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Test-enhanced web-based learning: optimizing the number of questions (a randomized crossover trial).

David A Cook1, Warren G Thompson, Kris G Thomas

  • 1Dr. Cook is professor of medicine and medical education, Department of Medicine, College of Medicine, Mayo Clinic, and director, Office of Education Research, Mayo Medical School, Rochester, Minnesota. Dr. Thompson is associate professor of medicine, Department of Medicine, College of Medicine, Mayo Clinic, Rochester, Minnesota. Dr. Thomas is associate professor of medicine, Department of Medicine, College of Medicine, Mayo Clinic, Rochester, Minnesota.

Academic Medicine : Journal of the Association of American Medical Colleges
|November 28, 2013
PubMed
Summary

Increasing self-assessment questions in web-based courses enhances learning up to a point. Too many questions do not add further educational value for medical residents.

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Area of Science:

  • Medical Education
  • E-learning

Background:

  • Self-assessment questions in web-based courses can enhance learning.
  • However, excessive questions may impede educational outcomes.

Purpose of the Study:

  • To investigate the impact of varying numbers of self-assessment questions on knowledge acquisition in web-based medical education.

Main Methods:

  • A randomized crossover trial was conducted with 180 residents across internal medicine and family medicine programs.
  • Eight web-based modules on ambulatory medicine were developed with 0, 1, 5, 10, or 15 self-assessment questions.
  • Participants completed modules in randomly assigned formats, with pretests administered for half the modules.

Main Results:

  • Posttest knowledge scores were highest for modules with 10 (75.7%) and 15 (74.4%) questions, compared to 0, 1, or 5 questions (all below 73.1%).
  • Modules with more questions generally took longer to complete and received slightly higher ratings.
  • Including a pretest significantly improved posttest knowledge scores (75.4% vs 72.2%).

Conclusions:

  • The number of self-assessment questions positively influences learning in web-based courses up to an optimal level.
  • Beyond this plateau, additional questions do not yield further learning benefits.