Just because students ace their tests in health class doesn’t mean they will remember and use lessons about preventing pregnancy and HIV infection when it counts, a new study suggests.

The researchers explored the effects of teaching sex-ed with a focus on making sure students master the material rather than just pass the tests and score well on assignments. They found big differences that could have life-altering repercussions, said study author Eric Anderman of The Ohio State University.

Students whose teachers worked to make sure they truly took in the material in health class, even if, for example, that meant retaking tests and repeating previously covered lessons, were more likely to grasp those lessons later, and to say they would take measures such as using condoms. The study appears online in the Journal of Educational Psychology.

“When teachers are focusing on mastery, they emphasize the importance of the lessons to the student’s life and, if necessary, go over topics again and again to make sure that students understand, as opposed to a ‘This is important because it’s going to be on the test Friday’ approach,” said Anderman, a professor of educational psychology at Ohio State.

“Mastery really, really matters in health education – if you teach things in such a way that kids remember it later, you could help prevent the spread of disease and unwanted pregnancies,” he said.

“What they learn in health class is going to affect them for the rest of their lives and having this information could save lives.”

Anderman is interested in understanding what motivates adolescents to learn, and much of his work has focused on the concept of a mastery-focused approach to teaching and learning. While students in a mastery classroom might be taught the same material as those in a more traditional classroom, there are important variations that can make a difference in the long term, he said.

In the current study, Anderman and his colleagues examined the use of the 14-lesson “Reducing the Risk” curriculum, a sexual education plan promoted by the Centers for Disease Control and Prevention.

The study included 636 high school students, mostly ninth-graders, from seven Midwest high schools. Researchers compared the students’ perceptions of their teachers’ classroom approach to outcomes a year later that included the students’ knowledge about HIV and pregnancy prevention, and their behavioral intentions regarding safe sex (how likely it was that they would use a condom every time they had intercourse).

Those students who said their teachers focused on mastering the material were more likely to have grasped sex-ed lessons and more likely to employ those lessons, particularly having greater intentions to use condoms. There was no such positive relationship between an education that emphasized getting good grades and either real-life knowledge or intentions to use condoms.

“Our findings demonstrate that teachers’ instructional practices emphasizing effort, truly understanding class material as opposed to simply memorizing facts and improving over time, were critical to students’ motivation and learning,” said the study’s lead author, Sungjun Won of the University of Victoria, formerly a graduate student in education at Ohio State.

“School administrators and health teachers should work together to foster learning environments where students perceive that their teachers really value their understanding, development and mastery – as opposed to just getting good test scores or grades.”

The researchers took into account other factors that could influence student responses, including prior sexual experience, gender and GPA.

A focus on mastery doesn’t abandon the idea of turning in assignments and taking tests for grades, Anderman said. But rather than allowing a student to score poorly and move on to new material, a mastery-focused teacher would provide opportunities such as reviewing past lessons and letting students re-take tests to reinforce the importance of the material.

“In a mastery-focused classroom a teacher would be saying things like, ‘Last week we talked about refusal behaviors. Let’s spend five minutes reviewing that,’” Anderman said.

He said that when a teacher offers opportunities for revisiting assignments or quizzes, the message is ‘You haven’t mastered it; you have to understand this.’

“You also want to stay away from comparing kids. You want to emphasize that the lessons are important for everyone to learn. You want kids to think, ‘I got an 80 this time, I didn’t know a couple of things, what can I do better?’”

Some entire schools have adopted the approach, but it is relatively uncommon in American education, in part due to other pressures including standardized tests and school report cards, Anderman said.

The National Institute of Nursing Research supported this study.

Rick Zimmerman of Louisiana State University also worked on the research.