Impact of Ungraded Readiness Assurance Tests on Student Preparation and Performance in an Integrated Required Pharmacy Course.

Objective: To examine the impact of ungraded Readiness Assurance Tests (RATs) on students' pre-class preparation and performance in a team-based learning integrated required professional pharmacy course.

Methods: This retrospective cohort study compared student performance and pre-class preparation quantitatively and qualitatively when RATs in a team-based learning course were ungraded vs. graded in a course in the second professional year. Student perceptions of the course were also summarized for the cohort that experienced ungraded RATs (2021). Four cohorts (2018, 2019, 2021, and 2022) were included in this study. Student performance was measured through individual RAT (iRAT) and exam scores. Student's pre-class preparation was measured by the number of unique viewers and portion of each video viewed for each pre-recorded lecture. The 2021 cohort's student evaluations of teaching were then analyzed for themes.

Results: iRAT scores decreased in the ungraded 2021 cohort (mean score 7.5) compared to graded cohorts (2018: 8.1, 2019: 8.1, 2022: 8.4). Overall exam performance was consistent across cohorts. The mean of unique viewers accessing pre-recorded lectures and the portion of each pre-recorded lecture viewed ranged from 72.9% to 83.1% and 74.3% to 80.5%, respectively. Themes from student evaluations of teaching in the ungraded 2021 cohort included change in course structure caused stress; change in motivation and pre-class preparation; benefits of retrieval practice; preference for graded iRAT.

Conclusions: Ungrading a single portion of the course resulted in lower performance on formative assessments, but similar performance on course exams. Students were uncomfortable with the change in grading structure in this course, which differed from their experiences in prior courses in the curriculum.