Relationship Between Team Dynamics and Performance in Solo‐Then‐Collaborative (Hybrid) High‐Stakes Testing in Pre‐Clerkship Medical Students

Abstract

ObjectivesTo characterize student perceptions of team dynamics and the relationship between team dynamics and performance within a novel hybrid exam platform.MethodsMedical students enrolled in pre‐clerkship year 1 at CNUCOM during academic year 2017–2018 were recruited for participation in this study. Data was collected at two timepoints— at the mid‐course exam in the final course of year 1 and at the mid‐course exam in the initial course of year 2. All participants completed a 100‐item selected‐response exam individually and then as part of a pre‐formed student team of 8–9 members. Following the team exam, students completed a 15‐item survey reflecting on their team interactions. In addition, faculty proctors of the team exam during course 1 completed a 15‐item survey reflecting on their observations of team dynamics. Finally, student performance (both individual and team exam scores) were collected for all participants. Team dynamics scores were calculated based on responses to survey questions regarding team interactions during the exam as identified by students and proctors (for course 1). This human subjects protocol was reviewed and approved by the CNUCOM Institutional Review Board.Results95 and 94 students completed the first and second hybrid exam surveys, respectively. Average individual scores (+/− SD) on the first and second exams were 69 (+/11) and 80 (+/− 10), and average team scores on the first and second exams were 92 (+/−3) and 99 (+/−1). At the first exam, student‐derived team dynamics score was highly correlated with team exam score, while team member average individual exam score did not strongly correlate with team exam score. {It is noted that teams for the first exam were formed 8 months prior to the exam and had been used extensively in other team‐based learning sessions.} Conversely, teams utilized in the second exam had been formed less than 1 month prior to the exam and had been functioning as a team for a limited number of sessions prior to the exam—on the second exam, team dynamics score was not well‐correlated with team exam score, and instead team member average individual exam score correlated more strongly with team score. Proctor’s assessment of team dynamics correlated moderately well with students’ assessment of team dynamics in course 1 (r = 0.24).ConclusionsOur data suggest that team dynamics play a role in team performance in hybrid testing utilized for high‐stakes exams among undergraduate medical students. This relationship may depend more on student comfort and familiarity within a team than on the individual knowledge and specific contributions of team members. More investigation on long‐term knowledge retention as related to dynamics within teams is desirable to further characterize outcomes utilizing this novel testing format.