Collaborative Testing in Medical Education: Insights from a Hybrid Individual-Group Examination Approach

Team-based learning is a widely accepted instructional approach in undergraduate medical education, but the application of its principles outside of its traditional framework has not been fully explored. Here, we describe the implementation of a hybrid individual-group examination format during a two-week Multisystems course at the University of Cincinnati College of Medicine. Students completed two separate in-house examinations during the course, each with individual and group components, as well as a cumulative NMBE final examination that was taken individually. A portion of the second individual examination retested concepts from the first examination to explore the impact that collaborative test-taking had on student learning. Student perceptions of the experience were evaluated using a survey after the final examination. We found a small but statistically significant decline in average in-house and NBME individual examination scores following the transition from traditional individual testing to the hybrid individual-group format. However, measured improvement in performance on retested concepts suggests that collaborative testing had a positive impact on student learning, especially among lower performing students. This testing model was overwhelmingly supported by students, who reported that group testing enhanced their learning experience and decreased the stress surrounding preparation for the examinations. Opinions on whether this approach to assessment should be utilized other courses were divided and heavily influenced by respondee class rank, highlighting a potential barrier to implementation. These findings shed light on the benefits and drawbacks of collaborative testing in the medical school context.