Episode

Episode | Quick Take

Krista Rompolski joins us for another Journal Club episode—bringing us a study about how students change answers on their tests. Is it better for a student to change their multiple choice response or to avoid doing that? The answer may surprise you!

• 00:00 | Introduction
• 00:45 | Journal Club
• 03:21 | Sponsored by AAA
• 03:53 | Article Summary
• 09:13 | Sponsored by HAPI
• 10:00 | Should Students Change Answers?
• 27:44 | Sponsored by HAPS
• 28:21 | Standardized Exams, Test Anxiety, and Mindset
• 53:14 | Staying Connected

Need help accessing resources locked behind a paywall?
Check out this advice from Episode 32 to get what you need!

Episode | Transcript

The A&P Professor podcast (TAPP radio) episodes are made for listening, not reading. This transcript is provided for your convenience, but hey, it’s just not possible to capture the emphasis and dramatic delivery of the audio version. Or the cool theme music.  Or laughs and snorts. And because it’s generated by a combo of machine and human transcription, it may not be exactly right. So I strongly recommend listening by clicking the audio player provided.

This searchable transcript is supported by the
American Association for Anatomy.
I'm a member—maybe you should be one, too!

Introduction

Kevin Patton (00:00):
The philosopher known as Confucius has been attributed this proverb, “Only the wisest and the stupidest people never change.”

Aileen (00:13):
Welcome to The A&P Professor, a few minutes to focus on teaching human anatomy and physiology with a veteran educator and teaching mentor, your host, Kevin Patton.

Kevin Patton (00:28):
This is a journal club episode with Krista Rompolski about a study of how students change answers on their tests.

Journal Club

Kevin Patton (00:45):
Well, here we are once again for another one of our favorite kind of episode and that is a journal club episode and so I’d like to welcome our journal club director, Krista Rompolski. Hi, Krista.

Krista Rompolski (01:01):
Hi, Kevin. It’s nice to be back.

Kevin Patton (01:04):
I tell you this, these journal club episodes are not only really fun to do, but I think they really resonate with our listeners because I do get a lot of comments on them and we do get a lot of … The stats show that they’re downloaded pretty frequently compared to other episodes. The topic for this one is another one of those things that just really cuts to the nitty gritty, where the rubber meets the road of the teaching process teaching and learning process. So what’s the topic that you’re bringing to us today?

Krista Rompolski (01:37):
So this article, the title says that everything, Should Students Change Their Answers On Multiple Choice Questions and I feel like every teacher or professor has dealt with this topic or has had students lamenting, “Oh, I changed my answer. That’s why I got it wrong,” or, “I had the right one,” and professor’s thinking or potentially giving out advice, “Oh, go with your first instinct. Don’t change your answer,” and that’s certainly something I’ve heard since I was in grade school, high school and following suit, something I’ve often said to students. So when I saw this article, I immediately grabbed it. And the findings definitely raise a lot of questions about that advice or that attitude for students. So I was excited you wanted to cover it.

Kevin Patton (02:30):
This is going to be a fun conversation…

because well as I said, it just really gets into that direct interaction that we have with our students and that coaching and mentoring role which is one of the parts of teaching that I really love. And so how do we do that effectively? Am I giving my students the right advice or am I leading them astray? So what we’re going to do is our usual thing, Krista. It has summarized the entire article for us, so that we don’t have to go back and read it first, and yet, we’ll be very well aware of the main content of it. And then after we do that, we’ll come back in a later segment and pull it apart and discuss it and think about how it affects our own lives as A&P instructors.

Krista Rompolski (03:17):
Sounds great.

Sponsored by AAA

Kevin Patton (03:22):
A searchable transcript and a captioned audiogram of this episode are funded by AAA, the American Association for Anatomy. One of my favorite resources from AAA is their journal for teaching and learning anatomy and physiology. It’s called Anatomical Sciences Education. You need to check it out and you can do that at anatomy.org.

Article Summary

Krista Rompolski (03:53):
Should Students Change Their Answers on Multiple Choice Questions, a study by Justin Merry, Mary Kate Elenchin and Renee Surma of the biology department at St. Francis University in Loretto, Pennsylvania. Multiple choice exams are a pervasive feature of secondary and undergraduate education under the primary question format for most standardized admission exams. Although there is substantial literature debating the limitations associated with these types of questions, students have little choice but to master this exam format to succeed in many fields of science education. Advice on test-taking strategies varies and is not always well informed by research.

Krista Rompolski (04:38):
In general, the literature suggests that students should change their initial responses that they think are incorrect, but many instructors persist in advising students not do so. The purpose of this study was to evaluate the question of whether students benefit or are harmed when they change their initial answers on multiple choice questions in the context of physiology and biology courses. The researchers examined answer changing on examinations in undergraduate biology, human anatomy and physiology and neuroscience courses. The primary alternative hypotheses tested were, one, if answer changing benefits student exam performance, and two, if answer changing is harmful to examination performance.

