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ILLUMINATIONS
Health and Sport Science Department
University of Dayton
300 College Park
Dayton, OH 45469-1210
E-mail: vanderburgh{at}udayton.edu
Open-book exams, sometimes used in courses more associated with math (1), have been touted as an evaluation method that promotes more active learning. Reported empirical benefits include the creative use of knowledge gained, "deep" probing of the study material, student self-evaluation of course material mastery, and an enhanced awareness of the learning process (1,2,4). Additionally, research evidence suggests that, armed with as many facts as possible, students stand the best chance of utilizing the highest possible levels of critical thinking (1–5). Limitations include excessive student time looking up answers, student anxiety due to exam rigor, a tendency not to adequately prepare for the exams, faculty spending too much time in exam preparation and grading, and faculty insufficiently trained or experienced in open-book test construction (1–4).
The lecture portion of the University of Dayton undergraduate Physiology course is taught to first- and second-year students pursuing majors in allied health, physical education, sport management, or exercise science and has no prerequisites. Student feedback and the above-mentioned literature suggested that the lecture portion of the course needed an evaluation structure that promoted more active learning. Class sizes between 25 and 50 students, with no graduate assistants or tutors, necessitated time-efficient grading. Accordingly, for a section of 42 students, we implemented the Open-Book Exam Student-Authored Question (OBESAQ) evaluation approach. It included, throughout the semester-long course, three open-book/notes exams and, for homework, eight sets of student-authored exam questions. The exam and homework questions, developed by the instructor and student, respectively, were of the same specific multiple-choice format.
The open-book, open-notes exam is the foundation for the evaluation portion of this undergraduate course. Given during the normal lecture time period, the exam consists of 10–12 multiple-choice questions and allows students to use any notes, references, books, or other hardcopy materials. Here is an example of such an exam question:
Select the correct response(s) by circling the corresponding letter. There may more than one correct answer or there may be no correct answer, in which case circle nothing.
Under normal circumstances, the aorta (CORRECT ANSWERS = a, b, c, d):
a. Always maintains a pressure higher than that of the left ventricle except when the aortic semilunar valve opens.
b. Sees a flow rate equal to that of the pulmonary artery.
c. Always maintains a higher blood pressure than even the largest veins.
d. Has pressure limits that define systolic and diastolic pressures.
Because none of these answers can be directly retrieved from the book or class notes, the student is forced to integrate multiple terms and concepts such as pressures, flow rates, temporal relationships, and functions and must also tap his/her organization and information retrieval skills. Evaluation is rather simple: a point is earned for each correct response circled and/or each incorrect response not circled. This allows credit for mastery of each item, not an all-or-nothing prospect, as is common in multiple-choice questions. Furthermore, with computer scoring, grading becomes expeditious.
Student-authored questions are the second element of the OBESAQ evaluation method. Students are required to develop, as homework, a sample test question using the same format as the exam question shown above with the addition of explanations of each response's correctness. Despite the identical format, student homework questions are not used for our actual exams due to student inexperience. Our intent is to test students' writing skills, creativity, and critical thinking and to use these exercises to aid them in exam preparation, an objective underscored in Ioannidou's work (3). Here is an example of an excellent student-authored question with explanations (references to page numbers and figures are fictitious).
Skeletal muscle, unlike smooth muscle (CORRECT ANSWERS = b, d):
a. Functions under tensile and compressive forces generated by its fibers.
b. Cannot contract without neural stimulation
c. Usually generates a force of contraction that is equal to the resistance that must be overcome.
d. Can easily use ATP faster than it can resynthesize it.
EXPLANATIONS:
a. No, p. 290. Neither muscle type functions with compressive forces. Skeletal or smooth muscle can only "pull," via tension, to exert their effects.
b. Yes, p. 308; Figs. 11–18. Skeletal muscle only contracts as part of a motor unit: the motor neuron and the muscle fibers it innervates. Smooth muscle, on the other hand, can be autorhythmic or innervated hormonally, so it must have the capability of contracting without neural stimulation.
c. No, p. 209. Skeletal muscle generally must exhibit much higher forces of contraction than the resistance that must be overcome because the insertion points are much closer to the axis of rotation than the resistance points. The up side of this design is speed of movement.
d. Yes, p. 309. Skeletal muscle, through recruitment of more muscle fibers and increased frequency of stimuli, can generate very large forces. The cost, though, is fatigue. Smooth muscle cannot be fatigued, but this is at the cost of being capable of very small forces of contraction.
Homework evaluation is divided into three categories: correctness, critical thinking, and writing. Excellent homework, then, is completely correct, draws on very high levels of critical thinking, is written succinctly with no grammar or punctuation errors, and tests the ability to think through the important and sometimes complicated concepts in physiology. Each is weighted equally, although any instructor can assign weights according to his/her preferences. Informal surveying of the class indicated that students spent 
1 h developing what would be considered an excellent question.
At the conclusion of the course, and before final grades were known, students conducted an evaluation of the OBESAQ using the standardized university evaluation survey. The more quantitative data suggested that the OBESAQ method offered some positive effects on critical thinking and writing skills as well as overall learning. Qualitative student comments, relevant to the course and not the instructor, are (by question, italicized) as follows:
What elements increased your knowledge and/or understanding?
What elements of this course need improvement?
There were several other observations of the OBESAQ method worth expounding upon. First, it still allowed for computer scoring of exams via mark sense forms, a most desirable method for the usually large sections in undergraduate physiology. Test construction, however, is rather time consuming. Furthermore, the ideal questions must take into account not only textbook material but class lecture content as well. Only the instructor knows both. Second, the assignment of homework is quite simple: students develop one or two exam questions from each chapter. Third, evaluation, just like test question development, is time consuming due to the necessity of editing and correcting.
In conclusion, the OBESAQ evaluation method in undergraduate physiology appears to be beneficial for and well received by students. It may promote a higher level of critical thinking and increased emphasis on writing skills and be more conducive to expedient grading (computer scoring). It probably, however, requires more time for exam development and homework grading. Faculty assigned to teach a similar course might consider this approach to promote more active learning and emphasis on writing skills.
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