The HAPS Standardized Exam, Course Performance and Subsequent Professional School Performance

In 2014, when I was teaching at a school of nursing, I was asked to develop a Human Anatomy and Physiology course sequence for undergraduates at our university who were interested in pursuing a degree in nursing.  Human Anatomy and Physiology was required for admission to our school, and we were interested in attracting more undergraduates from our university.  We wanted to make these undergraduates more aware of nursing as a possible career path, particularly bright students who already expressed an interest in science.  Additionally, we were seeing that many students who matriculated into our traditional BSN program (to obtain a first bachelor’s degree) either were not well prepared, or seemed to have forgotten a significant portion of their basic science coursework.  A colleague and I developed a pilot course that combined Human Anatomy and Physiology II (a common nursing prerequisite course) with Health Assessment (a course that is often offered early in the professional nursing curriculum) into a novel course that we called Physical Assessment:  Normal Human Form and Function.  Students in this novel course would take the traditional Human Anatomy and Physiology II lecture but would have a separate lab where the Health Assessment skills would be taught.  We got approval from our university’s IRB, and also from our School’s curriculum committee.  We obtained funding through a small grant from our university’s Center for Faculty Development and Excellence, and funds from the Center for Science Education.  Our pilot course launched in the spring of 2016 with 10 students.

Our hypothesis was that students who participated in the pilot offering of this novel course would demonstrate improved learning of the basic anatomy and physiology concepts, as well as better retention of these concepts, than students who did not participate in the innovative pilot course.  We used the HAPS standardized exam as a pre-test / post-test to measure students’ improvement from the beginning of the course sequence (August 2015) to the end (May 2016).   We found that all students had significantly improved post-test scores on the HAPS exam when compared to the pre-test scores.  We did see that participants in our pilot study did outscore non-participants in terms of exam scores, overall course scores and HAPS exam scores.  These students appeared to be more satisfied with their overall experience.  Further, participants also appeared to have stronger course scores in Pathophysiology, the first science course they encountered as professional nursing students, than non-participants.  We noted a correlation between the learning gains on the HAPS exam and scores in Pathophysiology – this may be the first observation of correlation of pre-professional coursework performance with professional performance.  Our pilot course experience resulted in a poster presentation at the 2017 annual HAPS meeting in Salt Lake City.

The biggest limitation of our study was the small sample size – our pilot cohort was 10 students.  We chose the students in this cohort carefully for this first iteration in an attempt to minimize the potential disruption to their entry and progression through a professional nursing curriculum (ie, we chose students that appeared likely to be successful).  Thus, we cannot generalize our results widely to pre-nursing students, and we cannot rule out the possibility that the participants would have out-scored their non-participant counterparts in any case.  

There were several challenges specifically associated with the HAPS exam we faced as we developed this course.  One challenge was the cost of the HAPS exam – about $10 per student.  Since we opted to use the exam as a pre-test / post-test assessment, we needed $20 per student to obtain this data.  Funding from the CFDE / Center for Science Education covered the cost of the exams.  Another challenge in the use of the HAPS exam was that it is completely online.  One required element in administering the exam is a professionally-supported computer lab.  Students were not allowed to use their own computers, and there is no compatibility with any “lock-down browser” mechanisms that would prevent students from accessing online resources during the exam.  While our school of nursing still had a computer lab, many schools have stopped supporting these in lieu of having students provide their own computers.  Some students taking the HAPS exam at the beginning of the academic year expressed their anxiety when viewing their scores, and some dropped the course shortly afterward.  Additionally, we did not include an incentive for students to perform to their best ability on either the pre-test or the post-test, which may have indicated that their HAPS exam score was not important.

This post comes from Dr. Ann Massey, PhD, Senior Lecturer for the Department of Cellular Biology at The University of Georgia.

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