Team-based learning pedagogy enhances the quality of Chinese pharmacy education: a systematic review and meta-analysis

Innovation and evaluation of vocational pharmaceutical education system under the 1 + X certificate system in China

BACKGROUND AND OBJECTIVES

The 1 + X certificate system, introduced in China in 2019, integrates academic credentials with vocational skill certificates to meet the heightened demand for skilled talents in the growing economy. This study aims to innovate and evaluate the vocational pharmaceutical education system under the 1 + X certificate framework, specifically addressing the gap between theoretical education and workplace requirements.

MATERIALS AND METHODS

A retrospective observational approach analyzed 490 pharmacy students over two academic years. The 2021 cohort underwent 1 + X integrated education, while the 2020 cohort followed conventional education. We collaborated closely with industry partners to identify and compile typical job competencies, formulating work projects aligned with industry demands. Combining the skill level standards and assessment content of "1+X Pharmaceutical Purchasing and Sales" and "1+X Pharmaceutical Preparation", we revised the course standards, incorporating typical work projects into the 2021 pharmacy professional teaching curriculum. This constituted the fundamental content of the 1 + X education reform. Statistical analysis compared course scores and 1 + X certificate examination performance.

RESULTS

The 2021 cohort, under the 1 + X educational model, demonstrated higher average scores in pharmacy courses, with significant improvements in pharmacology (1 + X vs. Traditional education: 58.40 ± 14.20 vs. 53.44 ± 14.67), clinical pharmacotherapy (72.74 ± 10.28 vs. 63.15 ± 11.03), and pharmaceutical distribution and marketing (79.34 ± 10.96 vs. 67.50 ± 15.82). 1 + X certificate pass rates and satisfaction with the model were also higher than the 2020 cohort.

CONCLUSION

The 1 + X certificate system is useful for developing talent in Chinese vocational education, effectively integrating assessments with industry standards. Future research should aim at evaluating long-term outcomes and improving quantitative skills assessments for enhanced effectiveness.

Team-based learning versus traditional teaching effect on pharmacy Students' Performance: A systematic review and Meta-Analysis

Background

Several pharmacy schools have implemented team-based learning (TBL) in their curriculum worldwide. Yet, TBL's effectiveness compared to traditional teaching in improving students' outcomes in pharmacy education is yet to be assessed collectively. Thus, the aim of this meta-analysis is to compare the performance of pharmacy students following the implementation of team-based learning (TBL) in the pharmacy curriculum as opposed to traditional learning methods.

Methods

This systematic review and meta-analysis included studies that assessed students' performance after TBL was implemented in a pharmacy curriculum. Adhering to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, the review conducted searches in Embase, MEDLINE, and Google Scholar until July 26, 2023.

Results

A total of 11 studies comparing TBL against traditional teaching methods and assessing students' performance were included. The pooled analysis, involving 2,400 students from 10 studies, demonstrated a mean difference (MD) in favor of TBL (MD = 2.27, 95 % CI [-0.85, 5.40]). However, notable heterogeneity was observed with an I2 value of 82 %, and the observed difference did not reach statistical significance.

Conclusion

TBL exhibited enhanced student performance in pharmacy education compared to traditional teaching, although the difference was not statistically significant. The meta-analysis findings support the use of TBL in pharmacy education for various pharmacy courses (pharmaceutical and clinical sciences courses) and students at different levels. However, there is a need for more robust studies to comprehensively evaluate TBL, considering aspects such as students' performance and engagement, skills development, and satisfaction.

Enhancing knowledge mastery in resident students through peer-teaching: a study in respiratory medicine

AIM

The transition from medical students to competent physicians requires comprehensive training during residency programs. In China, resident students typically undergo 2- or 3-year training programs. While they learn from patient interactions under the guidance of experienced doctors, integrating theoretical knowledge from textbooks into practical cases remains a challenge. This study aimed to explore the impact of medical interns acting as peer-students on the knowledge mastery of resident students.

