Team-based learning: design, facilitation and participation

Improving learning experience through implementing standardized team-based learning process in undergraduate medical education

INTRODUCTION

Team-Based Learning (TBL) is a highly structured active learning methodology shown to have positive learning outcomes in undergraduate medical education (UME). While many medical schools have increasingly adopted TBL, there is considerable variation reported in the literature in the implementation of the standard sequence and key components of TBL. The extent to which this variation affects the benefits of TBL is not well understood. This study aims to assess the impact of implementing the standardized framework of the TBL process on student perception of the benefits of TBL.

METHODS

Faculty at our institute were surveyed to determine the frequency of implementation of TBL standards, as described in the literature. Second-year osteopathic medical students (OMS II) were surveyed for their perception of the experience of TBL at the beginning of the academic year. Curricular interventions targeting the enforcement of the standard steps and key components of TBL were implemented in a particular 6-week system course. The students were re-surveyed at the end of the course. Descriptive and thematic analyses were performed on quantitative and qualitative data.

RESULTS

Twenty four of 31 (77.4%) faculty participated in the faculty survey, 53 of 105 OMS II students (50.4%) participated in the pre-intervention survey, and 72 of 104 OMS II students (69.2%) participated in the post-intervention survey. Faculty survey results indicated inconsistent implementation of key steps and components of the TBL process. Comparisons of student pre- and post-survey means of the perceived value of various aspects of TBL showed significant improvement in multiple aspects of the TBL process, including readiness assurance tests, immediate feedback, and application activities. Both before and after the intervention, students highly rated the value of teamwork and opportunities for practical application of concepts within TBL.

CONCLUSION

While medical students value teamwork in UME and professional development, their perception of TBL can be less than positive if not conducted deliberatively. Assessment of the implementation of the standard TBL steps and components and development of corresponding targeted interventions may improve the TBL experience of medical students. Our process could be generalized to help educators interested in improving TBL in their home institutes.

Examining the influence of team-based learning on medical students' comprehension and attitudes regarding psychedelic therapies

INTRODUCTION

This study evaluates the impact of a two-hour team-based learning (TBL) curriculum on medical students' knowledge, comprehension, ethical understanding, and attitudes towards psychedelic therapies.

METHODS

Sixty-three pre-surveys and fifty post-surveys assessed students' perceived knowledge and attitudes using Likert scales. Forty-eight matched pre/post-knowledge tests with multiple-choice questions quantified changes in comprehension. The TBL approach featured independent learning, team readiness assessments, and application exercises.

RESULTS

Post-curriculum, students demonstrated significantly improved test scores (mean 41.4% increase, p < 0.0001) and more positive attitudes across 16 of 18 items (p ≤ 0.0495). Overall attitude scores increased 23% (p < 0.0001). Qualitative feedback reflected enhanced comfort discussing psychedelics clinically. While some students expressed support for psychedelic-assisted therapy, others cited reservations.

DISCUSSION

This innovative curriculum bridged an important education gap given the increasing relevance of psychedelic medicine. Findings suggest TBL enhances medical student preparedness in this emerging field. Continued curricular development is warranted to ensure proper psychedelic education aligns with patient needs and legislative policies. As psychedelic research progresses, maintaining instructional excellence is crucial for future healthcare professionals.

The use of role-play in the learning of medical terminology for online and face-to-face courses

Student engagement while learning a new, unfamiliar vocabulary is challenging in health science courses. A group role-play activity was created to teach students medical terminology and learn why its correct usage is important. This activity brought engagement and relevance to a topic traditionally taught through lecture and rote memorization and led to the development of an undergraduate and a stand-alone introductory course to teach students medical terminology. The undergraduate course was designed to be a fully online medical terminology course for health science students and a face-to-face course for first-year dental students founded in active learning and group work. The course's centerpiece learning activity focused on using published case studies with role-play. In this group activity, students are challenged to interpret a published patient case study as one of the members of a healthcare team. This course models the group work inherent in modern health care to practice building community and practicing professional skills. This approach gives students the capacity to work asynchronously in a team-based approach using our learning management system's wiki tool and requires students to take responsibility for their learning and group dynamics. Students practice identification, writing, analyzing, and speaking medical terms while rotating through the roles. Students in both classes self-reported a 92% to 99% strong or somewhat agreement using a five-point Likert scale that the course pedagogy was valued and helpful in their learning of medical terminology. Overall, this method has proven to be an engaging way for students to learn medical terminology.NEW & NOTEWORTHY Role-play can engage students and encourage learning in identification, pronouncing, writing, and understanding medical terminology in multiple course formats.

Developing education in environmental health and medicine focusing on neurology: Initiatives in Sweden (the UPRISE model), France, and Turkey

BACKGROUND

The role of environmental factors in neurological disorders constitutes a topic of increasing importance. Teaching in European universities should expand and update this field gaining future health professionals including adjacent disciplines.

AIM

To describe recent efforts to create courses that cover crucial interdisciplinary content that we believe should be included in modern education, and to adapt modern pedagogic strategies.

METHODS

In collaboration with RISE (Rencontres Internationales Santé Environnement), elective courses focused on Environmental Health and Medicine (EHM) were developed, in France, Sweden, and Turkey. The courses combined classic teaching methods and new pedagogic and digital solutions to create environment-related health awareness and facilitate future interprofessional collaboration in this field.

RESULTS

UPRISE is an innovative elective course introduced in 2020 in Sweden's Uppsala University with the participation of lecturers from several countries and aim to recruit students from different universities. A total of 45, mainly female students (68%), participated in the course. In Strasbourg, France, a novel course on environmental medicine was held in 2019-2023 and examined 90 students, of which more than half were female. Nine graduate nurse students in Turkey attended ten seminar series focused on EHM. Overall, students expressed satisfaction with the courses.

CONCLUSIONS

This European project for courses in higher education arising from RISE was met with appreciation and challenges from academic institutions. However, due to considerable efforts to introduce the EHM concept, a unique compulsory course for all medical students in the second year of training started in 2023 in all French medical faculties. In 2023, UPRISE was integrated into ENLIGHT, the European University Network to promote equitable quality of Life, sustainability, and Global engagement through Higher education Transformation.

Team-based learning (TBL) curriculum combined with video vignettes improves performance of undergraduate medical students on OSCE compared with TBL alone

BACKGROUND

Clinical practitioners think of frequent causes of diseases first rather than expending resources searching for rare conditions. However, it is important to continue investigating when all common illnesses have been discarded. Undergraduate medical students must acquire skills to listen and ask relevant questions when seeking a potential diagnosis.

METHODOLOGY

Our objective was to determine whether team-based learning (TBL) focused on clinical reasoning in the context of rare diseases combined with video vignettes (intervention) improved the clinical and generic skills of students compared with TBL alone (comparator). We followed a single-center quasi-experimental posttest-only design involving fifth-year medical students.

RESULTS

The intervention group (n = 178) had a significantly higher mean overall score on the objective structured clinical examination (OSCE) (12.04 ± 2.54 vs. 11.27 ± 3.16; P = 0.021) and a higher mean percentage score in clinical skills (47.63% vs. 44.63%; P = 0.025) and generic skills (42.99% vs. 40.33%; P = 0.027) than the comparator group (n = 118). Success on the OSCE examination was significantly associated with the intervention (P = 0.002).

CONCLUSIONS

The TBL with video vignettes curriculum was associated with better performance of medical students on the OSCE. The concept presented here may be beneficial to other teaching institutions.

Team-based learning in the internal medicine clerkship didactics

BACKGROUND

Active-learning approaches, such as team-based learning, are infrequently used in internal medicine clerkship didactics even though there is increasing evidence to suggest medical students prefer it over traditional lecture-based learning. In this study, five team-based learning sessions were incorporated into three blocks of a 12-week internal medicine clerkship.

METHODS

The goal of this quasi-experimental study was to compare learner engagement, satisfaction and preference between team-based learning and lecture-based learning in the internal medicine clerkship didactics. Outcomes were compared using the Classroom Engagement Survey, a satisfaction questionnaire and the Team-Based Learning Student Assessment Instrument (TBL-SAI).

