Using poster presentation to assess large classes: A case study for first year undergraduate module in a South African University

doi:10.21203/rs.2.10122/v1

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Using poster presentation to assess large classes: A case study for first year undergraduate module in a South African University

https://doi.org/10.21203/rs.2.10122/v1

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published 21 Nov, 2019

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Background The massification of higher education is often associated with poor student engagement, poor development of their critical thinking, inadequate feedback and poor student throughput. Novel and innovative methods of teaching, assessing and giving feedback to large groups of learners therefore need to be developed to counter the challenges posed by the large class learning environment. The aim of this study was to obtain the perceptions of 1st year medical students and staff at the Nelson Mandela School of Medicine regarding the value of the posters as a teaching, assessment and feedback strategy.

Methods This observational, descriptive cross sectional study explored student and staff perceptions of using posters to manage the assessment and feedback of 1st year students’ work. A student and staff questionnaire using a five point Likert scale was used from which the data were extracted into Excel spreadsheet and analysed.

Results 230 questionnaires were completed giving a 92% return (230/250). Most students reported that the poster presentations helped them select important material (92%), understand disadvantage (86%) and make a difference in the community (92%). The majority felt that posters where an efficient (81%) and fair method (75%) of assessment and provided opportunity for meaningful feedback.

Discussion and conclusions Posters have been shown to promote learning and active engagement, and the development of higher order thinking, skills and transformative learning, as students were able to illustrate how they made a difference in the Making a Difference community to which they had been allocated. Poster presentations also allowed for quick and efficient marking, immediate feedback and validation of student participation. Poster presentations should be more widely considered as an innovative way of encouraging deeper engagement and learning in a large class setting. Summary

Educational Philosophy and Theory

Education

deep learning

assessment

posters

feedback

The South African (SA) National Development Plan has set targets that aim to increase the participation of students at Higher Educational institutions (HEIs) by at least 70% by 2030. This means that enrolments at HEIs need to increase from 950 000 students in 2010 to approximately 1.62 million by 2030. ⁽¹⁾ Medical schools have not been exempted from the process ⁽^2-4⁾ of massification of higher education due to the rapid increase in student enrolment. ⁽⁵⁾ At the Nelson R Mandela School of Medicine (NRMSM) of the University of KwaZulu-Natal (UKZN), the first year enrolment increased from 150 in 1990 to the current 250, while the members of staff who train on the programme have not increased proportionally.⁽⁶⁾

The massification of higher education, compounded by an inadequate numbers of academic staff,⁽⁴⁾ often results in the use of didactic teaching strategies, such as large group lectures, when teaching students. This instructive teaching method correlates poorly with the attainment of higher order learning, as it usually leads to an accumulation of factual information (Blooms taxonomy level 1) rather than deep engagement, insight, analysis and transformation (levels 4, 5 and 6 of Bloom’s taxonomy).⁽⁷⁾ In addition, large class didactic teaching is frequently associated with low student engagement with the academic staff and teaching material, and may manifest in low student motivation and poor student commitment on the course. This leads to a domino effect, where the students’ inadequate educational experience and superficial engagement with the educational material results in poor performance, with a higher number of students who fail or drop-out from their studies.⁽^8-10⁾

Assessment has been described as the single-most important determinant of student learning, ⁽¹¹^,¹²⁾ with their learning behaviour being greatly affected by the assessment type and content to be assessed.⁽¹³⁾ Identification of an assessment strategy that supports the ideals of deep learning is a major challenge in large classes, particularly in the context of staff shortages. As a result, many academics working at HEIs have resorted to the use of objective structured assessments, such as multiple choice questions (MCQs), which mainly test students’ ability to recall, memorise and understand (levels 1 and 2 of Blooms taxonomy). There is thus a real and logistical challenge for those who have to teach large numbers of students when selecting an assessment method, particularly when the skills to be assessed would best be demonstrated by means of a student assignment.