METHOD

The participants of this study consisted of resident students specializing in respiratory medicine at the Second Affiliated Hospital of Zhejiang University, School of Medicine. Resident students were given the opportunity to volunteer as peer-teachers for medical interns in the respiratory department. Those who chose to instruct interns were automatically placed into the test group, while those who opted not to partake in intern instruction formed the control group. In their role as peer-teachers, resident students assumed the responsibility of guiding interns in patient management throughout the entire continuum, spanning from initial engagement to discharge, a commitment that extended over a minimum period of 2 weeks. The resident students' academic performance was evaluated through a departmental examination consisting of 50 multiple-choice questions, which was administered upon completing their rotation. Statistical analysis was performed to assess the impact of peer-teaching on the resident students' performance.

RESULTS

Between January 2023 and June 2023, a total of 158 resident students completed their rotation in the respiratory department. Among them, 40 resident students willingly took on the responsibility of instructing medical interns, while 118 resident students did not participate in intern teaching. With a "one-to-one" teaching policy in place, the overall satisfaction rate of the interns was an impressive 95.35%. Pre-rotation test scores for the test group averaged 81.66 ± 8.325 (Mean ± SD) and the control group averaged 81.66 ± 8.002, without significance. The departmental examination scores of the test group averaged 85.60 ± 7.886, while the control group scored an average of 82.25 ± 8.292, with a statistically significant difference (p = 0.027).

CONCLUSION

In conclusion, our study underscores the positive influence of peer-teaching on the knowledge mastery of resident students.

Comparison of the impact of team-based learning and lecture-based learning on nursing students' core competencies: A systematic review and meta-analysis

AIM

This study aims to evaluate the effect of team-based learning on the core competence of nursing students compared with traditional teaching methods.

BACKGROUND

In recent years, team-based learning has been widely used as a learning and teaching method in the world. Not only the necessary knowledge, skills and attitudes, but also the core competence is necessary to cope with various clinical situations for nursing students. However, the effect of this new teaching method on core competence of nursing students is not consistent.

DESIGN

The study was designed according to the preferred reporting entries guidelines statement for systematic reviews and meta-analyses and population, intervention, comparison, outcome and study.

METHODS

Data were collected from PubMed, Embase, Web of Science, ScienceDirect and Scopus. The quality of studies was assessed using "The Newcastle Ottawa scale". A random-effect model of meta-analyses was conducted to generate pooled standardized mean differences (SMD) for core competence using Rev Man 5.4.1 software and STATASE 15. Moreover, subgroup, heterogeneity, sensitivity and publication bias analyses were conducted.

RESULTS

A total of 14 articles with 1942 participants were included in the meta-analysis. Compared with the traditional pedagogy among nursing students, team-based learning pedagogy significantly increased theoretical performance, professional effects (self-directed learning ability and communication ability) but did not affect practice skills. In addition, one study found that learning attitudes were not improved in students with high or low academic performance. This might mean that the teaching model should be implemented for a long time, which essentially changed students' learning attitudes to improve students' self-directed learning ability and core competence, especially for students with low scores.

CONCLUSIONS

In summary, findings indicated that team-based learning pedagogical approaches might be beneficial to improve teaching quality in nursing education. However, practice skills might not be sensitive to team-based learning because of the seriation of the original course. Nursing educators need to explore teaching strategies to cultivate high-quality nursing talents to cultivate nursing students with core competence and ensure that they are successfully qualified for new employment.

Implementation of Team-Based Learning for a Clinical Module of the Ethiopian Undergraduate Anesthesia Curriculum and Students' Perspectives: A Pilot Cross-Sectional Study

Introduction

Team-based learning (TBL) is an active learning strategy that gives students the opportunity to apply conceptual information through a series of tasks that incorporate individual effort, team collaboration, and immediate feedback. This study aimed to report baseline TBL implementation in a clinical module of a fourth-year competency-based undergraduate anesthesia curriculum and explore the perspectives of students.

