A comparison of team-based learning and lecture-based learning on clinical reasoning and classroom engagement: a cluster randomized controlled trial

Nurse-led World Café approach in promoting interprofessional collaborative behaviors and learning engagement among healthcare professionals

Effective interprofessional collaboration practice (IPCP) promotes healthcare outcomes but is often hindered by poor communication. Traditional teaching methods with limited interdisciplinary interactions may not effectively foster IPCP behaviors. This study evaluated the effectiveness of nurse-led World Cafe (NWC) approach in promoting IPCP behaviors and learning engagement. Seventy-six healthcare professionals (38 in each group) participated in this quasi-experimental study. Data were collected before, one-week, and four-week post-intervention, using Lee's (2016) Interprofessional Collaborative Practice Behavior Inventory (IPCPBI) and Ciou's (2020) Learning Engagement Scale. Five medical technologists in the control group were excluded from data analysis to ensure group equivalence. Before the intervention, there were no significant differences in IPCPBI between groups. One week post-intervention, the experimental group scored higher in IPCPBI, yet lacked statistical significance (p > .05). Four weeks post-intervention, the experimental group significantly improved in IPCPBI (p < .05). While no statistically significance was found in learning engagement between groups, the experimental group scored significantly higher in the active engagement sub-domain (p < .05). The NWC approach boosted IPCP behaviors and learning engagement, fostering a collaborative learning environment that improves outcomes through interdisciplinary interactions. Healthcare settings could benefit from adopting the NWC approach to enhance clinicians' IPCP competency.

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.

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.

Learning Collaborative Clinical Reasoning in Healthcare Education: An Integrative Review

BACKGROUND

Collaborative clinical reasoning (CCR) occurs when two or more healthcare professionals reflect and negotiate an issue regarding patient's situation or care. This represents a crucial learning goal that needs to be achieved during healthcare education.

PURPOSE

To describe the characteristics of and the pre-conditions for learning collaborative clinical reasoning in healthcare education.

METHOD

An integrative review was conducted. A systematic search was carried out in May 2020 (updated in August 2022) in four databases (CINAHL, Pubmed/Medline, Scopus and Eric/EBSCO). Thirty-three peer-reviewed research articles met the inclusion criteria and were included into a data quality appraisal and analysis. The data was analysed with inductive content analysis.

RESULTS

The characteristics of learning collaborative clinical reasoning were described using the following categories: 1) the collaborative clinical reasoning learning method 2) the collaborative clinical reasoning learning environment and 3) the collaborative clinical reasoning learners. The pre-conditions for learning collaborative clinical reasoning were described using the following categories: 1) the learning situation when learning collaborative clinical reasoning, 2) interaction when learning collaborative clinical reasoning and 3) clinical context when learning collaborative clinical reasoning. The learning situation includes the pedagogical preparation before the learning of collaborative clinical reasoning. The interaction consists of facilitation, feedback and peer communication during the learning of collaborative clinical reasoning. The clinical context utilized in the learning of collaborative clinical reasoning needs to be realistic and familiar for the students.

CONCLUSIONS

The results indicate that interventions enhancing collaboration and clinical reasoning apply a variety of learning methods, however there are certain characteristics of and pre-conditions for learning collaborative clinical reasoning to be considered.

A new attempt of applying hybrid team-based and case-based learning approach in dental materials science: Does it work?

INTRODUCTION

Limited studies have been conducted on the use of a hybrid team-based learning (TBL) and case-based learning (CBL) approach in dental education. The present study aims to evaluate students' experience of the hybrid TBL-CBL in learning dental materials science subjects.

METHODS

All second-year undergraduate Bachelor of Dental Surgery (BDS) students were invited to participate in a TBL-CBL session. These participants were randomly allocated to six different groups of 10-12 students, and the session was conducted by one lecturer as the facilitator. A 23-item questionnaire assessing four domains (perceptions of effectiveness, teacher, team interaction and learning environment) was administered at the end of the TBL-CBL session.