In addition to the challenges associated with teaching and assessment as highlighted above, large class sizes makes effective feedback to students regarding their performance extremely difficult.⁽¹⁴⁾ Compounding this challenge, Kulik and Kukil (1988), in their meta-analysis of 53 studies, highlighted the importance of feedback to be provided as soon as possible after the students’ performance, if it is to have any impact on their learning.⁽¹⁵⁾

Large classes may be associated with poor student engagement and lack of development of their critical thinking, inadequate feedback and poor student throughput. However, the lack of engagement and critical thinking is not necessarily synonymous with large class teaching, but more with the presentation of the learning material, methods of assessment and provision of feedback.⁽⁹⁾ It is therefore essential that lectures at HEIs develop novel and innovative methods of teaching, assessing and giving feedback to large groups of learners to counter the challenges posed by the large class learning environment.⁽⁸^,¹⁶⁾

The Making a Difference (MaD) group community service activity that is as offered at the NRMSM presents an innovative opportunity for staff to learn how to teach, assess and provide timely feedback to students. It is a 16 hour-curriculated component of the ‘Becoming a Professional’ (BaP) module at UKZN that requires a group consisting of four 1^st year students to spend a minimum of 16 hours engaged in service and educational activities to the benefit of a disadvantaged community. A previous publication has detailed the nature, purpose and types of facilities typically accessed by students when engaged in the MaD group community service activity.⁽¹⁷⁾

The MaD assignments are designed to encourage student engagement with both the course material and reflection for learning. Students are required to analyse, synthesize and evaluate as they participate in the service and educational activities, and reflect on the constructs of being ‘disadvantaged’, the meaning of illness, and how to communicate HIV prevention messages in appropriate ways to those living in these ‘disadvantaged’ communities. Each group of four students is required to design and present a poster to two faculty assessors and other groups of their 1^st year student peers. This poster assessment contributes 25% towards the module mark and is the culmination of the students’ experiences and learning during their MaD group community service activity. Each group is allocated 15 minutes for their presentation (10-minute presentation and 5 minutes for questions). Approximately 63 groups of four students each co-presented their work at the ‘Making a Difference Poster Day’, with an average of four groups being assessed per hour by two faculty assessors and their peers.

Although posters have been used for teaching and assessment in other settings,⁽¹⁸⁾ there is a scarcity of literature on the use of posters for teaching, assessment and to provide feedback to undergraduate medical students in the South African higher education environment. This study was therefore conducted to obtain the perceptions of students and staff regarding the value of the posters as a teaching, assessment and feedback strategy.

This observational, descriptive cross sectional study explored student and staff perceptions of the use of posters to manage the assessment and feedback of 250 first year students’ work at UKZN. The group- poster presentation method was selected as an assessment intervention due to the large number of students on the course and to ensure the fair and standardised way of assessing the work.

Setting

All 250 1^st year medical students were required to enroll in the BAP module in 2018. They were divided into 63 groups of four students per group and they identified 50 sites for their MaD projects (some sites had more than one group). Students were expected to visit the sites on four occasions between April 2018 and July 2018 to undertake their 16 hours of voluntary work. On completion of the MaD: group community service activities, all of the groups were required to present a poster detailing their experiences, with the October 2018 presentations being attended by the cohort as well as their eight faculty supervisors and four assessors.

At the end of the presentations, students were invited to complete a 17- item student questionnaire which elicited their opinion on their engagement with the learning material, their learning during the MaD: group community service activity, the extent to which they preferred group over individual assessment, and their experiences of feedback and fairness during their presentations. The staff questionnaire elicited the opinion of staff on the value of the posters as a learning, assessment and feedback strategy. A five point Likert scale ranging from totally disagree to totally agree was used to assess both sets of responses, with totally disagree and disagree being consolidated into one response as was totally agree and agree responses.

The data were extracted into Excel spreadsheet, with the quantitative data being analysed descriptively and the qualitative data analysed thematically. The data analysis was done by the authors independently and the themes identified were discussed to reach consensus.

Ethical approval for the study was obtained from the Biomedical Research Ethics Committee of the institution (R201/04). All participants were informed of the study, assured of their anonymity and their right to withdraw at any stage, with signed informed consent being obtained before the questionnaires were completed.

Of the 250 students invited to participate, 230 returned completed questionnaires, giving a 92% return (230/250). The student’s demographic breakdown indicated 220 (88%) black; 30 (12%) Indian and four (1.6%) white students, with 56% being females. Twelve members of staff were paired to assess the 63 groups over a four hour period, with two assessing each presentation. Ten (10/12) staff questionnaires were returned for analysis.

As a comparison, for two staff members to have marked each formal written group submission from each group (approximately 30 minutes per assignment), would have taken 3780 staff minutes, while the 12 members of staff took 2880 staff minutes to mark all the poster presentation and give feedback to students. (Table 1).

