When it comes to failure in assessment, I am no stranger to making mistakes. For me, however, the “worst assessment” I have ever encountered has not been one that I have taken or have given. In fact, it is the type of assessment that is given in medical schools all across the country, known as “Shelf Exams”. 

What is a Shelf Exam?

To summarize quickly, Shelf Exams are assessments that take place at the end of every rotation in the third year of medical school (BeMo, 2023). Their purpose is to assess the medical student’s knowledge on the specific field that they are currently rotating in. For more context on what they are and how they work, BeMo does a decent job laying it out for people not in medical school. In short, they are “ 110 multiple choice questions about various hypothetical cases, situations, and scenarios,” (BeMo, 2023). On paper, that seems like an obvious assessment and one that is extremely necessary for the field. However, when one compares what the assessment is with how they are “prepared for it”, it becomes shockingly clear why the assessment leaves much to be desired.

Issues with Shelf Exams

The main problems with these Shelf Exams is the way students are told to prepare for them as well as the structure of the assessment itself. For starters, medical students are asked to prepare for these high-stakes assessments while also working up to 40+ hours a week (unpaid) and being given little-to-no structure or guidance for how to best prepare for them. Instead, they are given practice questions and textbooks to review the material, and then the test can be given on any of the material that is within its scope. This process is the same for each exam. Which leads me to the other main problem: the structure. Montenegro and Jankowski assert that a weakness in assessment creation is to make all assessments the same, no matter the materials covered or the student who takes them (Montenegro & Jankowski, 2017). It does not matter if the medical student is about to take an exam after an emergency medicine rotation or a surgery rotation, the structure remains the same. Personally, if I was asked to create exams for medical school, I would try to focus on the structure the most.

How to fix them

The main issue I see with the Shelf Exams is the “cut and paste” nature of their structure. If a high school or even undergraduate program tested their students using the same structure for every subject, the program would be shut down. Not only does it go directly in the face of UDL, it completely ignores the idea of TPACK. To fix this, I would start at the TPK side of the TPACK framework, as the test does content knowledge quite well (Mishra, et al, 2006). I would design tests that would be more unique to each rotation, which might allow more creative approaches.

Closing

These exams are personal for me, as two close people in my life, my best friend and my girlfriend, are in or were in medical school, and as an educator, it frustrates me to see some of the most important professions we have assessed in such a poor manner.

References:

BeMo Academic Consulting Inc. (2023, March 31). How to study for Shelf Exams in 2023. BeMo®. https://bemoacademicconsulting.com/blog/how-to-study-for-shelf-exams#:~:text=What%20are%20shelf%20exams%3F,of%20learned%20knowledge%20during%20rotations. 

Mishra, P., & Koehler, M. J. (2006). Technological Pedagogical Content Knowledge: A framework for teacher knowledge. Teachers College Record, 108(6), 1017-1054.

Montenegro, E., & Jankowski, N. A. (2017). Equity and assessment: Moving towards culturally responsive assessment. (Occasional Paper No. 29). University of Illinois and Indiana University, National Institute for Learning Outcomes Assessment (NILOA).

NightCafe Studios (2023).Teacher Grading a Student's Paper . by NightCafe Studios, 2023 (https://creator.nightcafe.studio/)