Collaborative Assessment in the Gross Anatomy Lab.

Purpose: In 2018, the Michigan State University College of Human Medicine incorporated two-stage examinations into the gross anatomy curriculum. Multiple studies have investigated two-stage examinations and have largely reported positive findings. Here, we used a mixed-methods approach to further investigate the feasibility and student perceptions of the two-stage examination in the context of a medical school curriculum that emphasizes longitudinal group-based learning and formative assessments. Methods: Three student cohorts were assessed with a formative two-stage examination at the end of their first-year anatomy experience. Data for the quantitative analysis included examination scores from the individual and group portions of the two-stage examination. For the qualitative stage of this project, we utilized a constructivist grounded theory methodology in which data, including both post-examination survey results and one-on-one semi-structured student interviews, were transcribed (interviews), coded, inductively and iteratively reviewed, and thematically interpreted. Results: Survey and interview results revealed an overwhelmingly positive perception of the collaborative assessment experience. Student comments demonstrated educational value in the immediate feedback provided by this examination format and suggested that collaboration during the examination transformed the assessment into a learning experience. Conclusions: While two-stage examinations have the potential to positively transform an assessment into a learning experience, we also identified complex relationships between content knowledge and anxiety that may affect student perceptions. In addition, examination logistics (e.g., curricular timing) have the potential to negatively affect student perceptions, indicating that faculty should consider these factors when implementing collaborative assessments into their curriculum.

Two-stage collaborative group testing does not improve retention of anatomy among students studying medical radiation technology.

INTRODUCTION: Two-stage collaborative group testing is an assessment format where students first complete a summative assessment independently, and then immediately convene in a small group to complete the same assessment again. Research on two-stage collaborative group testing has shown that it increases immediate learning, improves communication and teamwork, and can lead to enhanced retention of course material; the latter of which is especially important for basic anatomical concepts among health care professionals such as medical radiation technologists. However, such previous research has often employed quasi-experimental designs that may limit both internal and external validity. METHODS: Using a randomized crossover design with both quantitative and qualitative data analyses including robust intra-individual statistical comparisons, this research compared the educational impact of the two-stage collaborative group testing format (the COL condition) to traditional independent testing (the IND condition). Students (n=196) from two successive renditions of an introductory anatomy course were randomly assigned into groups of 3-5 students. Groups worked together throughout the term on various course elements, including three in-class, non-cumulative term tests (TTs). After practicing the collaborative format during TT1, during TT2 half the groups were assigned to the COL condition while the other half were assigned to the IND condition. Groups crossed over for TT3. All students completed a cumulative final examination independently, with performance data from that examination coded and extracted according to previous TT condition. Educational impact was evaluated as both immediate learning (by comparing IND and COL performance on the associated TT) as well as retention (by comparing final examination performance for topics previously IND tested versus previously COL tested). Students' qualitative reflections were coded into categories and juxtaposed against quantitative Likert-style feedback to comprehensively explore students' perception of the testing format for evidence of enjoyment, acceptability, and influence on relevant CAMRT professional competencies. RESULTS: 167 students (85%) consented to data inclusion, with a final course grade of 75.5 ± 10.0%. On average, TT performance was 13.6 ± 11.6% greater on the COL test (90.4 ± 7.6%) than the IND test (76.7 ± 14.3%) (p<0.01, r = 0.76), results that support immediate learning. Contrary to expectations, final examination performance specific to the two experimental conditions was similar, with students earning an average of 69.6 ± 18.3% on questions that pertained to material they were previously IND tested on, and 67.4 ± 19.1% on questions they were previously COL tested on (ns). Students' overall perceptions of the two-stage collaborative group testing format were overwhelmingly positive, with 84% indicating a belief that the format was a constructive learning opportunity and 74% recommending continued use. Written reflections revealed that students believed that collaborative testing enhanced their learning by both clarifying previous mistakes and reinforcing correct knowledge. Relevant CAMRT professional competencies included oral communication and interprofessional skills, capacity for productive teamwork, and collaborative practice. SIGNIFICANCE: Although the results of this study do not support the use of two-stage collaborative group testing for retention of course material, they simultaneously reveal how the testing structure may be uniquely beneficial to students studying within the field of medical radiation sciences while also presenting a pragmatic example of how to implement this unique testing format.

A collaborative two-stage examination in biomedical sciences: Positive impact on feedback and peer collaboration.

Examinations present an intensely focused opportunity for student learning yet opportunities for collaboration, communication, and feedbacks are often wasted. Two-stage examinations where students first take examinations individually and then repeat the examination in small groups hold promise to address this issue. Here, we pilot and evaluate a two-stage examination within an advanced undergraduate biomedical sciences course. We evaluated this innovation by triangulation of data from a questionnaire, semi-structured student interviews, as well as, comparison of student grades between stages of examination across higher- and lower-performing student groups. Quantitative data from the structured questionnaire showed that a majority of students perceived the collaborative stage of two-stage examinations successful in promoting peer collaboration and communication. Furthermore, there was deepened conceptual understanding and provision of immediate feedback. The two-stage examination did not, however, ameliorate students' test anxiety. Qualitative data from semi-structured student interviews were consistent with quantitative data to show that a two-stage examination provides positive impact particularly on immediate feedback, peer collaboration and communication but contributed to sustained test anxiety possibly due to negative experiences during group interactions. Both lower- and higher-performing students showed improvement in the collaborative stage as compared to the preceding individual stage of two-stage examination. This would suggest possible benefits of two-stage examination for learning for all student abilities. This study discusses the advantages and pitfalls of two-stage examinations for biomedical sciences and will guide informed recommendations for subsequent implementation elsewhere.