block testing _ an innovation benefiting students and faculty

1. BLOCK TESTING _AN INNOVATION BENEFITING STUDENTS AND FACULTY Sidney S. Murphree University of Louisville School of Medicine

3. THE GREAT LAW OF MEDICAL STUDENT EXISTENCE

4. VIRTUALLY EVERY FACET OF A MEDICAL STUDENT�S LIFE IS GOVERNED BY A CONCERN ABOUT HOW THEY WILL PERFORM ON THEIR NEXT MAJOR EVALUATION

6. BEFORE BT

7. TRUE CONFESSIONS How I damaged the class of 2004

8. TEST OFTEN OR DIE Matched the frequency of tests used by other popular courses Changed testing from q 6 weeks to q 3 weeks Students had a test EVERY Monday from September till December 15 weeks of binge and purge Another round of intense testing in the spring

9. THE RESULTS STUDENTS STUDIED PATHOLOGY EVERY THREE WEEKS NO WEEKENDS OFF FOR FAMILIES CONTINUOUS HIGH STRESS LEVELS WORST SHELF EXAM RESULTS IN YEARS WORST NBME RESULTS IN YEARS

10. FREQUENT HIGH STAKES TESTING IS BAD AND CAN INTERFERE WITH LEARNING

11. UTMB GalvestonMedical College of South Carolina

12. GOALS FOR THE BLOCK TEST SYSTEM MINIMIZE COURSE COMPETITION IMPROVE NBME PREPARATION BY CREATING A TEST THAT WAS MORE NBME-LIKE IMPROVE THE OVERALL QUALITY OF TEST QUESTIONS CHANGE STUDENT STUDY HABITS

13. BLOCK TEST ONE TEST EVERY 5 TO SIX WEEKS EXAM QUESTIONS FROM ALL ACTIVE COURSES COMBINED ON ONE EXAM EXAM QUESTIONS INTERMINGLED AND NOT IDENTIFIED BY COURSE AFFILIATION

14. BLOCK TEST ONE BIG TEST EVERY 5 TO SIX WEEKS NO LECTURES OR REQUIRED STUDENT ACTIVITIES IN THE WEEK PRIOR TO THE BLOCK EXAM NO OTHER MAJOR EXAMS / TESTS GIVEN IN THE INTERIM [ SHORT QUIZZES OK -! Recommended ! ]

15. BLOCK TEST UNIFIED FORMATS AND STANDARDS TEST QUESTION DATABASE CENTRALIZED TEST PREPARATION CENTRALIZED GRADING AND ITEM ANALYSIS COSTS OF CENTRALIZED TEST PREPARATION SHARED CENTRALIZED HANDLING OF STUDENT CHALLENGES

16. BLOCK TEST ALL EXAM QUESTIONS REVIEWED BY A TEST COMMITTEE (COURSE DIRECTORS PLUS) ALL TEST QUESTIONS TIED TO COURSE SPECIFIC LEARNING OBJECTIVES CREATION OF INTEGRATED/COMBINED QUESTIONS AIDS IMMUNOLOGY/IMMUNOLOGIC DZ INFECTIOUS DZ GENETICS

17. OTHER CHANGES LECTURE HOURS REDUCED OVERALL 8 AM TO 2 PM RULE

18. RESULTS IMPROVED PATHOLOGY SHELF SCORES IMPROVED NBME SCORES ALTERED STUDENT STUDY HABITS

19. RESULTS ALTERED STUDENT STUDY HABITS HIGHER QUALITY EXAMINATIONS /EXAMINATION QUESTIONS major exams are more �BOARD-LIKE� BETTER COURSE INTEGRATION BETTER COMMUNICATION BETWEEN COURSES

20. STUDENT SURVEY :How did the new block examination system change your study habits when compared with your study habits in prior years?

21. From: Uldis N Streips To: Sidney S Murphree Date: 12/07/2004 4:28:06 PM Subject: Block Test benefits � the students�.credit Block Testing as the most important thing we have done for them. The culture has changed. The current students will tell you, they couldn't conceive of taking Boards without having Block tests first. Anecdotally this is the exact improvement Medical College of SC showed after initiating Block testing. They were at 89% and 2 years later at 93%.

22. The Block Exam system facilitated integrated learning.

23. The Block Exam system supported a cumulative approach to studying.

24. The Block Exam system helped me prepare for the Step 1 Board exam.

25. NBME I PASS RATE FOR FIRST TIME TAKERS

26. BLOCK TEST PROBLEMS OBTAINING TEST QUESTIONS FROM LECTURERS IN A TIMELY FASHION GRADING AND SORTING INDIVIDUAL COURSE RESULTS TEST QUESTION DATABASE EDUCATING FACULTY ABOUT TEST QUESTION STANDARDS AND FORMATS EMBEDDING IMAGES IN THE TEST POST TEST ISSUES: CHALLENGES ETC

