Collaborative Testing in Medical Education: Student Perceptions and Long-Term Knowledge Retention.

Collaborative testing blends collaborative learning and assessment, engaging small groups of students in answering exam questions as a team. Previous studies have shown that collaborative testing promotes increased student performance and short-term knowledge retention over individual testing alone. In this mixed-methods study, we examined the effects of collaborative testing on preclinical medical students' long-term retention of basic science knowledge, as well as students' approaches and perceptions of collaborative testing. Small groups of students consecutively experienced two conditions after their individual exams: collaborative testing, where they answered half of the exam questions together, and group exam review, where they discussed the other half of the questions with answers provided. Eight months later, students individually took a post-test that included a subset of the questions they had previously encountered in the context of collaborative testing and a subset of questions from group exam review. We found that both post-test performance and knowledge retained from initial individual exam to post-test were significantly higher for the collaborative testing condition. Qualitative findings suggest that knowledge retention was enhanced by collaborative processes and repeated knowledge retrieval elicited by collaborative testing. While students were appreciative of opportunities to discuss ideas and work as a team, many expressed negative opinions about not being certain of correct answers and experiencing interpersonal conflict in collaborative testing. We discuss implications of these findings to enhance design of collaborative testing opportunities and learning environments that support knowledge retention, productive views of authority and certainty of knowledge, and effective collaborative practice.