FINDINGS

There was a statistically significant difference in the classroom engagement scores between team- and lecture-based learning (P < 0.0001) with a median of 39.0 and 33.0 in the team-based learning and lecture-based learning groups. For learning preference, the median TBL-SAI score was substantially above neutral. Across all team-based learning sessions, 100% of students were satisfied or strongly satisfied with the learning style as a valuable experience and as a way to learn course material, and only one student was not satisfied or strongly satisfied with team-based learning to improve problem solving skills.

DISCUSSION

The classroom engagement and learning style preference findings were consistent with previously published data in other clerkship settings. Student satisfaction was more consistent with team-based learning than with the lecture-based learning, which may be because of the consistent format whereas lecture-based learning style was faculty dependent.

CONCLUSION

Students preferred team-based learning and had improved engagement and satisfaction when compared to lecture-based learning. This study provides evidence in favour of team-based learning as a strategy to incorporate active learning in clerkship didactics.

Student feedback on team-based learning in a preclinical oral surgery course: A pilot study

Objectives

Team-based learning (TBL) is a student-centered method where learning can be promoted and facilitated by changing the traditional teaching lecture into an active, dynamic, and more engaging problem-solving process. The present study evaluated the student's learning experience and satisfaction using a TBL method in a preclinical oral surgery course.

Methods

Twelve TBL sessions were designed for second-year dental students. Six 3-h and 2-h sessions with various preclinical topics were conducted in academic Terms 1 and 2, respectively. Teaching activities such as tests and group discussions were included in the sessions. The last post-session questionnaire sought students' feedback and satisfaction to assess four parameters related to students' knowledge acquirement, interpersonal skills enhancement, learning environment, and teacher-student relationships.

Results

Most average scores of the responses agreed with the related statements in the four parameters. The results of the Pearson's correlation test revealed that there was a significant relationship (r = 0.735; P < 0.05) between the parameters of the 3-h and 2-h sessions.

Conclusion

The TBL method yielded positive and high levels of satisfaction, which may be attributed to the proper implementation of TBL methodology by the teacher and students.

Exploring the dynamics of situational interest in team-based learning in undergraduate medical education

BACKGROUND

Team-based learning (TBL) is a widely recognized instructional approach in medical education blending direct instruction with active-cooperative learning in small groups. While TBL is known to enhance knowledge acquisition, its impact on student motivation, particularly through situational interest, remains underexplored. This study aimed to investigate the development of situational interest across the distinct phases of TBL, focusing on how each phase (individual readiness assurance test; iRAT, team readiness assurance test; tRAT, and application exercise; AE) influences students' situational interest. The study sought to provide insights into the motivational dynamics underpinning TBL in a medical education setting.

METHODS

A total of 88 medical students participated in a TBL session on "Bleeding during Pregnancy." Situational interest was measured after each TBL phase. A one-way repeated-measures analysis of variance (ANOVA) was conducted to assess the fluctuation of situational interest throughout the session.

RESULTS

The analysis revealed significant variations in situational interest across different TBL stages. There was a significant increase in situational interest following the tRAT (p = .001). Post-tRAT, situational interest significantly decreased after the AE (p = .007), returning to levels observed at the session's start. Post hoc correlation analysis suggested a negative association between tRAT performance and situational interest, indicating heightened interest in response to awareness of knowledge gaps during the tRAT.

CONCLUSIONS

The findings of this study may challenge the traditional view of TBL, suggesting a more integrated and dynamic interplay between knowledge acquisition and application phases. The results highlight the importance of the AE phase in clinical education and suggest that situational interest is one key driver in the learning process within TBL. Future research should focus on replicating these findings and comparing situational interest development between pre-clinical and clinical student cohorts to further understand the effects of situational interest on TBL in medical education.

Effect of Tronclass combined with team-based learning on nursing students' self-directed learning and academic performance: a pretest-posttest study

BACKGROUND

Self-directed learning ability is crucial for lifelong learning. The inadequate self-directed learning ability of nursing students in China may be due to their deficiency in self-management or learning initiative.

OBJECTIVE

To explore the effect of online learning platform (Tronclass) combined with team-based learning on nursing students' self-directed learning and academic performance.

DESIGN

Pretest-posttest design.

PARTICIPANTS

From March to July 2023, 69 undergraduate third-year nursing students from a university in Hunan Province were selected through a whole-group sampling method.

METHODS

This study used Tronclass to carry out team-based learning in the teaching process of pediatric nursing courses. It compared the self-directed learning ability nursing students before and after courses, and juxtaposed their academic performance with those of their counterparts who graduated in previous years.

RESULTS

When comparing compare motivation, self-management, teamwork and information literacy, which are four subscale aspects of the self-directed Learning Ability Scale, the post-survey scores for these four dimensions are greater than the pre-survey results. The results of the study showed a statistically significant difference (P < 0.05), in the students who engaged in Tronclass combined with team-based learning. Specifically, these students received higher midterm and final grades than to those who had already graduated and did not participate in these activities. (P < 0.05).

CONCLUSION

Combining Tronclass with team-based learning enhances nursing students' ability to engage in self-directed learning and improves their performance in midterms and finals, thereby fostering the development of comprehensive competence.

Application of Emerging Teaching Models in Dental Education: A Systematic Review and Meta-Analysis

INTRODUCTION AND AIMS

As an experimental teaching method, emerging learning methods including problem-based learning (PBL), case-based learning, team-based learning and flipped classroom (FC) have been widely applied in dental education. This study aims to evaluate the effect of these teaching methods on dental education performance compared to traditional lecture-based learning (LBL).

METHODS

The search was carried out in April 2024 in PubMed, EMBASE, Web of Science, and Cochrane Library. All randomized controlled trials were included and the methodological quality assessment was based on the guidelines described in the Cochrane Handbook for Systematic Reviews, followed by a meta-analysis using Stata 14.0 software. Using standard mean deviation (SMD) and 95% confidence interval (95% CI) to determine the effectiveness of emerging teaching methods and LBL in all dental disciplines. Meta-regression was used to analyse sources of heterogeneity. Sensitivity analysis was performed to determine the stability, and Begg's analysis was used to determine whether there is publication bias.

RESULTS

A total of 29 randomized controlled trials including 3502 students were included. The results indicate that emerging educational methods have a significantly positive effect on achieving higher scores (SMD = 0.48, 95% CI = 0.34-0.62, P < .001), whether it was theoretical scores (SMD = 0.52, 95% CI = 0.32-0.72, P < .001) or skill scores (SMD = 0.45, 95% CI = 0.15-0.76, P < .001). Compared to LBL, PBL (SMD = 0.33, 95% CI = 0.01-0.65, P = .045) and FC (SMD = 0.50, 95% CI = 0.31-0.69, P < .001) can both significantly improve students' academic performance.

CONCLUSION

Compared to LBL, emerging educational methods (PBL, case-based learning, and FC) have significantly improved the learning effectiveness of dental students. These emerging educational methods can be advocated and popularized as routine teaching methods.

CLINICAL RELEVANCE

This study is the first meta-analysis of the effects of emerging teaching methods in dental education which shows great impact of emerging teaching methods on students' development.

Team-based learning in Indonesian midwifery education: Implementation research

AIM

This study aims to implement team-based learning (TBL) and assess the impact on faculty members and students within midwifery education in Indonesia.

METHODS

Proctor's Framework for Implementation Research serves as the guiding approach in investigating the role of implementation strategies in implementing TBL within the context of midwifery education. The RE-AIM (Reach, Efficacy, Adoption, Implementation, and Maintenance) framework was utilized to assess the outcome.

RESULTS

In this study, the implementation of TBL has demonstrated significant reach, with broad participation among both faculty and students in two schools. The efficacy of TBL is evident through enhanced student knowledge, engagement and active learning. Adoption of TBL was observed in both schools, with faculty and students expressing interest and active participation. High levels of implementation fidelity were maintained, even though with challenges related to preparation and implementation. These findings suggest that TBL can be successfully integrated into midwifery education, with positive implications. Regarding maintenance, faculty members have expressed their intention to continue using TBL in various topics for future lectures.

CONCLUSIONS

The implementation of TBL in Indonesian midwifery education has shown substantial reach and efficacy. Faculty and students are highly interested in adopting TBL for future use. Despite some implementation challenges, the study suggests that TBL can be effectively incorporated with minor adjustments, emphasizing its feasibility and potential impact. This research contributes to understanding TBL's applicability in various educational settings, especially in low-resource institutions.

