For me, the biggest challenge of using clickers is coming up with good questions. I have never liked multiple-choice questions, partly because as a student, I always thought multiple-choice was WAY easier than open-ended. This is largely because, for many questions, it is really hard to come up with good 'wrong' answers. When I started teaching the 500-seater, I took a lot of questions from test banks but always felt I needed to change something so they wouldn't be so easy. But it's often been hard for me to tell ahead of time which questions would be good for peer instruction, i.e., that would generate a mixed distribution of answers the first time asked. Over time, I've used the answer distribution on exam questions to find these questions; that is, if a high percentage of students answer a question incorrectly on an exam, I think it's safe to assume I'll get a similar (or worse) distribution if I ask it as a clicker question in class the next semester (one big plus of scantrons is how easy it is to do item-response analysis).
But that still means I need to come up with new questions for exams (side note: I do not give the same exam twice, EVER. Some questions might be similar, since there are only so many ways you can ask about the effect of event X on market Y, but I'll use different goods, etc. I could write a whole separate rant about teachers who never change their exams...). I also post a quiz online that students can take in place of clicker points, meaning I need even more multiple-choice questions. So last semester, I gave an assignment that I am definitely going to repeat every semester from now on: I have students write the questions. The last week of the semester, they must submit one multiple-choice question, with at least three wrong answers, and an explanation of why the right answer is right and why the wrong answers are wrong. I have them post their questions and explanations in a Blackboard Discussion Board, with separate threads for groups of topics (e.g., 'Supply and Demand' is one thread, 'Externalities' is another, etc.). This has the added advantage that students can see what their classmates have posted and I tell them to use those as review for the final, with the caveat that their classmates might not actually be correct. I also give extra credit to the first person who identifies an error in someone else's post (there were surprisingly few).
While many students simply took questions they had already seen and made minor tweaks (I post answer keys for the midterms so they have all those available to them), a class of 500 is still going to yield at least a handful (maybe three or four for each topic) that are truly original and that I can use for future classes. And of the questions that are just minor tweaks of previous questions, many of those are still useful because they provide new examples that the students themselves find more relevant (like using tickets for Lady Gaga instead of generic widgets). Last week, as I was writing my first mid-term for this semester, out of 20 multiple-choice questions, at least 16 were pulled directly from (or strongly inspired by) last semester's submissions, cutting down my work tremendously! So I've sort of settled into a nice cycle: some exam questions become clicker questions the following semester, and many of those replaced clicker questions become online quiz questions, and new exam questions are pulled from the questions written by students in the previous semester(s).
One issue that arose with the question assignment, at least the way I structured it, is that there were some duplicate questions (that is, a few cases where two students submitted the exact same question). Since the Discussion Board posts are time-stamped, I simply gave zero credit to the second student, assuming he had copied the first. However, I got an email from one such student, asking why he got a zero. When I explained, he said that he did not copy from the other student; he had used a question from his A-Plus Review materials (A-Plus Review is a private tutoring company that serves a lot of our students). I replied that that really wasn't any better; it just meant both he and his classmate had plagiarized from the same third source! His comment did make me wonder how many other students simply copied from other sources...
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