Krista Rompolski (05:25):
Through tracking individual performances across multiple examinations, they also evaluated the hypothesis that some individual students are consistently more likely to be harmed or to benefit from answer changing compared with the population as a whole. Finally, they conducted a survey to assess opinions regarding answer changing among students and faculty. An email with separate surveys for students and faculty was distributed throughout the campus at St. Francis University and reached approximately 2,300 students and 130 full-time faculty members. The survey included basic demographic information and asked them to report their opinion about whether answer changing help or hurt grades and these were asked of the students and asked faculty whether or not they advise students to change their answers.

Krista Rompolski (06:18):
To determine if students changed answers, paper exams were reviewed visually for eraser marks and scratch outs that indicated an after change. Each change was coded as right to wrong, wrong to right or wrong to wrong. The researchers classified students by academic rank to see if they are more likely to change answers at different points in their academic career. 318 students and 97 faculty responded to the surveys. Across two exams, students changed their answers from an incorrect to a correct one nearly three times as often and therefore benefited from answer changing across two exams. Some students were also consistently more likely to change answers than others. However, the consequences of answer changes did not differ across academic rank.

Krista Rompolski (07:09):
The number of answer changes on exam one was a significant predictor of number of answer changes on exam two, but this did not result in a repeated benefit. In other words, there was no evidence that some students consistently were harmed or helped by answer changing decisions in ways that were different from other students. A plurality of faculty, roughly 36%, reported a belief that answer changes usually harm student grades, whereas a slim majority of students, only 51%, believed that answer changing help their scores. There were no differences in these opinions by sex or academic school or rank on whether answer changing was beneficial among students or faculty.

Krista Rompolski (07:54):
A majority of students and faculty agreed that they receive or give no instruction on answers changing. And when advice was given, students reported roughly 36% that they were advised to change answers, but only 19% of faculty reported giving this advice. So students may change answers for a variety of reasons, including reading errors, mismarking, confusion or lack of understanding. Previous research has shown that student answer changes were most likely to be successful when a student in the moment has low confidence in their initial answer. However, it has shown to be less successful when confidence was low.

Krista Rompolski (08:37):
Given the still pervasive opinion among faculty that changing initial answers harms students, the researchers argue that it is important that the results of studies like this are communicated to students and faculty. Students should be provided with evidence based on test-taking strategies grounded in knowledge, so that their knowledge of the subject rather than test-taking ability dictate their scores. Students should be advised to review answers and only change their initial answers if they are sure that is the correct course of action.

Sponsored by HAPI

Kevin Patton (09:13):
The free distribution of this podcast is sponsored by the Master of Science in Human Anatomy & Physiology Instruction, the HAPI degree. I’ve been on the faculty of this program at Northeastern College of Health Sciences from the beginning, just over 10 years ago and I’m still excited about all the evidence-based teaching strategies that our learners apply directly to all the major topics in the typical anatomy and physiology course. Check out this online graduate program at northeastcollege.edu/hapi. That’s H-A-P-I or click a link in the show notes or episode page.

Should Students Change Answers?

Krista Rompolski (10:01):
All right, Kevin, so what do you think?

Kevin Patton (10:04):
Well, I don’t know. I had a lot of different reactions as I went through this. The first gut reaction I’m going to have to say, and I hate to tell stories from the olden days but I’m going to anyway, is when I was in high school, I used to hang out in the high school library a lot. The librarian who was there was always recommending books to me. She came with this book that had just come in the library and she said, “You will be so interested in this book.” And I’m like, “Really? Okay, I wonder what that’s about.” It was a book on test taking, test-taking skills and I read it and it just blew my mind because I had never thought about there being skills to test taking. I thought it was a matter of whether you knew the information or not.

Kevin Patton (10:56):
And so that really helped me in my test performance. And I don’t remember, I don’t have a copy of that book, it was a library book, I returned it like a good library patron, I don’t remember whether it said you should change your answers or not, but I know I had that idea in my head from as far back as I can remember. So maybe it did say that you should not change your answers because I had the impression that if you change your answer, it’s very likely you’re going to change it to the wrong answer. You should go with that initial gut reaction.

Kevin Patton (11:30):
And so I went ahead with that idea in mind, and so then, I did some training in education. I got a teaching certificate and all that, did a lot of educational psychology, did all that stuff, so I felt like I was well prepared in teaching, starting out in high school and then later college and university teaching. And I don’t remember anywhere in there really being taught a lot about study skills and how to teach those to students. I don’t think any of us really get that anywhere, unless we seek that out and attend workshops or do reading or whatever. And so I pass that information along a lot and I have a couple of resources, some of which are on the web for my students to help them with their learning.

