Effectiveness of Integrating Test-Enhanced Learning into a BSN Foundations of Nursing Class: A Pilot Project

The purpose of this study was to evaluate the effectiveness of a pilot project designed to assist student learning by incorporating weekly post-lecture quizzes intended to increase the spacing time of studying.  Numerous studies have reported the positive effect that test-enhanced learning (TEL) has on the long-term retention of information, or what is known as the testing effect, and that it is an effective teaching/learning strategy. We hypothesized that weekly quizzes would increase the frequency and time that a student spent studying lecture material and that the result would be better long-term retention of information and increased grades. Using a pretest-posttest study design, we used three retrospective sets of data from second semester baccalaureate nursing students for fall 2013 (n = 75) and spring 2014 (n = 105). Data gathered included: the Assessment Technologies Institute (ATI) Registered Nurse Content Mastery Exam for Fundamentals; the number of students with a grade of <75 prior to the final exam; and the number of students that failed the course. Standard teaching/learning strategies were used fall 2013 (pretest group), while TEL was implemented in spring 2014 (posttest group). For the pretest group’s ATI scores, there were 6 (6%) Level 3, 61 (58%) Level 2, 13 (17%) Level 1, and 1 (<1%) below Level 1. For the posttest group’s ATI scores, there were 18 (23%) Level 3, 46 (59%) Level 2, 13 (17%) Level 1, and no students below Level 1. There were 52 (50%) students with a grade <75 before the final exam in the pretest group, and 6 (8%) students in the posttest group.  A total of 6 (6%) students failed the course in the pretest group, compared to 5 (6%) in the posttest group. The findings indicate that TEL is an effective teaching/learning strategy that had a positive impact on the retention of course material. Limitations include that the study was not randomized, used a small sample size, was conducted at a single institution, and in a single course. Additional research is needed to determine the effectiveness of TEL in other settings and courses.