VARK – Know Your Style

By Vicky Shah, Pharm.D., PGY-1 Pharmacy Practice Resident, Suburban Hospital

Developing good study habits as a student is extremely important in order to obtain the knowledge required in school as well as life. To be an effective student, it is imperative that students understand how they learn. The VARK questionnaire is a sixteen-question survey that can assist students do exactly that.¹ Whether the questionnaire truly assesses a student’s best method for learning or simply reflects what method he/she currently uses is controversial.²

VARK is an acronym that represents the different categories of preferred sensory methods for learning: V (Visual), A (Auditory), R (Read/Write) and K (Kinesthetic). In completing the VARK questionnaire and identifying how one best learns, a student could then identify how to get the most out of studying. No one particular style is better than another.² In fact, very rarely do individuals learn by one method alone. There are a few lucky individuals who learn equally through ALL sensory methods; they fall into a category called “multimodal” learners.^1,2

Visual!    

Students who are visual learners need to make a few adjustments while they are in class to understand the material. Visual learners, perhaps more than other students, need to attend lecture or procure a copy of the handout.  It can be helpful for visual learners to imagine the words on a slide or highlight and underline key words on the handout for added emphasis. Visual learners experience things with their eyes, such as watching the teacher’s body language and facial expressions to fully understand what’s being presented. They prefer to sit near the front of the class and prefer to see pictures and graphs rather than wordy explanations. Diagrams, illustrations and interactive whiteboards further assist the visual learners.^{3, 4}

As a teacher, we can do plenty of things to ensure that our visual learners have everything they need. We can provide visuals aides, such as graphs or pictures, coupled with words on slides. There is nothing wrong with repeating the same information if you are presenting it differently, such as pictures and words. If the teacher’s preferred method of teaching is through paragraphs on the slides or handouts, try to highlight or underline key words or color code items of importance to help visual learners. ^{3, 4}

Auditory!             

Auditory students prefer learning through discussions, talking through topics, and listening to others explain the material. These individuals use the tone and pitch of a person’s speech to interpret emotion. Students who learn through auditory methods usually listen during lecture rather than diligently take notes. If they try to multitask, they may miss an important message.^{3, 4}

In order to help students who learn through auditory means, teachers need to understand that they cannot just show a slide and say “know this slide.” For students who learn best through hearing, they need to explain their slides so the students can fully understand the information. Teachers can encourage group learning and should allow students to tape record the lecture for further review.^{3, 4} The act of merely reading an abbreviated version of the material presented can be quite effective for an auditory learner.

Read/Write!                 

Individuals who learn through reading and writing benefit from taking notes, sometimes multiple times.  This can be done by simply rewriting the same thing over and over, or by rewording the material in a different way. Rewriting the notes using different words can help a student understand the concept rather than just memorizing a series of words. Students are encouraged to review their notes every day to ensure continuous absorption of the information. They can also organize graphs into statements rather than trying to be too visual.^{3, 4} Most read/write learners are also have visual or kinesthetic learning tendencies.

Teachers can assist students who learn by read/write by providing additional resources for students to consult for further explanation regarding the topic.  Teachers may need to slow down a bit to ensure that students who learn through reading/writing have sufficient time to write notes during class.^{3, 4}

Kinesthetic!         

Students who are kinesthetic learners prefer a more hands-on approach. They tend to learn by learning by “doing” something. They like to physically experience the topic, rather than just reading about it, hearing about it, or watching someone else. Many of these students tend to thrive during clinical rotations as they have the opportunity to put their knowledge to use. Hands on experiences are the best method for these students, but they can become distracted by their need for movement and must learn to control this urge or use it for their benefit.^{3, 4}

Teachers can assist by providing opportunities outside the classroom that benefit these students. Lab practicals and clinical experiences allow these students to “do” what they’ve told about in the classroom.  This helps them to understand better than a traditional written exam. Teachers can try to include brief group exercises interspersed throughout their lectures where students can practice counseling or medication preparation in the classroom.^{3, 4}

The VARK questionnaire benefits students by providing them with information on their learning style and preferences. This tool benefits teachers by reminding them that each student is an individual and learns in a different way. By understanding the different ways through which learning occurs, teachers can reach more students and help foster stronger teacher-student relationships.⁵

References:

1. Fleming N. VARK -- A Guide to Learning Styles. VARK-LEARN Limited, 1987. Web. 10 Sept. 2014.
2. Fleming N and Baume D. Learning Styles Again: VARKING up the Right Tree!" Educational Developments 2006; 7: 4-7.
3. Cherry K. What Are the 4 VARK Learning Styles? About. About Education, n.d. Web. 10 Sept. 2014.
4. VARK: Learning Styles: Visual, Auditory, Read/Write, Kinesthetic. Southwestern Community College. Web. 10 Sept. 2014.
5. Fleming N. I'm Different; Not Dumb. Modes of Presentation (VARK) in the Tertiary Classroom. Research and Development in Higher Education, Proceedings of the 1995 Annual Conference of the Higher Education and Research Development Society of Australasia (HERDSA). HERDSA, 1995; 308-13. Web. 10 Sept. 2014.

Should Modified Essay Questions Be the Primary Method to Assessing Performance?