Improving Healthcare Professionals' Access to Addiction Medicine Education Through VHA Addiction Scholars Program

Introduction

The seemingly inexorable rise of opioid-related overdose deaths despite the reduced number of COVID-19 pandemic deaths demands novel responses and partnerships in our public health system's response. Addiction medicine is practiced in a broad range of siloed clinical environments that need to be included in addiction medicine training beyond the traditional fellowship programs. Our objective in this project was to implement a knowledge-based, live virtual training program that would provide clinicians and other healthcare professionals with an overview of addiction, substance use disorders (SUD), and clinical diagnosis and management of opioid use disorder (OUD).

Methods

The Veterans Health Administration (VHA) Emergency Department Opioid Safety Initiative (ED OSI) offered a four-day course for healthcare professionals interested in gaining knowledge and practical skills to improve VHA-based SUD care. The course topics centered around the diagnosis and treatment of SUD, with a focus on OUD. Additionally, trainees received six months of support to develop addiction medicine treatment programs. Evaluations of the course were performed immediately after completion of the program and again at the six-month mark to assess its effectiveness.

Results

A total of 56 clinicians and other healthcare professionals participated in the Addiction Scholars Program (ASP). The participants represented nine Veteran Integrated Service Networks and 21 different VHA medical facilities. Nearly 70% of participants completed the initial post-survey. Thirty-eight respondents (97.4%) felt the ASP series contained practical examples and useful information that could be applied in their work. Thirty-eight respondents (97.4%) felt the workshop series provided new information or insights into the diagnosis and treatment of SUD. Eleven capstone projects based on the information acquired during the ASP were funded (a total of $407,178). Twenty participants (35.7%) completed the six-month follow-up survey. Notably, 90% of respondents reported increased naloxone prescribing and 50% reported increased prescribing of buprenorphine to treat patients with OUD since completing the course.

Conclusion

The ASP provided healthcare professionals with insight into managing SUD and equipped them with practical clinical skills. The students translated the information from the course to develop medication for opioid use disorder (M-OUD) programs at their home institutions.

Team-, case-, lecture- and evidence-based learning in medical postgraduates training

BACKGROUND

The aim of this study was to evaluate the effectiveness of team-, case-, lecture-, and evidence-based learning (TCLEBL) methods in cultivating students' clinical and research abilities, as compared to traditional lecture-based learning (LBL) approaches.

METHODS

Forty-one medical postgraduates were divided into two groups, a TCLEBL group and an LBL group. Teaching effectiveness was evaluated through student- and teacher-feedback questionnaires, scores from theoretical examinations and written literature reviews, and student learning burdens.

RESULTS

Compared to the LBL approach, both teachers and students were more satisfied with the TCLEBL model (p < 0.001 for both teachers and students). The TCLEBL group performed significantly higher on the theory test compared to the LBL group (p = 0.009). There were significant differences between the LBL and TCLEBL groups, respectively, in terms of literature review and citations (12.683 ± 2.207 vs. 16.302 ± 1.095, p < 0.001), argument and perspective (12.55 ± 1.572 vs. 16.333 ± 1.354, p < 0.001), comprehensiveness of content (13.3 ± 2.268 vs. 16.683 ± 1.344, p < 0.001), and scientific rigor and accuracy (10.317 ± 1.167 vs. 12.746 ± 0.706, p < 0.001). There was no significant difference in the total extracurricular time expended between the two groups (323.75 ± 30.987 min vs. 322.619 ± 24.679 min, respectively for LBL vs. TCLEBL groups, p = 0.898).

CONCLUSIONS

TCLEBL is an effective teaching method that cultivates students' clinical and research abilities.

Using Team-Based Learning to Teach Pharmacology within the Medical Curriculum

The primary goal of pharmacology teaching is to prepare medical students to prescribe medications both safely and efficiently. At the Utrecht University Medical School, pharmacology is integrated into the three-year bachelor's curriculum, primarily through large group sessions with limited interaction. A recent evaluation highlighted students' appreciation for pharmacology teaching, but students admitted to attending these teaching moments unprepared, resulting in passive learning. To address this, team-based learning (TBL) was implemented to facilitate learning through interaction, critical thinking, problem solving and reflection through six steps, from superficial to deeper cognitive learning. This study, conducted over two academic years, assessed students' perception and performance regarding TBL. Analysis of a digital questionnaire using a 5-point Likert scale showed high student satisfaction with TBL as a teaching methodology. However, confidence in pharmacology knowledge following TBL was moderate. TBL attendees outperformed non-attendees in pharmacology-related exam questions, indicating that TBL has a positive impact on student performance. We conclude that TBL is an engaging and effective method for pharmacology education, positively influencing student learning and performance. This method could be broadly applied for teaching pharmacology within the medical curriculum or other biomedical programs.

Inquiry-Team-Based Lab Course Design Enhances Underrepresented Undergraduate Predictors of Persistence in the Sciences

Introduction

Persistence in Science, Technology, Engineering, and Mathematics (STEM) may be promoted in underrepresented student populations by implementing an authentic inquiry-team-based learning (ITBL) STEM laboratory course design.

Methods

Between Spring 2021 and Spring 2022, the research team compared junior and senior undergraduates enrolled in an ITBL-based pharmaceutical science lab course to a comparative student population enrolled in a traditionally designed biology lab course. At the end of either STEM lab course, students completed the experimentally validated Persistence in the Sciences (PITS) survey and an open-ended question asking them to recount a moment that validated or questioned their science identity determined the effect of the ITBL STEM lab course design on factors that may impact underrepresented students' indicators of science identity formation and persistence in STEM.

Results

Students taking an ITBL-based pharmaceutical sciences lab course demonstrated higher scores on the persistence in the sciences instrument compared to students in the traditionally designed biology lab. Interestingly, different underrepresented student communities scored differently among the six factors. Multiple mechanisms of validating science identity were cited by students such as through gaining confidence in individualistic laboratory performance, collaborating through learning barriers, and fostering confidence and societal impact in a future career in pharmacy.

Conclusion

The pharmaceutical sciences ITBL lab offered a collaborative, growth-promoting environment with experiments that are authentic to perspective pharmacists, which resulted in students reporting higher persistence in the sciences scores indicative of feeling like a pharmacist such as project ownership content/emotion, science identity, and networking across various student demographics.

The outcomes of team-based learning vs small group interactive learning in the obstetrics and gynecology course for undergraduate students

INTRODUCTION

Team-based learning (TBL) is a well-established active teaching method which has been shown to have pedagogical advantages in some areas such as business education and preclinical disciplines in undergraduate medical education. Increasingly, it has been adapted to clinical disciplines. However, its superiority over conventional learning methods used in clinical years of medical school remains unclear. The aim of this study was to compare TBL with traditional seminars delivered in small group interactive learning (SIL) format in terms of knowledge acquisition and retention, satisfaction and engagement of undergraduate medical students during the 6-week obstetrics and gynecology clerkship.

MATERIAL AND METHODS

The study was conducted at Karolinska Institutet, a medical university in Sweden, and had a prospective, crossover design. All fifth-year medical students attending the obstetrics and gynecology clerkship, at four different teaching hospitals in Stockholm (approximately 40 students per site), in the Autumn semester of 2022 were invited to participate. Two seminars (one in obstetrics and one in gynecology) were designed and delivered in two different formats, ie TBL and SIL. The student:teacher ratio was approximately 10:1 in the traditional SIL seminars and 20:1 in the TBL. All TBL seminars were facilitated by a single teacher who had been trained and certified in TBL. Student knowledge acquisition and retention were assessed by final examination scores, and the engagement and satisfaction were assessed by questionnaires. For the TBL seminars, individual and team readiness assurance tests were also performed and evaluated.

RESULTS

Of 148 students participating in the classrooms, 132 answered the questionnaires. No statistically significant differences were observed between TBL and SIL methods with regard to student knowledge acquisition and retention, engagement and satisfaction.

