Grade Inflation: What Is It and What Can We Do?

by Brittany Lovko, Pharm.D., PGY1 Pharmacy Practice Resident, Suburban Hospital

Have you noticed that it’s getting easier to get an A in high school or college?  If you are student in (or recently graduated from) a rigorous curriculum like pharmacy, it may not have seemed so easy earning that “A”, but studies show it’s true. Grade inflation, first identified in the 1960s, is a growing problem in public and private institutions, including pharmacy schools.¹ One study published in 2003 reviewed grade point averages at the University of Arkansas pharmacy school over a 20 year period and found a significant upward trend.  Grades increased by approximately 1% per year!¹  From a teacher's perspective, this might be perceived as a positive sign. Shouldn't the goal be to educate students so that they’re all achieving the highest grade possible? Perhaps. But numerous studies have shown that student performance hasn’t really increased over the past 40 years based on indicators such as standardized test scores and scholastic aptitude tests.²

One might ask why grade inflation matters.  Grade inflation depreciates the value of an “A” and diminishes the meaning of a high grade point average.  How will students be able to set themselves apart if more (perhaps most) students graduate with a similarly elevated GPA? There is also some concern that grade inflation is leading to a culture of academic entitlement.³  Furthermore, graduates may have a false (inflated) sense of their knowledge and skills – and may not be able to delivery the standard of care expected in the health care today.³  So what can be done to curb this growing trend?

Normative vs. Criterion Grading⁴

There are two main types of grading systems – norm-referenced and criterion-referenced.  Normative grading is based on the direct comparison of a student to his/her peers. Thus, in a class of 20 students, you could decide that 5 would be assigned A's, 8 would be assigned B's, 5 would be assigned a C, and 2 students would get a D (or perhaps an F) based upon how each student's performance compared to the class average.  Normative grades are probably best suited for those courses that do not require absolute mastery of the subject matter.  Criterion-referenced grading, on the other hand, involves comparing the student's performance to a standard set by the teacher (or a standard established by some governing body).  This grading system is the most widely used.  We are all familiar with the percentage-based grading scheme where a score of 90% or above earns an “A”, an 80-89% earns a “B”, and so forth.  However, these cut points may or may not represent “mastery” of the material.  If criterion-based grading is to be used as recommended for courses that require mastery of the material, some experts recommend using a pass/fail system.⁴

Standardized Tests⁵

Another way to remedy grade inflation could be by using a well-accepted, national standard, as determined by standardized tests. The Pharmacy Curriculums Outcomes Assessment (PCOA) is a nationwide, standardized pharmacy assessment tool that can be used to measure academic progress of pharmacy students. This 220 question multiple choice test was created based upon the ACPE accreditation standards. The test is given annually to all professional students at participating institutions and the results are then reported both as a scale score and a national percentile rank.  The problem with this tool is that it still has not been widely implemented, in part due to the cost of administering the exam (which must be absorbed by the student or school).  If the PCOA were universally adopted, a new means to evaluate students could be established.   Colleges / schools of pharmacy could potentially move away from the traditional grading scheme and evaluate their pharmacy students in a more meaningful way. 

Numbers Instead of Letters⁴

Have you ever stopped to consider how arbitrary the traditional cut points are for each letter grade?  These cut points are not grounded in empirical data; rather, they are de facto “standards” merely because individual course instructors have repeatedly adopted them. Thus, letter grades can be misleading.  For example, two students who score only one percentage point apart in the course could end up with two different letter grades.  Some educators have recommended we stop converting these numbers into letter grades. Instead, we should report the class mean on a transcript next to the student's score to allow a more meaningful comparison.  Another normative approach would be to report each student’s class rank on his/her transcript. Both these methods would allow for students to be compared to each other.

Student Accountability for Learning³

For better or worse, the culture in which we live has put undue emphasis on the achievement of high letter grades. Thus, students will seek to achieve high grades and may pressure faculty members to reward them with high grades. This culture of academic entitlement refers to the growing anecdotal evidence that more and more students view their education as a commodity for purchase, meaning that they should be the ones in charge of dictating its path. This attitude can not only lead to grade inflation but also result in decreased faculty morale, disrespectful student behavior, and altered classroom practices. It is important that faculty members encourage students to take responsibility for their learning and professional development and not rely on educators to give them the grade they feel they “need” to succeed.

While grade inflation is certainly not an issue that can be fixed by a single teacher, or even by all teachers at a single institution, these principles are important to consider when choosing how to evaluate students.

References:

1. Granberry MC, Stiegler KA. Documentation and analysis of increased grade point averages at a college of pharmacy over 20 years. Am J Pharm Educ. 2003;67(3):Article 77.
2. Rojstaczer S, Healy C. Where A is ordinary: the evolution of American college and university grading, 1940-2009. Teachers College Record. 2012;114(7):1-23.
3. Cain J, Romanelli F, Smith KM. Academic entitlement in pharmacy education. Am J Pharm Educ. 2012;76(10):Article 189.
4. Weil RR, Kroontje W. Grade inflation: causes and cures. J Agron Educ. 1977:29-34.
5. Scott DM, Bennett LL, Ferrill MJ, Brown DL. Pharmacy curriculum outcomes assessment for individual student assessment and curricular evaluation. Am J Pharm Educ. 2010;74(10): Article 183.

