The Impact of examination pacing structure on student anxiety and performance with an undergraduate anatomy course

  • Professor Danielle Bentley, Division of Anatomy, Faculty of Medicine


The use of a traditional laboratory examination structure for the evaluation of student knowledge has a long history of success in anatomical education. This traditional design requires students to answer in-lab identification questions pertaining to anatomical specimens with advancement to the next question (termed “station”) indicated using a “bell”; typically referred to as a “bell-ringer”. Various professional and graduate level programs have previously experimented with self-paced (SP) vs belled-paced (BP) bellringer examination structures, revealing that students typically prefer SP as this reduces anxiety while producing comparable performance (knowledge) outcomes. Such success among these senior level students in completing the SP structure may depend on one’s ability to self-monitor and self-regulate progression through the examination in order to ensure sufficient timing for all stations. It is currently unknown if this innovated SP bell-ringer examination structure would also benefit more junior
undergraduate students.

Using a randomized cross-over design, this research will comprehensively evaluate the impact of an SP vs. BP laboratory examination structures on student anxiety and student performance. Undergraduate students (n=20) in an advanced dissection course will complete both a midterm and a final laboratory examination; one of which was randomly SP and the other was BP with equal total test time between the two structures. Test anxiety will be measured pre- and post-examination using a modified State-Trait Anxiety Inventory (out of 60). Differences in performance and change in anxiety level pre- to post-examination will be compared using unpaired t-tests. Student perceptions of the examination structure will be collected via open-ended feedback and qualitatively assessed. Results of this preliminary work will directly in form my own design of anatomy laboratory exams for related undergraduate Arts & Science courses.