CONCLUSIONS

We found no differences in student learning outcomes or satisfaction using TBL or SIL methods. However, as TBL had a double the student to teacher ratio as compared with SIL, in settings where teachers are scarce and suitable rooms are available for TBL sessions, the method may be beneficial in reducing faculty workload without compromising students' learning outcomes.

Opening the black box of team-based learning (TBL): A study of verbal interactions in online application sessions

CONTEXT

In team-based learning (TBL), an instructional strategy that encourages in-depth team discussion and deep learning, interactions in terms of sharing, co-construction, constructive conflict and procedural interactions are important. Since TBL has also been applied online in recent years, the question is whether these interactions are sufficiently present in an online setting.

AIM

Gain insight into the nature and extent of these types of interactions in online TBL application sessions and to what extent these vary between teams and sessions.

METHODS

We made audiovisual recordings of 12 TBL teams in two online application sessions during assignments. Transcripts were coded and analyzed using a framework derived.

RESULTS

Teams spent more than 85% of their time on all four types of interactions in both sessions. The largest proportion of time was spent on sharing and co-construction. Constructive conflict occurred to a limited extent. We observed variation in proportion of time spent on and the distribution of the four types of interactions between teams and sessions.

DISCUSSION

All interactions important for achieving deep learning occurred in online TBL application sessions. However, the effective use of these types of interaction should not be left to chance.

Applying simulation learning theory to identify instructional strategies for Generation Z emergency medicine residency education

Introduction

Generation Z learners are entering emergency medicine (EM) residency training, bringing unique learning preferences that influence their engagement with residency education. To optimally teach and motivate this incoming generation of learners, EM educators must understand and adapt to the changing instructional landscape.

Methodology

The Simulation Leaders Advancing the Next Generation in Emergency Medicine (SLANG-EM) Workgroup was created to identify effective educational strategies for Generation Z learners entering EM. Members were faculty in the Society for Academic Emergency Medicine (SAEM) Simulation Academy, well versed in learning theory supporting simulation-based education (SBE) and actively involved in EM residency education.

Unique treatment/analysis

Through primary and secondary literature searches, the SLANG-EM Workgroup identified four distinctive learning preferences of Generation Z learners: (1) individualized and self-paced learning, (2) engaging and visual learning environments, (3) immediate and actionable feedback, and (4) combined personal and academic support. Workgroup members evaluated these learning preferences using a novel conceptual framework informed by the theoretical principles underpinning SBE, recommending instructional strategies for Generation Z EM residency learners across multiple educational environments.

Implications for educators

Instructional strategies were described for the didactic, simulation, and clinical learning environments. In the didactic environment, identified instructional strategies included meaningful asynchronous education, interactive small-group learning, and improved multimedia design. In the simulation environment, educational innovations particularly suitable for Generation Z learners included learner-centered debriefing, rapid-cycle deliberate practice, and virtual simulation. In the clinical environment, described instructional strategies involved setting learner-centered goals and delivering facilitative feedback in the context of an educational alliance. Overall, these instructional strategies were clustered around themes of student-centered education and the educator as facilitator, which align well with Generation Z learning preferences. These findings were synthesized and presented as an advanced workshop, "Delivering Effective Education to the Next Generation," at the 2023 SAEM Annual Meeting.

An early-curricular team learning activity to foster integration of biochemical concepts and clinical sciences in undergraduate medical education

The ability to connect key concepts of biochemistry with clinical presentations is essential for the development of clinical reasoning skills and adaptive expertise in medical trainees. To support the integration of foundational and clinical sciences in our undergraduate health science curricula, we developed a small group active learning exercise during which interprofessional groups of students use clinical cases to explore the biochemistry, diagnostic strategy, and evidence-based treatment options of inborn errors of metabolism (IEM). We designed multistage learning modules consisting of (1.) low-fidelity case simulations of pediatric patients presenting with IEMs, (2.) guided group discussions on clinical biochemistry, differential diagnoses, and diagnostic strategies, (3.) oral presentations of clinical reasoning strategies, and (4.) discussion of relevant evidence-based medicine topics related to the cases. These modules Scientific Knowledge Integrated in Patient Presentations (SKIPPs) were added to a first-semester foundational sciences course serving five health professions programs. The assessment of learning outcomes by students and faculty shows that SKIPPs sessions are well-received activities that significantly improve trainees' ability to integrate foundational science concepts into clinical scenarios, to practice interprofessional teamwork and to develop clinical reasoning skills.

The Use of Animations Depicting Cardiac Electrical Activity to Improve Confidence in Understanding of Cardiac Pathology and Electrocardiography Traces Among Final-Year Medical Students: Nonrandomized Controlled Trial

Background

Electrocardiography (ECG) interpretation is a fundamental skill for medical students and practicing medical professionals. Recognizing ECG pathologies promptly allows for quick intervention, especially in acute settings where urgent care is needed. However, many medical students find ECG interpretation and understanding of the underlying pathology challenging, with teaching methods varying greatly.

Objective

This study involved the development of novel animations demonstrating the passage of electrical activity for well-described cardiac pathologies and showcased them alongside the corresponding live ECG traces during a web-based tutorial for final-year medical students. We aimed to assess whether the animations improved medical students' confidence in visualizing cardiac electrical activity and ECG interpretation, compared to standard ECG teaching methods.

Methods

Final-year medical students at Imperial College London attended a web-based tutorial demonstrating the 7 animations depicting cardiac electrical activity and the corresponding ECG trace. Another tutorial without the animations was held to act as a control. Students completed a questionnaire assessing their confidence in interpreting ECGs and visualizing cardiovascular electrical transmission before and after the tutorial. Intervention-arm participants were also invited to a web-based focus group to explore their experiences of past ECG teaching and the tutorial, particularly on aspects they found helpful and what could be further improved in the tutorial and animations. Wilcoxon signed-rank tests and Mann-Whitney U tests were used to assess the statistical significance of any changes in confidence. Focus group transcripts were analyzed using inductive thematic analysis.

Results

Overall, 19 students attended the intervention arm, with 15 (79%) completing both the pre- and posttutorial questionnaires and 15 (79%) participating in focus groups, whereas 14 students attended the control arm, with 13 (93%) completing both questionnaires. Median confidence in interpreting ECGs in the intervention arm increased after the tutorial (2, IQR 1.5-3.0 vs 3, IQR 3-4.5; P<.001). Improvement was seen in both confidence in reviewing or diagnosing cardiac rhythms and the visualization of cardiac electrical activity. However, there was no significant difference between the intervention and control arms, for all pathologies (all P>.05). The main themes from the thematic analysis were that ECGs are a complex topic and past ECG teaching has focused on memorizing traces; the visualizations enabled deeper understanding of cardiac pathology; and ECG learning requires repetition, and clinical links remain essential.

Conclusions

This study highlights the value of providing concise explanations of the meaning and pathophysiology behind ECG traces, both visually and verbally. ECG teaching that incorporates relevant pathophysiology, alongside vignettes with discussions regarding investigations and management options, is likely more helpful to students than practices based solely on pattern recognition. Although the animations supported student learning, the key element was the tutor's explanations. These animations may be more helpful as a supplement to teaching, for instance, as open-access videos.

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.

Pharmacy Students' Attitudes Toward Distance Learning After the COVID-19 Pandemic: Cross-Sectional Study From Saudi Arabia

BACKGROUND

Electronic learning refers to the use of assistive tools in offline and distance learning environments. It allows students to access learning tools and materials anytime and anywhere. However, distance learning courses depend on several factors that affect the quality of learning, which consequently affect students' preferences in the settings and tools used to deliver educational materials.

OBJECTIVE

This study aimed to evaluate students' preferences for continuing distance learning after the pandemic and to assess the distance educational environment after the pandemic. It also aimed to identify the factors affecting distance learning and evaluate students' preferences regarding modes of communication with instructors.

METHODS

A web-based survey was used to conduct this cross-sectional study. The target participants of this study were students in the doctor of pharmacy program at Unaizah College of Pharmacy, Qassim, Saudi Arabia. All students enrolled from December 2022 to January 2023 received an invitation with a link to the web-based survey.

