Twelve tips for facilitating team-based learning

Impact of Facilitation on Cognitive Flow in a Novel Diabetes Management Rehearsal Game for Health Professions Education: Mixed Methods, Open-Label, Superiority Randomized Controlled Trial

BACKGROUND

Though the prevalence of diabetes is set to increase, most serious game solutions typically target patient self-management and education. Few games target health care professions education, and even fewer consider the factors that may increase their efficacies. The impact of facilitation, a prominent feature of health professions education, is examined in the context of a rehearsal-based diabetes management serious game.

OBJECTIVE

In this mixed methods, open-label, superiority randomized controlled trial, we compare student performance, attitudes, and perceptions of a rehearsal-based diabetes management game for health care professionals.

METHODS

Student participants were randomized into 2 groups to play a diabetes management game. The control group played the game alone, and the intervention group played the same game alongside a facilitator tasked to moderate overall challenge levels and address queries. Both groups were administered the Flow Short Scale, a 13-item measure rated on a 7-point Likert scale ranging from 1 ("not at all") to 7 ("very much") immediately after the game. Students were then invited to voluntary focus group discussions to elicit their attitudes and perceptions of the game. Findings were subject to between-group comparisons and inductive thematic analysis respectively.

RESULTS

A total of 48 (26 control, 22 intervention) clinical-year undergraduates from the Lee Kong Chian School of Medicine in Singapore participated in this study, with 18 continuing to the focus group discussions. Flow Short Scale results indicated the superiority of the intervention group for overall flow (t46=-2.17, P=.04) and the absorption subdomain (t46=-2.6, P=.01). Qualitative results indicated students viewed facilitation as helpful and appropriate, and were able to identify improvable elements of the game's theoretical foundations and overall design.

CONCLUSIONS

While serious games are efficacious means of rehearsing previously learned knowledge, facilitation allows for their efficiency to be greatly increased. Such increases are likely crucial in the coming years with the increased digitization of health care professions education and the prevalence of diabetes.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05637749; https://www.clinicaltrials.gov/study/NCT05637749.

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.

Twelve tips for conducting team-based learning session online in synchronous setting

INTRODUCTION

COVID-19 pandemic has challenged the educators to creatively develop teaching and assessment methods that can work effectively and efficiently while maintaining the social distancing and avoiding the gatherings of the classrooms and examination halls. Online approach has emerged as an effective alternate for classroom teaching.

AIM

To equip faculty with tools to conduct TBL session online, synchronously, effectively and efficiently.

METHODS

We examined the published literature in the area of online teaching and combined it with our own experience of conducting TBL sessions online.

RESULTS

We created 12 tips to assist faculty to facilitate an effective and engaging TBL session online.

CONCLUSIONS

Applying these 12 tips while facilitating a TBL-online session will ensure the full engagement of students in the process of active learning.

Team-Based Learning in Medical Colleges: Need, Scope, and the Potential Factors for Successful Implementation

Owing to the rapid advancements in the field of medicine, it is a major challenge for the medical educators to prepare the medical students to be ready and competent in their future clinical practice. It is a must that the medical students should not only be knowledgeable and skilled but also acquire the trait of being a lifelong learner. The adoption of team-based learning is an effective teaching-learning strategy to prepare the medical students for all the above roles, as it envisages working in teams to resolve the clinical-practice-related issues. In conclusion, team-based learning is an effective teaching-learning method that advocates practical application of the learned knowledge and encourages teamwork for the resolution of medical problems. However, successful implementation of team-based learning in a medical college is dependent upon the support from administrators, faculty members, and active participation of the medical students.

