In this study, the overall progress of students’ knowledge throughout the course is reflected in the improved pretest-posttest scores. However, the single group pretest posttest design has several limitations as reviewed recently [8]. Although the pretest score was not a significant predictor of the midterm test score, the pretest is the earliest test taken by the newly enrolled students. The questions in the pretest encompass all of the pre and post midterm topics, but the correlation of the pretest score with the midterm and final exam score is low. Entrance exam scores are additional pre-course data that have been shown to be a strong predictor of students’ achievement [9]. However, not every course coordinator has access to the entrance scores and they may not be equally related to student achievement in various specific courses. Providing the pretest with similar types of questions used in the later examinations also can give students an overview to the subject material and provide some details of the knowledge that should be gained and will be tested during the course.
Two-step cluster analysis is useful for predicting student achievement [10]. Detection of low achieving students as early as possible is important but can be challenging. Using premidterm scores, the students are divided into four clusters and the low achievers are distributed almost equally to the three groups based on final examination score. Therefore, the four clusters are not useful for prediction and subsequent intervention. Adding the midterm examination score to the premidterm scores revealed two clusters that predict the final examination result more accurately. At the time of the midterm, 34% of the overall scores were already obtained but the other 66% could still be improved after the midterm.
Ideally, the identification of low achieving students should be followed by an appropriate intervention [11]. By nature, the middle achieving students may have more probability to improve by proper interventions [12]. The challenge for the lecturers is in providing timely interventions that are equally encouraging for all students. The use of information technology has been reported to be advantageous and can enrich students’ understanding [13]. In online courses, the use of videos is an interesting method for content delivery and may improve students’ understanding [14]. However, low achieving students may need more direct face to face explanations from the lecturer [15].
In this course, the study material accompanied by miniquizzes are provided several days before the online meeting. Providing the material earlier may give low achieving students more opportunity to self-adjust to the schedule of their learning activities [16]. Additionally, improving the study material into a better guided learning resource may improve basic science learning for under privileged students as reported by a previous review [17]. Data on the student access to the videos and provided materials can be obtained from the learning management system. However, many students prefer to download the video and learning material making it difficult to track the frequency that the materials are used. Although not part of the grading components, the strong contribution of miniquizzes in determining examination scores may reflect the individual students’ resources such as time and speed to access the Internet and their level of motivation. The tasks or questions in the miniquizzes are varied and the students’ answers are discussed during the online meetings to increase their motivation. Allowing multiple access to the learning materials and providing the miniquizzes earlier can provide more time and opportunity for low achieving students to take more quizzes and benefit more from the learning process.
The project assignment in small groups also provides a significant contribution to the learning process. In this course, the students create a video, poster or crossword puzzle with an assigned topic related to the lectures. Providing a platform for communicating with other students is crucial in distant learning. Other possible assignments as peer-learning activities may be considered [18].
Class assessment for some topics can be replaced by after class assignments, since they give more time for low achieving students to learn. In this way, low achieving students will have opportunity to communicate with other students. Moreover, using a variety of assignment types is reported to increase student enthusiasm and make the learning process more enriching and exciting [19]. The feedback from our students confirmed the efficacy of this approach. Class assessment contributes significantly to student achievement in the examinations, probably by acting as a stimulus for more active learning through increasing the students’ motivation and retention [20]. However, class assessments may add some stress for the low achieving students that could be counter-productive.
As the online course begin at the beginning of the unexpected global pandemi, many students are experiencing online learning for the first time. Being unfamiliar with online learning may add to students anxiety. Student anxiety especially in learning basic bioscience is suggested to be problematic by a previous study [21]. Anxiety may induce maladaptive coping mechanisms such as avoidance and isolation [22] that are more difficult to detect in an online course.