Kevin Patton (12:18):
And I remember a number of years ago, I have a page on test-taking skills, it’s just a real short summary, and I had in there this idea that don’t change your answer once you have it because you likely change it to the wrong answer. And somebody contacted me, instructor contacted me and said, “The research shows something different, that that’s not really the case.” I’m like, “Oh, that can’t be right.” So I looked into it and they were right. So I took that out of my webpage on test-taking skills and have gone further. And so I’ve been somewhat conscious of that since that time when I’m discussing things with students and trying to listen for what they’re doing and not doing. You know what? I’ve never been satisfied with the advice that I give them.

Kevin Patton (13:14):
And in this research paper, they talked about what advice we should give and I think it’s a good way to phrase it. And let me pull that out here. It was right at the end of the paper, very last line of the paper. I’m quoting them talking to students. So this is what they advised me say to students, “Review your answers before turning in your test. If you think your initial answer is wrong and another response is correct, change your answer.” I think that that is good advice. I think I’m still a little worried about what I say beyond that, especially if I’m one on one, students will ask me more questions about that, “Well, what if this? What if that?” and so on.

Kevin Patton (14:01):
And I guess you have to take that on a case-by-case basis, but I really like how they attacked this question and they did an attitude survey and showed that there’s a big difference between the faculty attitude toward this and the student attitude toward this, which blew my mind. I don’t know, I have a theory about why that may be. They talked about, “Well, maybe because it’s a different generation or something like that. I think that kind of plays into my take on it. I think school colleges especially, colleges are much more likely now to offer opportunities for test-taking skills to students than they ever did before. And I think that my also account …

Kevin Patton (14:53):
Well, so that accounts for the students having this attitude that changing their test answers is okay or maybe even good because I think a lot of those workshops that they take or other opportunities about learning about study skills, books or pamphlets or whatever, handouts, I think those are mostly evidence based. At least nowadays, they are mostly evidence based and so they’re getting this evidence-based information and we’re not necessarily seeing that unless we sit in on those opportunities or go through those materials that students are going through.

Kevin Patton (15:30):
And so here, we, faculty, are just sitting here with our own preconceptions and the students are being taught the evidence-based strategies. And so I’m thinking that possibly has something to do with the difference there, but I think it’s important because I really do believe that one of our major roles besides leading students along the content of our course, the concepts of our course, part of that and a big part of that, an important part of that is we’re mentors, we’re coaches, we’re facilitators. And if we’re not facilitating or coaching appropriately, then we’re not doing our job and we might be harming our students in some ways rather than helping them.

Kevin Patton (16:16):
So my overall impression was to convince me further that I need to hold back on this thing. My brain is still trying to hold on to of, “Don’t change your answers,” or, “Well, maybe sometimes you shouldn’t change your answer.” I don’t know if I should even go that far.

Krista Rompolski (16:37):
I think Kevin, the problem, this paper was very black and white about, “Look at the metrics, right? If they changed their answer, this is why it was good. This is when it was not beneficial.” So just to summarize from my audio, they changed from incorrect to correct 2.8 times versus correct incorrect 1.0 times. So in black and white, purely data perspective, yes, it was almost three times more beneficial to change to the correct answers. So you could say, “Oh, then our advice is bad.” I think we just have to have a more nuanced conversation about what should drive an answer change versus just change them or don’t change.

Krista Rompolski (17:20):
So something that they say and they looked at in this, I forget how they measured this specifically, but the answer change was more likely to be successful if their initial confidence in their first answer was low. So basically, if they weren’t sure when they first answered, it was much more their answer change was much more successful versus if they had high confidence in their first answer and then changed their mind. So I think what we need to do is shift the conversation about, “How do you feel confident in your answer? How do you know you feel confident in your answer or how do you feel confident in your change?”

Krista Rompolski (18:03):
So what I’ve always said to my students about this is, when they’re saying, “Oh, I changed. I changed my answers. That’s my problem,” because lots of students, although this data and the findings say that, I think the survey says, “When you change your answers, you think it will most likely …” and the students only 51% said, “Hurt your score,” right? So not a vast majority. Only quarter said, “Hurt your score.” And realize this is one college, one study, so we always have to keep that in mind. But I tell my students like, “You shouldn’t change your answer unless you have that blow your hair back like, ‘Oh, my God, I can’t believe I almost changed that answer,’ right? Or a new piece of information pops back into your memory that makes you be like, ‘Oh, I have to change it. That’s absolutely right.’ And if you don’t have that moment, you’re probably going to change it to an incorrect answer.”

