Educators must continuously assess and adjust to maximize the amount of information students retain. One way to evaluate teaching effectiveness is thru pre- and post-semester assessments. Factors such as individual willingness to participate can affect the validity of these assessments. Our hypothesis was that students will more actively participate in a group activity compared with written pre- and post-semester assessments. In this study, we evaluated 3 different types of pre- and post-assessments to assess knowledge retention and participation. Participation decreased as the semester progressed resulting in only 31 of 57 students who completed all 6 of the assessments. There was an interaction (P < 0.001) between the type (individual, team, or activity) and time of assessment. The percentage of correct answers increased (P < 0.001) between pre-semester (average 32.92 ± 1.58) and post-semester assessments (average 47.54 ± 1.58). There was a correlation (P = 0.04) between the final course grade and the post-semester individual written assessment. In conclusion, participation throughout the semester is a major issue in assessing teaching quality and knowledge retention and the utilization of group activities does not appear to impact that participation. However, the best assessment for knowledge learned remains the classical written individual assessment.