Post-Exam Wrappers: A Tool for Critical Reflection
Abstract
Background
Post-exam review sessions that reveal a completed exam to students can be time-consuming and ineffective. Additionally, the review may jeopardize exam integrity by exposing the individual items.
Method
To promote critical reflection, an exam wrapper, without the return of a completed exam, was implemented. Students were encouraged to take deeper ownership of learning and be active in the process of exam review.
Results
Most students strongly agreed or agreed that they adjusted their study strategies based on their self-reflection (68.5%) or on the instructor feedback (66.7%) provided through the wrapper. All faculty stated the process of using wrappers was much more or more valuable and efficient, compared to prior post-exam feedback methods.
Conclusion
Using an exam wrapper as a stand-alone, post-exam debrief, students assume a more proactive role by reflecting on individual exam preparation and learning strategies without the return of a completed exam. [J Nurs Educ. 2025;64(1):48–51.]
Introduction
Summative exams are an established evaluative practice in nursing programs and serve as a basis for grading decisions, while assignments and quizzes are typically used as formative assessments to guide further instruction (Oermann, 2017). After a summative exam is taken, nursing students often expect to view their exam through some form of a post-exam review process. While students and many faculty believe post-exam reviews with return of the completed exam are a valuable learning experience, there is little evidence to support this belief (Royal et al., 2015).
Providing correct answers to students after an exam may increase a student's probability of answering that same item correctly in the future; however, faculty seldom use the exact same items on future exams. In addition, when a correct answer is provided after an exam, and a similar (but not exactly the same) item is on a future exam, students demonstrate no difference in accuracy compared to no review at all (Royal et al., 2015). Post-exam reviews consume valuable time (Gerdes, 2018), provide a platform for possible contentious student-faculty exchanges when students debate correct versus incorrect answers (Royal et al., 2015; Williams, 2021), and pose threats to exam integrity through exposure of the exam items (Khalaila, 2015; McClung & Gaberson, 2021; Palmer et al., 2016).
Still, many faculty provide students with some type of a post-exam review to offer academic support and an opportunity for debriefing (Sethares & Asselin, 2022; Spencer, 2017). One form of exam review is through student completion of an exam wrapper, a self-evaluation activity that guides students to think about their exam preparation and performance (Butzlaff et al., 2018). Exam wrappers are often completed by students as they view their returned, completed exam (Burgess et al., 2020; Gerdes, 2018; Poorman & Mastorovich, 2016; Schuler & Chung, 2019; Sethares et al., 2021; Williams, 2021). In this article we discuss the use of an exam wrapper as a stand-alone post-exam debrief, without return of a completed exam or sharing exam items with students. Use of exam wrappers in this way helps preserve exam integrity and promotes student engagement in critical reflection (Ash & Clayton, 2009).
Background
Exam wrappers have been implemented in nursing (Burgess et al., 2020; Butzlaff et al., 2018; Gerdes, 2018; Poorman & Mastorovich, 2016; Schuler & Chung, 2019; Sethares et al., 2021; Williams, 2021), and other disciplines, including organic chemistry (Grandoit et al., 2020) and criminology (Owen, 2019). Students may complete a wrapper during a class or an individual proctored review of the exam (Burgess et al., 2020; Poorman & Mastorovich, 2016; Sethares et al., 2021; Wiles, 2015). Alternatively, the wrappers could be completed outside of class hours (Butzlaff et al., 2018; Gerdes, 2018; Schuler & Chung, 2019; Williams, 2021).
