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      Test-enhanced learning: analysis of an experience with undergraduate nursing students

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          Abstract

          Background

          This study is based on the evidence that tests can be used as an educational tool to enhance learning, not just as an evaluation tool. There is a growing body of research that shows that participating in repeated testing improves learning, a phenomenon defined as Test-Enhanced Learning. The aim of the present study was to analyse the effect of the use of a test enhanced learning program integrated into a general psychology course for undergraduate nursing students and its interaction with the students’ test anxiety.

          Methods

          161 undergraduate nursing students attending a General Psychology course followed an educational program based on Test-Enhanced Learning methodology. Students were divided into two groups, an experimental group (TEL group) and a control group (Re-study group). TEL students took a multiple-choice test on the lecture topics. The Re-study group just read study material. Testing and re-study occurred at intervals of about a week after each lesson. TEL students received feedback immediately after each test. About two weeks after the end of the lessons, all the students took a final cumulative test on all the topics. Statistical analysis was used to analyse students’ performances. After the administration of the cumulative unit test, all the students took a graded examination.

          Results

          Students in the TEL group performed better than the controls, both in the final cumulative test and in a graded examination. TEL participants experienced better final cumulative test results than students not tested ( M TEL = 23.11, M Re-study = 20.47, t(109.86) = −2.57, p < 0.05 , r = 0.24). Test-Enhanced Learning program participation has a positive impact on exam performance (β G_Step1 = 0.46, p < 0.001). Finally, the analysis performed shows a slight moderating effect of test anxiety on Test-Enhanced Learning (β GxTA_Step3 = 0.15, p < 0.05).

          Discussion and Conclusions

          Test-Enhanced Learning can be an effective tool for promoting and enhancing learning. In fact, taking tests after studying produced better long-term retention and then better final test performance than re-reading without testing.

          Both students in the TEL group and the Re-study group with a high test anxiety level perform less well than colleagues with lower test anxiety. Nevertheless, students with higher test anxiety may obtain more benefits from participating in a Test-Enhanced Learning process than people with lower test anxiety.

          Further studies on larger and more representative samples are necessary in order to investigate the effect of test anxiety on Test-Enhanced Learning.

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          Most cited references27

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          Reliability and Predictive Validity of the Motivated Strategies for Learning Questionnaire (Mslq)

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            Test-enhanced learning: taking memory tests improves long-term retention.

            Taking a memory test not only assesses what one knows, but also enhances later retention, a phenomenon known as the testing effect. We studied this effect with educationally relevant materials and investigated whether testing facilitates learning only because tests offer an opportunity to restudy material. In two experiments, students studied prose passages and took one or three immediate free-recall tests, without feedback, or restudied the material the same number of times as the students who received tests. Students then took a final retention test 5 min, 2 days, or 1 week later. When the final test was given after 5 min, repeated studying improved recall relative to repeated testing. However, on the delayed tests, prior testing produced substantially greater retention than studying, even though repeated studying increased students' confidence in their ability to remember the material. Testing is a powerful means of improving learning, not just assessing it.
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              The Power of Testing Memory: Basic Research and Implications for Educational Practice.

              A powerful way of improving one's memory for material is to be tested on that material. Tests enhance later retention more than additional study of the material, even when tests are given without feedback. This surprising phenomenon is called the testing effect, and although it has been studied by cognitive psychologists sporadically over the years, today there is a renewed effort to learn why testing is effective and to apply testing in educational settings. In this article, we selectively review laboratory studies that reveal the power of testing in improving retention and then turn to studies that demonstrate the basic effects in educational settings. We also consider the related concepts of dynamic testing and formative assessment as other means of using tests to improve learning. Finally, we consider some negative consequences of testing that may occur in certain circumstances, though these negative effects are often small and do not cancel out the large positive effects of testing. Frequent testing in the classroom may boost educational achievement at all levels of education.
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                Author and article information

                Contributors
                linda.messineo@itd.cnr.it
                manuel.gentile@itd.cnr.it
                mario.allegra@itd.cnr.it
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                24 October 2015
                24 October 2015
                2015
                : 15
                : 182
                Affiliations
                Institute for Educational Technologies, National Research Council, CNR-ITD, Via Ugo La Malfa 153, Palermo, 90146 Italy
                Article
                464
                10.1186/s12909-015-0464-5
                4619564
                26498207
                10a26457-1f2c-44cd-aeb9-9aaee3bf5ec1
                © Messineo et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 2 July 2014
                : 14 October 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Education
                test-enhanced learning,undergraduate nursing students,psychology education,test anxiety

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