Examining the Testing Effect in University Teaching: Retrievability and Question Format Matter

Review of learned material is crucial for the learning process. One approach that promises to increase the effectiveness of reviewing during learning is to answer questions about the learning content rather than restudying the material (testing effect). This effect is well established in lab experiments. However, existing research in educational contexts has often combined testing with additional didactical measures that hampers the interpretation of testing effects. We aimed to examine the testing effect in its pure form by implementing a minimal intervention design in a university lecture (N = 92). The last 10 min of each lecture session were used for reviewing the lecture content by either answering short-answer questions, multiple-choice questions, or reading summarizing statements about core lecture content. Three unannounced criterial tests measured the retention of learning content at different times (1, 12, and 23 weeks after the last lecture). A positive testing effect emerged for short-answer questions that targeted information that participants could retrieve from memory. This effect was independent of the time of test. The results indicated no testing effect for multiple-choice testing. These results suggest that short-answer testing but not multiple-choice testing may benefit learning in higher education contexts

Comparability of (post-concussion) symptoms across time in individuals after traumatic brain injury: results from the CENTER-TBI study

Post-concussion symptoms often occur after TBI, persist and cause disabilities. The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) is widely used in this population, but little is known about the comparability of the symptoms over time, i.e., longitudinal measurement invariance (MI). The objectives of this study were to analyze the longitudinal MI of RPQ symptoms from three to twelve months after TBI and to find factors related to RPQ symptoms. The study involved 1023 individuals after TBI who took part in the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study and completed the RPQ at three, six and twelve months postinjury. Longitudinal confirmatory factor analysis showed that the three-factor structure (somatic, emotional and cognitive) remains stable within one year after TBI. Linear mixed models revealed that sex, injury cause and prior psychiatric problems were related to the RPQ three-factor structure as well as to the RPQ total score. The study strengthens evidence for the RPQ’s factorial structure stability within one year after TBI and identifies sex, injury cause and prior psychiatric problems as important factors that may help clinicians to prevent future complications of symptomatology after TBI.CENTER-TBI was supported by the European Union 7th Framework program (EC grant 602150). Additional funding was obtained from the Hannelore Kohl Stiftung (Germany), from OneMind (USA) and from Integra LifeSciences Corporation (USA). The funders of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report

Quality of life after brain injury in children and adolescents (QOLIBRI-KID/ADO)-The first disease-specific self-report questionnaire after traumatic brain injury

The subjective impact of the consequences of pediatric traumatic brain injury (pTBI) on different life dimensions should be assessed multidimensionally and as sensitively as possible using a disease-specific health-related quality of life (HRQoL) instrument. The development and psychometrics of the first such self-report questionnaire for children and adolescents after TBI are reported here. Focus group interviews with children, adolescents, and their parents, cognitive debriefing, item pool generation and reduction using Delphi expert panels were performed. The resulting version was psychometrically tested on 300 individuals aged 8–17 years. After item reduction based on factor analyses, differential item functioning, reliability, and validity were investigated. The final 35 items were associated with six scales (Cognition, Self, Daily Life and Autonomy, Social Relationships, Emotions, Physical Problems). Internal consistency and construct validity were satisfactory. Health-related Quality of life (HRQoL) was significantly lower in older and in female participants, as well as those with cognitive disabilities, anxiety, depression and post-concussion symptoms, than in comparative groups. The new QOLIBRI-KID/ADO is a comprehensive, multidimensional, reliable, and valid instrument, comparable in content and items to the QOLIBRI adult version. Therefore, disease-specific HRQoL can now be measured across the lifespan and may support the amelioration of treatment, care, rehabilitation, and daily life of children and adolescents after TBI.This research was funded by Dr. Senckenbergische Stiftung/Clementine Kinderhospital Dr. Christ‘sche Stiftungen (Germany), and Uniscientia Stiftung (Switzerland)

Wünschenswerte Erschwernisse in angewandten Lernumgebungen: Mechanismen und Effekte

