Impact of Varying Active Learning Time on Student Performance on a Standardized Exam in the Psychiatry Clerkship

Objective As medical schools reform clinical curricula, an increasing amount of time is spent in active learning activities. The authors hypothesized that students who spent more time in active learning educational activities (e.g., team-based learning, small group activities, clinical simulation) would receive higher NBME Subject Exam scores compared to students with less. Methods This cohort study included 518 students from 2014 to 2016 who completed at least six contiguous weeks of a psychiatry clerkship. Active learning time percent was calculated by dividing the amount of time in active learning by the total in-classroom time during the clerkship. Analysis was conducted using ANOVA and linear regression. Results Analysis found that increasing the amount of active learning was not significantly associated with student scores on the NBME Subject Exam in psychiatry (F = 0.91, p = 0.402). However, when controlling for possible confounding variables (including clerkship length and order), clerkship order was a significant predictor of student performance (r = 0.19, beta = 0.18, p < 0.0001); students who took the clerkship later in the academic year-and after the internal medicine rotation-performed significantly better on the exam. Conclusions This study found that increasing the amount of active learning did not improve student performance on the NBME Subject Exam in psychiatry. This study provides preliminary, but unexpected, evidence of interest to medical educators and curriculum reformers that increasing the amount of active learning is not significantly associated with improved student test performance.