Purpose
It is widely acknowledged that active learning is an important pedagogical approach in medical education. As we explore more individualized learning experiences in our active-learning curriculum, we are investigating how matriculating medical students' learning approaches, demographics, and knowledge base impact performance. Ultimately, these findings will guide curricular changes aimed at more individualized education and faculty development in active learning and precision education.

Methods
Our study is a multi-year, mixed-methods, case study at Ohio University - Heritage College of Osteopathic Medicine. Phase 1 includes collecting quantitative data on student learning approaches using validated survey instruments (e.g., LASSI) to build predictive models of student achievement in our curriculum. Phase 2 will focus on qualitative investigation of students’ perceptions of how matriculating factors impacted their performance. We report initial findings from a voluntary sample of matriculating students (n=32) who completed surveys examining learning approaches. We compared learning approaches to exam performance during their first semester using two-sample t-tests (x=0.05). Ohio University IRB approved this research (IRB-FY24-365).

Results
We divided participants into tertiles (i.e., thirds) based on the cohort’s score distribution for each exam (e.g., participants’ tertiles may change depending on exam scores). The highest and lowest tertiles differed significantly in LASSI elements related to Attitude (P=0.004) and Time Management (P=0.015) on Exam 1. Only Time Management persisted as a significant factor in Exam 2 (P=0.05), while LASSI-Test Taking Strategies differed in Exam 3 (P=0.005). In the subsequent two exams, motivational differences tended to predominate between the highest and lowest tertile performers.

Conclusion
These results highlight the significance of time management skills early in our curriculum and emphasize that the impact of specific learning approaches on performance may shift over time as medical students adapt to the challenges of medical school.