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.