Methods

In April 2023, 18 students participated in two TBL sessions over two weeks, and readiness assurance test results and post-TBL evaluations were analyzed. Week one TBL implementation scores were compared with week two, establishing a longitudinal analysis over two points in time. Students also participated in an online survey to assess their views on the advantages and design of TBL, their perceptions of its best and worst features, and their suggestions for its implementation.

Results

Of 18 students, 16 (89%) responded to the survey. Most students believed that TBL was an effective educational strategy but expressed concern about the amount of time required for TBL preparation and the need for student readiness. The individual readiness assurance test scores did not differ significantly between weeks 1 and 2 (mean difference [MD] = 0.39, P= 0.519, 95% CI: -0.824 to 1.60). However, the students' median [IQR] team readiness assurance test scores increased significantly from week one to week two, from 8 [2] to 10 [1] (p = 0.004). Peer evaluation scores also showed a significant increase in week 2 (MD = 2.4, P = 0.001, 95% CI: -3.760 to -0.996).

Conclusion

TBL was successfully implemented for a clinical module at Dilla University-Ethiopia for the first time. Students perceived it positively, but some criticized its preparation time, workload, and minimal facilitator engagement. We suggest convenient and flexible scheduling personalized for each student's needs when TBL is applied for clinical modules.

A Scoping Review of Educator Proficiency Interventions in Pharmacy Education Illustrated by an Interdisciplinary Model Integrating Pedagogical Theories into Practice

Pharmacy schools recognize the need for flexibility and comprehensive curricular transformation with a competency-based focus to effectively prepare for the evolving practitioner competencies and challenges of the pharmacy profession. The curricular implementation of evidence-based teaching and learning theories and practices demands educator proficiency through skills development with indispensable faculty leadership support. Our scoping review of online databases and pharmacy education-related journals aims to identify faculty development interventions or teaching proficiency programs that integrate educational and pedagogical theories. Original studies and reviews published between 2010 and 2022 were screened based on four inclusion criteria. Thirty-four manuscripts were eligible for full-text analysis, of which seven results referenced target faculty pedagogy knowledge development. Nine key messages, as Results Statements, synthesize and provide a framework for our results analysis. An ongoing Hungarian intervention model of comprehensive faculty development with strong interdisciplinary cooperation is discussed in our study to illustrate the applicability of the Results Statements through each stage of the process. Educator motivation and relatedness to students or awareness of the educator roles are intrinsic factors, which may not be easily detectable yet significantly impact teaching proficiency and student learning outcomes. The integration of evidence-based pedagogical knowledge and training in educator proficiency development contributes to the sustainability and cost-effectiveness of faculty interventions.

Comparison of the Effect of Education Using Team-based Learning Method and Lecture Method on Controlling Diabetes in the Elderly: A Quasi-Experimental Study

Background

Patient education is considered as an essential part of diabetes control. This research is conducted to compare the effect of education using team-based learning (TBL) method and lecture method on blood pressure (BP), serum levels of fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), and Body mass index (BMI) in the elderly with diabetes.

Methods

This quasi-experimental study was conducted on 61 elderly patients with type 2 diabetes in diabetes clinics in Rafsanjan, during October 2018 to January 2019. Patients were selected using simple random sampling. They were divided into two groups of TBL and lecture-based learning. For each group, educational content was presented through 2-hour sessions held once a week for 1 months. FBS, HbA1c, BMI, and BP were measured at baseline and 3 months after the intervention. Data were analyzed through SPSS 21, using Chi-square test, independent t-test, and paired t-test; A P-value<0.05 was considered as significant.

Results

After the intervention, the TBL group had a significant decrease in systolic and diastolic BP compared to the lecture group (P<0.001). Before and 3 months after the intervention in the TBL group, there was a significant decrease between the means of FBS (P=0.01), HbA1c (P<0.001), and systolic and diastolic BP (P<0.001), but in the lecture group, only the systolic BP showed a significant decrease (P<0.001).

