Journal of Professional Exercise Physiology     
                                                              Vol 2 No 2 February 2004
 
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The Center for Exercise Physiologyonline  / Exercise Physiology FORUM
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    Content Area Analysis
    Jesse Pittsley, MA
    Assistant Professor
    Departmetn of Human Performance and Exercise Science
    Winston Salem State University
    Winston Salem, NC
       
      "A man with a new idea is a Crank, until the idea succeeds." -- M. Twain
       
    Several weeks ago, in the Department of Human Performance and Exercise Science at Winston Salem State University, Dr. Cynthia Stanley a professor of Therapeutic Recreation, presented her thoughts and ideas about the evaluation and documentation of student competency in specific content areas.  She stated that, despite the noble attempts of many faculty members to document objectives and test for specific content areas, it is always difficult to know if students are proficient in the content areas.  Just because students earn a high grade on a final exam, it does not mean that the students are competent in all areas of the course content.  In fact, when applied on a larger scale, it is possible that an entire class of graduates may complete a program and lack competency in specific content areas.  The would be unfortunate because university teachers often assume that students with high grades have mastered the academic program and its specific content.  Dr. Stanley proposed that more objective steps should be taken to evaluate if students and the courses have met the appropriate learning outcomes.   In this article, I outline how Dr. Stanley documented competency in a specific content area using an exercise physiology example.  Also, I exam breifly the feasibility of this method and its role in the design of an exercise physiology program.

    Professional Organizations and the Quest for Competency
    Before outlining the method proposed by Dr. Stanley, it is useful to emphasize that professional organizations are responsible for the implementation of programs that encourage professional competency and ethical thinking.  To standardize the educational programs and progression, professional organizations establish accreditation guidelines and certification procedures.  These programs are designed to monitor curriculum content and enhance the students’ critical thinking skill before entering the profession.  As a result, accreditation and certification are important aspects of the standardization and quality control of the profession. 

    Accreditation, in particular, is designed to develop consistency in the primary courses, learning objectives, and the clinical and/or corporate hands-on experiences offered by institutions that have specific academic programs.  When an academic program applies for accreditation with a professional organization, representatives from the professional organization examine the curriculum, faculty, and relevant teaching resources such as laboratory equipment and space to see if the program complies with national standards. Following the evaluation, the professional organization or, more specifically, the accrediting branch of the organization states that the academic program is accredited or that it fails to meet the accreditation guidelines. 

    Theoretically, once students graduate from an accredited institution, they should then sit for the certification exam that is linked to the accreditation and the respective profession.  The exam is created by the professional organization to determine if the graduates of accredited institutions meet the designated learning outcomes to become a member of a profession.  To create the exams, the learning objectives of the academic courses are listed and test questions or situations (during the “practical” or “hands-on” portion of the test) are created from the specified content areas.  As a result, the tests are typically comprehensive exams that measure the students’ academic performance across the spectrum of content areas. 

    Most professions have designed accreditation and certification procedures to ensure quality and consistency among their members.  Professions such as nursing, physical therapy, and teaching have long established accreditation and certification processes.  In exercise physiology, there have been several certification exams offered by various professional organizations for over 20 years.  Only just recently has the American Society of Exercise Physiologists (ASEP) implemented the first full accreditation process for exercise physiology.  As a result, exercise physiologists involved in accreditation are quickly becoming no stranger to academic standardization and quality control. 

    Academic Department's Role in the Development of Competency
    Considering that a major role of an academic department is to develop a comprehensive program that prepares students for their respective certification exams and eventual employment, it is important that each department has an understanding of its success in teaching specific content areas.  For example, certain exercise physiology programs may have very developed units and courses teaching topics such as resistance training, but may lack emphasis in cardiovascular testing and ECG analysis.  Or, in a more hidden sense, departments may consistently produce graduates that are weak in certain areas despite a good curriculum.  Either way, it is important for the departments to know this information. 

    One possible approach to exam student performance in specific content areas is test item analysis.  Test item analysis allows exam proctors to evaluate if certain questions are more consistently answered correctly or incorrectly.  Furthermore, after examining a bulk of tests, it is possible to detect improperly worded test items or content areas where student performance is weak.  For example, the American Society of Exercise Physiologists (ASEP) accreditation document [1] requires that exercise physiology programs teach materials from several course areas including: muscle physiology, cardiovascular physiology, function anatomy, ECG interpretation, and other relevant areas.   The Exercise Physiologist Certified (EPC) exam offered by ASEP includes items regarding those topics.  If ASEP were to perform a test item analysis of the completed exams, certain trends may become evident regarding the difficulty of certain questions and, from a more global perspective, testing performance in certain areas. 

    These types of analyses are not uncommon and are consistently performed on large-scale standardized tests.   Secondary and post-secondary institutions use the analysis of these exams to evaluate their students’ performance and/or evaluate what type of students attend their institutions (i.e., students at MIT may score high on the math sections of the SAT).  Unfortunately, these analyses are less common with academic departments and these data are often not available from professional organizations offering the certification exams.  As a result, this burden may fall upon the shoulders of the specific academic departments to analyze competency of certain learning outcomes. 

    The Itemization of Competency
    Dr. Stanley set out to examine this issue on a smaller scale.  Instead of diving head first into a department level learning outcome assessment, she itemized and examined the performance on one final exam in one course.  To do this, the faculty member must perform the following steps: (1) examine each item of the test and place each specific question in a knowledge category that was representative of the course and program objectives; (2) determine which student responses were correct and incorrect; (3) calculate the total correct responses in each category from a student and class perspective; (4) evaluate the student performance of the specific content categories. This process is not either new or unusual.  Although this example was performed by hand, there are several software packages that offer test item analysis.  For example, one of the most common educational tools used on college campuses is BlackboardTM [2]. 