RESULTS

The survey was completed by 141 students (58 female students and 83 male students). The research results showed that most students (102/141, 72.3%) did not wish to continue distance education for laboratory courses, and 60.3% (85/141) did not wish to continue taking distance team-based learning after the pandemic. Additionally, 83.7% (118/141) of the students indicated that distance courses were simple. More than half of the participants (79/141, 56%) stated that having a camera on during class negatively impacted their learning, and only 29.1% (41/141) of the students stated that nonvisual communication with their fellow students impacted their learning. A large proportion of students (83/141, 58.9%) reported impairment of social engagement on campus, 44% (62/141) in-person interactions during classes, and 73.7% (104/141) were relieved that their classes were not disrupted.

CONCLUSIONS

Similar to all types of education, distance learning is characterized by advantages and disadvantages, as reported by students. Students felt that the course material was intelligible, and the distance course was uncomplicated. Moreover, they expressed relief that their studies were not disrupted. However, they also reported the loss of face-to-face contact during courses as the most significant drawback of distance learning versus face-to-face learning, followed by a lack of social connection on campus.

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.

Inconvenient sampling: Community-engaged and restorative justice approaches to genetic counseling student research

Genetic counseling research requires a comprehensive approach since it frequently serves as the foundation for clinical care practice. Genetic counseling students play a pivotal role in advancing the profession, as they contribute a significant proportion of the research conducted within the genetic counseling community. However, a prevailing trend of convenience sampling of genetic counselors has limited the diversity of perspectives in student research projects. This article promotes a strategy for greater inclusivity and equity in research by emphasizing community-engaged and empowered research through the perspective of restorative justice. Reflecting on the shadow of the harmful ideologies of eugenics in our profession underscores the need to amplify patients' voices and diverse experiences. Community-engaged research-in collaboration with individuals, families, and communities directly impacted by genetic counseling-transcends traditional research paradigms, empowering patients and addressing systemic inequities. Incorporating community-engaged research into genetic counseling student projects aims to empower future professionals to better understand patient perspectives and needs while working toward addressing historical injustices. This article explores the potential benefits and pathways of incorporating community-engaged research and restorative justice principles into genetic counseling scholarly work, promoting empathy, cultural responsiveness, and ultimately, a more patient-centered approach to research and clinical care. By embracing this collective journey toward authentic partnership in the production of high-quality evidence in genetic counseling student research and more broadly, genetic counseling can become a more just and inclusive practice.

A mixed methods, longitudinal study: characterizing the differences in engagement and perceived learning of medical students in online and in-person team-based learning classes

Background

The rapid transition to online delivery of medical curriculum has facilitated the continuation of medical education during the COVID-19 pandemic. Whilst active learning approaches, including Team-Based Learning (TBL), are generally more supportive of the learner's needs during such transition, it remains elusive how different learning environments affect a learner's motivation, engagement, and perceived learning over a prolonged period. We leveraged on Self-Determination Theory (SDT) and key learners' characteristics to explore the levels of student's engagement and perceived learning in two TBL learning environments, online and in-person, over an extended period. We hypothesize that students' self-reported perceptions of engagement and learning will be lower in online compared to in-person TBL classes.

Methods

This is a mixed methods study with 49 preclinical graduate medical students completing the same questionnaire twice for each learning environment, online TBL and in-person TBL, over an eight-month period. Quantitative data were collected on learners' characteristics, basic psychological needs satisfaction, motivation, student's engagement and perceived learning. The final questionnaire also explored participants' perception on which learning environment better supported their learning.

Results

We found that autonomy support, perceived competence and needs satisfaction, and perceived learning were higher in-person than online. Additionally, most learners felt that in-person TBL was better for learning, as the concepts of learning space and the community of practice were mediated by being in-person.

Conclusions

TBL, being an active instructional method, can maintain students' engagement because it supports many aspects of SDT constructs and perceived learning. However, online TBL is unable to fully support the students' needs and perceived learning. Hence, we strongly advocate for any in-person opportunities to be included in a course, as in-person classes best supports students' engagement and perceived learning.

An Opportunity for Change: Principles for Reforming Internal Medicine Inpatient Conferences

Inpatient educational conferences are a key part of internal medicine residency training. Many residencies made conferences virtual during the COVID-19 pandemic, and are now returning to in-person sessions. As we navigate this change, we can seize this opportunity to re-evaluate the role that inpatient conferences serve in resident education. In this paper, we briefly review the history of inpatient educational conferences before offering five recommendations for improvement. Our recommendations include grounding conference formats in educational theory, leveraging the expertise of all potential educators, broadening content to include health equity and justice throughout all curricula, and explicitly focusing on cultivating community among participants. Recognizing that each residency program is different, we anticipate that these recommendations may be implemented differently based on program size, available resources, and current institutional practices. We also include examples of prior successful curricular reforms aligned with our principles. We hope these recommendations ensure inpatient conferences continue to be a central part of residency education for future generations of internal medicine residents.

Impact of Team-Based Learning on the Development of Critical Thinking Disposition in Entry-Level Master's Nursing Students

ABSTRACT

Team-based learning (TBL) is an evidence-based teaching-learning strategy increasingly used in nursing education to improve student learning outcomes. Few studies have focused on its effects on the critical thinking disposition of second-degree nursing students enrolled in accelerated, entry-level master's programs. The purpose of this study was to evaluate the impact of TBL on the critical thinking disposition of entry-level master's nursing students. Critical thinking disposition scores did not significantly improve, but students' confidence in reasoning skills and intellectual curiosity were strengthened, suggesting that TBL is an instructional strategy worth pursuing in entry-level master's nursing programs.

Team-based learning (TBL) in clinical disciplines for undergraduate medical students-a scoping review

BACKGROUND

Team-based learning (TBL) is an evidence-based pedagogical method that has been used in undergraduate medical education since 2001. However, its use in clinical disciplines is rarely reported, and the impact of its implementation is not known. The aim of this study was to explore and map the published literature on the impact of implementing TBL in clinical disciplines in undergraduate medical education.

METHODS

A comprehensive search of Medline, Education Resources Information Center (ERIC), and Web of Science databases was performed on November 24, 2021 and updated April 6, 2023, using relevant Medical Subject Headings (MeSH) and free-text terms. Original research studies reporting on the implementation of TBL in clinical disciplines in undergraduate medical education published in peer-reviewed English language journals were included irrespective of their methodological design.

RESULTS

The initial search identified 2,383 records. Of these, 49 met the inclusion criteria. Most of the studies (n = 44, 90%) described the implementation of a modified version of TBL in which one or more TBL steps were missing, and one study had undefined protocol for the implementation. The most reported outcomes were knowledge acquisition (n = 38, 78%) and students' satisfaction or attitudes toward TBL (n = 34, 69%). Despite some differences in their results, the studies found that implementing TBL is associated with increased knowledge acquisition (n = 19, 39%), student engagement (n = 6, 12%), and student satisfaction (n = 31, 63%).

CONCLUSIONS

Most of the studies reported positive results in students' satisfaction and students' engagement, whilst the results on knowledge acquisition and retention were more contradictory. In most of the studies, TBL was implemented in a modified form and diverse comparators were used. The methodological quality also varied. Thus, no unequivocal conclusions could be drawn regarding the value of implementing TBL in clinical disciplines. More studies with rigorous methodologies are needed in this field.

Employment of Small-Group Discussions to Ensure the Effective Delivery of Medical Education

The changing landscape of medical education has made small-group discussions crucial components. These sessions, including problem-based learning (PBL), case-based learning (CBL), and team-based learning (TBL), revolutionize learning by fostering active participation, critical thinking, and practical skills application. They bridge theory with practice, preparing future healthcare professionals for the dynamic challenges of modern healthcare. Despite their transformative potential, there are challenges in faculty preparation, resource allocation, and effective evaluation. The best practices include aligning discussions with curriculum goals, skilled facilitation, promoting active participation, and robust assessment strategies. Looking ahead, adapting to emerging health trends, ongoing research, and evolving healthcare demands will ensure the continued relevance and effectiveness of small-group discussions, shaping competent and adaptable healthcare providers equipped for the ever-evolving healthcare landscape.