Conclusion

TBL method had more effects on controlling diabetes type 2 in the elderly than the lecture method. It is suggested that health providers should consider TBL for the education of the elderly with diabetes.

Application of team-based learning to ophthalmology in China

Objectives

The purpose of this study was to explore whether team-based learning (TBL) was more effective than traditional didactic lectures (TDLs) in improving medical students' problem-solving and study skills in the clinical course of ophthalmology. In addition, we were also concerned about Chinese students' satisfaction with TBL.

Methods

Our study program involved 275 students of the 5-year clinical medicine program from Central South China University, of which 140 were enrolled in a modified TBL course. A questionnaire that included closed-ended and open-ended items was distributed to students immediately following the completion of the TBL session, and 108 valid questionnaires were collected. Descriptive statistics were used to analyze quantitative data. The effects of the TBL module on students' performance were measured between the groups using a one-way between-group analysis of variance (ANOVA) test by the individual readiness assurance test (IRAT), the group readiness assurance test (GRAT), and final examination scores (FESs), compared with a class without the TBL session.

Results

With our modified TBL strategy, 140 students achieved a mean test score of 72.65 on test questions that assessed their knowledge of ophthalmology compared to 135 students who achieved a mean score of 70.8 using the TDL method (p = 0.3434). The performance in a pre-class quiz was significantly better in the GRAT compared to the IRAT. In comparison to the TDL session, the modified TBL was preferred and acceptable by most medical students.

Conclusions

By applying the modified TBL to ophthalmology, students improved their performance, self-study, and teamwork, and their class engagement and satisfaction were enhanced. However, TBL should be further optimized and developed to enhance educational outcomes.

Flipped classroom improves student learning outcome in Chinese pharmacy education: A systematic review and meta-analysis

Background: The application of flipped classroom (FC) pedagogy has recently become increasingly popular in Chinese pharmacy education. However, its effectiveness in improving student learning has not yet been assessed. This study aimed to evaluate the effects of teaching with such pedagogical approach by examining studies that compare the FC approach with the traditional lecture-based learning (LBL) module through a systematic review and meta-analysis.

Methods: Seven databases, including the PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journals Database, Chinese Wanfang database, and China Biomedical Literature Database, were searched from the inception to 30 June 2021, to identify eligible articles of randomized controlled studies. The primary outcomes included the theoretical and experimental test scores, and the secondary outcomes were the results from questionnaires about the number of students who preferred the FC or endorsed its improving effects on their learning enthusiasm, self-learning ability, thinking skills, communication skills, and learning efficiency. The quantitative synthesis was conducted with Revman V.5.3 software following the Cochrane Reviewer’s Handbook guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

Results: Eleven eligible studies published from 2017 to 2020 enrolling 1,200 students were included in this meta-analysis. The quantitative synthesis demonstrated that the FC module presented an overall more significant effectiveness over traditional LBL approach for Chinese pharmacy education in improving student academic performance as measured by theoretical test scores (SMD = 1.08, 95% CI: 0.60–1.56, p < 0.00001) and experimental test scores (MD = 6.62, 95% CI: 4.42–8.82, p < 0.00001). Further sub-group analysis revealed that the preferable effectiveness of FC was also evident in both theory-oriented (SMD = 0.77, 95% CI: 0.10–1.45, p < 0.00001) and experiments-oriented courses (MD = 6.52, 95% CI: 3.48–9.56, p < 0.00001) for both undergraduate (SMD = 0.84, 95% CI: 0.31–1.37, p < 0.00001) and 3-year junior-college students (MD = 8.17, 95% CI: 6.44–9.89, p < 0.00001). Additionally, analysis on the questionnaire outcomes revealed that more respondents preferred for FC and endorsed its improvement effects on developing students’ learning enthusiasm, self-learning ability, thinking skills, communication skills, and learning efficiency.

Conclusion: Current evidence suggests that FC pedagogical approach can effectively improve student learning outcomes and is applicable to Chinese pharmacy education.