Going virtual and going wide: comparing Team-Based Learning in-class versus online and across disciplines

Team-based learning (TBL) is an active learning pedagogy developed for in-class sessions and based on the collaborative work of small groups of students. The increasing push to online and blended learning has enhanced the need to expand this pedagogy to a virtual environment, but little evidence has been produced on how students accept online synchronous sessions of TBL. The purpose of this study, that relies on 427 responses, is to present a comparative perspective of traditional in-class versus adapted fully synchronous online TBL and across different disciplinary fields. Students of two different academic years and different programs were surveyed for their acceptance of TBL. They were invited to answer closed-ended questions focused on their engagement in all TBL learning process and the final outcomes provided. Results obtained from this unique comparative study revealed a wide approval of TBL, regardless of the environment (online or in-class TBL sessions), scientific area of courses and student gender. The acceptance of fully online TBL sessions, in a similar way as traditional in-class sessions, could be a rationale for giving more use to the 'virtual' context. Other results corroborated previous researches on TBL, such the need of student awareness of TBL benefits to get more engaged in the process or the impact of student activities overload on the TBL process. Implications are informative for pedagogical practice.

Team-based learning versus traditional didactic lectures in teaching clinical biochemistry at King Abdulaziz University; learning outcomes and student satisfaction

Team-based learning (TBL), which encourages students to become active rather than passive learners, has gained world-wide popularity in medical education due to its proven positive effect on more than one aspect of the educational process. At King Abdulaziz University (KAU), clinical biochemistry is still taught in the form of didactic lectures, and while there is a need for introducing active learning, student learning response from TBL has not been explored. In this quasi-experimental non-equivalent comparison group design, we compared learning outcomes and student satisfaction in a clinical biochemistry course taught either via TBL to second year clinical nutrition students (n = 33) or via traditional lectures to same year nursing students (n = 70). The same summative post-course exam was given to both student groups to assess impact on learning. Focus group discussion and a self-administered questionnaire were used to gain insight into clinical nutrition students' level of satisfaction with TBL. In the post-course exam results of recall and reasoning questions, nursing students (Lectures) scored an average of 38% ± 2.4 in the recall questions while clinical nutrition students (TBL) scored higher with an average of 74.5% ± 4.3 (p < .0001). In reasoning questions, nursing students (Lectures) scored lower than clinical nutrition students (TBL), 23% ± 2.7 versus 40% ± 4.2, respectively (p < .001). In comparing results of pre- and post-test recall questions within each group, there was no significant difference between pre- and post-results for nursing students (Lectures) while clinical nutrition students (TBL) showed a significant increase in post-versus pre-test results of 71% versus 41% (p < .0001). In the final summative post-course exam, nursing students scored an average of 60% ± 2.4 while clinical nutrition students (TBL) scored significantly higher with an average of 78% ± 2.4 (p < .001). Qualitative studies revealed that accountability and team-work were positive aspects perceived by students regarding TBL. The study showed that 84% of surveyed students enjoyed the experience, however, when asked about challenges self-study was their main challenge. TBL proved to be a successful, learner-centered approach for clinical nutrition students at KAU in their clinical biochemistry course resulting in improved learning outcomes and higher student satisfaction when compared with traditional didactic methods of teaching.

Design of a foundational sciences curriculum: Applying the ICAP framework to pharmacology education in integrated medical curricula

Expectations for physicians are rapidly changing, as is the environment in which they will practice. In response, preclerkship medical education curricula are adapting to meet these demands, often by reducing the time for foundational sciences. This descriptive study compares preclerkship pharmacology education curricular practices from seven allopathic medical schools across the United States. We compare factors and practices that affect how pharmacology is integrated into the undergraduate medical education curriculum, including teaching techniques, resources, time allocated to pharmacology teaching, and assessment strategies. We use data from seven medical schools in the United States, along with results from a literature survey, to inform the strengths and weaknesses of various approaches and to raise important questions that can guide future research regarding integration of foundational sciences in medical school and health professions' curricula. In this comparative study, we found that there is significant heterogeneity in the number of hours dedicated to pharmacology in the preclerkship curriculum, whereas there was concordance in the use of active learning pedagogies for content delivery. Applying the ICAP (Interactive, Constructive, Active, Passive) Framework for cognitive engagement, our data showed that pharmacology was presented using more highly engaging pedagogies during sessions that are integrated with other foundational sciences. These findings can serve as a model that can be applied beyond pharmacology to other foundational sciences such as genetics, pathology, microbiology, biochemistry, etc.