Exam wrappers typically contain a series of questions that guide students in identifying study strategies and plans for improvement (Butzlaff et al., 2018; Gerdes, 2018; Grandoit et al., 2020). When faculty return a completed exam with the wrapper, the wrapper also guides students in identifying why they believe individual items were answered incorrectly (Burgess et al., 2020; Poorman & Mastorovich, 2016; Sethares et al., 2021; Wiles, 2015; Williams, 2021). Faculty who employ exam wrappers deliver feedback in various ways: as a group in the classroom setting (Owen, 2019; Poorman & Mastorovich, 2016; Sethares et al., 2021), in individual meetings (Burgess et al., 2020; Wiles, 2015), or through written, asynchronous faculty comments, personalized to the student (Gerdes, 2018). Faculty may employ enhanced feedback features like pairing peer-feedback with instructor-feedback (Owen, 2019), combining homework and lecture wrappers along with exam wrappers (Poorman & Mastorovich, 2016), or utilizing a grid or table that identifies student errors that are associated with Bloom's taxonomy, the nursing process, and/or the NCLEX-RN© blueprint (Wiles, 2015).
Metacognition, the practice of examining one's own thinking or cultivating insight into understanding (Flavell, 1979), is the guiding model behind exam wrappers (Burgess et al., 2020; Butzlaff et al., 2018; Owen, 2019; Poorman & Mastorovich, 2016; Schuler & Chung, 2019; Williams, 2021). Researchers have found that students who complete exam wrappers indicate adjusting study strategies after completion of wrappers (Butzlaff et al., 2018), have increases in their metacognition (Schuler & Chung, 2019), and have improved performance on future exams (Butzlaff et al., 2018; Owen, 2019; Poorman & Mastorovich, 2016). However, in terms of exam wrapper utility, students report mixed reviews. Schuler and Chung (2019) found that students did not find the practice of the wrapper useful, even while other students indicated they benefitted from the review provided with the exam wrapper (Burgess et al., 2020) or found the completion of the wrapper meaningful (Butzlaff et al., 2018).
Exam wrappers provide students an opportunity to create links between identified knowledge gaps and study strategies. Creating these links requires the student to engage in metacognition (Flavell, 1979). In a practical sense, these links can be achieved through critical reflection (Ash & Clayton, 2009) via completion of an exam wrapper.
Theoretical Framework
Critical reflection is the underpinning of a student's completion of an exam wrapper (Ash & Clayton, 2009). The Description, Examination, Articulation of Learning (DEAL) model (Ash & Clayton, 2009) provided the theoretical framework for this study's use of exam wrappers to guide students in critical reflection without return of a completed exam. The intent of this practice was to encourage students to take deeper ownership of learning and be active in the process.
The DEAL Model (Ash & Clayton, 2009) was used to structure the exam wrapper into three parts. Description of learning experiences was the first portion of the wrapper wherein students answered objective questions about exam preparation strategies and anticipated/actual performance on the exam. Examination of learning experiences was the next portion of the wrapper in which students considered their performance in light of the preparation and/or events that occurred leading up to the exam. Students were asked to identify which strategies were most successful, which were less so, and to consider if other factors, such as distractions, lack of motivation, environment, or support systems influenced their exam performance. Articulation of Learning was the third and final portion of the wrapper. Students were asked to list specific goals for future action based upon their reflections.
By using this three-step process, students were directed to identify sources and examine areas that may have contributed to gaps in their knowledge while motivating them to be more involved in making meaningful adjustments in their study approaches. After a student submitted an exam wrapper, faculty provided feedback to help students derive meaning in their reflection, while holding students accountable for their learning. Using the DEAL model (Ash & Clayton, 2009), students are guided to think deeply about their learning and build the capacity to self-direct their success.
Methods
Design and Sample
A descriptive retrospective research design was used. The study site, a mid-sized private university in the Midwest US, provided Institutional Review Board approval. Data were collected over one semester, between August 2021 and December 2021. Six nursing faculty members implemented exam wrappers in their respective courses: Pathophysiology, Pharmacology, and Maternal-Child Health Nursing. A total of 387 BSN students were enrolled across the three courses; 185 students completed at least one exam wrapper.
