The effect of online and in-person team-based learning (TBL) on undergraduate endocrinology teaching during COVID-19 pandemic

Short-term cognitive learning outcomes in team-based learning: is the permanent team important?

Assigning students to work in permanent teams is a design principle in Team-based learning (TBL). It has been assumed that a stable team composition supports the emergence of collaborative problem-solving and learning: when students became more familiar with each other, they shared more information and resolved discrepancies together, which in turn stimulated knowledge acquisition and comprehension. However, this assumption had not been probed by a randomized controlled trial with performance assessment as an outcome. In an online course for second term medical students, 50% of the students were reassigned to new teams for each of the 24 problems to be solved during four classes, thus precluding familiarity. The learning outcome was assessed shortly after the third of four classes by a domain knowledge test. Whether TBL teams were permanent or temporary did not affect the score of a domain knowledge test. As expected, participation in online TBL improved the domain knowledge test results. Overall, the permanent team seems to be less important for cognitive learning outcomes than previously assumed, but this may depend on the specific educational setting. However, team familiarity may still be important for team decision-making. As clinical reasoning in the medical workplace often involves collaborating in changing teams, future research on TBL should focus on how to utilize this format to prepare medical students for decision-making and optimal learning outcomes under these conditions.

A systematic review of online team based learning approaches in health professional education

AIMS AND OBJECTIVES

The purpose of this study was to systematically review studies related to the use of online Team Based Learning (TBL) platforms with a focus on health professional education. The objectives were to identify best practices, highlight what technological platforms are effective for TBL processes and evaluate educational outcomes in terms of student experience, learning and preference.

DESIGN

A systematic review of published TBL research was undertaken between August and October 2021 and supplemented in September 2022.

DATA SOURCES

ERIC, PsycINFO, Scopus, Embase, Medline, and Cinahl databases were used. The keywords were identified from researchers' knowledge and PICO/PICo framework.

REVIEW METHODS

Titles and abstracts were screened individually by two reviewers for eligibility. Data extraction was undertaken by two researchers independently and checked for consistency by discussion between the two. Articles were appraised using the Mixed Methods Appraisal Tool (MMAT).

RESULTS

Out of 656 articles 14 were involved in the final review. All others were rejected due to duplication, ineligibility, or poor quality. The studies were from a range of countries and focussed on a range of health professionals including nursing. Inconsistencies in approaches for TBL, platforms used and mixed results in terms of outcomes were noted. There was no real consensus other than that TBL was equally as effective if carried out online or face-to-face, with no clear differences to outcomes related to satisfaction in online or traditional TBL approaches.

CONCLUSIONS

It is recommended that further research is carried out into the outcomes of TBL on learning and experiences of students in health professional courses. The development and appraisal of integrated TBL platforms should be invested in and infrastructure and resources are put in place to support this.

Application of lecture-and-team-based learning in stomatology: in-class and online

BACKGROUND

This study aimed to evaluate stomatological students' learning efficacy and their attitude towards Lecture-Team-Based Learning (LTBL) on topics regarding the design of removable partial dentures via in-class, online, and both in combination.

METHODS

Students from seven distinct grades participated in the course in their fourth academic year (Years 2015, 2016, 2017, 2018, 2019, 2020, and 2021). Students of Years 2015-2019 attended in-class LTBL, students of Year 2020 attended online LTBL, and students of Year 2021 attended the combination mode. The scores of three examinations were compared, namely, individual readiness assessment test, team readiness assurance test, and individual application test. Visual Analog Scales (VAS) were used for students to self-assess their mastery of prosthodontics knowledge before and after the course. Anonymous questionnaires were delivered to evaluate their satisfaction with LTBL via a Likert scale.

RESULTS

In each academic year, the three exam scores were significantly improved as the course progressed and VAS-post scores were significantly higher than VAS-pre scores. The three examination and VAS scores of students in Year 2020 were significantly lower than those in Years 2019 and 2021. Students were highly satisfied with the LTBL course based on the three parameters of knowledge acquisition, teamwork, and classroom atmosphere.

CONCLUSION

Students were highly satisfied with the LTBL course and their learning performance was improved as the course progressed both in-class and online. Online LTBL could be adopted when students have to study online, while in-class LTBL could perform better when combined with video records of an online LTBL course.

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.

Effectiveness of Online Team-based Learning for Pharmacists on How to Conduct Clinical Medication Reviews for Old Patients in Japan: A Randomized Controlled Trial

BACKGROUND/AIM

This study aimed to determine the effectiveness of online team-based learning (TBL) and the factors influencing dropouts from online TBL for pharmacists on how to conduct clinical medication reviews for older adults.

PARTICIPANTS AND METHODS

All participants were randomly assigned to the TBL or non-TBL group by using a random number sequence table matched by their years of experience working as a pharmacist. The primary outcome was whether the score on the team readiness assurance test (TRAT) in the TBL group differed from that on the second individual readiness assurance test (IRAT) in the non-TBL group. The secondary outcome was to identify factors contributing to dropouts from the online TBL program.

