), 17–28.

    Article  Google Scholar 

  • Dihoff, R. A., Brosvic, G. M., & Epstein, M. L. (2003). The role of feedback during academic testing: The delay retention effect revisited. Psychological Record, 53(4), 533–548.

    Article  Google Scholar 

  • Hays, M. J., Kornell, N., & Bjork, R. A. (2010). The costs and benefits of providing feedback during learning. Psychonomic Bulletin & Review, 17(6), 797–801.

    Article  Google Scholar 

  • Kang, S. H. K., McDermott, K. G., & Roediger, H. L., III. (2007). Test format and corrective feedback modify the effect of testing on leng-term rentention. European Journal of Congnitive Psychology, 19(4/5), 528–558.

    Article  Google Scholar 

  • Krathwohl, D. R. (2002). A revision of Bloom’s Taxonomy: An overview. Theory Into Practice, 41(4), 212–218.

    Article  Google Scholar 

  • Kulhavy, R. W. (1977). Feedback in written instruction. Review of Educational Research, 47(1), 211–232.

    Article  Google Scholar 

  • Kulick, J. A., & Kulik, C. L. (1988). Timing of feedback and verbal learning. Review of Educational Research, 58(1), 79–97.

    Article  Google Scholar 

  • Levant, B., & Paolo, A. (2017). A between-exam review does not affect re-test performance of medical students in a two-test system. Medical Science Educator, 27, 29–32.

    Article  Google Scholar 

  • McDaniel, M. A., Roediger, H. L., III, & McDermott, K. G. (2007). Generalizing test-enhanced learning from the laboratory to the classroom. Psychonomic Bulletin & Review, 14(2), 200–206.

    Article  Google Scholar 

  • Merrill, J. (1987). Levels of questioning and forms of feedback: Instructional factors in courseware design. Journal of Computer-based Instruction, 14(1), 18–22.

    Google Scholar 

  • Morrison, G. R., Ross, S. M., Gopalakrishnan, M., & Casey, J. (1995). The effects of feedback and incentives on achievement in computer-based instruction. Contemporary Educational Psychology, 20, 32–50.

    Article  Google Scholar 

  • Roediger, H. L., III, & Karpicke, J. D. (2006). Test-enhanced learning. Psychological Science, 17(3), 249–255. https://doi.org/10.1111/j.1467-9280.2006.01693.x.

    Article  Google Scholar 

  • Royal, K. D., Henderson, A. G., & Hedgpeth, M.-W. (2015). Post-exam reviews: A consideration of costs and uninteded consequences. Medical Science Educator, 25, 327–329.

    Article  Google Scholar 

  • Shute, V. J. (2008). Focus on formative feedback. Review of Educational Research, 78(1), 153–189.

    Article  Google Scholar 

  • Sinha, N., & Glass, A. L. (2015). Delayed, but not immediate, feedback after multiple-cnoice questions increases performance on subsequent short-answer, but not multiple-choice, exam: Evidence for the dual-porcess theory of memory. Journal of General Psychology, 142(2), 118–134.

    Article  Google Scholar 

  • Smith, T. A., & Kimball, D. R. (2010). Learning from feedback: Spacing and the delay-renetion effect. Journal of Experimental Psychology, 36(1), 80–95.

    Google Scholar 

  • van der Kleij, F. M., Eggen, T. J. H. M., Timmers, C. F., & Veldkamp, B. P. (2012). Effects of feedback in a computer-based assessment for learning. Computers & Education, 58, 263–272.

    Article  Google Scholar 

  • Winniger, S. R. (2005). Using your tests to teach: Formative summative assessment. Teaching of Psychology, 32(3), 164–166.

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank Tim Doughty for his assistance with ExamSoft.

Author information

Authors and Affiliations

  1. Department of Pharmacology, Toxicology, and Therapeutics, University of Kansas Medical Center, Kansas City, KS, 66160, USA

    Beth Levant

  2. Department of Microbiology, Molecular Genetics and Immunology, University of Kansas Medical Center, Kansas City, KS, 66160, USA

    Wolfram Zückert

  3. Office of Medical Education, University of Kansas Medical Center, Kansas City, KS, 66160, USA

    Anthony Paolo

Authors
  1. Beth Levant
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wolfram Zückert
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anthony Paolo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Beth Levant.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Kansas Medical Center Institutional Review Board (Study #2981, approved 7/5/2017) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study is retrospective. For this type of study, formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Levant, B., Zückert, W. & Paolo, A. Post-exam feedback with question rationales improves re-test performance of medical students on a multiple-choice exam. Adv in Health Sci Educ 23, 995–1003 (2018). https://doi.org/10.1007/s10459-018-9844-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10459-018-9844-z

Keywords

Search

Navigation