Predictive Value of TBL Individual Readiness Assurance Tests on Subsequent Exam Performance

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Conference Proceeding

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PURPOSE: The Individual Readiness Assurance Test (IRAT) is a critical component of TBL, encouraging individual preparation and accountability. IRATs may also be an early warning mechanism for students at academic risk. We analyzed IRAT and exam data from our gross anatomy course to assess the effectiveness of IRATs as a predictor of exam performance.

METHODS: Averages from four IRATs, which preceded any of the course exams, along with subsequent exam scores were subject to Fisher's exact test (N=910 students from 9 years). Groups were defined as passing or failing IRATs and passing or failing one or more course exams (70% pass/fail cutoff).

RESULTS: Overall, 30.0% of students failed at least one exam. Students who failed the initial IRATs had a significantly higher exam failure rate. As a diagnostic test, the IRATs had a positive predictive value of 0.754, a negative predictive value of 0.770, a likelihood ratio (LR) of 7.16 for failing at least one exam (i.e., students failing IRATs are 7 times more likely to fail an exam) and a LR of 6.04 for failing the course. Scores from only the first one or two IRATs had a much lower predictive value. Female students had lower performance on both IRATs and exams. Their IRAT performance was also less predictive of exam performance (LR=5.19 for females v. 11.82 for males). This may be due to a significant trend of females to perform more poorly in the first two IRATs than in subsequent IRATs and exams. The predictive value of IRATs was much higher than that of entry credentials such as MCAT scores.

CONCLUSIONS: In addition to its role in TBL per se, IRATs may be useful in identifying at risk students prior to high stakes exams. Formal intervention, or at least informing students of their risk, may help them remedy early academic problems.


Presented at the 16th Annual Meeting of the International Association of Medical Sciences Educators (IAMSE), Portland, OR.

TBL/PBL Abstract ID: 226 Award Nominee

© IAMSE 2012