Table 2 gives the student’s responses to the questions relating to learning, assessment and feedback.

While 26 students indicated that they would have preferred to be assessed in an alternative way to the poster presentation, only 13 made comments or suggestions, with six suggesting a Power Point presentation, others a site evaluation (two), feedback from the organisation (one), a video submission (one), a test (one), and a reflective summary (two).

Table 3 gives the staff responses on the issues of learning, assessment and feedback. One assessor indicated that the MaD project could have been more efficiently assessed in a different format, but did not provide additional details as to how this might be done.

The increased enrolments of students at HEIs have necessitated the development and use of appropriate teaching, assessment and feedback methods to promote engagement and critical thinking to ensure that students achieve the stated learning outcomes of each module. Such activities should also be efficient in terms of its use of available time and human resources. The use of posters as a teaching, assessment and feedback strategy is relatively new in the MBChB program at UKZN, and is currently only used in the MaD and Selective 02 modules. Posters have however been used extensively with psychology and nursing students, and have been shown to promote collaboration and enjoyment in learning about research.⁽¹⁸⁾ Researchers also report that the educational use of posters increases students’ enjoyment of the learning process, helps create a positive learning environment, and assists with consolidation of their new knowledge, which greatly adds to their confidence to discuss research related topics.⁽¹⁸⁾

A key challenge in teaching large classes is to promote deep learning, and for the students to actively engage with the learning material. The poster preparation and presentation required students to analyse their experiences, obtain feedback from participants, and evaluate the impact of the MaD: group community service activity on themselves and those with whom they had worked. Students reported that this form of assessment promoted active engagement with the learning material, as they had to select important aspects from their interaction with participants at their MaD sites to demonstrate how they had understood ‘disadvantage’; made a difference in the community; engaged with the community around issues of HIV and how they had learnt from the people at the site. The posters also promoted learning and active engagement, as the students organised their thoughts through the rich learning context provided at their MaD sites, which promoted higher order thinking skills and deep learning. ⁽¹⁹⁾ The majority of staff members (90%) indicated that the poster presentation had allowed students to demonstrate their engagement in a meaningful and appropriate way around issues of disadvantage and HIV, as well as how they learnt from others. The posters therefore allowed students to present to the assessors and their peers how their hands-on experiences at their service sites had culminated into new learning.

All the students and staff members indicated that the poster presentation allowed students to demonstrate how they had made a difference in the MaD community to which they had been allocated. This is an important transformative outcome, as students needed to feel and experience that they can make a difference, even at 1^st year level, without having to wait until they qualified to contribute in their chosen community. Brooks et al (2018) highlighted that student transformative learning experiences are enhanced when they feel that they are making a significant difference and are able to contribute to medical citizenship.⁽²⁰⁾ Coria et al (2013) drew attention to the fact that assignments that ensure students confront real issues relating to social justice should be included in medical school curriculum, as an increasing number of medical students want to find ways to decrease health disparities and are willing to work with underserved people.⁽²¹⁾

Learning to collaborate and learn in teams is a key competency for health care professionals (HCP) to attain and an important core outcome competency, as specified by the Health Professions Council of South Africa (HPCSA).⁽²²⁾ Designing assignments that promote students’ collaborative leaning in teams is therefore an important outcome on the MBChB teaching platform, which should be assessed at various intervals during the 6-year programme. With increased polarisation of the South African society, there is a tendency among students to prefer to work in homogenous groups. However, due to their being assigned to racially and culturally diverse groups, they were encouraged to interact and learn about one another, and to work together in preparing and presenting their posters as an outcome of this module. Most of students (89%; 201) indicated that working in groups had helped them to learn more than they would have learnt if they had worked alone. In addition, 93% (211) indicated that the poster preparation and presentation encouraged interaction within the group. Researchers in other contexts have similarly recognised the value of posters to promote team work and learning from one another.⁽¹⁸^,²³⁾ Mellor identified group work as a way of supporting effective student learning,⁽¹⁶⁾ and highlighted that working in groups promotes collaboration and socialisation⁽¹⁶⁾ as they share their ideas, clarify differences, and develop conflict management skills through interaction with others.⁽⁸^,¹⁶⁾

Effective communication is another essential skill for HCPs to demonstrate,⁽²⁴⁾ with most (77%; 175) students reporting that the posters presentation had introduced them to a new way to share information with others. Other researchers have reported that poster presentations provide an excellent medium for developing communication skills and reflective thinking, and provides an opportunity for peer learning.⁽¹⁸^,²⁵⁾ Spiller highlighted the importance of clearly communicating the assessment requirements, methods and learning outcomes to students to ensure that learning is effective.⁽¹¹^,²⁶⁾ When asked, 100% of staff indicated that the marking rubric provided consistency in the marking, and 75% of the students considered that the poster presentations, as a means of assessment to be fair to all students. However, only 60% of the staff indicated that it was fair to give the same mark to all members of the group, as it may not reflect the amount of work done by each person.

