Nonhuman questions are underutilized tools in assessing higher-order cognitive skills in human physiology

Since most physiology core concepts are equally applicable to humans and other multicellular organisms, human physiology instructors may reasonably wonder whether consistent use of nonhuman assessment questions would enhance students' understanding of human biology, perhaps by offering novel contexts that demand application of human physiology concepts. In this study, we explore this by comparing two types of assessments: test banks from human physiology textbooks and vetted assessments prioritizing physiology core concept knowledge. We checked for nonhuman questions and further categorized each nonhuman example as having No Analogy or Perfect Analogy or Uncertain Analogy to humans, with the latter having potential for assessment of higher-order cognitive skills (HOCS). We found that of nearly 14,000 test bank questions from 6 different human physiology textbooks, only 53 concerned nonhumans, and only 6 of those were judged to be Uncertain Analogy. Practice Medical College Admission Test (MCAT) exams and physiology concept inventories included nonhuman questions at rates ranging from 11% to 80%. We further classified the nonhuman questions (n = 164) from all sources as assessing lower-order cognitive skills (LOCS) or HOCS and found that on average the Uncertain Analogy bin (n = 67) had the highest average percentage of HOCS questions at 61.6%. Our data suggest a mismatch between the potentially high value of nonhuman questions for HOCS development and their rarity in test banks, and we recommend greater inclusion of nonhuman questions in test banks. For instructors interested in using nonhuman examples in assessments, Test Question Templates (TQTs), which help generate questions based on lesson learning objectives, may be useful.NEW & NOTEWORTHY This study analyzed human physiology textbook test banks and vetted physiology assessments for nonhuman questions that might challenge students to apply human physiology concepts in novel scenarios. We found that test banks had a far lower proportion of nonhuman questions compared with Medical College Admission Test (MCAT) practice tests and physiology concept inventories. We recommend nonhuman questions in human physiology assessments to enhance higher-order cognition about physiology core concepts and recommend using TQTs to generate such novel questions.