Pathology teaching in different undergraduate medical curricula within and outside the United States: a pilot study

Pathology education is taught using different curricula in the United States (USA) and abroad. We evaluate and compare the hours spent in different forms of pathology teaching such as lectures, team-based learning (TBL), problem-based learning (PBL), and other methods taught in general and systemic pathology amongst different medical schools within the USA and outside the USA. The total number of lecture hours taught in general and systemic pathology combined was greater in outside schools than within the USA (141 h vs 97.8 h, respectively). Three subjects in general pathology and six subjects in systemic pathology had a significantly greater lecture hours in outside medical schools. The greatest difference was the hours spent in labs were longer for both general and systems pathology in schools outside the USA. The overall utilization of PBL in general and systemic pathology teaching combined was much greater outside the USA compared to within the USA (average overall hours PBL - 97.2 outside vs 16.5 in the USA), however, the reverse was observed for using TBL (average overall hours TBL - 59.5 outside vs 84.5 in USA). Average hours used with other methods of teaching was also greater in outside medical schools compared to USA medical schools (80.8 h vs 44 h, respectively). Pathology teaching in both general and systemic pathology has more extensive lecture hours, laboratory hours, PBL, and other methods of teaching pathology in outside medical schools with different curricula than USA medical schools. TBL is utilized more extensively in USA medical schools.

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.

Understanding medical professionalism using express team-based learning; a qualitative case-based study

Medical Professionalism (MP) defined as values, behaviours and attitudes that promote professional relationships, public trust and patient safety is a vital competency in health profession education. MP has a distinctive uniqueness due to cultural, contextual, conceptual, and generational variations. There is no standard instructional strategy to probe the understanding of MP in a cohesive, structured, interactive manner. This study aimed to investigate undergraduate medical students' understanding of MP using express team-based learning (e-TBL) at both campuses of Royal College of Surgeons Ireland (RCSI). Using the key principles of a sociocultural theoretical lens in adult learning theory, we designed e-TBL as a context-learning-based educational strategy. We conducted three e-TBL sessions on cross-cultural communication and health disparities, a reflective report on clinical encounters, and professionalism in practice. We collected, collated, and analyzed the student experiences qualitatively using data gathered from team-based case discussions during e-TBL sessions. A dedicated working group developed very short-answer questions for the individual readiness assurance test (IRAT) and MP-based case scenarios for team discussions. In this adapted 4-step e-TBL session, pre-class material was administered, IRAT was undertaken, and team-based discussions were facilitated, followed by facilitator feedback. A qualitative inductive thematic analysis was performed, which generated subthemes and themes illustrated in excerpts. Our thematic analysis of data from 172 students (101 from Bahrain and 71 from Dublin) yielded four unique themes: incoming professional attitudes, transformative experiences, sociological understanding of professionalism, and new professional identity formation. This qualitative study provides a deeper understanding of medical students' perceptions of medical professionalism. The generated themes resonated with divergent and evolving elements of MP in an era of socioeconomic and cultural diversity, transformative experiences, and professional identity formation. The core elements of these themes can be integrated into the teaching of MP to prepare fit-to-practice future doctors.

Effectiveness of the refined health literacy course on improving the health literacy competencies of undergraduate nursing students: quantitative and qualitative perspectives

People with limited health literacy comprise a high-risk group for adverse health outcomes. Nurses must be made aware of the importance of health literacy and communicate with patients in plain language, which will solve the obstacles for patients using health care services. Providing health literacy education for nurses is an important strategy for health literacy practices. This study aimed to develop a refined health literacy course for nursing students and evaluate its effectiveness. The study used a single-group pre- and post-test quasi-experimental design and conducted focus group interviews. The intervention was an eight-hour course and applied team-based learning combined with various teaching methods. The study enrolled second-year nursing students of a university in eastern Taiwan via convenient sampling. A self-reported structured questionnaire was used to compare the participants' familiarity with health literacy, attitude, confidence in oral communication, and ability in written communication before and after the course. To discuss the learning experience of the course, the study held two focus groups with 12 participants. A total of 81 participants completed the pre- and post-test questionnaires. The results showed that familiarity with health literacy (t=9.12, t<.001), attitude (t=4.89, t<.001), confidence in oral communication (t=4.12, t<.001), and ability in written communication (t=8.83, t<.001) showed improvement after the course. Data analysis of focus group interviews yielded two categories and seven themes for the learning experience, most of which showed participants' positive learning experiences in the health literacy course. The course effectively enhanced the nursing students' knowledge and attitude toward health literacy and the ability to communicate with patients using health literacy principles. The results can provide a reference for integrating health literacy education into the undergraduate nursing curriculum.

An innovative and collaborative teaching approach to delivering mental health capabilities in the UK Foundation Programme Curriculum 2021

About 45% of foundation doctors in the UK now have a placement in psychiatry. However, the current UK Foundation Programme Curriculum states that all foundation doctors need to demonstrate basic mental health-related capabilities. To address this we developed a novel teaching approach to cover these new capabilities using principles of team-based learning (TBL). This can be delivered to all foundation doctors both face to face and online using case scenarios and in no more than 4 hours over the 2-year foundation programme. The approach can be easily be replicated, but collaboration between mental health and acute trusts is essential for delivery.

Comparison of Didactic Lectures and Activity-Based Learning for Teaching First-Professional MBBS Students in the Subject of Anatomy

Background In the field of medical education, traditional methods of teaching and learning have been used for a long time. Various new methods of learning, like activity-based learning (ABL), case-based discussion (CBD), and problem-based learning (PBL), are laying the foundation for this modern era of teaching. This study was a comparative study conducted to determine the effectiveness of activity-based learning and traditional lectures by teaching two topics to MBBS first-year professional students. Aims The study compares the effectiveness of didactic lectures and activity-based learning for MBBS first-year professional students in the subject of anatomy.  Methodology The study was conducted in the Department of Anatomy Hind Institute of Medical Sciences, Barabanki, and included 100 MBBS (2022-2023) first-year students randomly assigned to Group A (n=50, 16 females and 34 males) and Group B (n=50, 23 females and 27 males) through chit methods. The participants were exposed to two different topics of anatomy in the form of activity-based learning as well as didactic lectures. Assessments were done immediately after the exposure in the form of a post-test, and results were analyzed for both groups. Result The results of the study showed that both activity-based learning and didactic lectures were effective in teaching the two topics, but the didactic lecture group had higher retention rates than the activity-based learning group. The mean score of post-tests of students who attended a didactic lecture on the brachial plexus (6.166± 2.11) was slightly higher than that obtained by students who attended activity-based learning (5.625 ± 2.12), but the p-value obtained was not significant (0.249). Whereas the mean of the scores of the post-test obtained by students who attended a didactic lecture on mammary gland was (8.45± 1.20), slightly lower than the mean of the scores of the post-test of students who attended activity-based learning on mammary gland (8.60± 1.16), but the p-value obtained was not significant (0.520). Conclusion This study provides evidence that didactic lectures play an important role in teaching anatomy to MBBS first-year students and cannot be replaced by activity-based learning alone. Lectures followed by activity-based learning can prove to be a newer and more effective teaching-learning method with better outcomes in the form of retention and conceptual understanding of the topics in anatomy.

"It kinda helped us to be there": students' perspectives on the use of virtual patient software in psychiatry posting

BACKGROUND

At the Faculty of Medicine of the National University of Malaysia, a virtual patient software program, DxR Clinician, was utilised for the teaching of neurocognitive disorder topics during the psychiatry posting of undergraduate medical students in a modified team-based learning (TBL) module. This study aimed to explore medical students' learning experiences with virtual patient.

METHODS

Ten students who previously underwent the learning module were recruited through purposive sampling. The inclusion criteria were: (a) Fourth-year medical students; and (b) Completed psychiatry posting with the new module. Students who dropped out or were unable to participate in data collection were excluded. Two online focus group discussions (FGDs) with five participants each were conducted by an independent facilitator, guided by a questioning route. The data were transcribed verbatim and coded using the thematic analysis approach to identify themes.

RESULTS

Three main themes of their learning experience were identified: (1) fulfilment of the desired pedagogy (2), realism of the clinical case, and (3) ease of use related to technical settings. The pedagogy theme was further divided into the following subthemes: level of entry for students, flexibility of presentation of content, provision of learning guidance, collaboration with peers, provision of feedback, and assessment of performance. The realism theme had two subthemes: how much the virtual patient experience mimicked an actual patient and how much the case scenario reflected real conditions in the Malaysian context. The technical setting theme entailed two subthemes: access to the software and appearance of the user interface. The study findings are considered in the light of learning formats, pedagogical and learning theories, and technological frameworks.