    Item Analysis of an Exercise Physiology Exam
    The purpose of this section is to provide a quick example of how the categorization of test items into their respective content areas allows for an in-depth analysis of student performances.  The test items below were taken from a practice version of ASEP’s EPC exam.   These questions and answers may be found in the EPC manual [3].

    Example Questions from the EPC Exercise Physiology Test

    1.  The respiratory centers are located in the ___. 

      a. cerebral cortex 
      b. medulla oblongata 
      c. thalamus 
      d. central thorax 
    2.  The cuff pressure at which the last sound can be detected is the ___   pressure. 
      a. systolic 
      b. diastolic 
      c. mean 
      d. mean arterial
    3.  The initial increase in heart rate with exercise appears to be a result of a(an) _____, and later during exercise a(an) _____. 
      a. decrease in accelerator tone/increase in vagal tone 
      b. withdrawal of vagal influence/increase in SNS tone 
      c. increase in PsNS tone/increase in sympathetic tone 
      d. none of the above
    4.  When the inspiratory center is triggered into action, the ___ space becomes ___ subatmospheric, thus causing the ___ space to become subatmospheric and air moves ___ the lungs. 
      a. intrapleural/less/intrapulmonary/out 
      b. intrapulmonary/less/intrapleural/in 
      c. intrapulmonary/more/intrapleural/out 
      d. intrapleural/more/intrapulmonary/in 
    5. When doing a squat exercise, which phase is considered eccentric for the quadriceps muscle group ___. 
      a. when the hips, knees, and ankles undergo flexion 
      b. when the hips, knees, and ankles undergo extension 
      c. both flexion and extension are eccentric 
      d. neither a nor b is eccentric
    6. All of the following muscles flex the shoulder joint except ___. 
      a. subscapularis 
      b. biceps brachii 
      c. coracobrachialis 
      d. anterior deltoid
    7. Of the following types of resistance training protocols, which is static? 
      a. circuit 
      b. isotonic 
      c. isometric 
      d. pyramid
    8. Regarding the following types of research, which one examines cause-and-effect relationships? 
      a. qualitative 
      b. descriptive
      c. longitudinal 
      d. experimental
    9. In research, ___ variables are manipulated by the investigator. 
      a. dependent 
      b. representative 
      c. independent 
      d. control
    10. Researchers use correlational research because it allows them to ___. 
      a. predict relationships
      b. establish cause-and-effect between two variables 
      c. provide proof to support conclusions 
      d. all of the above
     
    Now that the test items are listed, I’ve created Table 1 which is a fictional example of an item analysis and content analysis after 10 students completed the exam.  Each test item is listed with the amount of correct responses reported in its respective content area.  For example, eight of the 10 students answered question one from the respiratory physiology category correctly. 

    Table 1.  The amount of correct answers per test item and the average amount of correct responses per content area in a 10-item exercise physiology exam taken by 10 students.

                                                   Content Areas
    Test Item Respiratory Physiology Cardiovascular Physiology Training Research Methods
    1
    8
    2
    7
    3
    9
    4
    8
    5
    9
    6
    3
    7
    7
    8
    2
    9
    4
    10
    3
    Average
    8
    8
    6.3
    3

    The data indicate that students performed strongly in the content areas of cardiovascular and respiratory physiology, but were weak in the content area of research methods.  On closer analysis, one may also find reason to investigate questions #6 since few students responded correctly despite the otherwise strong performance in that category. 

    Final Thoughts
    The example was designed to present the general concept that test items may be divided into specific content areas and used for analysis.  A short 10-item test was divided into four content areas and the performance of 10 students was documented.  The data indicate that the students were strong in two categories and possibly weak in another.  Overall, this is good information that could be used to modify course content or a curriculum.  Interestingly, despite the quality information, one must question if this is feasible, considering the possible effort to perform such analysis.

    Obviously, the analysis would be difficult to perform on a substantial number of tests through the course of an academic year.  The amount of time and effort each test would require would make the task daunting considering the rewards.  In contrast, it may be feasible to investigate only comprehensive final exams since the quantity of information would match the quantity of work.  Furthermore, there are several test analysis programs available that would make this procedure more realistic.  Unfortunately, these systems may limit the type of questions offered since multiple choices tests are usually required for the quick analysis. 

    An idea that may make content area analysis more realistic is to offer a comprehensive exit exam that students would take upon completing a program.  The exam could be offered during the final months of a degree and contain questions from all the major topic areas covered in the curriculum.  It could also be used as a “warm-up” for the final certification exams offered by professional organizations.  The test items could follow a multiple-choice format that could be directly entered into a computer or easily graded.   Such an exam would allow programs to assess if the documented learning outcomes had been addressed properly.  Aside from assessing students at an individual level, exercise physiology programs could investigate if too much of an emphasis was placed in one topic area versus another.
    As an educator, I am curious how my students have retained the information that has been provided, and I consider content area analysis as a potential means of finding the answers. 


    Note:  The author of this paper would like to thank Dr. Cynthia Stanley, a professor of Therapeutic Recreation here at Winston Salem State, for making an excellent and inspiring presentation on her adventure with learning outcome analysis. 

    References
    1. American Society of Exercise Physiologists. (2004). The ASEP Accreditation Document. [Online].  http://www.asep.org/accreditation/
    2. The BlackboardTM Homepage. [Online]. http://www.blackboard.com
    3. American Society of Exercise Physiologists. (2004). The ASEP- EPC Manual.  [Online]. http://www.asep.org/epcmanual/