Impact of readiness assurance process and faculty feedback on individual application exercises: a model for continuous assessment in physiology

This study is aimed at the implementation of a continuous assessment model in physiology for a large-enrollment classroom with 250 students. The readiness assurance process (RAP) and immediate feedback elements from team-based learning (TBL) methodology were adopted to test their ability to guide students to solve applications exercises individually. Three continuous assessments in physiology (CAPs) were conducted with the RAP to include individual (iRAT) and group readiness assurance tests (gRAT). Immediate feedback was provided with faculty-student discussion (FSD), and the individual application exercises (iAE) were designed to be answered individually. Each CAP was subjected to three types of experimental manipulation in subgroups created out of 250 students. The intervention began with iRAT for all three subgroups. The sequence of iRAT, gRAT, FSD, and iAE varied between subgroups within a CAP. In a cross-over study design, each subgroup of students was subjected to all three intervention types over three CAPs. The subgroup completing iAE after RAP and FSD showed higher scores than the subgroup with RAP alone. One hundred eight-two students (82.35% response rate; 101 women and 81 men) responded to the questionnaire. The majority of students (87.4%) felt that doing iRAT and gRAT at the beginning helped them to solve iAE better. Most of the students (86.8%) responded that they received useful feedback and clarification during the discussion with the teacher after the gRAT. In conclusion, the administration of iRAT first followed by gRAT and immediate feedback from faculty seem to be beneficial to prepare students to tackle application-based exercises.

Redesigning team-based learning facilitation for an online platform to deliver preclinical curriculum: A response to the COVID-19 pandemic

This article was migrated. The article was marked as recommended. Due to the increasing number of COVID-19 cases globally, and the need for critical containment, Duke-NUS Medical School, Singapore, moved all of its preclinical classes online, keeping with national and university guidelines. The sudden move from face-to-face to online learning posed several challenges to the school's team-based learning (TBL) pedagogy. In TBL, student engagement is key to promote peer-to-peer learning. The educational faculty found that it was challenging to ensure student engagement through an online platform. Additionally, online TBL is heavily dependent on the use of technology. Technological and internet connectivity issues were potential obstacles to the learning process. This manuscript proposes practical tips for a facilitator of an online TBL class to engage learners in this new format. To overcome technical complications, a dedicated centralized administrative team managed the logistics of hosting TBL online. Working synergistically, the facilitator, and the administrative team were instrumental in recreating the learning environment of a face-to-face TBL in an online platform.

How about including free-standing, open-ended questions for readiness assessment and application activities in team-based learning, in addition to MCQs?

In conventional team-based learning (TBL), readiness assurance test (RAT) items must be formatted as free-standing multiple-choice questions (MCQs). Even in the application phase of TBL, all teams must work on the same, significant problem and be required to make a specific choice and simultaneously report them to the whole class, which the MCQ format with predetermined answer choices allows. However, the founders of the TBL method rightly emphasize that the intended learning outcomes of a course using TBL underlie the design of the various components of TBL. The main point of this brief essay is to suggest that, if the ability to generate solutions to problems without predetermined answer choices is an intended learning outcome, it is advantageous to include carefully constructed free-standing, open-ended questions (OEQ) for both RAT and application activities in courses using TBL as the primary instructional method, in addition to the use of MCQs. Free-standing OEQs are OEQs not linked to an MCQ used for RAT or application activities. How this might be incorporated in what one may envision as TBL is discussed.

Not Another Boring Resident Didactic Conference

BACKGROUND

The Accreditation Council for Graduate Medical Education (ACGME) requires that residency programs in emergency medicine plan at least 5 hours of didactic experiences per week. Instructional methods should include small-group techniques, problem-based learning, or computer-based instruction. Despite recommendations from the ACGME, many programs' conference didactics continue to include primarily lecture-based instruction.

METHODS

The authors describe instructional methods that promote active learning and may be superior to traditional lecture-based education.

RESULTS

These methods include varying instructional methods, case-based learning, team-based learning and the flipped classroom, audience response systems, simulation, "wars," oral boards, escape rooms and scavenger hunts, expert panel discussions, debates, clinical pathologic cases, and leaderboards. The authors discuss how these methods can be implemented to make emergency medicine didactic conferences more varied and interactive for learners.