RESULTS

The response rate was 91.9% (n = 68). Mean scores for the questionnaire items ranged from 4.13 to 4.60 suggesting a positive perception among the students towards the hybrid TBL-CBL approach. Regarding the open-response questions, students emphasised that the TBL-CBL session was effective for team interaction and group discussions. However, students wished to have a better venue for future sessions.

CONCLUSION

Positive perceptions of the students encourage future educators to consider the use of TBL-CBL approach in teaching dental materials science and to avoid the reliance on standalone conventional lectures. Future research could consider examining its effects on students' academic achievement as well as the perspectives of teachers regarding its adoption in different dental specialities.

The application of flipped classroom combined with team-based learning in the orthopedic clinical teaching

BACKGROUND

Medical education has evolved rapidly, with the development of flipped classrooms and team-based learning based on lecture-based learning, but the novel model of combining flipped classrooms with team-based learning has been poorly investigated in orthopedic education.

METHODS

A femoral neck fracture teaching mode was chosen to 109 clinical internship students to explore the effectiveness of flipped classroom combined with team-based learning in internship education. They were enrolled and randomly divided into either the flipped classroom combined with team-based learning group (FTG, n = 55) or the traditional lecture-based classroom group (n = 54). All students completed the learning according to the course flow and took before-class and after-class tests. The questionnaires were used to compare students perceptions and satisfaction with the different teaching methods and were utilized to assess the strengths and weaknesses of the 2 groups.

RESULTS

The post-class test scores of both groups significantly improved compared to pre-class test scores. Regarding the post-class test scores, FTG's was significantly higher than the traditional lecture-based classroom group's, mainly in clinical areas such as imaging analysis, fracture classification, treatment options, and management of postoperative complications, but there was no significant difference in the mastery of basic theoretical knowledge. The students were more satisfied with the FTG and believed that it improved their various competencies, but with significantly more time spent.

CONCLUSION

FTG is generally recognized as a promising option for training clinical interns and is worth spreading as it has outstanding merits in developing students clinical competence.

Student engagement in health professions education: AMEE Guide No. 152

This guide aims to support our colleagues to have comprehensive understanding of student engagement in health professions education. Despite the universal agreement about the significance of student engagement, there is lack of uniformity in conceptualizing and operationalizing this emerging construct. We review the theoretical basis explaining student engagement from three main perspectives: behavioral, psychological, and socio-cultural. In addition, we propose a contemporary and comprehensive framework for the student engagement in higher education, which is applicable to health professions education contexts. Drawing from this framework, we explain the conceptualization of the construct and its preceding factors, mediators, dimensions, spheres, and outcomes of student engagement. The proposed framework introduces student 'engagement through partnerships' as a novel component compared with the existing models of student engagement in higher education. This way, we are proposing a mixed model that not only considers the student as a 'customer' but also as a 'partner' in education. Engagement of students through partnerships include four areas: (1) provision of the education program, (2) scholarly research, (3) governance and quality assurance, and (4) community activities. This guide will provide practical applications on how to improve student engagement in health professions education. Finally, we highlight the current gaps in areas of research in the student engagement literature and suggested plans for future directions.[Box: see text].

Promoting clinical reasoning with meta-memory techniques to teach broad differential diagnosis generation in a pediatric core clerkship

OBJECTIVES

Clinical reasoning with generation and prioritization of differential diagnoses (DDx) is a key skill for medical students, but no consensus exists on the best method to teach these skills. Meta-memory techniques (MMTs) may be useful, but the efficacy of individual MMTs is unclear.

METHODS

We designed a 3-part curriculum for pediatric clerkship students to teach one of 3 MMTs and provide practice in DDx generation through case-based sessions. Students submitted DDx lists during two sessions and completed pre- and post-curriculum surveys assessing self-reported confidence and perceived helpfulness of the curriculum. Results were analyzed using ANOVA with multiple linear regression.