Are Online Synchronous Team-Based-Learning (TBL) pedagogy effective?: Perspectives from a study on medical students in Oman

INTRODUCTION

Team-based learning (TBL) is a highly structured, instructive, and student-focused pedagogy used by medical educators to foster the students' learning. The present study aimed to qualitatively explore the students' perception of the effectiveness of online synchronous TBL pedagogical strategy in promoting learning outcomes.

METHODS

A cross-over interventional study was conducted on MD4 year medical students, using four modified TBL sessions on common immunological diseases on four different dates. 139 participants were divided into 4 groups [35 each in A, B, C, & 34 in D]. For TBL session 1, Group A and group B were the study and control groups, respectively. For the second session on different topics, the groups were reversed with group B and group A as the study and control groups, respectively. The same was followed for groups C and D. The means and standard deviations of the pre-test and post-test scores were compared after calculating the improvement in scores from pre- to post-tests. Repeated measures ANOVA suitably coded in SPSS for cross-over design was used to find out confounding by sequence of interventions with a p-value of <0.05 signifying the significance.  Students' feedback on online TBL sessions was collected through a predesigned questionnaire on a 3-point Likert scale. The data were analyzed using SPSS version 22 and expressed as number and percentage.

RESULTS

The post-test scores of the students who participated in the TBL session were significantly higher when compared to the self-study (SS) arm. The overall improvement in scores was 4.98 (1.4) in TBL group, whereas in the SS arm it was only 2.29 (1.51). The new method was found far superior to the self-study method regardless of being applied before or after the comparison mode of self-study (P<0.0001). The scores of the self-study was marginally better when offered first rather than after a TBL session, indicating the negative effect of cross-over on SS mode (P=0.024). The overall response of our students toward the effectiveness of online TBL pedagogy was overwhelmingly positive in terms of an opinion survey which had a Cronbach's alpha of 0.932. The majority (>80%) perceived TBL as an enjoyable active session that promoted their active participation and engagement through student-led discussions. Many stated that TBL enhanced their critical thinking, problem-solving ability, communication skills, and knowledge.

CONCLUSION

TBL is an instructive and highly structured teaching-learning strategy, welcomed by the majority of our participants. Online TBL sessions are effective in fostering the students' learning and can be used confidently when needed.

The effectiveness of team-based learning in nursing education: A systematic review

AIM

Team-Based Learning (TBL) is an active teaching methodology, recently implemented also in the field of nursing education. The main objective of this study was to identify, appraise and summarize primary studies on the effectiveness of TBL in achieving learning outcomes in undergraduate nursing students. The secondary objective was to explore the generic competencies the students developed, and their reactions and attitudes.

STUDY DESIGN

A systematic review of experimental and quasi-experimental studies.

DATABASES SOURCES

Cochrane Library, Pubmed/Medline, Cinahl, PsycINFO, and Eric; Google Scholar was used to search for grey literature and the reference lists of the retrieved papers.

REVIEW METHODS

A research protocol was developed according to the PRISMA-P guidelines. Two reviewers conducted the selection process. The "JBI Critical Appraisal Checklist" was used to check the quality of the selected studies.

RESULTS

We included 12 studies: 2 monocentric randomized controlled trials and 10 quasi-experimental studies. Nine out of 12 studies produced significant results in favour of TBL in terms of academic performance and skills development, however results were divergent when TBL was compared with other teaching methods. The results of 7 studies highlighted the effectiveness of TBL in improving the development of communication skills, interprofessional learning, and self-directed learning. Divergent results were obtained with regard to problem solving and critical thinking skills. TBL promoted classroom engagement, however it did not seem to be associated with better learning outcomes.

CONCLUSIONS

Overall, TBL was found to be effective in achieving undergraduate nursing students' learning outcomes, but evidence was not sufficiently strong to warrant that it is more effective than other teaching methods. The results of this review are in favour of the implementation of TBL in nursing education, however studies with more rigorous methods and with a mixed method design are required to improve the transferability of results.