I've been meaning to write this post for some time now. The idea came from a comment a friend made to me in an email. I told her that my grades for my classes were mostly As and a few Bs. She replied that she supposed it didn't matter if I didn't learn everything now because I would learn it later when I began practicing. I was quite surprised and had to read her reply several times. It seemed like she was suggesting that a grade of a B in a course meant I had learned less than someone who had earned an A in that course. And that's not how it works at all!
We are deep in the throes of midterms. Vet school is a succession of "midterms" that begin as early as the first or second week of the term and relentlessly continue up to the final exam. Week after week, term after term, for the first two and a half years. It's sort of cute/not cute that the instructors retain the old-fashioned name "midterm" for these exams. I'm far too busy studying for all of those exams to have the energy or the time to engage in a heated discussion of semantics with my instructors. They can call it whatever they want to call it.
But here's the connection to the comment my friend made. The grade that you get on an exam, and in a class, can be distinctly unrelated to what you have learned in that class. This is true not only for vet school but for any sort of formal testing situation.
Take systemic pathology. In this class, we study the specific changes that cells and animals experience when certain disease conditions are present. It's a super interesting course with lectures and textbooks chock full of beautifully staged and lit photographs of horrifically diseased organs. We are methodically moving through the body systems during our second year (skin, renal, cardiovascular, reproductive, etc). Each system is taught by a different instructor, and every week or so we have to adjust to a different style of instruction. One common thread is that all of the instructors give us assignments in addition to exams. The assignments involve lots of research, reading, and assimilation of concepts. I excel at that kind of work and knock the darned things out of the park. Every single instructor comments on my assignments: "Well done!" "Great job" "Impressive that you found a disease for every lesion on the list". You get the idea. I asked around and found that almost none of my classmates get comments on their assignments, even those who get full marks like I do. So I know that when I have time to ponder and cogitate, I demonstrate sufficient mastery of the required learning that it drives my instructors to comment. Woohoo for me.
But when I take tests in this class, I fall apart. At this point, it is entirely a mental thing. I have so much test anxiety for sys path exams that I will find myself staring at the exam sheet with a completely empty brain. I am engaging in one of the hardest courses of post-graduate study there is and I never have text anxiety in any course except sys path. I know this material. I proved that I know it. Yet I suck at taking the exams. I make a B in the course as a result despite perfect marks on the assignments.
(As an aside, I had similar test anxiety for gross anatomy during my first year. I really struggled in that class. But I signed up last term to be a teaching assistant for gross anatomy labs. I put on a lab coat and gloves and wander around the lab looking for first-years with sad faces. I go into the labs cold, with no review of the material, and discover that I actually know what and where all the fiddly bits are, despite my troubled exam performance during my own first year. I actually learned an enormous amount of anatomy but it has taken my returning to the scene of the crime to demonstrate that.)
Let me give you another example of the disconnect between test-taking and what has been learned. We are taking diagnostic imaging this term, a course that introduces us to radiology (x-rays). It's really an interesting class. Like sys path, it is also team-taught. When discussing osteosarcoma, one of the instructors put up a slide that said it can be primarily lytic (loss of bone), primarily productive (inappropriate new bone forms), or both. Three bullet points, one after the other. Very clear. Then she throws up a question on the recent "midterm" that asked whether osteosarcoma was (a) focal lytic, (b) focal productive, (c) diffuse lytic, or (d) diffuse productive. Can you see the problem? Based on the information she gave us, it could be either lytic or productive--she attached no relative percentages of likelihood to her three bullet points. And she did not define what "focal" or "diffuse" meant in the context of the question. The question was written exactly as I wrote it above. Was the lesion to be considered focal to the bone it was in, the limb it was in, the whole animal it was in? Productivity can be a function of activity of the lesion; was the lesion referred to in the question active or inactive? Acute or chronic? How in the hell could I know what she had in mind? Was I going to be tested on how well I could read her mind? How well I could guess?
I nearly lost my shit right then and there. Based on the information she had given us in lecture, which I had most assuredly learned, the question was ambiguous, and even worse, it was unanswerable as posed. As such, there was no way that question could objectively evaluate my learning. I wrote several careful but heated emails to the course coordinator and the instructor in question (screencapping her own damned powerpoint slide in the email because I'm an asshole like that), and the question was dropped from the exam.
Our culture generally accepts a "test" in some form to be a reasonable evaluation of "learning." If the "test" is poorly phrased or ambiguous, it cannot be used in this way. If the student demonstrates learning in one testing format but does not perform as well in another testing format, that does not mean the student has not learned.
I've mentioned before that I probably could make all As but I have made other life choices (a naughty puppy comes to mind). In other words, I make grades commensurate with the amount of studying that I do (which is considerable; one does not make even a single A in vet school without a lot of hard work). They are not automatically equivalent to the quality or quantity of my learning.
I attended a lunchtime talk yesterday given by a rep from one of the commercial test-prep sites for the national vet board exams, which we take in December of our fourth year. I learned that the board exam is pass/fail and you only need to get 70% of the questions right to pass. Your actual score is never seen by anyone but you. Next time you visit a vet for your pet, consider that they could have made 70% (or worse, curves do exist) on every exam in vet school AND on the national board exam, and yet there they are, getting ready to inject your pet with some medication. Now it is possible that they might have indeed learned less. There is a woman in our class who consistently makes the lowest score on every exam in every class. Her under-performance is impressive in a sad way. I've not yet been forced to do any group work with her but I hear that she is also consistently unprepared and hapless. I truly believe that she is an exception. For the most part, that exam score doesn't reflect what we have learned.
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