Procedures
Students were introduced to the concept of exam wrappers at the start of the semester, and the exam wrapper template was posted as an optional assignment after each course exam. No points or incentives were offered for completion. All courses had four exams. Faculty informed the students that they would not be able to see their completed exam but could submit an exam wrapper and receive written feedback via the returned document. See Table 1 for exemplars of wrapper questions and student responses.
| Question | Response |
|---|---|
| Where did you spend most of your time preparing? Should the location be changed? | I am a commuter, so the time I spend studying is really distracting with my family always around. I am going to try to go to the library close to my house for future studying. |
| What strategies did you study? Did the strategies work well for you? If not, what will you change? | In the past, my strategies (rewriting notes and exam blueprint/Quizlets) have worked well for me. I might try to do more practice NCLEX style questions for the future to help me with critically thinking and applying the material. |
| When did you begin studying/reviewing for the exam? Was this enough time? | I started rereading my notes after each week to gauge where I was and what I needed to study more. I think that I may have misjudged what I thought I knew and what I thought I didn't know. |
| Were there any additional things that you think contributed positively or negatively to your exam score? If so, describe what these are and how you will prepare for them. | I think second guessing myself and going back multiple times to change my answers was the wrong thing to do, but I got so nervous that I could not help myself. |
| Based on your findings above, list at minimum three activities you will do differently or continue to use in preparing for the next exam. | Communicate with my instructor. Reach out to friends to group study. Change location for studying. |
General faculty comments provided via the returned wrapper included the pace at which students completed the exam (i.e., the duration of time taken on the exam/time remaining), identified patterns (e.g., priority items frequently answered incorrectly) and specific content areas for review. Students were encouraged to complete an exam wrapper for each unit exam and offered a 30-minute face-to-face meeting with their faculty to discuss how any changes they implemented in their study habits were reflected in their exam performance. Referrals to university success/support services for student assistance and advocacy were made if a need was revealed through the wrapper or verbal discussion. At the end of the semester, students who completed at least one wrapper were requested to provide feedback regarding the wrappers through an anonymized online survey.
Instruments
The research team developed online surveys used to collect data. The student feedback survey contained six multiple choice items and one free response item. Using a five-point Likert scale (strongly agree, agree, unsure, disagree, strongly disagree), students provided responses regarding use of the wrappers and adjustments in study strategies, and improvements in exam performance. Students also indicated their perceived usefulness (extremely useful, very useful, moderately useful, slightly useful, not at all useful) of the exam wrappers. Students averaged two minutes to complete the survey. The faculty feedback survey consisted of three items regarding average time to complete the faculty portion of the wrapper, and using a five-point Likert scale, perception of value and efficiency of the wrappers (much more valuable/efficient, more valuable/efficient, equally valuable/efficient, less valuable/efficient, much less valuable/efficient) compared to previous post-exam methods used.
Data Collection and Analysis
Data were collected through a university purchased secure online survey system. At the end of the semester, faculty emailed the survey link to students who completed at least one wrapper. All surveys/data were anonymized. Descriptive statistics were provided via the survey system.
Results
Fifty-four of the 185 students who completed at least one exam wrapper completed the survey (29.2% response rate). The number of wrappers each student completed varied, with a range between one (minimum) and four (maximum). Students reported an average of 5 to 10 minutes to complete one wrapper. Most students (68.5%) strongly agreed or agreed that they adjusted their study strategies based on their self-reflection on wrappers. Similarly, most students strongly agreed or agreed (66.7%) that they adjusted their study strategies based on the instructor feedback provided on the wrapper. Nearly half (46.29%) of students strongly agreed or agreed they believed the wrappers helped them improve their future exam performance. Students' perceived usefulness of wrappers varied between not useful at all (16.67%) to extremely useful (18.52%).