27. SUMMARY BLOCK TESTING IMPROVED STUDENT PERFORMANCE ON NBME I ALTERED STUDENTS STUDY HABITS IMPROVED COMMUNICATION AND INTEGRATION BETWEEN COURSES IMPROVED THE OVERALL QUALITY OF TESTING IN THE SECOND YEAR MANY TECHNICAL PROBLEMS TO OVERCOME

28. CRITERIA FOR HONORS

29. WHO SHOULD GET HONORS TWO APPROACHES ONLY THE TOP 10% AS MANY STUDENTS AS CAN MEET PRE-ESTABLISHED CRITERIA

30. LIMITED/CURVE BASED HONORSONLY THE TOP 10% HONORS SHOULD �MEAN SOMETHING� AVOIDING GRADE INFLATION COMPETITION IS AN IMPORTANT PART OF THE PROCESS DEAN AND RESIDENCY DIRECTORS NEED TO BE ABLE TO IDENTIFY THE �CREAM OF THE CROP�

31. HONORS SHOULD NOT BE A MOVING TARGET COMPETITION HAS LITTLE TO DO WITH THE REAL WORLD OF MEDICINE EFFECT ON SHELF EXAM SCORES /MOTIVATION ISSUES

32. SHELF EXAM SCORES OVERALL SHELF EXAM SCORES BEST PREDICTOR OF USMLE I PERFORMANCE USED TO COMPARE CLASS PERFORMANCE YEAR TO YEAR USED TO EVALUATE THE PATHOLOGY COURSE STRENGTHS AND WEAKNESSES SHELF EXAM GIVEN ON BT DAY IN JAN STUDENTS HAVE TO MAKE CHOICES ABOUT HOW TO ALLOCATE THEIR LIMITED STUDY TIME IMPORTANT TO HAVE A LARGE NUMBER OF STUDENTS MOTIVATED TO STUDY THE PATHOLOGY SHELF EXAM LIKELIHOOD OF �PAYOFF� IMPACTS SHELF RESULTS LIKELY TO ACHIEVE HONORS 15 VS 50 STUDENTS

33. OPEN CRITERIA FOR HONORS Can motivate a large pool of students who might otherwise chose to study other materials MULTISTEP CRITERIA FOR HONORS ENSURE PARTICIPATION IS ALL FACETS OF A MEDICAL STUDENT COURSE

34. MULTISTEP CRITERIA FOR HONORS 85% OF TBL QUIZ POINTS 85% OF TOTAL BLOCK TEST RESULTS [ JUST A FEW POINTS ABOVE HONORS] COMPLETED ALL FOUR PROJECTS(AUTOPSY, LECTURE EVALUATION, ONE PAGE LO, PRECEPTORSHIP)

35. 40-45% OF THE CLASS ENTER THE WEEK LEADING UP TO THE SHELF EXAM ELIGIBLE FOR HONORS

36. GLASS SLIDE EXAM FINAL HURDLE FOR HONORS IN PATHOLOGY QUALITY ASSURANCE TOOL HAVE NOT SEEN A SINGLE GLASS SLIDE ALL YEAR [OUTSIDE OF PRECEPTORSHIPS]

37. GLASS SLIDE EXAM MUST MEET ALL PRIOR CRITERIA FOR HONORS [ GSE not given until after shelf exam results are known] 10 STUDENTS AT A TIME TEN-HEADED MICROSCOPE ESSAY / SHORT ANSWERS 20 SLIDES / 20 QUESTIONS IDENTIFICATION PLUS A SECOND STEP HISTOLOGY � in a diseased organ[ IDENTIFY ARTERY DISTORTED BY SEVERE ATHEROSCLEROSIS] ETIOLOGY/DISEASE ASSOCIATIONS [ LIST 4 POSSIBLE CAUSES OF DISSECTING AORTIC ANEURYSMS] CLINICAL PATHOLOGIC ASSOCIATIONS [ BLOOD SUGAR LEVELS IN A PATIENT WITH INSULINOMA] COMBINATION HISTOLOGY / ETIOLOGY [ COCCI IN LYMPH NODE]

38. TRENDS IN THE GLASS SLIDE EXAM 95% PASS RATE DESPITE a MISMATCH IN HOW HISTOPATHOLOGY WAS LEARNED POOREST PERFORMANCE ON QUESTIONS THAT HINGE ON HISTOLOGY [ TAUGHT IN FIRST YEAR WITH GLASS SLIDES] POOR PERFORMANCE ON QUESTIONS THAT HINGE ON MICROBIOLOGY [ COCCI IN LN ]

39. SUMMARY: CRITERIA FOR HONORS STUDENTS CAN BE MOTIVATED IN POSITIVE AND NEGATIVE WAYS BY THE LIKELIHOOD OF OBTAINING �HONORS� MULTISTEP CRITERIA FOR HONORS HELP INSURE BROAD PARTICIPATION IN ALL COURSE COMPONENTS AND CAN AFFECTSTUDENT MOTIVATION IN LATER STAGES OF A PATHOLOGY COURSE

40. LIVE LIKE YOU WILL DIE TOMORROW. LEARN AS IF YOU WILL LIVE FOREVER. GHANDI ALL YOU ARE IS ALL YOU LOVE.