Improving retention of learned content by means of a practice test is a learning strategy that has been researched since a century and has been consistently found to be more effective than comparable learning strategies such as restudy (i.e., the testing effect). Most importantly, practicing test questions has been found to outperform restudy even when no additional information about the correct answers was provided to practice test takers, rendering practice tests effective and efficient in fostering retention of learning content. Since 15 years, additional scientific attention is devoted to this memory phenomenon and additional research investigated to what extend practicing test questions is relevant in real-world educational settings. This dissertation first presents the evidence for testing effects in applied educational settings by presenting key publications and presenting findings from a methodological review conducted for this purpose. Within this dissertation, theories are presented why practicing test questions should benefit learning in real-world educational settings even without the provision of additional information and key variables for the effectiveness of practicing test questions are presented. Four studies presented in this dissertation aimed at exploring these assumptions in actual university classrooms while also trying to implement new methods of practicing learning content and thus augment course procedures. Findings from these studies—although not often consistent—will be incorporated and interpreted in the light of the theoretical accounts on the testing effect. The main conclusion that can be drawn from this dissertation is that, given the right circumstances, practicing test questions can elicit beneficial effects on the retention of learning content that are independent of additional information and thus taking a practice test per se, can foster retention of real-world learning content.Seit einem Jahrhundert wird die positive Wirkung von Abrufübungen auf das Behalten gelernter Inhalte untersucht. Diese Untersuchungen belegen durchgängig, dass Abrufübungen für das Behalten förderlicher sind als vergleichbare Lernaktivitäten wie beispielsweise nochmaliges Lesen (Der Testungseffekt). Der Testungseffekt ist besonders bedeutsam wenn er in Settings untersucht wird in denen keine Informationen über die Richtigkeit des abgelegten Tests an die Lernenden gegeben werden und somit belegen, dass Abrufübungen nicht nur effektive sondern auch effiziente Methoden der Behaltensförderung darstellen. Seit 15 Jahren intensiviert sich das wissenschaftliche Interesse am Testungseffekt und immer mehr Forschung untersucht auch das Ausmaß der Übertragbarkeit auf reale Lernumgebungen. Diese Dissertation stellt zuerst Befunde aus Untersuchungen des Testungseffekts in angewandten Lernsettings dar, wobei zentrale Studien besprochen werden und hier ein eigens zu diesem Zweck angestelltes methodisches Review vorgestellt wird. Innerhalb der Dissertationen werden Theorien erläutert, warum Abrufübungen in realen Lernsettings das Behalten auch ohne zusätzliche Darbietung der korrekten Antwort fördern sollten und welche Variablen dafür essentiell sind. In dieser Dissertation warden zudem vier Studien präsentiert, die diese Variablen in universitären Lernumgebungen untersuchten, teilweise mit dem Ziel, Abrufübungen noch effektiver zu machen. Die gewonnenen Erkenntnisse aus diesen vier Studien—obwohl sie nicht immer konsistent sind—werden abschließend diskutiert und in Bezug zu den vorgestellten Theorien gesetzt. Eine zetrale Schlussfolgerung aus den vorgestellten Studien ist die Erkenntnis, dass unter den richtigen Bedingungen Abrufübungen den Testungseffekt hervorrufen können, die unabhängig von zusätlicher Information sind und dass es demnach die Abrufübung per se ist, die zum Behalten gelernter Information beiträgt

Reference Values of the Quality of Life after Brain Injury (QOLIBRI) from a General Population Sample in Italy

