The Role of Cheat Sheets in Human Anatomy & Physiology: Content Design and Impact on Exam Performance

Cheat sheets, which are student-prepared reference pages containing notes, figures, and key concepts, are a common assessment aid in undergraduate science courses, yet their effects on learning and exam performance remain unclear. This thesis examined whether cheat sheet design influences student outcomes on exams and whether allowing cheat sheets impacts exam performance overall in Human Anatomy & Physiology (BIOL 252) at the University of North Carolina at Chapel Hill. In Project 1, cheat sheets from three midterms were categorized as text-based, mixed, or visual and exam scores for each were compared using one-way ANOVA. Results showed no consistent performance differences among formats, indicating that design style did not significantly affect exam scores. In Project 2, exam performance was compared between semesters that either allowed or prohibited cheat sheet use, with all exam questions coded by Bloom’s taxonomy. Students permitted to use cheat sheets performed significantly lower on lower- and mid-level Bloom’s questions and on total exam scores for the first two exams, while higher-order performance occasionally improved with the use of cheat sheets. These results suggest that cheat sheet use may alter study behaviors, promoting surface preparation and dependence on external aids rather than durable learning. Although cheat sheets may reduce anxiety and support reasoning under certain conditions, their overall effect appears to either not impact or hinder exam achievement in BIOL 252. The findings highlight the need for instructors to reconsider cheat sheet policies or to integrate guided construction strategies that promote metacognitive engagement and practical learning rather than reliance.