Using confidence-based marking in a laboratory setting: A tool for student self-assessment and learning

Objective Confidence-based marking (CBM), developed by A. R. Gardner-Medwin et al., has been used for many years in the medical school setting as an assessment tool. Our study evaluates the use of CBM in the neuroanatomy laboratory setting, and its effectiveness as a tool for student self-assessment and learning. Methods The subjects were 224 students enrolled in Neuroscience I over a period of four trimesters. Regional neuroanatomy multiple choice question (MCQ) quizzes were administered the week following topic presentation in the laboratory. A total of six quizzes was administered during the trimester and the MCQ was paired with a confidence question, and the paired questions were scored using a three-level CBM scoring scheme. Results Spearman's rho correlation coefficients indicated that the number of correct answers was correlated highly with the CBM score (high, medium, low) for each topic. The χ2 analysis within each neuroscience topic detected that the distribution of students into low, medium, and high confidence levels was a function of number of correct answers on the quiz (p < .05). Pairwise comparisons of quiz performance with CBM score as the covariate detected that the student's level of understanding of course content was greatest for information related to spinal cord and medulla, and least for information related to midbrain and cerebrum. Conclusion CBM is a reliable strategy for challenging students to think discriminately-based on their knowledge of material. The three-level CBM scoring scheme was a valid tool to assess student learning of core neuroanatomic topics regarding structure and function.