RESULTS

The TRAT score in the TBL group was significantly higher than the second IRAT score in the non-TBL group during the first session (p=0.010). There were no differences in TRAT and IRAT scores between groups in two subsequent sessions. Logistic regression analysis revealed that less than 10 years of pharmacy experience was a contributor to dropouts (p=0.039), whereas experience in home-based care prevented dropouts (p=0.026) in our online TBL program.

CONCLUSION

This study revealed the short-term usefulness of online TBL on medication reviews for older adults and elucidated the factors related to dropouts. Although instructors should provide positive feedback to participants with insufficient experience in pharmacy practice and home-based care, online TBL has the potential to improve educational effectiveness for community pharmacists during the COVID-19 pandemic.

Effects of Prebriefing Using Online Team-Based Learning in Advanced Life Support Education for Nurses

An effective prebriefing strategy is needed that can improve the learning outcomes of nurses in advanced life support education. This study aimed to identify the effects of prebriefing with online team-based learning on hospital nurses' knowledge, performance, and self-efficacy in advanced life support education. A nonequivalent control group pretest-posttest design was adopted. Nurses in the experimental group (n = 26) participated in prebriefing using online team-based learning followed by self-directed learning, whereas nurses in the control group (n = 27) experienced only self-directed learning before advanced life support education. Wilcoxon signed-ranks tests were used to identify the posttest-pretest differences of the study variables in each group. Both groups showed improved knowledge, individual performance, and self-efficacy after the education. Nurses in the experimental group reported higher self-efficacy scores compared with those in the control group. There were no differences between the experimental and control groups in knowledge, individual performances, or team performance. Online team-based learning as a prebriefing modality resulted in greater improvements in self-efficacy in advanced life support education.

Comparing Student Performance in Emergency Remote and Face-to-Face Collaborative Learning Courses

The start of the COVID-19 pandemic forced an unprecedented shift from face-to-face (F2F) instruction to emergency remote teaching (ERT) for over one billion learners worldwide. Studies from K-12 and higher education have begun to address the impact of ERT on student learning and well-being. The lessons learned from ERT will likely shape the response to future public health emergencies and inform the design and implementation of remote courses. As such, it will be important to identify teaching practices in ERT that promoted student engagement and learning. Here, we address whether undergraduate collaborative learning courses were able to support student content knowledge outcomes at similar levels in ERT as compared to F2F classroom environments. Specifically, we tracked student performance in three different team-based undergraduate neuroscience courses. These courses were all taught by the same instructor during the academic years 2020-2021 and 2021-2022. Importantly, we found that student scores on individual and team assessments as well as measures of course satisfaction were similar between ERT and F2F. Taken together, our data suggest that the virtual collaborative learning environment in these courses was not associated with a decrease in student or team performance when compared to a traditional F2F classroom.

Online flipped classroom with team-based learning promoted learning activity in a clinical laboratory immunology class: response to the COVID-19 pandemic

BACKGROUND

Given the rapid development of clinical immunology technologies, students majoring in laboratory medicine should master the technological principles and application of clinical laboratory immunology. However, many are required to take online courses due to COVID-19 restrictions, which highlights the need to revisit teaching strategies. Recently, various medical education courses (such as Biochemistry, Physiology, etc.) have implemented the flipped classroom (FC) and team-based learning (TBL) methods, resulting in more positive teaching evaluations. To promote the students' mastery of the difficult knowledge effectively during the online teaching work, we evaluated the performance of online FC-TBL in a clinical laboratory immunology course.

METHODS

Sixty-two third-year students from two classes majoring in Laboratory Medicine were recruited and divided into two groups, including one group with traditional lecture-based learning teaching strategy (LBL group) and the other group with LBL or online FC combined with TBL teaching strategy (FC-TBL group). We selected three chapters to conduct FC-TBL teaching in class. All participants took in-class quizzes and final examinations that targeted the same knowledge points. Finally, all participants completed anonymous questionnaires asking for their perceptions of the respective teaching models. In addition, we conducted a survey of teaching suggestions by a FC-TBL class of students majoring in Laboratory Medicine.

RESULTS

The FC-TBL group (vs LBL group) had significantly higher scores on the in-class quizzes and final examinations, and also reported high satisfaction with the FC-TBL model. These findings indicate that FC-TBL is suitable for clinical laboratory immunology, as the participants quickly gained essential knowledge. Specifically, FC-TBL helped to "increase learning motivation," "promote self-directed learning skills," "extend more related knowledge," "enhance problem-solving abilities," "enhance clinical reasoning abilities," and "enhance communication skills." For participants' suggestions, 48.38% (15/31) students held positive attitude to FC-TBL teaching strategy compared to 25.81% (8/31) students who considered FC-TBL teaching strategy still needs continuous improvement, and 25.81% (8/31) students reported that they believed FC-TBL teaching strategy was perfect and no further suggestions.

CONCLUSIONS

Online FC-TBL effectively enhanced learning activity among students of a clinical laboratory immunology course. This is particularly useful in the COVID-19 context.