Krista Rompolski (19:07):
Because I tell them that, all of this comes back to, we can go down another wormhole of talking, but you preach the right word, but you talk so much about the importance of retrieval practice. And you’ve had a whole podcast series lately on examination strategies in that sense. And so it’s like, “Well, how do you get confidence in your answers?” Retrieval practice, right? You’ve practiced retrieving this from your memory, so you know why you recognize your initial answer as probably the correct answer because you’ve practiced it multiple times.

Krista Rompolski (19:43):
So when students have studied and studied and studied, but they haven’t done retrieval practice, they’re probably more likely to recognize that correct answer but not really know why they’re recognizing it as the correct. So I often say to my students like, “You’re recognizing it is the correct answer because you did learn, right? You did the work. You just didn’t practice pulling it out of your memory. So that’s why you’re potentially not feeling confident in it and why potentially changing your answer is going to hurt you in that sense.” So I think that the conversation just needs to be much more nuanced and tie in their studying and preparation strategies much more. But of course, that takes a lot of time.

Krista Rompolski (20:30):
So that’s where you know what I carried away from this, but to make sure that I’m not giving black and white, “Never change your answers,” but to talk to students about their thought process behind changing answers and also incorporate, “Okay,” as we look at the rest of the test, rather than just hone in on the wrong answers, “Do you see that you changed your answer to the correct side?” and focus on bolstering their bad thought process because I think it’s easy for them to beat up on themselves for changing answers to incorrect and then completely brush over the right things they did, which would boost their self-esteem and incompetence going into the next exam.

Krista Rompolski (21:14):
And I think we missed that opportunity probably because when you have limited time to meet with potentially hundreds of students that you’re managing, you just hone in on the wrong answers because that’s what they’re interested in looking at. And wouldn’t it be amazing if we could review exams and focus on everything they got right and have the time to do that? So that’s another, in a perfect world, where all of us had 20 teaching assistants, right? We could do a little bit more. But do you see what I mean by we focus on the things that probably don’t help their confidence rather than the things that potentially could?

Kevin Patton (21:54):
Well, Krista, I just got to say that the insight that you just had about focusing on what’s right rather than what’s wrong has made this entire episode worth it just for that, for me. Well, seriously, because I think we do tend to do that. I know, I tend to do that. I tend to do that both as a teacher and as a student myself when I’m learning something. If I take a test on something, I always focus on what went wrong. That’s immediately where I go, “What went wrong? Why did I get that wrong? Why is it wrong?” and that’s good. I need to do that because I need to get it right eventually and that’s how I learn is by failing. But I often just totally ignore, “What did I get right on this?”

Kevin Patton (22:38):
And I think that that’s important, especially for us teachers if we’re having a discussion with a student that we do take time to do that with students, is to not only acknowledge that there’s a lot they did right on that test. Maybe they didn’t do as well is any of us would have liked, but there’s a lot of it that’s right. So here’s the strengths here and not just talk about the weaknesses because I think that really motivates students to keep going. If all we do is ever talk about what they got wrong, I think that is going to contribute to demotivating that student. And so I think that that’s a wonderful insight that you had about that, what we do right.

Kevin Patton (23:21):
And so the more I can encourage my students to look at it that way too, I think that the more they’re going to gain confidence as learners and see that that happens. And a glimmer of that insight that you just had I think was beginning to occur to me as I went through it because when I go through any paper that I really want to dive in to and learn from, I always jot little thoughts about questions I have about what they came up with because a lot of times later in the paper, that question is answered. Sometimes it’s not. And actually, I don’t recall ever reading a paper where I’ve jotted down notes where all my questions were answered because no one paper can do that.

Kevin Patton (24:10):
Just the way research works, you tend to isolate specific questions rather than ask really broad questions, because number one, those are hard to test, but the only way to test them is to break them down into smaller questions. And anyone paper is just going to tap one of those smaller questions. So a couple other questions that I wrote down that occurred to me play into this and I was thinking, “Well, what about poorly performing students?” What I mean by that is students who generally struggle in school, are certainly struggling in your course and that could be for a variety of reasons. There’s lots of reasons why students struggle, a lot of different reasons.

Kevin Patton (24:52):
Sometimes there’s more than one reason in a particular student is to why they’re struggling and I just wonder If we compared those struggling students with the students who are typically doing pretty well if there’s a difference and they’re changing of answers. Are they doing that? Because a lot of the students that I really have those heart-to-heart conversations about their test-taking skills are the poorly performing students. The high-performing students do ask me those questions sometimes, but usually, they’re not prolonged conversations because they’re wondering why they didn’t get 100%.

Kevin Patton (25:33):
And so that’s a whole different problem then, “Why can’t I pass this or why can’t I get that minimum of a B that I need to sustain to get out of this course and remain in my program or get into my nursing program?” or whatever it is. So I still have that question. I’d still like to know the answer to that because there might be difference. And then that led me down the road of, “Well, what about students who have a consistent circumstance in their life that is an obstacle or sometimes an obstacle for them?” For example, students that are on the autism spectrum, students who have attention deficit disorders or related disorders like that. That’s going to affect their ability to not only focus on the tasks sometimes, but also to really interpret what is being asked by the question.

