University of South Alabama's College of Medicine


At the University of South Alabama (USA) in Mobile, the College of Medicine offers courses in various specialties to students in their first two years of medical school. Each year, two classes of about 75 students each pass through courses in such topics as pathology, neuroscience, microbiology, gross anatomy, histology, and medical genetics. The Educational Technologies and Services Department creates the online tests that students must pass during each course.

Moving Assessments Online

For many years, tests in the College of Medicine were administered by way of paper and pencil. But the Board of Medical Examiners requires medical students to take its certification exams online, and faculty wanted USA students to be prepared for those tests as best as possible.

The department began using Questionmark in 2006. Today, all assessments for most courses in the basic medical sciences are conducted online. There are 10 assessments scheduled for first-year students in the fall semester of 2008, and 13 for second-year students. Assessments can be anywhere from 50 to 150 questions long. 

High-Resolution Graphics

They also wanted to be able to use high-resolution images and graphics in assessments. Before Questionmark, images for assessment questions came from poor quality photocopies or slides, and students had to wait for each other instead of finishing the test at their own pace. Now, students can look at these images—which depict cells, abnormalities, and processes that they must identify—individually.

Authoring Made Easy

In the paper-and-pencil days, faculty wrote questions for tests and department secretaries typed them up. Today, secretaries use Authoring Manager to create the questions in Questionmark. One professor creates and types in his own department's questions, using the browser-based authoring tool.

Most test questions are multiple-choice. "We recommend that to faculty, because that's how board exams are written," says Dr. Joyce Guest, Ph.D., an instructional design specialist in the Educational Technologies and Services Department.

Secure Testing System

Security was an important consideration for these online assessments, and the college uses Questionmark Secure to prevent cheating. The department created a portable computer lab that consists of rented laptops dedicated strictly to online testing, with Questionmark Secure installed..


The departmental secretary or Dr. Guest sends the Item Analysis and the Question Statistics report to faculty after each test, so that they can tell which questions performed well, which were more difficult, and whether each question was viable.

They also get the Assessment Overview Report and the Report for Excel, which shows how each student answered each question. If students have questions about their test results, faculty can get a coaching report for individual students.

Immediate Feedback

Dr. Guest says that for both practical and educational concerns, one important benefit of Questionmark is that students can look at the images in tests at their own pace. But the ability to give immediate feedback on exam results is another, almost more significant benefit. "The more immediate the feedback, the better the learning outcome," she says. "Immediate feedback on assessments helps students identify study needs in specific content areas, and faculty to see whether revision of questions is necessary."