Table 2 summarises students’ preferences for tutorial options, their subsequent participation in the tutorial option of their choice and their performance in the final assignment. In each semester included in the analyses, 150 to 200 students were enrolled in online mode. A total of 40% to 49% were female and 85% to 96% were medical doctors across all semesters.
Table 2. Students’ choice of tutorial option and their subsequent participation and performance
|
Semester 1 2015
|
Semester 2 2015
|
Semester 1 2016
|
Semester 1 2017†
|
Semester 1 2018
|
|
Ungraded asynchronous
online
discussion
|
Ungraded
asynchronous
online
discussion
(modified delivery*)
|
Ungraded intensive workshops
|
Graded individual
answer
submission
|
Graded individual
answer
submission
|
Graded asynchronous
online
discussion
|
Graded individual
answer
submission
|
Graded intensive
workshops
|
Number
|
186
(100%)
|
133
(89%)
|
17
(11%)
|
190
(100%)
|
192
(96%)
|
8
(4%)
|
162
(85%)
|
28
(15%)
|
Accessed external discussion website
at least once
|
160
(86%)
|
113
(85%)
|
NA
|
NA
|
NA
|
NA
|
NA
|
NA
|
Median posts
(Q1, Q3)
|
2
(0, 12)
|
1
(0, 8)
|
NA
|
NA
|
NA
|
18
(11,25)
|
NA
|
NA
|
Posted at least 1 post
|
118
(63%)
|
72
(53%)
|
NA
|
NA
|
NA
|
8
(100%)
|
NA
|
NA
|
Completed at least
1/10 tutorial
|
NA
|
NA
|
NA
|
187
(98%)
|
189
(98%)
|
8
(100%)
|
134
(83%)
|
NA
|
Completed at least
5/10 tutorials
|
NA
|
NA
|
Data
unavailable
|
176
(93%)
|
179
(93%)
|
7
(87%)
|
129
(80%)
|
28
(100%)
|
Completed at least
8/10 tutorials
|
NA
|
NA
|
NA
|
148
(78%)
|
158
(82%)
|
2
(25%)
|
107
(66%)
|
NA
|
Completed at least
10/10 tutorials
|
NA
|
NA
|
Data
unavailable
|
86
(45%)
|
102
(52%)
|
1
(13%)
|
65
(40%)
|
25
(89%)
|
% Median final assignment marks
(Q1, Q3)
|
69.6
(60.5, 78.0)
|
65.7
(54.3, 77.5)
|
64.8
(50.0, 80.4)
|
74.1
(64.0, 81.7)
|
71.7
(61.9, 77.5)
|
69.1
(62.5, 77.3)
|
76.7
(66.7, 83.3)
|
84.2
(75.4, 90.0)
|
There was no experiment in Semester 2 2016 or Semester 2 2017. *The tutorial group size was increased, specific questions were allocated to each student, and access to the model answers was restricted to those who visited the discussion website. † Only one student selected weekly evening face-to-face tutorials and as a result these were cancelled.
In Semester 1 2015, participation in the non-mandatory asynchronous discussion was very poor. Fourteen percent (26/186) did not log on to the discussion board site a single time and only 63% (118/186) posted at least one post with a median of two posts over the 10 tutorials.
In Semester 2 2015, most students selected ungraded asynchronous online discussions (133/150, 89%) and only 11% (17/150) opted to attend the ungraded intensive workshops. In the online discussion group, students’ participation did not increase although the delivery was modified. Participation data were not gathered for the ungraded intensive workshops. The median (Q1, Q3) final assignment marks were not different between groups (p=0.45, 65.7% (54.3%, 77.5%) in the online discussion group and 64.8% (50.0%, 80.4%) in the intensive workshop group).
In Semester 1 2016 when all students submitted their own answers individually and small participation marks were awarded, participation increased dramatically with 98% (187/190) submitting satisfactory work for at least 1 out of 10 weekly tutorials. Seventy eight percent (148/190) submitted satisfactory work for at least 8 out of 10 tutorials. In addition, the mark distribution lost the tail of poorly performing students compared to the previous semesters (Figure 1).
Figure 1. Distribution of final assignment marks by semester and tutorial option

ASYNC, asynchronous online discussion; WS, intensive face-to-face workshops; INDV, individual answer submission.
In Semester 1 2017, most students (96%, 192/200) selected graded individual answer submission and very few (4%, 8/200) chose graded asynchronous online discussions. The evening tutorial was cancelled as only one student selected this option. Even in this self-selected online discussion group, participation was not optimal with substantially fewer students in the online discussion group completing satisfactory work for at least 8 out of 10 tutorials compared to the individual answer submission group (25%, 2/8 in the online discussion group vs 82%, 158/192 in the individual answer submission group). However, 100% (8/8) in the graded online discussion group posted at least once and the median (Q1, Q3) number of postings was 18 (11, 25), which was substantially better than the first two semesters when participation marks were not offered. Seven out of the 8 students who elected to join the online discussions answered their allocated questions every week to receive 0.5% mark but 5 of them received the full mark for also responding to others’ posts only for 0 to 5 weeks. Most students posted all the comments in one module on the same day and did not return to post again. The median (Q1, Q3) final assignment marks were not different between groups (p=0.80, 71.7% (61.9%, 77.5%) in the individual submission group and 69.1% (62.5%, 77.3%) in the online discussion group).
In Semester 1 2018, most students (162/190, 85%) selected graded individual answer submission and 15% (28/190) opted to attend the graded intensive workshops. Participation rates differed somewhat by location of the students: 23% (18/77) of students living in the Sydney metropolitan area and 9% (10/111) of students living outside of the Sydney metropolitan area chose to attend the workshops. Participation in the intensive workshop group was even better than that in the individual answer submission group (89%, 25/28 attended both workshops which is equivalent to all 10 tutorials whilst only 40%, 65/162 submitted satisfactory work for all 10 tutorials online). The median final assignment mark (Q1, Q3) was also higher in the intensive workshop group (84.2% (75.4%, 90.0%) compared to the individual submission group (76.7% (66.7%, 83.3%)) (p=0.007). In the anonymous feedback survey completed by students attending the intensive workshops, 29 out of 30 indicated that they were highly satisfied with the experience. In addition to general comments that they prefer to have some face-to-face component in their learning, the following four themes emerged: ease of asking questions in person (“Face to face tute easier to ask questions”), immediate feedback (“Questions answered on the spot”); social interaction (“Interaction with everyone and being able to talk about other things”); and flexibility of not having to meet the weekly due dates ( “Due to time constraints with work (often working weekends), it is difficult to meet the weekly deadlines for submission. Easier to do it all in one go.”)