Kevin Patton (26:28):
And so that might affect changing of answers, whether they’re changing from right to wrong or wrong to right too, I don’t know. Because I know in autism spectrum, that’s a whole basket of a lot of different kinds of not typical patterns of thought about things. So one person … Well, the saying is, “If you’ve met somebody on the autism spectrum, you’ve met one person on the autism spectrum. You haven’t met all of them because there’s so much difference.” And I noticed that in my class that even students who weren’t diagnosed being on the spectrum, not everyone thinks the same. And so sometimes there’s a clash between my pattern of thinking having written the question and their pattern of thinking in interpreting that question and so that could affect the changes of answers. So there’s lots of questions that remain to be answered in all of this. This is certainly … They brought together a lot of information here to help us continue down that road of helping students.

Sponsored by HAPS

Kevin Patton (27:44):
Marketing support for this podcast is provided by HAPS, the Human Anatomy & Physiology Society. Promoting excellence in the teaching of human anatomy and physiology for over 30 years. Looking for teaching tips and articles outlining research about what works in teaching and learning anatomy and physiology. Well, you need to check out the HAPS Educator, available online at theAPprofessor.org/haps. That’s H-A-P-S.

Standardized Exams, Test Anxiety, and Mindset

Krista Rompolski (28:22):
If you don’t mind, I’d love to talk about the introduction that talked about the No Child Left Behind Act and Every Student Succeeds Act. So just for some background there, I recall that, I believe No Child Left Behind started during the Bush administration, so I remember being roughly 2005, because I was doing a master’s or my undergraduate clinical internship at that time and I was helping to develop some healthy eating and nutritional curricula to incorporate into a local grade school. I have my undergraduate degree in exercise science, so I’m working with a local hospital that was trying to incorporate lessons about nutrition and healthy habits into the math curriculum and reading and things like that.

Krista Rompolski (29:13):
I knew very little about it, but I didn’t realize how much of those acts involve much more standardized testing and teaching and specific instruction on test-taking strategies. So in the article here, it says, “Elementary teachers are incentivized to not only teach to the test, but provide specific instruction on multiple choice test-taking strategies,” and I was aware and this says this, that the impact of test scores, test scores impact the evaluation of districts. Unfortunately, it sounds like the better students do, the more money these districts get which basically creates this snowball effect of the students that need the most support are in schools that are getting the least amount of funding and support which is so inequitable, but that’s another conversation for another day.

Krista Rompolski (30:09):
And certainly not being in the primary or secondary school, it’s something I couldn’t speak about with enough knowledge or eloquence, do a justice. But the point there is I’ve seen … So I tracked, “Okay, when were those students that were maybe in elementary school, when did they hit my college classroom?” And I noticed, so I’m trying to do the math on that like a 10-year difference [inaudible 00:30:35]. So I noticed a stark difference right around 2015 in terms of the expectations and anxiety levels around tests that my anatomy and physiology students had. It seemed like overnight tests were terrifying.

Krista Rompolski (30:54):
They didn’t know how to approach them and they not only felt so much more anxiety about them, but they also had all these ideas and expectations about the test that had nothing to do with the content. So for example, it was like, “Well, I didn’t think that was the answer because it was too straightforward,” or, “It was too simple.”

Kevin Patton (31:17):
Right.

Krista Rompolski (31:18):
Or, “Well, that couldn’t have been the answer, because a couldn’t have been the answer because the previous two answers were a.” So they were coming up with all these rationale that had absolutely nothing to do with the content. And I’m like, “Dude, what is going on?” Prior to entering college that they have not only all this paranoia, but all these assumptions about the test that I’m like, “This is random. If you know the answer, you know the answer.” So it’s almost like they had trauma about test taking and I think the irony there is you think, “Okay, if we talk about retrieval practice and you take tests to get good at taking tests, if they’re doing all the standardized testing, shouldn’t the students today be the most relaxed and phenomenal test takers we’ve ever seen?” but it’s the opposite.

Krista Rompolski (32:16):
I feel like there needs to be more coordination between the compulsory education and higher education to bridge these gaps or we need more education at the higher ed level about what they’re being taught and the effect of standardized testing and how do we better support and bridge these gaps? Because clearly they’re not preparing them better to take tests at the collegiate level. I would argue that maybe they’re being exposed to these test-taking strategies, but I have no clue what they are, do you? I have no idea what the test-taking strategies that instructors at the primary or secondary school level are being required or encouraged to teach and the implications of that when they get to college and they’re supposed to be answering questions based on their knowledge and critical thinking, not this specific gaming the test sort of strategy.

