Student Performance With Graded vs. Ungraded Readiness Assurance Tests in a Team-Based Learning Elective

Abstract

Objective. Team-based Learning (TBL) is widely used in pharmacy education. There is debate regarding the necessity of graded readiness assurance tests (RATs) as incentive to complete pre-class preparation. The purpose of this study was to determine the effect of graded vs ungraded RATs on exam performance in an Ambulatory Care elective course for third year student pharmacists.

Methods. For the course offered in Spring 2020 and 2021, standard TBL framework was employed. RATs were graded in 2020 (graded RAT cohort), but did not contribute to overall course grade in 2021 (ungraded RAT cohort). An online anonymous survey of students determining class preparation and perceived team accountability was administered at course completion in the ungraded RAT cohort.

Results. There was no significant difference between the graded RAT (n=47) and ungraded RAT cohorts (n=36) in overall mean percentage score on individual RATs (76% vs 74%) and individual exams (82 vs 80%). Most students (69-91%) in the ungraded RAT cohort reported completing pre-class preparation assignments. Ninety-four percent agreed or strongly agreed they contributed to team members’ learning and 86% agreed or strongly agreed they were proud of their ability to assist in the team’s learning.

Conclusion. Ungraded RATs did not significantly impact student exam performance in an elective course. Removal of this assessment that promotes the performance-approach to learning may have contributed to a shift in motivation to the mastery-approach in the context of pre-class preparation. This challenges a widely held belief that grades are necessary incentives for pre-class preparation within TBL.