All the staff members indicated that marking the poster presentations in this multiple-reviewer context was quicker and more efficient than marking written assignments. The poster presentation ensured that all the marking was completed in one morning, allowed for immediate feedback, and for staff to validate student participation in the MaD group community service activity, which would not have been possible if they were marking a written assignment.

All staff members reported that probing questions at the poster presentation about the meaning of disadvantage, how students made a difference and how they learnt from participants at the sites proved to be an effective way of validating that students had participated in the activity. However, only 76% of students indicated that the poster presentation validated their participation, which may have been because it was a group activity, and not all members may have participated equally. Plagiarism is a growing problem at all universities and a number of proactive and punitive mechanisms have been put in place at NRMSM and other universities around the world to ensure that students submit their own work and to combat plagiarism.⁽²⁷⁾ The poster presentations provided an easy and low-tech mechanism of validating student participation at their community site. More research is needed to find effective proactive ways to combat plagiarism and to ensure students participate and submit their own work.

Providing timely feedback is an important way to promote learning and engagement with the learning material.⁽¹⁵^,²⁸⁾ Feedback is said to develop self-awareness as students answer the following questions: ‘How am I doing?’ and ‘How can I get better?’. However, providing constructive feedback that is timely, meaningful, specific, effective, relevant to the current needs of the learner and gives suggestions to improve their learning ⁽²⁸⁾ is difficult to provide in the large class context as well as when marking a large number of assignments, with students rarely getting adequate feedback. Most students (87%; 144) and staff (90%) agreed that the poster presentations allowed for immediate and effective feedback to groups about their presentation and the activities during the MaD group community service activity. It is important, even in large classes to find effective ways to give appropriate feedback to students to encourage their deep and meaningful engagement with the learning material. This is an area that requires more research to find effective ways to provide feedback to large student groups enrolled at HEIs.

Although only 1.1% (26/ 230) of students wanted an alternative form of assessment, most students and staff were positive about the use of posters as a means of teaching, assessment and providing feedback. The alternatives suggested, such as power point presentations, would have taken more time to prepare and need additional logistical support. Site visits and direct feedback from the organisation have been built into student assessment in other countries, notably in the decentralized medical education in the Philippines.⁽²⁹⁾ Although this method of assessment is very effective in validating student experiences and evaluating the evidence of transformation in the communities, the site visit can be time consuming, costly and difficult to implement in a large class setting.

The poster preparation and presentations encouraged student engagement with the learning objectives and collaboration with other students. The posters assessed a range of generic and practical graduate competencies that require a higher level of learning, and allowed for feedback and validation of the student learning experiences. The presentations were seen an efficient and effective way of teaching, assessing and providing feedback to a large group of 1^st year medical students. Poster presentations should be more widely considered as an innovative way to encourage deeper engagement and learning in a large class setting. More local research is needed to identifying practical and time efficient methods of teaching, assessment and feedback that would encourage engagement, and deep learning among students attending HEIs in SA.

This study was only conducted with one cohort of MaD students at NRMSM and may not be applicable in other settings. However, the participation rate was very high, with the results being a good reflection of the student and staff perceptions at NRMSM of the use of posters for teaching, assessment and feedback.

Ethical approval for the study was obtained from the Biomedical Research Ethics Committee of the institution (R201/04). All participants were informed of the study, assured of their anonymity and their right to withdraw at any stage. All data was kept in a secured office and password protected computer. Signed informed consent was obtained before the questionnaires were completed.

Availability of data and materials

The datasets used during this study are available from the corresponding author on reasonable request.

Competing interests

The authors declare that they have no competing interests

Funding

This research project was self-funded with no external funding

Author’s contributions

AR, TH and JvW were involved in the writing of the protocol and the collection of data. JvW analysed the data. AR, TH and JvW were involved with the writing of the manuscript.