Krista Rompolski (33:19):
So I don’t know. It’s a really interesting conversation and I’m glad that they put that in the introduction, but like I said, I think there needs to be more conversation between all the levels of education here.

Kevin Patton (33:34):
When I saw that in the paper, It struck me because that’s not something that would have occurred to me, even though I know about the whole scenario of the testing that goes on in schools because that my kids have gone through all of that stuff. One is still in high school and so he still has a lot of that testing to go. And we do see testing, even though there’s been a lot of debate in the public forum about college entrance exams and things like that and some schools are shying away from them and so on-

Krista Rompolski (34:15):
We did. We dropped SAT as a requirement.

Kevin Patton (34:17):
And more and more schools are doing that. And I think we might be misled by those changes in thinking that standardized testing is going away in academia and it’s not really. I really think those are good … Myself, I personally like to see those kinds of changes, but certainly at the elementary and secondary level, we I don’t know if it’s getting worse, but it’s not getting better. And there’s a lot of debate recently with schools having suddenly switched to remote learning and then some of them put some of those tests on hold and then they got to a point like, “We can’t keep putting it on hold because the state says we have to.”

Kevin Patton (35:00):
Even though the circumstances for taking those tests had changed dramatically, they were going to be compared to results from prior years where things were different with no accommodation for that and that just doesn’t make sense to me, but they never asked me. But the point you’re making is a good one and that is the be all and end all of their initial years of education. And I think that anxiety from the educators rubs off on the students and so their anxiety level is increased. And then you also have some of these misunderstandings and myths that creep in there. You pointed out your examples of, “Well, there were two a’s in a row, so the third one couldn’t possibly be a.”

Kevin Patton (35:59):
I think that probably students were coached that use test-taking skills. And again, who knows what they were taught exactly? But I think sometimes, especially when you have an immature brain at those younger ages, you take to heart some things in a very literal way that shouldn’t be taken so literally, that are really more flexible things, “If you don’t know the answer and there had been a bunch of a’s, well, statistically, odds are, it’s not an a. So if you’re going to guess, here’s a way to do that.” So maybe that’s where that comes from. The much better answer or the much better strategy, of course, is to know the material. So you don’t ever have to fall back on these little tricks or strategies or whatever.

Kevin Patton (36:51):
And so you mentioned me preaching about retrieval practice and I’ll take that term. I do preach about it because I really believe in it. I’ve done it for a long time. And I really think that retrieval practice and not necessarily the way I do it, but any way that it can be done, I think really does help with that learning process and that’s what prepares you for the test. And now later in my teaching of anatomy and physiology, I had more and more tests that were online and you could do them over again online and only my midterm and final exam or the kind of exam we’re talking about in this paper here, where it’s probably on a scanned sheet and got a lot of multiple choice items on it.

Kevin Patton (37:41):
The thing is when I’m doing these retrieval practice things, in the early part of the course, I get a lot more students coming to me individually to figure out what went wrong because sometimes they don’t have good test-taking skills. So they’re just glancing at keywords and giving an answer and then I have to coach them, “Well, you can’t just glance at the keyword. You have to see what is the question asking and here’s some tips on how to do that.” There’s a variety of different kinds of issues they have like that, so that’s one of the things I like about those do over kinds of tests is that it prompts students to get help, either for me, from the learning center or from each other in a study group, that they’re getting the kind of help they need and getting those strategies and so on.

Kevin Patton (38:37):
I think that does help a lot, but coming back to your point, I think test anxiety is a big … And that’s one of the little notes I wrote on the side here and they do address that test anxiety issue that that is a potential factor in how this all exists. And my belief is that all students, including myself, have some level of test anxiety on every test.

Krista Rompolski (39:04):
I feel like we need a journal club about that because that was another thing that I’ve seen. That term just became catch all over the years. It started as a few students would mention it and now I feel like every student says that they have it. And so I think I personally believe and I don’t want to make assumptions, but what’s happened is any amount of nervousness about taking an exam is now labeled that but it is normal … There’s the eustress versus distress, right? But I think today so many students and young people like stress is just stress. There’s no such thing as good stress, right? Any amount of anxiety is bad and scary, and in the end, they think it’s abnormal or contributing to their perceived lack of success on an exam.

Krista Rompolski (40:01):
So I think another, and this is like a whole other topic, but I think we need to do a lot more work with our young adults and younger students at basically just like managing … Imagine there was a class in grade school and high school that was managing stress and anxiety and the impact that that would have long term in every aspect of their lives. And I realized that especially at the undergraduate level for so many students that we teach that are intending to go into health professions, they have to be obsessed with their grades because they need certain GPAs even be looked at on a transcript. I teach at the graduate level now and we have cut offs.

