Effect of incentives on student performance on Milemarker examinations.

OBJECTIVES: The objective of this study was to evaluate the effect of incentives on student performance on comprehensive cumulative examinations administered at the College of Pharmacy, University of Houston.
METHODS: This study is a retrospective longitudinal study conducted over a period of 6 years, from 2000 to 2005. Passing rates on the cumulative examinations administered during the first 3 years of the doctor of pharmacy curriculum were obtained. These cumulative examinations, known as the Milemarker assessments, involve 3 examinations: Milemarker I, II and III, each offered after completion of each progressive year. Milemarker I and II examinations were phased in throughout the years with various incentives to increase student performance. Incentives for these examinations included books, achievement letters, bonus points, and remediation exercises. Incentives with respect to Milemarker III examination was determination of students' progression into the experiential year of the curriculum and did not change over the study period. Passing rates were compared for these examinations before and after the implementation of these incentives.
RESULTS: Passing rates for Milemarker I increased significantly by 185% from 2003 to 2004 when incentives were changed from awards such as books and achievement letters from the Dean's office to bonus points towards future examinations and a remediation process. Similar results were seen for Milemarker II, where the passing rates increased by 590% during the same period for similar incentives. However, passing rates were much higher throughout the time period for Milemarker III due to the high-stakes incentive of stops on progression to the next year.
CONCLUSION: Appropriate incentives may be effective in changing student performance on comprehensive cumulative examinations.