Effects of graded versus ungraded individual readiness assurance scores in team-based learning: a quasi-experimental study

  • Koh Ying Yun Juliana Email author
  • Jerome I. Rotgans
  • Preman Rajalingam
  • Paul Gagnon
  • Naomi Low-Beer
  • Henk G. Schmidt


Pre-class preparation is a crucial component of team-based learning (TBL). Lack of preparation hinders both individual learning and team performance during TBL. The purpose of the present study was to explore how the grading of the individual readiness assurance test (iRAT) can affect pre-class preparation, iRAT performance and performance in the end-of-year examination. Using a quasi-experimental design, Year 1 and 2 students’ download frequency for their pre-class materials, performance on iRAT and examination were examined under two conditions; (1) under which the iRAT was graded and (2) under which the iRAT was ungraded. Medical students (N = 220) from three cohorts were included in the study. Differences between both conditions were tested by means of six separate ANCOVAs, using medical school entry test scores as the covariate to account for potential cohort effects. Results revealed that students were downloading more pre-class materials prior to their TBL sessions, and were performed significantly better on iRAT when their performance was graded, even after controlling for cohort effects. Analysis of covariance demonstrated that performance on iRAT also appeared to affect performance on their examination scores. The results of the study suggest that grading has a positive effect on students’ iRAT scores. Implications for TBL are discussed.


Academic achievement Higher education Medical education Team-based learning Quasi-experiment 



  1. Azzi, A. J., Ramnanan, C. J., Smith, J., Dionne, E., & Jalali, A. (2015). To quiz or not to quiz: Formative tests help detect students at risk of failing the clinical anatomy course. Anatomical Sciences Education, 8, 413–420. Scholar
  2. Burgess, A., McGregor, D., & Mellis, C. (2014). Applying established guidelines to team-based learning programs in medical schools: A systematic review. Academic Medicine, 89, 678–688. Scholar
  3. Epstein, R. M. (2007). Assessment in medical education. The New England Journal of Medicine, 2007, 387–396. Scholar
  4. Haidet, P., Levine, R. E., Parmelee, D. X., Crow, S., Kennedy, F., Kelly, P. A., et al. (2012). Perspective: Guidelines for reporting team-based learning activities in the medical and health sciences education literature. Academic Medicine, 87, 292–299. Scholar
  5. Hrynchak, P., & Batty, H. (2012). The educational theory basis of team-based learning. Medical Teacher, 34, 796–801. Scholar
  6. Koles, P. G., Stolfi, A., Borges, N. J., Nelson, S., & Parmelee, D. X. (2010). The impact of team-based learning on medical students’ academic performance. Academic Medicine, 85, 1739–1745. Scholar
  7. McLachlan, J. C. (2006). The relationship between assessment and learning. Medical Education, 40, 716–717. Scholar
  8. Michaelsen, L. K., & Knight, A. B. (2004). Creating effective assignments: A key component of team-based learning. In L. K. Michaelsen, A. B. Knight, & L. D. Fink (Eds.), Team-based learning: A transformative use of small groups in college teaching (pp. 51–72). Sterling: Stylus Publishing, LLC.Google Scholar
  9. Michaelsen, L. K., Parmelee, D. X., McMahon, K. K., & Levine, R. E. (2008). Team-based learning for health professions education: A guide to using small groups for improving learning. Sterling: Stylus.Google Scholar
  10. Michaelsen, L. K., & Sweet, M. (2008). Fundamental principles and practices of team-based learning. In L. K. Michaelsen, D. X. Parmelee, K. K. McMahon, & R. E. Levine (Eds.), Team-based learning for health professions education: A guide to using small groups for improving learning (pp. 9–34). Sterling: Stylus Publishing LLC.Google Scholar
  11. Park, H.-R., Kim, C.-J., Park, J.-W., & Park, E. (2015). Effects of team-based learning on perceived teamwork and academic performance in a health assessment subject. Collegian, 22, 299–305. Scholar
  12. Parmelee, D. X., & Hudes, P. (2012). Team-based learning: A relevant strategy in health professionals’ education. Medical Teacher, 34, 411–413. Scholar
  13. Parmelee, D. X., Michaelsen, L. K., Cook, S., & Hudes, P. D. (2012). Team-based learning: A practical guide: AMEE Guide No. 65. Medical Teacher, 34, e275–e287. Scholar
  14. Pulfrey, C., Buchs, C., & Butera, F. (2011). Why grades engender performance-avoidance goals: The mediating role of autonomous motivation. Journal of Educational Psychology, 103, 683–700. Scholar
  15. Rajalingam, P., Rotgans, J. I., Zary, N., Ferenczi, M. A., Gagnon, P., & Low-Beer, N. (2018). Implementation of team-based learning on a large scale: Three factors to keep in mind. Medical Teacher, 40, 1–7. Scholar
  16. Schinske, J., & Tanner, K. (2014). Teaching more by grading less (or differently). CBE-Life Sciences Education, 13, 159–166. Scholar
  17. Sweet, M., & Pelton-Sweet, L. (2008). The social foundation of team-based learning: Students accountable to students. In L. K. Michaelsen, M. Sweet, & D. X. Parmelee (Eds.), Team-based learning: Small-group learning’s next big step (Vol. 2008, pp. 29–40). San Francisco: Wiley Preiodicals, Inc.Google Scholar
  18. Thompson, B. M., Schneider, V. F., Haidet, P., Levine, R. E., McMahon, K. K., Perkowski, L. C., et al. (2007). Team-based learning at ten medical schools: Two years later. Medical Education, 41, 250–257. Scholar
  19. Tweddell, S., Clark, D., & Nelson, M. (2016). Team-based learning in pharmacy: The faculty experience. Currents in Pharmacy Teaching and Learning, 8, 7–17. Scholar
  20. Zgheib, N. K., Dimassi, Z., Bou Akl, I., Badr, K. F., & Sabra, R. (2016). The long-term impact of team-based learning on medical students’ team performance scores and on their peer evaluation scores. Medical Teacher, 38, 1017–1024. Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Lee Kong Chian School of MedicineNanyang Technological UniversitySingaporeSingapore
  2. 2.Erasmus University RotterdamRotterdamNetherlands

Personalised recommendations