Krista Rompolski (40:47):
So no wonder they’re so stressed about their grades in that sense. I don’t know. And I wonder how much and again, this is another conversation, but I wonder how much dropping things like the SAT requirements will help or hurt in the long run. And I definitely was interested in hearing, without our episode going too long, hearing your thoughts on why you feel that dropping SAT requirements is necessarily a good thing. And I asked that because I’m doing some recent research with a colleague right now about mindset and growth mindset versus fixed mindset and the impact of that on academic performance.

Krista Rompolski (41:29):
And overall, the literature shows there’s very little impact on basically how much you believe your intelligence can change. A lot of literature suggests and makes an argument that intelligence is fixed and not a changed quality and that we’re potentially doing students a disservice by not acknowledging that because it feels very uncomfortable to say, “This is your intelligence. There’s not much you can do about it. You can change your effort, but you’re never going to potentially do as well as someone who is more intelligent than you putting out the same amount of effort. Like athletics, right? Because some people are genetically predetermined to be better at certain sports.

Krista Rompolski (42:10):
I just think that when we’re thinking about inspiring and motivating students, assuming that intelligence, which is potentially measured by something like the SAT feels uncomfortable and feels like a creates disadvantage. So like I said, that’s a bare of a conversation I just potentially brought up and we’re getting away from the main topic, but it’s all about testing, right? And how are we testing and how are we setting students up to be successful versus not? So I don’t know, I thought it would be a good point too or a good endpoint to see because this is something that I bet a lot of listeners are being faced with at their own institutions and dropping SATs or GREs and things like what your thoughts are or why you thought it was a good thing? And I’m not saying I don’t. I’m just curious to hear your historical perspective.

Kevin Patton (43:03):
I’m not aware of that more recent research that you were just alluding to, so I’m going to look into that a little bit and see what’s going on, but I question the applicability of that in the broader picture. I do understand the analogy of, for example, athletic ability, but in my view, it’s pretty clear to me that I will, not just because of my age and where I am in my life, but just my 18-year-old self could never have been an elite athlete because I just don’t think that I’m built to be an elite athlete. But I think I could have been a much better athlete than I was if I had applied myself. I just got interested in other kinds of things, some of which were active and athletic but weren’t a sport. And I could have been better at those things too had I applied myself more, but I just had this mindset that I wasn’t good at athletics, and so therefore, I wasn’t going to be good at anything that involved athletic ability or skill or anything like that. And so I never pushed myself.

Kevin Patton (44:13):
And so I think, now that I am older, I’ve become much more conscious about my level of activity and how much muscle I have and therefore bone density and so on. So I’m being much more intentional about doing athletic-type things now and I found out that I’m much more coordinated than I thought I was. And I am able to build more strength than I thought I was able to build. I can do some complicated moves with my body that I didn’t think that I would be able to do and I better balanced than I thought that I had. But I know that I’ll never be an elite athlete.

Kevin Patton (44:54):
And so I think that that is analogous to what we see you in A&P, let’s use that as our example, I think that students can always be better than they think they can do in A&P.

Krista Rompolski (45:09):
100%.

Kevin Patton (45:10):
So that’s how I use the growth mindset thing. In the end, if everybody pushes themselves equally hard, there’s going to be a difference in ability.

Krista Rompolski (45:19):
Exactly. That’s what I was trying to say that mindset is more associated with effort or willingness to keep trying or striving or grit, things like that. So my thought about dropping some of the standardized testing is, well, and I’d still want to hear your thoughts on that, is dropping it entirely, not taking into account that maybe that is a measure of just intelligence and it should be more into a piece in the puzzle, not a hard cut off requirement, if that makes sense? Because-

Kevin Patton (46:01):
Yeah. Oh, go ahead. Sorry.

Krista Rompolski (46:03):
…so to be admitting students into, for example, something an undergraduate biochemistry major who got an 800 on their SATs, you know what I’m saying? Are they really going to be able to be successful at that level? As someone who believes in my students and always cheers for them, I’m not even comfortable having that conversation, but it is a … I think it will be a bigger debate as more schools adopt these more holistic, admissions processes.

Kevin Patton (46:35):
That’s kind of the view I have is that I’m uncomfortable with the idea of a test being the major determiner a person’s fate.

Krista Rompolski (46:50):
Absolutely.

Kevin Patton (46:51):
And having such a faithful role in their lives and so that’s why I like some of these changes in terms of the SAT and ACT and so on, because number one, having written some test items beyond my course for different kinds of tests and standardized tests, if they’re letting people like me do it, then they’re not going to … We have to think about the fact that these are going to be imperfect tools. No matter who it is, not just people like me who are not necessarily well trained in test writing and so on, but in a lot of those big tests, I know that they have training processes and vetting processes and so on. And that’s great. If you’re going to have a live or die-type exam, you better be doing stuff.