RESULTS

A total of 130 students participated in the curriculum, with 96 % (125/130) completing at least one DDx session, and 44 % (57/130) completing the post-curriculum survey. On average, 66 % of students rated all three sessions as "quite helpful" (4/5 on 5-point Likert scale) or "extremely helpful" (5/5) without difference between MMT groups. Students generated an average of 8.8, 7.1 and 6.4 diagnoses using the VINDICATES, Mental CT, and Constellations methods, respectively. When controlling for case, case order, and number of prior rotations, students using VINDICATES produced 2.8 more diagnoses than those using Constellations (95 % CI [1.1,4.5], p<0.001). There was no significant difference between VINDICATES and Mental CT (Δ=1.6, 95 % CI [-0.2,3.4], p=0.11) or Mental CT and Constellations (Δ=1.2, 95 % CI [-0.7,3.1], p=0.36).

CONCLUSIONS

Medical education should include curricula focused on enhancing DDx development. Although VINDICATES helped students produce the most DDx, further research is needed to identify which MMT generates more accurate DDx.

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.

Measurement of student engagement in health professions education: a review of literature

Student engagement is a complex multidimensional construct that has attained great interest in health professions education (HPE). Definition and conceptualization of student engagement is an important step that should drive the development of the instruments for its measurement. We have recently proposed a comprehensive framework for student engagement in HPE with a definition of engagement as student investment of time and energy in academic and non-academic experiences that include learning, teaching, research, governance, and community activities. The dimensions of student engagement in this framework included the cognitive, affective, behavioral, agentic, and socio-cultural. Guided by the student engagement framework, this non-systematic review aims to identify, critically appraise, and summarize the existing methods for measuring student engagement in HPE. Extrapolating from higher education literature, we attempted to link the theoretical perspectives of student engagement with the published methods of its measurement in HPE context. In addition, we have described the different methods of measuring student engagement including self-report surveys, real time measures, direct observation, interviews/focus groups, and the use of multiple instruments. The span of engagement dimensions measured by self-report surveys ranges from one to five dimensions. However, measurement of agentic and sociocultural dimensions of engagement in HPE is still limited and further research is required. We have also reflected on the existing methods of measuring engagement of students as active partners in HPE. The review also describes the advantages, limitations, and psychometric properties of each method for measuring student engagement. We ended the review with a guiding conclusion on how to develop and select an instrument for measuring student engagement in HPE. Finally, we addressed the gaps in the literature about measuring engagement of HPE students and future research plans.

The effects of an active learning mechanism on cognitive load and learning achievement: A new approach for pharmacology teaching to Taiwanese nursing students

BACKGROUND

Nursing students require learning strategies when studying pharmacology. The COVID-19 pandemic has increased the prevalence of online self-study. The design of effective online learning materials has therefore become vital to nursing education.

OBJECTIVES

The objective of this study was to describe the active learning mechanism that helped nursing students learn pharmacology through interactive learning materials and to demonstrate that no increased cognitive load in nursing students when studying pharmacology using interactive learning materials.

METHOD

We designed an active learning mechanism to help nursing students study pharmacology by using interactive learning materials. An experimental pre- and post-test design was conducted. The participants were second-year nursing students (age 16-17) in a junior college of nursing. Students were randomly assigned to an experimental group (n = 98) and a control group (n = 90).

RESULTS

We developed multi-media interactive learning materials and an active learning mechanism to enable nursing students to learn pharmacology. The proposed approach not only improved learning achievements but also reduced the cognitive load of nursing students.

CONCLUSION

The major contribution of this study exhibits a new approach to practice wherein active learning is incorporated into interactive pharmacology materials for nursing students. This can be attributed to the design features of "explanation," "quiz and feedback," and "encouragement." Our results aid the development of effective interactive learning materials for pharmacology for Taiwanese nursing students.

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.

