Course directors often note that medical science classes struggle with beginning medical courses when the material introduces novel concepts and terminology or requires recall of previously learned material. Pre-class quizzes induce students to review past courses and pre-read before the class is initiated, fostering easier entry into the subject matter
Students in professional schools are often challenged to apply previously learned, as well as some novel material, in required professional courses. Based on their understanding of the objectives of prerequisite courses, instructors often assume that students have understood prior concepts. However, this assumption is often incorrect. The earlier courses may not have taught what was assumed, or students may have learned material superficially for a summative exam, but never internalized it for later application. Frequently, there is a long time lag between the prerequisite course and the new one. These mistaken assumptions may continue within a course—the instructor assumes learning of initial material prior to moving on with more advanced content, but students may not have done so. Students may not pre-read the required texts and may then struggle as the course quickly moves on into even more complex ideas and material. These challenges were met at two professional schools by using online pre-quizzes at the start of required courses in Microbiology/Immunology (University of Louisville School of Medicine, U of L) and Nephrology (University of California Davis School of Medicine, UCD). Online quizzes have been used in several curricula to stimulate review or provide formative feedback1-10. Those described pre-quizzes differed from those in this manuscript because ours are given at the beginning of major courses.
At UCD a 30 question online quiz was distributed 3 days before the start of the year 2 Nephrology course. The quiz covered normal renal histology and physiology that had been taught one year earlier in required year 1 courses and was designed to reflect the key concepts needed for success in understanding renal pathophysiology. Students had 2 weeks to complete it, taking it at most once per day and keeping their best score. WebCT software was used for administration. Questions were scrambled on each administration to prevent students generating a standard key. The quiz was open book, but students were asked to complete it independently. Questions were a mix of factual recall and short vignettes requiring understanding or application of knowledge (sample questions are shown in Table 1 with correct answers bolded).