Question-writing as a learning tool for students--outcomes from curricular exams

Writing exam questions can be a valuable learning tool. We asked students to construct multiple choice questions for curricular exams in Internal Medicine. The questions for the particular exams were chosen from a pool of at least 300 student-written questions. The uncorrected pool was accessible to all students. We studied the influence of this approach on the students' learning habits and their test results. We hypothesized that creating a pool of their own questions for the exams could encourage students to discuss the learning material. All students had to pass 4 exams in 7 fields of Internal Medicine. Three exams were comprised of 20 questions, and we applied the new method in one of these exams. The fourth exam was comprised of 30 questions, 15 of which were chosen from a students' pool. After all exams had been completed we asked the students to fill in a web-based questionnaire on their learning habits and their views on the new approach. The test-results were compared to the results of the lecturers' questions that defined high and low performing students. A total of 102 students completed all four exams in a row, 68 of whom filled in the questionnaire. Low performing students achieved significantly better results in the students' questions. There was no difference in the number of constructed questions between both groups of students. The new method did not promote group work significantly. However, high performing students stated a stronger wish to be rewarded by good performance. Creating a curricular exam by choosing questions from a pool constructed by students did not influence the learning habits significantly and favored low performing students. Since the high performing students sought to be rewarded for their efforts, we do not consider the approach applied in our study to be appropriate.