Test-enhanced learning: analysis of an experience with undergraduate nursing students

Background This study is based on the evidence that tests can be used as an educational tool to enhance learning, not just as an evaluation tool. There is a growing body of research that shows that participating in repeated testing improves learning, a phenomenon defined as Test-Enhanced Learning. The aim of the present study was to analyse the effect of the use of a test enhanced learning program integrated into a general psychology course for undergraduate nursing students and its interaction with the students' test anxiety. Methods 161 undergraduate nursing students attending a General Psychology course followed an educational program based on Test-Enhanced Learning methodology. Students were divided into two groups, an experimental group (TEL group) and a control group (Re-study group). TEL students took a multiple-choice test on the lecture topics. The Re-study group just read study material. Testing and re-study occurred at intervals of about a week after each lesson. TEL students received feedback immediately after each test. About two weeks after the end of the lessons, all the students took a final cumulative test on all the topics. Statistical analysis was used to analyse students' performances. After the administration of the cumulative unit test, all the students took a graded examination. Results Students in the TEL group performed better than the controls, both in the final cumulative test and in a graded examination. TEL participants experienced better final cumulative test results than students not tested (M TEL = 23.11, M Re-study = 20.47, t(109.86) = -2.57, p < 0.05, r = 0.24). Test-Enhanced Learning program participation has a positive impact on exam performance (? G_Step1 = 0.46, p < 0.001). Finally, the analysis performed shows a slight moderating effect of test anxiety on Test-Enhanced Learning (? GxTA_Step3 = 0.15, p < 0.05). Discussion and Conclusions Test-Enhanced Learning can be an effective tool for promoting and enhancing learning. In fact, taking tests after studying produced better long-term retention and then better final test performance than re-reading without testing. Both students in the TEL group and the Re-study group with a high test anxiety level perform less well than colleagues with lower test anxiety. Nevertheless, students with higher test anxiety may obtain more benefits from participating in a Test-Enhanced Learning process than people with lower test anxiety. Further studies on larger and more representative samples are necessary in order to investigate the effect of test anxiety on Test-Enhanced Learning.