CONCLUSIONS

The findings shed light on both positive and negative aspects of using virtual patients for medical students' psychiatry posting, which opens room for further improvement of their usage in undergraduate psychiatry education.

Do we need a co-pilot in the operating theatre? A cross-sectional study on surgeons' perceptions

OBJECTIVE

The aim of this original study was to investigate general surgeons' perceptions on the role of dual surgeon operating for high-risk, elective complex surgical procedures.

MATERIAL AND METHODS

A 21-part cross-sectional online survey was self-completed by 85 general surgeons across hospitals in the UK. The survey assessed the perception of dual surgeon operating on patient morbidity and mortality, surgeons' burnout rates, complaints, patient waiting times and overall trainee experience. Statistical analysis was performed using R version 3.6.1.

RESULTS

Overall 78.8% believed that dual surgeon operating could help to overcome these human factors. Sub-analysis includes improve surgeon fatigue (89.4%), improve confidence (83.5%), improve decision-making (76.5%), minimise technical error (69.4%), improve communication, team work and leadership skills (65.9%). 65.9% believed it would reduce surgeons' burnout. There was a statistically significant relationship between the participants believing it would reduce surgeons' burnout and those who felt it would reduce complaints, Chi-squared(4) = [30.8], p = [0.00000342]. A statistically significant relationship was noted between participants believing it would reduce surgeons' burnout and those who felt it would reduce patient mortality/morbidity, Chi-squared(4) = [19.9], p = [0.000517].

CONCLUSION

The survey has highlighted positive surgeons' perceptions regarding dual surgeon operating.

Flipped Classrooms in Medical Education: Improving Learning Outcomes and Engaging Students in Critical Thinking Skills

The flipped classroom (FC) model involves students independently acquiring knowledge before in-person class sessions, during which they engage in active discussions and problem-solving. Various methods to implement FC are quizzes, e-content, case-based learning, problem-based learning, and reading assignments. The advantages of the FC approach included improved student preparation, active participation, and the promotion of critical thinking skills. Some disadvantages identified are technical problems like internet connection, improper planning and preparation, which increases teacher workload, and lack of self-motivation. This review underscores the potential of the FC approach to improve medical education by promoting independent learning, active participation, and deeper understanding. Consideration of factors such as curriculum design, faculty development, technological infrastructure, and student readiness is vital for successfully implementing the FC model. Balancing self-directed study with meaningful face-to-face interactions remains crucial to harnessing the full benefits of this innovative approach. By leveraging technology and student-centered methods, medical educators can create an enriched learning experience that positively influences future healthcare professionals.

Learning How to Learn: An Innovative Medical School Orientation Activity

PROBLEM

In 2018, Creighton University School of Medicine initiated a multiyear strategy to redesign the pedagogic approach of its educational program, transitioning from large-group, lecture-based experiences to small-group, active learning experiences using case-based learning (CBL) as required prework for team-based learning (TBL). In July 2019, the authors introduced their first-year medical students to the pedagogic and empiric underpinnings of the new curriculum they would experience. Initially, and ironically, this introduction was presented as a 30-minute didactic lecture, and students' ability to assimilate this information in any meaningful way was challenged. In addition, students required several sessions of the CBL-TBL activities during the official curriculum before they were able to effectively function as a team of learners. The authors created a novel introduction to their educational program that was active, meaningful, and efficient.

APPROACH

In 2022, the authors created a 2-hour, small-group CBL activity using a fictional narrative of a medical student encountering their curriculum. During development, the authors recognized that the narrative was conducive to introduction of affective responses to medical education stressors, such as imposter phenomenon and Stanford duck syndrome. The CBL activity was given 4 hours during the formal 2022 orientation; 230 students participated. The CBL activity occurred on the second day of orientation and the TBL activity on the third (final) day of orientation.

OUTCOMES

The results of the TBL activity indicate that students acquired a fundamental understanding of the attributes of active learning, features of imposter syndrome, substance abuse associated with Stanford duck syndrome, and peer evaluation.

NEXT STEPS

This CBL-TBL activity will become a permanent part of orientation. The authors hope to evaluate the qualitative outcomes of this innovation on students' professional identity formation, institutional affiliation, and motivation. The authors will assess for any negative impact of this experience and the overall orientation.

Dental Education: A Guide for Novice Tutors

The primary objective of undergraduate-level dental education is to produce proficient dental practitioners who can effectively address the oral health needs of the community and enhance the overall oral health of the population. The field of dental education is subject to continuous change that is shaped by many factors, including changing societal norms, shifting responsibilities of dental practitioners, changing healthcare environments, and rapidly evolving dental science. Learning theories significantly impact the advancement of dental education, and educators must recognize and acknowledge their influence. Dental faculties must be adequately prepared and motivated to use innovations, which enable them to impart knowledge in a practical and organized manner. This review provides an overview of teaching methodologies that have gained acceptance in recent years. It highlights the importance of their implementation in facilitating an effective teaching and learning process in consideration of their history, style, and core focus. A clearer understanding of these techniques can enhance education standards, help establish dental instructors' responsibilities and career advancement, and provide insights for future research.

Effects of the mini-clinical evaluation exercise teaching mode based on nurse-faculty cooperation in Fundamentals of Nursing course: A quasi-experimental study

Objectives

This study aimed to explore the effects of the mini-clinical evaluation exercise (mini-CEX) teaching model based on nurse-faculty collaboration in Fundamentals of Nursing course.

Methods

A quasi-experimental design was conducted. A total of 111 nursing students of two parallel classes were recruited from a nursing college in Guilin, China from February to December 2022, and allocated to the intervention group (n = 56) and control group (n = 55). The intervention group received a mini-CEX teaching model based on nurse-faculty collaboration, the teaching-learning process included scenario creation (10 min), inquiry-based learning (30 min), case report (30 min), scenario simulation exercise (40 min), and effectiveness evaluation (10 min). While the control group received conventional teaching method. All students were invited to complete the College Classroom Climate Assessment Scale (CCCA) and the Chinese version of the Competency Inventory for Nursing Students (CINS-CV) before and after the intervention. Course achievement of students was evaluated. After the intervention, the intervention group was asked an open-ended question to explore the difficulties or challenges they had encountered.

Results

After intervention, the CCCA score (208.36 ± 23.25 vs. 190.60 ± 28.83), CINS-CV score(106.95 ± 14.48 vs. 99.55 ± 14.60), the oretical exam score (83.01 ± 4.27 vs. 79.75 ± 5.45), and scenario simulation exam score (89.23 ± 3.17 vs. 81.42 ± 7.19) of intervention group were higher than those of the control group (P＜0.01). The open-ended questionnaire survey revealed that the difficulties or challenges faced by the intervention group were mainly related to case analysis, group cooperation, learning material acquisition, and teacher guidance.

Conclusion

Applying the mini-CEX teaching model based on nurse-faculty collaboration could cultivate nursing students' competency, build a positive classroom climate, and improve the course achievement of students.

Team-based learning complemented by interactive response system: Application of a strategy on the course of human growth and development for nursing students

OBJECTIVE

Lecture-based learning (LBL) strategy cannot stimulate learners' ability to think and learn independently. Recently team-based learning (TBL), a learner-centered strategy, gained popularity in health education. An interactive response system (IRS) assists educators in providing instant feedback on classroom activities. This study was to evaluate the TBL strategy supplemented by IRS (TBL/IRS) on the learning effects of the core course, the human growth and development (HGD), in nursing education.

MATERIALS AND METHODS

A quasi-experimental study design with two-group, pretests and posttests was employed with year-one students enrolled in two HGD classes in the nursing department of a university in central Taiwan. Both HGD classes employed the LBL method at the beginning of a semester. TBL/IRS strategy was introduced to the experimental class 6 weeks later. Three scales were used to measure self-directed learning, classroom engagement, and team learning. Individual and group readiness assurance tests (IRATs and GRATs) were administered. Final exams were also compared between the groups. For thematic analysis, learners' experience with TBL/IRS was collected from learner reports and a semi-structured questionnaire designed for the study.

