February 21st, 2012

The Challenge of Teaching Content When Test Stakes Are High


As educators, we share the challenge of how to teach an overwhelming amount of content in a short period of time to a sometimes motivated but often bored and listless student population. I do believe that most students enter higher education with a true desire to master their subject area. Some are even interested in learning for the sake of learning. But lectures overloaded with PowerPoint slides quickly change the motivation to extrinsic. This is especially true in fields where high-stakes testing determines future career options.

In the case of medical school, where I work, it’s a combination of boards (testing subject knowledge) and licensing examinations. But undergraduates face similar high-stakes testing when they take medical, legal, business, or graduate entrance exams. Even a course final that counts for a large portion of the grade can change the motivation to extrinsic.

Intrinsic motivation wanes quickly when facts are hurled at students via a PowerPoint lecture format, which appears to be the only practical way to get large volumes of information communicated during the class period. This approach virtually curtails teacher-student interaction; there is simply no time for it. I am not condemning lectures per se, but rather wish to raise the dilemma faced by me and other educators who teach content students must know for high-stakes testing. Do we conduct a meaningful discussion of core concepts, or must we deliver a lecture filled with volumes of minutiae and often seemingly irrelevant facts?

By core concepts I am referring to meaningful and relevant material related to the content and presented in class. Teachers provide a scaffold on which the students add facts through individual or group study both in and out of class. This approach encourages students to interact, engage, and connect actively with the subject matter and learning process. I recently tried this approach and would like to share what happened.

I began my class with a slide that read: “If I did not have to be here, would I?” Understandably, most of the 27 medical students in my class unconsciously shook their heads “no.” I then limited my hour-long discussion to 12 slides. There were two breaks during the didactics. During the first break I divided students into four groups. Each group had a pad of paper and instructions to write about the material I had just covered. They were not allowed to use computers, the Internet, or books. After five minutes, the pads were passed to another group, until each group had every pad once, and the final groups did not know the names of any of the writers on the pads of paper. We then discussed what was written on the pads.

My exercise for the second break was a version of the think-pair-share strategy, which students used to determine the best treatment for the disease we were discussing. After class, the students approached me and told me they had thoroughly enjoyed this class session. To my surprise, even though these students had been in classes together for more than two years, many of them said that this was the first time they got to work together in groups. Some said they had discovered that “lectures” could be fun!

But I had another surprise when I looked at the recommended practice test questions on this material. They are supposed to help students prepare for the high-stakes tests. As a practicing physician, I couldn’t answer some of the questions. I wrote what I thought were more pertinent, thought-provoking, and fair test questions; but I worry that these won’t be the ones on those tests that matter.

So I’m back to the dilemma. Are PowerPoint slides that expose students to any foreseeable question on the high-stakes exam the way to go? When I say yes, I see the bored, glazed-over student faces. I see desperate attempts to passively absorb the mountains of facts that accumulate when there are hours of back-to-back lectures in a single day. How much more rewarding it was for me as an educator to watch their boredom become enthusiasm when I made the classroom environment one of interaction and exploration.

This dilemma is one faced by many college educators teaching in programs where students face high-stakes testing. Currently, these high-stakes exams are often tests of rote memorization, not of inquiry or enthusiasm about a subject. Sharing this spirit of inquiry is the reason most of us became educators in the first place. We are teachers, not fact-reciting machines. We need to find a way out of this dilemma that compromises so much of what education should be about.

David Scott Trochtenberg is an associate professor of internal medicine at Meharry Medical College.

Reprinted from The Teaching Professor, 24.8 (2010): 5.

  • corkfree

    David,__First, let me congradulate you for being innovative enough to stir the intrinsic motivation of your students! What an awesome idea, to shut down technology and ramp up interdependant learning processes! I think it is fair to say from both the student and professor's standpoint that learning can be and should be interactive, enjoyable, and informative. _I would share with my students that what we are doing in class is designed to stimulate their epistemological juices, get them to thinking outside the box, and discover the joy and purpose of learning. I would also let them know that because you do not write the exams they are charged with passing, the data for doing so is contained on the PPT slides. Give them the option of either using class time as "lecture time" to cover required test slides, or engaging in interactive learning sessions. Regardless of their majority choice, provide them with the PPT slides on a flash drive and let them learn in ways that work for them._Just a thought and suggestion, good luck and keep up the good work!!!

  • Hello Professor David:

    I was immediately interested in your article by the very first sentence when you described the challenge of delivering a large amount of content to a group of students that may or may not be interested in it.

    I’ve taken a similar approach to the one you’ve described and include group activities throughout the class time – instead of lecturing for the entire class period. In addition, I’ve thought about the effectiveness of PowerPoint slides and I utilize them only to show key concepts. I’ll then discuss those concepts in detail, utilize videos or other interactive media, and add a group learning activity to reinforce learning and collaboration.

    I realize that your article is related to high-stakes testing; however, it is an instructional strategy that all instructors can use. How do you assign students to each group? Do you vary the group members on a regular basis?
    Dr. J

  • Barbara

    Hello Dr David
    Thank you for that great post. Many of us are caught in the dilema of teaching to the test and I appreciate your perspective. I especially appreciated the example of what you did in class. What a novel idea for the students to write down what is in their head rather that use their electronic resources etc. That engages them in thinking! I am curious about how the discussion took place after that. Did each group discuss it with the whole class based on the information that was on their pad or did they hand in the pad to you and you lead the rest of the discussion?
    Thank you again for this article.

  • kingscollegecelt

    Thanks for a great, thoughtful post. You present a great idea for active learning in lectures, but as you say, it's not clear that teaching for long-term learning will always result in the best results on the assessments that matter most to the students and the profession. I blogged about your post here: http://kingscollegecelt.wordpress.com/2012/03/12/

  • Pingback: Tough questions for active learning | CELT Blog()

  • Dr. Moheb Youssef

    Teaching to the test is a major issue that always backfires. Students are eager to pass rather than learn, which brings education to unprecedented low levels and graduates weak clinicians. PBL, that is common use in medical schools should be implemented from the start when basic sciences. the luxury of the power point must slowly dissipate, and as most replies have mentioned, go into oblivion. Students think that power points are a "study guide", a low-key concept inherited from high and elementary school, another puzzle to solve. Down with the podium, up with collaborative learning. I am linking an eye opener youtube video from Dr. Eric Mazur, a Harvard Physics Professor, who discovered peer Instruction as the best pedagogy for students to learn from each other, with the professor as a facilitator; a method that evolved to the flipped-classroom concepts. Students taking ownership of their learning, would make learning more fun than facebook, and build excellent clinicians.