By Kim-Ngan Tran, Pharm.D.,  PGY1 Pharmacy Practice Resident, Medstar Union Memorial Hospital

Multiple-choice questions (MCQs) are widely used as the primary means to assess student performance in most pharmacy and medical programs because they are a standardized method that can yield an objective score for a large number of test takers in a short period of time. Medical/pharmacy programs have changed their curricula to include more problem-based learning, which is an essential skill for a clinical practitioner. However, it is quite challenging for teachers to construct good MCQs that evaluate a student’s problem-solving skills.

Let’s discuss the advantages and disadvantages of MCQ and essay exams. MCQ exams are cheap and easy to score.  They can test a breadth of knowledge within a short examination time.  Moreover, it is the most commonly used as an evaluation method for licensure and board examinations.  Therefore, student must get practice with the MCQ format in order to confidently take licensure and board exams.  Another positive effect is that students’ final exam scores often improve because they have been previous tested on similar material during the semester.¹ Despite those advantages, MCQs have some weaknesses. There is a risk of students guessing answers and thus the results are not a true reflection of what the student knows. Writing MCQs is very time-consuming and fairly difficult because you would want to produce questions that can evaluate students’ ability to understand and apply concepts — not just recall facts based on memorization. Because of these challenges, many teachers do not return an exam or discuss exam answer keys with students in order to reuse the questions in the future. Thus students are not able to review missed or wrongly answered questions … and thus failing to learn important concepts.¹  In contrast to MCQ exam, an essay exam is relatively easier to write and less time consuming for teachers to create. This method provides teachers a better away to assess their students’ thought process, critical thinking, and writing skills. By providing an answer and not selecting choices, guessing is minimized. Nevertheless, grading essay exams is very time consuming and difficult to score objectively. Longer examination times are needed for students to finish an essay exam when compared to a MCQ exam if you wish to test an equal breadth of knowledge. Thus, essay exams are typically used for small classes and when teachers desire to measure students’ problem-solving skills.

Is there another approach?   Is there another question type that has the advantages of both the MCQ and traditional essay exam technique?   The modified essay question (MEQ) was developed by Hodgkin and Knox as an examination tool for the Royal College of General Practitioners.² MEQ exams include multiple problem-solving questions that are designed to test higher cognitive skills and can be consistently, objectively, and efficiently scored. By using MEQs, teachers can measure the knowledge retained and evaluate the students’ thinking and reasoning skills.^2,3 A typical MEQ provides a clinical scenario and one or more short answer questions based on Bloom’s taxonomy (memorizing, understanding, evaluating, analyzing, and creating).^4,5 For example, instead of using MCQ to test students about chronic obstructive pulmonary disease, a teacher could use MEQ to assess students’ ability to evaluate and provide an appropriate treatment plan for a patient scenario (Table 1). Students have to understand signs and symptoms related to the disease state and how to diagnose that condition. Then, they must apply their knowledge to develop an individualized treatment plan.

Table 1: Example MEQ

A 56 year old African American male presents to the emergency department with a complaint of worsening shortness of breath and cough for two weeks. He is a smoker with 40 pack year history. His past medical history includes hypertension, diabetes, hyperlipidemia, chronic obstructive pulmonary disease (COPD), and obstructive sleep apnea. List the differential diagnoses based on this patient’s symptoms? List the laboratory tests needed to confirm the diagnosis? What is the best initial treatment plan for this patient? After 3 days, the patient is stable and can be discharged. What is the best discharge treatment plan for this patient? State the current guideline that supports your answer.

To ensure the quality of the exam, questions must be relevant, valid, reliable, and objective. Teachers should define intended learning objectives to be assessed by each question. Patient cases should be clearly developed, include the relevant data needed to answer questions, and avoid extraneous information. MEQs should not be long.  Ask a colleague  to review the exam and provide suggestions to improve the questions. The common problem of essay exams is that grading may not be standardized. To address this problem, teachers should have key answers for all questions and assign a specific number of points to each. Then, if a student’s answer matches the keyed answers, he/she will get full credit. Partial credit can be given if a question contains more than one part; therefore, each answer must be assigned points in the key. The duration of the exam and the amount of time allotted to each question is important because if you do not give students enough time to answer questions, they will perform poorly and you can’t evaluate the students’ actual performance.

The MEQ model will work better if a teacher has help from a teaching assistant (or colleague) to grade all the responses. MEQs should only be used in a class that requires students to build higher-order thinking skills. Clearly, Pharmacotherapy and therapeutics course are intended to build critical thinking and decision-making skills.   These would be appropriate environments to use MEQ to evaluate students’ clinical knowledge.

References

1. Roediger H, Marsh E. The positive and negative consequences of multiple-choice testing. J Exp Psychol Learn Mem Cogn. 2005;31: 1155-9.
2. The Boards of Censors of the Royal College of General Practitioners. The modified essay question. J Roy Coll Gen Practit. 1971;21: 373-6.
3. Stratford P, Perice-Fenn H. Modified essay question. Physical Therapy. 1985;65: 1075-9.
4. Khan M, Aljarallah B. Evaluation of modified essay questions (MEQ) and multiple choice questions (MCQ) as a tool for Assessing the Cognitive Skills of Undergraduate Medical Students. International Journal of Health Sciences. 2011;5: 39-43.
5. Palmer E, Devitt P. Assessment of higher order cognitive skills in undergraduate education: Modified essay or multiple choice questions? Research paper. BMC Medical Education. 2007;7:49.