Medical students proposing questions for their own written final examination: evaluation of an educational project

Background In order to emphasise learning more than control, from autumn 2000 we have invited medical students to propose questions for their own written examination in family medicine. One out of three student's proposals was guaranteed to be a part of their coming written examination, possibly somewhat modified. Aim To evaluate how sixth year medical students experienced the project, and to what extent their performance in the examination was influenced. Participants Sixth year medical students. Main outcome measures The project was evaluated using (i) marks in examination; (ii) scores on self-administered questionnaires; and (iii) students' free text evaluation. Results Fifty-seven of 64 (89%) students taking their examination in autumn 2000, and 56 of 59 (95%) students taking the exam in spring 2001, responded. In autumn 2000, 34 (60%) students reported that the project had changed their learning strategies. During spring 2001, 46 of 56 students participated in producing questions, using a mean of 2.6 hours on the work. Students got 5-7% higher marks on their own questions on a scale ranging from 1 to 12. The students' free text evaluation showed that they had prepared especially thoroughly for the topics proposed by the students. They found it comforting to know at least one of the questions in the examination, and the students' questions were found relevant for general practice. Conclusion Encouraging students to write questions for their own examination makes them feel more confident during the examination period, and may increase their reflective learning, without seriously limiting topics studied or violating the control function of the examination.