Exposure to similar types of questions may give some advantage to the students because the learning strategy needs to be adjusted to the type of questions provided in the examination. Limited familiarity with the MCQs used in the midterm and final examinations could become an obstacle for middle and low achieving students. Providing a bank of questions accessible to the student throughout the course as part of the learning process may give the students more opportunity to practice in taking examinations [23]. However, the method requires more effort from the lecturers in authoring the MCQs. Other than the pretest and posttest, students usually have access to a similar set of MCQs used in the course examinations of the previous batch from senior students. The lecturers are aware of this phenomenon and need to create new set of questions for every batch. Whether the first year students during online courses in the pandemic era obtain course information from their seniors is an interesting subject to be investigated.
Cheating is another issue to consider in every assessment [24], especially in online courses. We supervise the midterm and final examinations, but not the class assessments. Judging from their answers and scores, we trust our students' honesty is upright based on professionalism and an ‘honor system’. Encouraging student integrity is also an important part of an educator’s task and we always deliver this message to the students. Nevertheless, further study needs to be done on this subject, particularly related to issues concerning plagiarism.
One limitation of this study is the scores of the students who are retakers of the course were not separately presented. These students have the advantage of being exposed to the course content previously. However, apart from the students with low grades who are obliged to retake the course, some of the retakers are middle achieving students that want to improve their grade. Another limitation is the lack of data concerning the learning strategy based on student motivation, concentration, learning resources, anxiety, and environment at home. The learning strategy is another factor that can influence students' achievement [12]. Recent research showed online learning behavior [9] and social networking in online collaborative learning [25] also contribute to student performance. Because motivation and engagement differ majorly between the high achieving students and the low achieving students [26], increasing their motivation and engagement can be a significant factor to improve outcomes. Also, this course is delivered in the first semester, when the new students have to adapt to the higher education environment which may become an additional burden for some of them [27]. Although in online courses, homesickness may not be a problem, time management and socializing with lecturers and other students may become more challenging. Obtaining those data is another challenge in research concerning online education. Due to the specific context of this course offering in the medical professions program, the findings in this study may not be extrapolated and generalized to other programs.
One way to increase student motivation is by giving assignments early in the course about the relevancy and the benefits of the course topics to the student daily experiences [3]. This kind of intervention conveys the significance of the course topic and, thus, can stimulate greater interest in particular topics. Gamification of in-class activities is also valuable in encouraging student motivation [28]. However, the effect of gamification on learning depends on the design and difficulty level of the game or quiz [29]. Providing students information about their current grade in the course can also be an effective tool to increase motivation [30, 31]. Table 6 lists some possible interventions that may benefit low and middle achieving students. In general, the modifications of the program can provide more time for low and middle achieving students to learn the study material and the opportunity to challenge themselves by taking a quiz or test in multiple attempts. The availability of supplemental resources should be considered in selecting appropriate interventions.
Table 6
Interventions that may benefit low and middle achieving students
| Activities | in this course | possible modification / intervention |
| Availability of learning material (text, video) | 2–4 days before the schedule | at the beginning of the course, more examples on daily application |
| Mini-quizzes | single trial, days before online meeting | enable multiple trials, available at the beginning of the course |
| Online meeting Class assessments | emphasizing on question and answer session single trial, during the online meeting or after class assignment | additional explanation on selected topic several trials with mark points deducted in second trial and so on while maintaining the variability of the task |
| Group assignment | after midterm, feedback delivery still can be improved | early group formation starting after second meeting, regrouping may be considered after midterm, high quality feedback |
| Points earning | not all scores revealed immediately to the students | students may monitor their own points at any stage of the course |
| Familiarity with the questions used in examination | pretest and posttest, one trial each | additional questions for practice, with multiple trial enabled setting |
| Special attention to the low achieving students | minimal, during online meeting or via social media | scheduled some encouraging personal messages |
In conclusion, we analyzed and identified several predictors of the midterm and final examination scores in an online Cell Biology course for our undergraduate health nutrition program. We discussed several possibilities of using the results of this analysis for redesigning and improving our online courses, especially to assist low and middle achieving students.