Modified interteaching sessions as application-based examinations reduce student exam stress in an upper-level pathophysiology class

Testing is a highly important tool, used ubiquitously in academia, to assess student comprehension and understanding of material. Unfortunately, the emphasis placed on test grades has resulted in a modern epidemic of test-related anxiety, which can have adverse health effects on students. Over time, novel testing strategies have been developed to more precisely assess individual skills such as remembering, analyzing, and synthesizing. Yet, there exist few strategies that were also developed to simultaneously reduce stress in the testing environment. We posit here a teaching innovation whereby we modified the classic interteaching session developed in the social sciences to serve as a stress-reduction testing format that also builds student communication and critical thinking skills in an upper-level pathophysiology course. After implementing this novel testing approach, we anonymously surveyed the students in the class to understand how the testing format affected their self-perceived stress levels and their self-perceived learning and to identify their testing preferences. Of 28 students, 12 responded (43%). Our survey data highlight that students largely preferred partnered, open-response, case-based exams to multiple-choice exams. Moreover, students perceived themselves as having lower test-related stress when taking partnered, open-response, case-based exams, as well as a strong overall agreement that partnered, open-response, case-based exams enhanced their learning. We posit this application of modified interteaching can be employed in upper-level physiology or pathophysiology courses as a stress-reduction testing strategy.<b>NEW & NOTEWORTHY</b> We have identified an approach to testing in pathophysiology that can simultaneously enhance student learning while reducing test-related stress. In our study, students ubiquitously agreed that open-response, partnered, case-based exams were preferable to multiple-choice exams and that their stress levels were lower while learning was enhanced as a function of this testing strategy.