Traumatic brain injury (TBI) may affect the lives of the individuals concerned and their relatives negatively in many dimensions. Health-related quality of life (HRQoL) is a comprehensive and complex concept that can assess one’s satisfaction with a broad range of areas of life and health. The Quality of Life after Traumatic Brain Injury (QOLIBRI) questionnaire is a TBI-specific measure for HRQoL which is used in research and health services worldwide. When evaluating self-reported HRQoL after TBI, reference values from a general population are helpful to perform clinically relevant evaluations and decisions about the condition of an affected person by comparing the patient scores with reference values. Despite the widespread use of the QOLIBRI, reference values have until now only been available for the Netherlands and the United Kingdom. The aim of this study was to validate the QOLIBRI for the general population in Italy and to provide reference values. An adapted form of the QOLIBRI was administered to 3298 Italians from a healthy general population using an online survey. Their scores were compared with those of 298 individuals post-TBI recruited within the international longitudinal observational cohort CENTER-TBI study in Italian hospitals, who completed the original questionnaire. The psychometric characteristics and the measurement invariance of the QOLIBRI were assessed. A regression analysis was performed to identify predictors relevant for HRQoL in the general population. Reference values were provided using percentiles. Measurement invariance analysis showed that the QOLIBRI captures the same HRQoL constructs in an Italian general population and Italian TBI sample from the observational Center-TBI study. Higher age, higher education and the absence of a chronic health condition were associated with higher QOLIBRI scores, suggesting better HRQoL. Reference values were provided for a general Italian population adjusted for age, sex, education and presence of chronic health conditions. We recommend using these for a better interpretation of the QOLIBRI score in clinical practice and research in Italy

Reference Values of the Quality of Life after Brain Injury (QOLIBRI) from a General Population Sample in Italy

Traumatic brain injury (TBI) may affect the lives of the individuals concerned and their relatives negatively in many dimensions. Health-related quality of life (HRQoL) is a comprehensive and complex concept that can assess one’s satisfaction with a broad range of areas of life and health. The Quality of Life after Traumatic Brain Injury (QOLIBRI) questionnaire is a TBI-specific measure for HRQoL which is used in research and health services worldwide. When evaluating self-reported HRQoL after TBI, reference values from a general population are helpful to perform clinically relevant evaluations and decisions about the condition of an affected person by comparing the patient scores with reference values. Despite the widespread use of the QOLIBRI, reference values have until now only been available for the Netherlands and the United Kingdom. The aim of this study was to validate the QOLIBRI for the general population in Italy and to provide reference values. An adapted form of the QOLIBRI was administered to 3298 Italians from a healthy general population using an online survey. Their scores were compared with those of 298 individuals post-TBI recruited within the international longitudinal observational cohort CENTER-TBI study in Italian hospitals, who completed the original questionnaire. The psychometric characteristics and the measurement invariance of the QOLIBRI were assessed. A regression analysis was performed to identify predictors relevant for HRQoL in the general population. Reference values were provided using percentiles. Measurement invariance analysis showed that the QOLIBRI captures the same HRQoL constructs in an Italian general population and Italian TBI sample from the observational Center-TBI study. Higher age, higher education and the absence of a chronic health condition were associated with higher QOLIBRI scores, suggesting better HRQoL. Reference values were provided for a general Italian population adjusted for age, sex, education and presence of chronic health conditions. We recommend using these for a better interpretation of the QOLIBRI score in clinical practice and research in Italy

Comparability of (Post-Concussion) Symptoms across Time in Individuals after Traumatic Brain Injury: Results from the CENTER-TBI Study

Post-concussion symptoms often occur after TBI, persist and cause disabilities. The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) is widely used in this population, but little is known about the comparability of the symptoms over time, i.e., longitudinal measurement invariance (MI). The objectives of this study were to analyze the longitudinal MI of RPQ symptoms from three to twelve months after TBI and to find factors related to RPQ symptoms. The study involved 1023 individuals after TBI who took part in the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study and completed the RPQ at three, six and twelve months post-injury. Longitudinal confirmatory factor analysis showed that the three-factor structure (somatic, emotional and cognitive) remains stable within one year after TBI. Linear mixed models revealed that sex, injury cause and prior psychiatric problems were related to the RPQ three-factor structure as well as to the RPQ total score. The study strengthens evidence for the RPQ’s factorial structure stability within one year after TBI and identifies sex, injury cause and prior psychiatric problems as important factors that may help clinicians to prevent future complications of symptomatology after TBI