Acknowledgments

Not applicable

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Table 1. Comparison of staff time to mark poster presentations verses the same number of written submission.

	Scenario 1	Scenario 2
Students (n=250)	63 groups	63 groups
Staff to mark	12	12
Type of Assessment	Poster presentation	Assignment
Time to complete the task	4 hours allocated (240 minutes) X 12 staff members = 2880 staff minutes	2 staff to mark each assignment (30 minutes to mark each assignment). 63 groups x 2 staff members x 30 minutes = 3780 staff minutes
Advantages:	Immediate group and peer feedback	Individual reading and assessment, can be done at a time / place that is convenient to member of staff

Table 2. Student responses (n=230)*

Statements

Disagree

No. (%)

Neutral

No. (%)

Agree

No. (%)

Learning

The poster preparation helped me to select important points for the presentation (n= 229)

(0.4%)

(8%)

211

(92%)

The poster presentation allowed our group to show why we considered this MaD community to be a disadvantage group (n = 228)

3 (1.3%)

29 (

13%)

196

(86%)

The poster presentation allowed me to demonstrate how I made a difference in this MaD community (n=229)

3 (1.3%

(7%)

211

(92%)

The poster presentation allowed me to demonstrate my engagement in a meaningful and appropriate way around issues of HIV (n= 230)

5 (2.2%)

(11%)

199

(87%)

The poster presentation allowed me to demonstrate how I learnt from the participants at the MaD site (n=227)

3 (1.3%

(11%)

198

(87%)

Posters are an effective way to show that I achieved the learning objectives of the MAD (n = 228)

7 (3.1%)

(12.2%)

193

(84.7%)

The poster preparation and presentation encouraged my interaction with my group (n= 226)

1 (0.4%)

(6%)

211

(93%)

Working in the group helped me learn more than what I would have learnt on my own (n= 226)

6 (2.7%)

(8%)

201

(89%)

Posters introduced a new way of sharing information for me (n= 228)

15 (6.6%)

(17%)

175

(77%)

I found the peer assessment to be beneficial to my learning (n=228)

14 (6.1%)

(15%)

179

(79%)

Assessment

In my view, the poster presentation was an efficient form of assessment (228)

9 (3.9%)

(15%)

184

(81%)

In my view, poster presentations are a fair way to assess students

19 (8.4%)

(17%)

169

(75%)

Posters are an effective way for staff to validate our engagement with a disadvantaged community (n= 228)

10 (4.4%)

(19%)

174

(76%)

Feedback

The interactions with staff and peers provided opportunities for meaningful feedback (n= 165)

5 (3%)

(10%)

144

(87%)

* Not every question was answered by every student.

Table 3: Staff responses (n=10)

Statements	% Disagree	% Neutral	% Agree
Assessment of student learning
The poster preparation enabled students to show why they considered this MaD Community as a disadvantage group	0	0	100
The poster presentation allowed students to demonstrate how they had made a difference in this MAD Community	0	0	100
The poster presentation allowed students to demonstrate their engagement in a meaningful and appropriate way around issues of HIV	0	10	90
The poster presentation allowed students to demonstrate how they had learnt from the participants at the MAD site	0	10	90
The poster and presentation demonstrated that students interacted with their groups	0	10	90
Group work in the project and on the poster supported individual students to learn more than if they had worked alone	0	0	100
Assessment
The poster presentations was a more efficient way to mark the work of 250 students than marking written assignments	0	0	100
In my opinion the posters are a fair method to assess the group	10	20	70
Feedback
In my opinion, the posters are an effective way to provide feedback to all students	0	0	100

Download PDF

Journal Publication

published 21 Nov, 2019

Read the published version in BMC Medical Education →

Review #1 received at journal
23 Jul, 2019
Editorial decision: Major revision
23 Jul, 2019
Reviewer #2 agreed at journal
01 Jul, 2019
Review #2 received at journal
01 Jul, 2019
Reviewer #1 agreed at journal
25 Jun, 2019
Reviewers invited by journal
24 Jun, 2019
Submission checks completed at journal
04 Jun, 2019
Editor invited by journal
04 Jun, 2019
Editor assigned by journal
04 Jun, 2019
First submitted to journal
29 May, 2019

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Using poster presentation to assess large classes: A case study for first year undergraduate module in a South African University

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Abstract

Background

Methods

Results

Discussion

Conclusions

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