Abstract Objective Assess pharmacy student's perceptions of small group (n=10) versus large group discussion during recitation (n =>80) and perceived learning benefits based on access to patient cases. Methods Respondents selected responses on a 5-point Likert scale regarding their access to patient cases prior to recitation. Respondents ranked their preference for small versus large group discussion based on the setting in which patient cases were reviewed. Respondents were able to express their thoughts in writing for five items. Results One-hundred seventeen second professional year Doctor of Pharmacy students participated. Small group discussions in separate rooms and reviewing patient cases as a group in the separate room was least preferred by respondents regardless of if they received patients cases prior to (p<0.001) or during recitation (p<0.001). Most respondents preferred a large group discussion in an auditorium and reviewing patient cases as a whole class if provided patient cases prior to recitation (p=0.0094). Respondents favored small group discussions in an auditorium and reviewing patient cases as a whole class if they received patient cases during recitation (p<0.001). Conclusions Preference for small or large group recitation discussions was dependent on when respondents received patient cases. Faculty may coordinate the group setting in recitation based on pharmacy students' access to course material.