Kevin Patton (47:47):
But even in doing all that stuff, it’s still going to have flaws. And even if it is the perfect test, what’s it going to be like on that day? What if somebody is in an automobile accident on the way there? What if they’re sick? What if they’re coming down with a virus as the test progresses? What if they ate the wrong thing last night, it’s coming back to haunt them? There’s all kinds of things, circumstances in their life that happened, they just found out some tragic news about a friend or family and here they are walking into their SAT. And yeah, you can take them over again, but sometimes those circumstances don’t go away.

Kevin Patton (48:29):
So there’s those things and I really do … I don’t know. You see some of these studies and anecdotal reports and so on of some of these tests having biases built into them and there’s that. Now, that’s one end of it. That’s one reason I don’t like it. Another reason why I don’t want them to have the power they have or I don’t think that’s a good idea for us to give them the power that they have is that I’ve had so many students and I think probably, I’m just guessing, I don’t know, I probably see this because of the kind of schools that I’ve taught at, especially at the community college, where it’s absolutely open enrollment. Our only stipulation is the ability to benefit, “If you have an ability to benefit, sign right here and pick a class or two.”

Kevin Patton (49:26):
I see a really wide spectrum of people coming in to my course, wide spectrum of ages, of backgrounds, of academic experiences, academic successes or failures that come into my course and I’ve worked with some students, and again this is just anecdotal, I haven’t tallied them up or anything or done a study, but there are more than a handful of students I’ve worked with over the decades who don’t do well on those standardized tests and actually struggle with test performance in general. But when you sit down and talk to them and have them work through, talk about case study, “What if you had a patient who did this and so on? And what if their blood pressure was doing this, how do you know you think their stroke factor was going up or stroke volume was going up or down?”

Kevin Patton (50:27):
And they can do that really easily. They know this stuff, they just struggle with the test for whatever reason. I don’t know what the reason is necessarily.

Krista Rompolski (50:37):
I think that’s what we need to understand more or do more investigation into. When a student can sit there and explain content to you and apply it, where is the disconnect on a multiple choice exam? Because I have graduate students right now that I’m going through that exact same process, they’re brilliant, they’re going to be wonderful clinicians, no one doubts it, but tests are a real challenge. It’s a real mystery figuring out, “Okay, we can just throw them out, especially because in most graduate programs, they all have some version of a multiple choice board test or undergraduate nursing students have the NCLEX so we have to prepare them to take these exams, but balanced that,” like you said,” with other types of assignments and assessments that accurately reflect what they know and what they’re capable of.”

Kevin Patton (51:32):
Right, exactly. And the older I get, the more I interact with our healthcare system. I have an elderly parent who has been interacting a lot lately and I’ve been by her side trying to interpret what’s going on. Being an effective healthcare provider is not just about what and how well you can apply it. It’s how you interact with the patient. None of these tests are testing for the kind of personality traits and willingness to empathize that are what I think keys to being a truly effective healthcare professional. So there’s another rabbit hole we can go down to.

Krista Rompolski (52:21):
This is a great conversation. Although it diverged a bit from the article, I think it was a conversation I’m often having with my colleagues and I bet our listeners too, so definitely hopefully worthwhile.

Kevin Patton (52:34):
And I’m all about diverging in topics, so that’s fine with me. And thanks again, Krista, for bringing us a thought-provoking paper and one that I think will help us help our students better by reminding us that sometimes our assumptions about the advice we give are not necessarily the best or the most well-informed things, so a good reminder.

Krista Rompolski (52:58):
Right.

Kevin Patton (52:59):
Thank you for joining Krista and I for this and I’m looking forward to our next journal club episode.

Krista Rompolski (53:07):
Great. Kevin, really I think we have a lot of ideas for next time.

Staying Connected

Kevin Patton (53:15):
Hey, why not share this episode with a colleague and get their thoughts on it? It’s easy to do. Just go to theAPprofessor.org/refer to get a personalized share link that will get your friend all set up. I always provide links if you want to know more about the topics of this episode. If you don’t see links in your podcast player, go to the show notes at the episode page at theAPprofessor.org/podcast. And while you’re there, you can claim your digital credential for listening to this episode. And you’re always encouraged to call in with your questions, your comments and ideas at the podcast hotline. That’s 1-833-LION-DEN or 1-833-5466-336 or send a recording or a written message to podcast@theAPprofessor.org. You’re invited to join my private A&P teaching community at theAPprofessor.org/community. I’ll see you down the road.

Aileen (54:33):
The A&P Professor is hosted by Dr. Kevin Patton, an award winning professor and textbook author in human anatomy and physiology.

Kevin Patton (54:45):
Misuse of this episode may cause injury or death.

[/expand]