Students were also afforded the opportunity to provide comments regarding exam wrappers via an open-ended question. One student shared “I found the exam wrapper to be more meaningful than viewing my individual exam results, or a sample test with correct answers and rationale. On my own I probably wouldn't have made the connections.” A different student stated “I loved doing the exam wrappers. They were really helpful, and the feedback given by the instructor was beneficial.” Another student wrote “incorrectly answered exam questions were due to wording or misunderstanding questions…this was not something the exam wrapper could have improved for me. What would have helped me would have been more questions to get more familiar with the types of questions the teacher would provide and how to process them.” Faculty (N = 6) reported an average of 10 to 25 minutes to complete their wrapper portion and detail concepts for student review and provide thoughtful comments to identified challenges. All faculty stated the new process of using wrappers was much more or more valuable and efficient, compared to prior post-exam feedback methods.
Discussion
Use of exam wrappers in the post-exam review process presents an opportunity for students to evaluate study strategies, learning processes, and plans for future exam preparation. From the faculty perspective, use of exam wrappers protects exam security and classroom time (Gerdes, 2018; Khalaila, 2015; McClung & Gaberson, 2021; Palmer et al., 2016; Royal et al., 2015). In this study, faculty found the practice to be valuable, yet the implementation of exam wrappers as a new process for post-exam review presented several challenges, including initial procedural adjustments and student uptake barriers.
Adopting exam wrapper review and developing personalized feedback for individual students required an initial investment of time to learn the nuances of a new process. Other variables affected the time/energy expenditure of the faculty, including the course subject matter/sequence (e.g., freshman vs. senior level course), number of exam wrappers submitted, the individual student's exam performance, and the depth of personalized feedback preferred by an individual faculty member. As the semester progressed and familiarity with the exam wrappers evolved, faculty became more efficient. For example, a repository of comments (concepts to remediate, common suggestions like time management, tutoring recommendation) enabled cut/paste shortcuts for sections of the wrapper feedback. New faculty adopting the exam wrappers would face a similar initial outset of energy; however, this upfront cost would be repaid in efficiency after the practice was established.
Schuler and Chung (2019) discuss the benefit of students' increased metacognition with the use of exam wrappers, though students in their study perceived the practice as less useful. This is consistent with our findings and identifies its most noteworthy limitation: students' perceptions of the correlation of the exam wrapper and improved exam performance. This process of exam review will not satisfy the student question, “what did I get wrong?” Student uptake may require a culture shift to recognize that post-exam review time may be more effectively spent addressing knowledge gaps and preparation, versus explaining individual items. To set appropriate expectations and garner student interest, we oriented students to the practice at the start of the semester, highlighting improved quality of interaction as well as being upfront about exam security concerns. Other recommendations for student uptake include adding a syllabus statement (Gerdes, 2018) or incentivizing students with course credit for submission of exam wrappers (Butzlaff et al., 2018).
Safeguarding exam security by using exam wrappers without return of a completed exam as the sole post-exam review process provides a prominent faculty benefit, especially in modern higher education where opportunities for academic dishonesty abound (Khalaila, 2015; McClung & Gaberson, 2021; Palmer et al., 2016; Royal et al., 2015). Additional faculty benefits of using exam wrappers include rich insight into study approaches that a student may otherwise perceive as too vulnerable to share with faculty in face-to-face setting. Finally, exam wrappers offer an opportunity to improve the quality of faculty-student interactions. Absent the focus on individual exam items, more room exists for robust discussions about exam preparation and concept review.
Conclusion
Exam wrappers provide an alternative approach to traditional post-exam feedback processes, wherein students view the questions they answered incorrectly in a primarily passive way. This traditional method comes with significant time demands on the faculty and threatens exam integrity. Through the use of an exam wrapper as a stand-alone, post-exam debrief, without return of a completed exam, students assume a more active role by reflecting on their exam preparation and learning strategies. This modality provides valuable insight into students' preparation and learning strategies, better equipping faculty to provide meaningful feedback to students in both online and face to face courses. The combination of student reflection and faculty feedback helps the student redirect their learning approach with the intent of supporting success in their academic journey.
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