Awareness of Universal Design for Learning among anatomy educators in higher level institutions in the Republic of Ireland and United Kingdom

There is an increasing need to facilitate enhanced student engagement in anatomy education. Higher education students differ in academic preferences and abilities and so, not all teaching strategies suit all students. Therefore, it is suggested that curricula design and delivery adapt to sustain learner engagement. Enhanced learner engagement is a fundamental feature of Universal Design for Learning (UDL). The aim of this study is to determine if anatomy educators in the Republic of Ireland (ROI) and United Kingdom (UK) are aware of UDL and to assess if, and to what extent, it has been implemented in the design and delivery of anatomy curricula for healthcare students. An anonymous online questionnaire was administered to anatomy educators in higher level institutions in the ROI and UK. Inductive content analysis was used to identify the impact of UDL on student learning, engagement, and motivation, as perceived by the participants. The response rate was 23% (n = 61). Nineteen participants stated they knew of UDL. Of these, 15 had utilized UDL in their teaching of anatomy. Analysis indicated that the perception of UDL was mixed. However, the majority of responses relating to UDL were positive. The majority of the respondents were unaware of UDL but identified the frameworks' checkpoints within their curriculum, suggesting they have unknowingly incorporated elements of UDL in their curriculum design and delivery. There is a lack of information on the benefits of explicit utilization of UDL for engagement and motivation to learn anatomy in healthcare programs in the ROI and UK.

Outcomes of problem-based learning in nurse education: A systematic review and meta-analysis

OBJECTIVE

To investigate the effectiveness of problem-based learning (PBL) in nursing students, including recently reported trials.

DESIGN

Meta-analysis was performed to obtain summary conclusions on the influence of PBL on nursing students' learning outcomes.

DATA SOURCES

Academic Search Complete, CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, and Web of Science were searched for relevant studies from the period between database inception and March 3, 2022.

REVIEW METHODS

A random-effects model was used to generate pooled standardized mean differences (SMD) for critical thinking, problem-solving, and self-confidence. The heterogeneity of each variable in the pooled estimate was determined using a random-effects model.

RESULTS

Overall, PBL had a greater positive effect than traditional learning on critical thinking (SMD: 0.44; 95 % CI: 0.14-0.73), analysis (SMD: 0.72; 95 % CI: 0.84-1.25), and evaluation (SMD: 0.33; 95 % CI: 0.05-0.61). However, the impact of PBL on problem-solving and self-confidence need further investigation.

CONCLUSIONS

PBL appears to improve nursing students' critical thinking skills, especially their ability to analyze and evaluate. The findings of this study may be used as evidence of PBL being a more effective method than traditional/conventional learning techniques for increasing students' critical thinking.

Humanistic Spirit Training of Medical Students Based on Multisource Medical Data Fusion

Medical colleges need to strengthen the cultivation of medical students' humanistic and spiritual literacy. First of all, schools need to change the current educational concept and the cultivation mode of humanistic quality. In educational work, schools should pay attention to the social cognitive skills of medical students, and at the same time pay attention to the cultivation of students' basic qualities. Schools need to find problems in time, and schools need to take corresponding measures to deal with these problems. Medical colleges need to strengthen the training of medical students' comprehensive quality and incorporate humanistic education into the goal of all-round development of medical students. Specifically, schools need to adopt a work method of distributed implementation and distributed guidance to fully mobilize the enthusiasm and initiative of school leaders, teachers, and students themselves. Schools need to strengthen inspection and supervision and summarize the experiences and lessons that students have learned in their learning. On this basis, schools need to improve the quality and efficiency of students' humanities education work. Through the analysis of multisource medical data, this paper conducts research on the working mode of humanistic quality cultivation in medical colleges. Specifically, school education will be people-centered. Schools need to cultivate the humanistic spirit of medical students in the ideological and political education work. This paper conducts mathematical statistical analysis based on multisource medical data and analyzes the differences in the effect of different teaching modes and training methods on the cultivation of medical students' humanistic spiritual literacy. Based on this, the research proposes recommendations for the future development of medical schools. First of all, schools need to build a humanized classroom, combine skills education with moral education, and improve the learning efficiency of student groups. In addition, schools need to teach students to feel respected and valued. Secondly, schools need to implement human-oriented teaching work to give full play to students' own talents and personalities. During school education work, schools need to organically combine classroom education and social practice. Schools need to link teaching and real society and link students' learning process with real life. Schools need to organically combine reading and learning with life, so as to promote the all-round development of students' humanistic quality.