Evaluation of the Inclusion of Weekly Quizzes on Academic Performance in First Year Medical Students

Modifications are continually made within medical school curricula to improve effectiveness of their educational programs. For the 2014–2015 academic year, the Medical College of Georgia implemented an assessment strategy change to include both formative and summative assessments in its preclinical curriculum. Formative assessments included weekly quizzes with individual and small group contributions. While weekly quizzes did count towards module grades, they were low stakes because each contributed <10% toward the overall grade. This strategy required students to keep up with content weekly. The quiz group component provided opportunities for peer teaching and immediate review of concepts. A comprehensive module exam was added to encourage students to retain concepts in active memory throughout the module. The purpose of this study was to determine the impact of an assessment program that included weekly independent and group quizzes and a comprehensive module exam. Since frequent testing has been shown to increase long term retention, we hypothesized that inclusion of weekly quizzes would result in stronger performance on comprehensive module exams. Exam data from first year medical students (n≈192 per year) was evaluated to compare performance of a cohort of students who had exams every 2–3 weeks rather than weekly quizzes (AY 2013–14) with a cohort who had weekly quizzes and a comprehensive module exam (AY 2014–15). De‐identified results from questions used during both academic years were compared for Tissues/Musculoskeletal (TMSK) and Cardiopulmonary (CP) modules. In AY 2013–14, the TMSK module consisted of 4 exams, while the CP module consisted of a quiz and 2 exams. In AY 2014–15, the TMSK module consisted of 2 blocks that each included 2 weekly quizzes followed by a comprehensive block exam; the CP module consisted of 3 quizzes and a comprehensive exam. Data were analyzed using a two‐tailed t‐test. Overall performance in TMSK was significantly lower for the cohort with weekly quizzes and a comprehensive exam compared to the cohort with no quizzes (82.7% vs. 79.1%; p<0.05). To further assess why the cohort with weekly quizzes had a lower overall module performance, we looked at performance by assessment and quartiles. While there was no difference between common test items on the first 2 quizzes or first comprehensive block exam across groups, performance of students in the 4 th quartile was significantly lower on items from the second quiz in the second block (85.1% vs. 76.6%; p< 0.005). Additionally, performance of both 1 st and 4 th quartiles was significantly lower on common items on the second comprehensive block exam (Q1: 95.4% vs. 90.6%; Q4: 77.0% vs. 65.4%; p<0.005). Similarly, overall performance in the CP module was significantly lower for the cohort with weekly quizzes compared to the cohort without them (86.1% vs. 81.2%; p<0.005). This significant decrease in performance was also seen in 1 st and 4 th quartiles with this group (Q1: 91.4% vs. 93.7%; Q4: 70.5% vs. 77.3%, p<0.05). Furthermore, overall performance and both 1 st and 4 th quartile performance were significantly lower on common items on the CP comprehensive exam (Overall: 85.3% vs. 79.3%; Q1: 93.5% vs. 90.2%; Q4: 76% vs. 68.8%; p<0.05). This preliminary data indicate that students find weekly quizzes and a comprehensive exam a more rigorous assessment strategy than exams every two weeks. Additional factors resulting in the difference in performance between the two cohorts need to be further explored.