(62) Exploring the Impact of Self-Explanation Prompting on Performance and Exam-Taking Behavior in a Pharmacotherapy Course

Objective : Previous findings indicated that self-explanation prompting can enhance student performance in multiple-choice exams. The objective of this study was to investigate the impact of self-explanation prompts on students' performance in a pharmacotherapy exam as well as the associated changes in students' exam-taking behaviors.

Methods: In a pharmacotherapy multiple-choice exam, we compared three challenging multiple-choice questions (control question group) with similarly mirrored questions that included a self-explanation prompt (intervention question group). Using a sequential mixed-methods design, we first qualitatively analyzed ExamSoft snapshots to identify major exam-taking behavioral outcomes. Next, focusing on the top and bottom 10 performers, we quantitatively examined changes in both performance and quantified behavioral patterns across the control, intervention, and remaining regular multiple-choice questions in the exam.

Results: Data analysis indicated that top performers had significantly higher scores for both control questions (p <.01) and regular questions (p <.05) but there was no significant difference for the intervention questions that included self-explanation prompting. When exam-taking behaviors were analyzed, a chi-square analysis showed that the gap in positive and beneficial outcomes between top and bottom performers decreased from 23.4% for control questions (p <.10) to 10% for intervention questions. A similar trend was found for the reduction of the gap in the detrimental and negative behaviors.

Conclusions: Our study indicated that self-explanation prompts narrowed the performance gap between top and bottom performers and enhanced beneficial exam-taking behaviors, particularly among lower-performing students. Our findings align with prior research on the benefits of self-explanation prompting. Furthermore, they suggest the potential for creating a scaffolding strategy driven by fading strength of self-explanation prompts to foster enduring, beneficial self-explanation-driven exam-taking behaviors in pharmacy students, extending beyond the use of these prompts.