Effect of Multiple-Choice Question-Based Small-Group Teaching Versus Conventional Tutorials on Academic Performance in Pathology

Background: Active learning strategies may improve student engagement and academic performance in medical education. This study compared the effectiveness of multiple-choice question (MCQ)-based small-group teaching with conventional tutorials in undergraduate pathology.Methods: A quasi-experimental crossover study was conducted among 50 second-professional MBBS students at Venkateshwara Institute of Medical Sciences, Uttar Pradesh, during November–December 2024. Students participated in both teaching methods across two pathology topics. Academic performance was assessed through normalized viva-voce scores. Student and faculty perceptions were evaluated using structured Likert-scale questionnaires.Results: Mean viva-voce scores were significantly higher following MCQ-based teaching than conventional tutorials (67.5% versus 53.3%; mean difference 14.2 percentage points; 95% CI 6.4–21.9; p<0.001). Improved performance was observed in 62.0% of students. MCQ-based teaching received significantly more favourable student ratings for clinical reasoning (58.0% versus 40.0%; adjusted p=0.019) and examination preparedness (72.0% versus 58.0%; adjusted p=0.049). Faculty feedback showed no statistically significant differences.Conclusion: MCQ-based small-group teaching was associated with improved viva-voce performance and favourable perceptions of clinical reasoning and examination preparedness, supporting its use as a supplementary pathology teaching strategy.