How do block scheduling and integrated testing affect medical student performance?

The selection process of medical school often favors students who can recall a large amount of information for a brief period of time. This trait may persist in the early years of medical education as most courses are taught and tested independently. However, the ability to synthesize material from different courses both promotes a deeper level of learning and better prepares students to practice medicine. This study examines how 2nd year medical students handled a transition to block course scheduling and integrated exams (pathology, pharmacology, and medicine at Indiana University School of Medicine). Specifically, comparison of similar pathology questions between the different exam formats was used to assess changes in student performance between the traditional and revised curricular years. Additionally, each pathology question was evaluated using Bloom's taxonomy to a) compare overall exam makeup, and b) determine if student performance differed based on taxonomic assignment. Pathology scores on the first block exam were slightly lower than the previous year's single subject exam. However, on subsequent exams block scheduling students performed better than their previous year counterparts, despite integrated exams being longer and arguably more difficult. We suggest that an integrated testing format discourages “cramming” and promotes a deeper level of learning.