Stop Re-Reading … and Try Self-Testing!

by Amanda Schartel, Pharm.D., PGY2 Ambulatory Care Resident, University of Maryland School of Pharmacy

Take a minute and think back on the hundreds of quizzes, tests, and other assessments you have taken during your years in school.  Remember the countless hours and late nights you put in trying to learn everything in time?  Now think about how much of that information you actually remember days, weeks, months, and years later.  If you’re like me, you probably realize just how much of that information you have forgotten.  While you put in a lot of time and effort studying, the information learned was all too soon forgotten.  This is due, in part, to the ineffective and inefficient study strategies that most of us employ.  As students progress on to college and graduate school, poor study habits becomes a bigger problem as the material becomes increasing complex. This problem is particularly important for students training to become healthcare professionals given the fast pace at which medical information changes.¹

Student Perceptions and Use of Study Strategies

In order to help our students succeed, we must first identify what study strategies they currently use and what perceptions they have about effective ways to learn.  A survey of undergraduate students at a top university found that repeated re-reading was the most common study strategy (83.6%) with more than half of the students ranking re-reading as their preferred study strategy.  One of the least common study strategies used was self-testing (10.7%).  And the majority of these students avoided self-testing if they could not go back to re-read the material.²

These findings are similar to a study conducted by Hagemeier and colleagues who surveyed pharmacy students about their study habits.  They found that only 11.6% of students would self-test if they did not have the option of going back to re-read the material.  Half of the students reported that if they self-tested, it was to see what they had learned.  Only a third of the students believed self-testing helped them learn more.  The majority of students stated that spreading out study sessions was beneficial, but only 17% scheduled study sessions in advance and 60.2% reported that they crammed for exams.  

The majority of students state that their study habits are NOT based on formal instruction on how to study.¹ This suggests that most students have never been trained to study in effective ways.  Interventions by educators may give students the tools needed to succeed.

(In)Effective Study Strategies

We now know that many students use re-reading as their preferred study strategy. But is this actually an effective way to study? Are there other study strategies that are more effective?

 

While re-reading is common, it has only modest benefits on learning.³  Re-reading is most effective when there is a short delay between readings.  It is not effective when the material is re-read immediately following the initial reading.  Re-reading is most useful for recall-based tasks, and its effects on comprehension are questionable.  In head-to-head studies, re-reading has been found to be inferior to several other study strategies, including self-testing, elaborative interrogation, and self-explanation.³  Students may be under the false impression that re-reading is an effective strategy because they are committing a great amount of time when using this strategy.  But this may be a “labor-in-vain” phenomenon, whereby spending extra time memorizing information does not promote meaningful learning.² In a comprehensive review of learning techniques by Dunlosky and colleagues, re-reading, summarization, highlighting/underlining, keyword mnemonic, and imagery for text were identified as a low utility learning strategies.³  This was based on research showing that these techniques do not increase performance, lead only to short-term retention of information, and are only helpful for some students and in some contexts.³

So if these commonly used learning strategies are ineffective, which strategies would be more effective for students to use?  Dunlosky and colleagues identified two high utility strategies:  self-testing and distributed practice.³  Both of these strategies benefit learners of different ages and abilities, as well as increase performance across many tasks and contexts.²

Self-Testing

The literature has described the concept of the “testing effect” since the 1600s.  It suggests that the act of retrieving information from memory increases long-term retention.¹  Also, it has been proposed that self-testing may improve performance by enhancing how students mentally organize and process information.²  The testing effect is not just limited to formal assessments, but can also be seen when students practice recall on their own (i.e. complete practice problems, use flashcards).  In a study of first-year medical students by West and colleagues, researchers found that self-testing was a significant predictor of first-semester final grades and practical examination averages.⁴

Distributed Practice

We know that many students typically pack their studying into a short period of time before an exam.  While this may lead to short-term retention of the material, it has been shown that spreading out study activities over time, or distributed practice, has greater benefits and leads to long-term retention.  This may be because distributed study sessions force students to repeatedly retrieve previous knowledge, which is known to reinforce memory and retention.  Furthermore, when study sessions are spaced out, it forces the student to work harder to retrieve the information from memory and allows them to more accurately assess their understanding.³ Similar to self-testing, West and colleagues found that time management—including maintaining a study schedule—was a significant predictor of first-semester final grades and written examination averages.⁴

Help Students Adopt Better Study Habits

Given that many students use study strategies that are less than optimal, educators should provide guidance to students about the value of alternative strategies such as self-testing and distributed practice.  Furthermore, structuring instruction to encourage students to use these strategies, such as creating practice problem sets for self-testing, can help the students to become successful lifelong learners.

References

1. Hagemeier NE, Mason HL. Student pharmacists’ perceptions of testing and study strategies. Am J Pharm Educ. 2011;75:Article 35.
2. Karpicke JD, Butler AC, Roediger HL. Metacognitive strategies in student learning: do students practise retrieval when they study on their own? Memory 2009;17:471-9.
3. Dunlosky J, Rawson KA, Marsh EJ, Nathan MJ, Willingham DT. Improving students’ learning with effective learning techniques: promising directions from cognitive and educational psychology. Psychol Sci Public Interest 2013; 14:4-58.
4. West C, Sadoski M. Do study strategies predict academic performance in medical school? Med Educ. 2011;45:696-703.