Using the ‘Answer Until Correct’ Assessment Method to Enhance Learning

by Zemen Habtemariam, Doctor of Pharmacy Candidate, University of Maryland School of Pharmacy

Ultimately the goal of teaching is for students to learn.  Not simply for purposes of doing well on a test or getting a good grade, but to encourage students to engage in learning, to see more than one interpretation of the answer, and to improve retention. However, in my experience, how we are assessed in the classroom is not always reflective of what we are supposed to learn or what we actually have learned. Therefore, using a method of assessment that effectively reflects the desired goal – that is learning — is attractive to me.

Let’s look at an example. In my pharmacy school, a common method of assessment is the multiple choice examination (MCE).  Indeed, it's the most widely used form of assessment at many schools.  During a MCE, students are presented with a series of questions and they are asked to pick the one best answer. While these tests have been used for a very long time and are “objective” measures of knowledge, they have their flaws – and may actually discourage learning. For starters, multiple choice examinations foster the short memorization of facts and not the long term retention of concepts. They often foster “binge and purge” behaviors. In addition, MCEs can provoke anxiety because the learner is often forced to deliberate between two arguably good choices. I know these flaws all too well.

However, MCEs are not the only testing method available. Another testing method that might effectively addresses the “flaws” of the MCE is the Answer-Until-Correct (AUC) method. Under the AUC procedure, examinees can select an option for the multiple-choice question.  If the selected answer is not the best choice, the students is permitted to select another answer.  And they can continue to select other answer choices until the best answer is revealed. This type of testing often awards more points for selecting the best response first and awards fewer points as the students additional choices. This method of testing can enhance learning principally by providing formative feedback. Formative assessment is an approach whereby students receive immediate feedback on their work. This can be a critical element for students to achieve deeper learning.¹ Epstein and colleagues² developed a tool using the AUC method on three multiple-choice examinations in an introductory psychology course. Not only did the study find that students taking these types of exams performed better on the course’s final examination, but students would have received higher scores (when compared to students who had previously taken the course) even if a traditional MCE approach had been used. In this manner, the AUC approach actually helped students to retain their knowledge.

In addition to improving student learning, the AUC method may also reduce test anxiety – something many students experience. One study examined the effect of anxiety on student performance during a series of tests of varying levels of difficulty.³ The study found that although highly anxious students tended to do poorly on examinations, students who were prone to anxiety who received positive feedback from their examinations tended to have big gains in their performance, especially on exams of low difficulty (“easy”). The authors highlighted how items or questions of optimal difficulty on an examination often induced anxiety.  But that’s a Catch-22.  Students can only perform at their optimum when their anxiety is reasonably low.  The take-home message from this study is that students can show improvement in their test performance when anxiety is not highly apparent. Therefore, a testing approach that reduces the risk of selecting a wrong answer and utilizes immediate feedback can be expected to reduce anxiety.  This, in turn, allows learns to perform at their best.

Now that we have covered how the AUC method works and its potential benefits, one may be curious as to when and where it can be applied. Health professionals must be able to perform well on a test, but also be able to apply that knowledge to patient care or in the work environment. A good application of the AUC method would be a pharmacy law course. Pharmacy law, not unlike many topics in a pharmacy school curriculum, is important because every pharmacist must understand and adhere to the laws and regulations that govern pharmacy practice and the sale of medications. Traditional testing methods often require long periods of time to score or grade them.  Thus, students won’t know what answers they got wrong until they get their exam back some days or even weeks later.¹ Thus, students are forced to progress to the next topic in the course without having mastered the previous material and don’t have the opportunity to learn from their mistakes. Thus, educators can apply the AUC method by having students take law exams and answer each question until they reach the correct response. This not only teaches them what the correct answers are, but perhaps more importantly, students begin to learn why the other answers are not correct.

Students and educators will benefit from using the AUC method. This assessment technique has been shown to improve academic performance, alleviate anxiety that can hinder students from learning and test-taking, and addresses some of the limitations inherent in more traditional multiple choice exam formats.

References

1. Persky A, Pollack G. Using Answer-Until-Correct examinations to provide immediate feedback to students in a pharmacokinetics course. Am J Pharm Educ. 2008; 72(4): Article 83.

2. Epstein M, Epstein B, Brosvic G. Immediate feedback during academic testing. Psychological Reports. 2001; 88: 889-94.

3. Rocklin T, Thompson J. Interactive effects of test anxiety, test difficulty, and feedback. Journal Of Educational Psychology. 1985; 77(3): 368-72.  [accessed April 21, 2015]