RESULTS

A total of 105 learners-48 in TBL/IRS and 55 in LBL-were recruited. Self-directed learning, classroom engagement and team learning were improved significantly in TBL/IRS whereas only self-directed learning was improved in LBL. In the TBL/IRS group, GRAT scores were significantly higher than IRAT. However, the difference in final exams between the groups was non-significant. Four themes emerged from learners' experiences with TBL/IRS: stimulate self-learning; a diverse and flexible learning method; promote high-level thinking and deepen learning results; and, cultivate teamwork and application.

CONCLUSIONS

This study confirmed that TBL/IRS was effective in enhancing learners' abilities to integrate concepts and skills, thereby cultivating competence in problem-solving and teamwork. The TBL/IRS strategy was cost-effective in promoting active learning of HGD in nursing students.

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.

Using team-based learning to optimize undergraduate family medicine clerkship training: mixed methods study

BACKGROUND

Team-Based Learning (TBL) is an established educational strategy which has become increasingly popular in the training of healthcare professionals. TBL is highly suitable for teaching Family Medicine (FM) especially that teamwork and collaborative care, in this medical discipline, are at the core of safe and effective practice. Despite the established suitability of TBL for teaching FM, there are no empirical studies that capture the students' perception of a TBL in FM undergraduate learning experience in the Middle East and North Africa region (MENA).

OBJECTIVE

The overall objective of this study was to investigate the perception of students regarding a TBL in FM intervention (in Dubai, United Arab Emirates), that was designed and implemented in alignment with a constructivist learning theory.

METHODS

A convergent mixed methods study design was utilized to develop a thorough understanding of the students' perceptions. Qualitative and quantitative data were concurrently collected and independently analyzed. The output of thematic analysis was systematically merged with the quantitative descriptive and inferential findings using the iterative joint display process.

RESULTS

The qualitative findings shed light on the students' perception of TBL in FM, and the interplay between team cohesion and engagement with the course. As for the quantitative findings, they showed that the percentage of the total average of the Satisfaction with TBL in FM score was 88.80%. As for change in impression of FM discipline, the percentage of the total average was 83.10%. The perception of team cohesion, with a mean of agreement of 8.62(1.34), seemed to be significantly associated with the students' perception of the team test phase component, only (P < 0.05). As for the perception of the level of engagement with the course, with a mean of agreement of 9.29(0.84), it turned out to be significantly associated with the change in impression of FM discipline (P < 0.05). Lastly, the joint display analysis showed how the quantitative and qualitative findings built upon each other, revealing how best to leverage TBL in FM trainings.

CONCLUSION

The current study showed that TBL embedded in a FM clinical clerkship was well-received by students. It is worth leveraging the lessons learned from the first-hand experience reported upon in the current study to optimize the utilization of TBL in FM.

Interactive Patient Safety and Quality Improvement capstone during transition-to-residency program: virtual and in-person focused workshop for EPA 13

Identifying systems failures and contributing to a safety culture is the Association of American Colleges (AAMC's) thirteenth Entrustable Professional Activity (EPA). While most curricula teach Patient Safety (PS) and Quality Improvement (QI) principles, student participation in live QI/PS activities remains limited. This workshop enabled late Clerkship phase students to apply these Health Systems Science (HSS) principles to real adverse patient event cases through team-based simulation.This 3-h capstone included both a didactic review of QI, PS, and TeamSTEPPS® tools and an experiential component where student-led interactive small group discussions were augmented by resident and faculty preceptors. Collaboratively, students composed an adverse patient event report, conducted a Root Cause Analysis (RCA) during role-play, and proposed error prevention ideas after identifying systems problems. In April 2020, the in-person workshop became fully virtual due to the COVID-19 pandemic.A statistically significant increase in ability to identify Serious Safety Events, Escalation Chain of Command, and define a Plan-Do-Study-Act (PDSA) cycle was observed. Comfort with RCA increased from 48 to 87% and comfort with TeamSTEPPS® principles increased from 68% to 85.5%This novel capstone provided students with the tools to synthesize HSS concepts through problem-solving processes and recognize EPA 13's importance. Their increased capability to identify appropriate chain of command, escalate concerns, and recognize serious adverse patient events also has training and practice readiness implications.

Multidisciplinary simulation of local anaesthetic systemic toxicity improves diagnostic and treatment skills and self-confidence for pain clinic procedural staff

Local anaesthetic systemic toxicity (LAST) is a rare complication after outpatient interventional pain procedures, which can present as an emergent and life-threatening condition. Proficiency and confidence in managing this rare situation necessitates strategies to ensure team members can perform necessary tasks. The primary objective was to familiarse the pain clinic procedural staff-physicians, nurses, medical assistants, and radiation technologists-with concise and current instruction and an opportunity to practice in a controlled environment. A two-part series was designed and led by the pain physicians, with the assistance of the simulation centre and clinic staff. A 20 min didactic session was held to familiarise the providers with relevant details and information regarding LAST. Then, 2 weeks later, all team members participated in a simulation exercise intended to portray a LAST encounter, tasking participants to recognise and manage the condition in a team-based model. Before and after the didactic and simulation sessions, the staff was administered a questionnaire to assess knowledge of LAST signs, symptoms, management strategies, and priorities. Respondents were better able to identify signs and symptoms of toxicity and prioritise management steps, and felt more confident in recognising symptoms, starting treatment and coordinating care. Furthermore, participants emphasised the positive of debriefing, practicing a rare situation and learning strategies for effective communication, team dynamics and role clarity.

FORMAT

Small group didactic session, simulation exercise in a clinical simulation lab.

TARGET AUDIENCE

Attending, fellow, and resident physicians, medical students, registered nurses, certified medical assistants, and radiation technologists working in a pain clinic procedure suite.

OBJECTIVES

To acquaint the pain clinic procedural staff with current training related to LAST and an opportunity to practice in a controlled environment.

Optimizing teaching effectiveness in dental education for a new generation of learners

PURPOSE

Today's dental students, Generation Z (Gen Z), are said to learn differently than those of previous generations. As generations of dental students vary, our teaching styles must keep up with unique and changing groups of individuals.

METHODS

This article discusses learner-focused teaching methods including techniques that address the characteristics of Gen Z learners. Blended learning methods that combine online media with traditional face-to-face sessions, team-based learning, and a flipped classroom format have previously been suggested as ways to increase learning effectiveness and student satisfaction.

RESULTS

In this paper, the characteristics and preferences of Gen Z students are described along with the challenges they create with conventional teaching methods. An implementation strategy using principles from organizational agility and Bolman and Deal's Four Frames Model is proposed for dental schools to transition to a more learner-centered teaching approach.

CONCLUSIONS

The suggested strategy can be customized and could be useful to schools that wish to enhance their teaching methods to meet the learning needs of Gen Z dental students and beyond.

Team-based learning vs. lecture-based learning in nursing: A systematic review of randomized controlled trials

Introduction

Our study aims to identify, appraise, and summarize randomized controlled trials (RCT) on the effectiveness of team-based learning (TBL) versus lecture-based learning (LBL) in nursing students.

Methods

We searched PubMed, Ovid, Embase, Cochrane, CBM, VIP, CNKI, and Wan Fang databases from inception to 22nd July 2022 to enroll RCTs that compared TBL versus LBL. The studies reporting the performance of nursing students receiving TBL pedagogy compared to those receiving traditional lecture-based learning (LBL) were to be analyzed. Scores of academic or nursing abilities were considered the primary outcome, and the results of nursing competencies, students' engagement with, behaviors, attitudes toward, experience, satisfaction, or perceptions of TBL were considered the secondary outcome. This systematic review was conducted following the guidelines of the Cochrane Reviewer's Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

Results

A total of 1,009 participants in 10 RCTs were enrolled in this study. Of the 10 RCTs, eight studies investigated undergraduate students, one involved vocational college students, and one enrolled secondary school students. The most reported outcomes were class engagement survey toward TBL (n = 8); students' ability (n = 5), academic knowledge or performance (n = 4); students' experience (n = 4), satisfaction or perceptions of TBL (n = 4).

Conclusion

This review suggested that the TBL was an effective pedagogy in improving academic performance and general ability in nursing students. High-quality trials are needed, and standardized outcomes should be used.