CONCLUSIONS

While there is minimal research on the efficacy of these methods in graduate medical education, many have shown to improvement engagement of learners and to be effective in undergraduate medical education. Further research will be needed to determine if long-term learning outcomes can be improved with these strategies.

Using problem-based learning to improve patient safety in the emergency department

Pressures from rising patient numbers and overcrowding in emergency departments (EDs) are putting patients' safety at risk. Beyond improved provision of resources, two elements are essential to patient safety in emergency care - work culture and staff training. In traditional training environments, the teacher dispenses knowledge to nursing students in a classroom setting. However, problem-based learning (PBL) and the related concept of team-based learning (TBL) aim to enhance learners' knowledge and skills in non-technical subjects, such as patient safety, as well as their ability to address challenges they encounter in clinical practice. This article explores the theories that underpin PBL and TBL and discusses how they can be used by nurse educators to motivate staff and improve patient safety in the ED.

The Facilitator Instrument for Team-Based Learning (FIT)

Construct: We sought to evaluate the quality of Team-Based Learning facilitation in both large and small group settings. Background: Team Based Learning (TBL) is an increasingly popular small group instructional strategy in health science education. TBL facilitation skills are unique and differ from those needed to lecture or facilitate other types of small groups. Measuring facilitation skills and providing feedback to TBL instructors is important, yet to date no valid instrument has been developed and published for this purpose. Approach: We created an 11-item instrument (ratings of each item on a 7-point scale) designed to assess TBL facilitation skills, considering major sources of validity. Twelve experts in TBL facilitation and training developed the content of the FIT. To ensure response processes were valid, we used an immediate retrospective probing technique with 4th year medical students who were not part of the study. The Facilitator Instrument for Team-Based Learning (FIT) was piloted with 2,840 medical students in 7 schools in large (year 1 and 2) and small (year 3) courses. The internal structure of the FIT was analyzed. Results: In total, 1,559 and 1,281 medical students in large and small TBL classes, respectively (response rate 88%) rated 33 TBL facilitators. The composite mean score for the FIT was 6.19 (SD = 1.10). Exploratory factor analysis and Cronbach's alpha indicated that all items loaded on 1 factor, accounting for 77% of the item variance. Cronbach's alpha for the 11 items was 0.97. Analysis of facilitator variables and course context indicated that FIT scores were statistically significantly correlated with type of class (pre-clinical or clinical) and size of class as well as the facilitator enjoyment in using TBL as a method. Gender and the amount that facilitators used TBL each year was weakly correlated, with other factors not correlated (years facilitating TBL, confidence in facilitating TBL, and age). Conclusions: Analysis of FIT scores from 2,840 medical students across multiple institutions and teaching settings suggests the utility of the FIT in determining the quality of TBL facilitation across a range of medical education settings. Future research is needed to further analyze course contexts and facilitator variables that may influence FIT scores with additional facilitators. Additionally, FIT scores should be correlated with additional measures of TBL facilitator quality, such as direct observations, especially if these data are used for summative decision-making purposes.

The Value of Longitudinal Integrated TBLs and How to Create Them

To mimic the experiences clinicians have with patients, longitudinally integrated team-based learning application exercises involving a group of patients who reappear across multiple courses in an integrated organ system-based curriculum were created to illustrate the multisystem nature of pathology. The aim of these cases was to provide student-centered learning opportunities that demonstrate how organ systems are interconnected in injury and disease and illustrate how a longitudinally integrated series of team-based learning activities can be woven throughout the preclinical curriculum.

Determining Indicators of High-Quality Application Activities for Team-Based Learning

Objective. To determine the indicators of quality for application activities in pharmacy team-based learning (TBL). Methods. A modified Delphi process was conducted with pharmacy TBL experts. Twenty-three experts met the inclusion criteria, including having at least four years of TBL experience, designing at least eight TBL sessions, training others to use TBL, and authoring a peer-reviewed TBL pharmacy paper. In round 1, panelists responded to five open-ended questions about their successful TBL applications activities, including satisfaction with the activity and methods for creating positive student outcomes. In round 2, panelists indicated their level of agreement with the round 1 quality indicators using a four-point Likert rating. Consensus was set at 80% strongly agree/agree. In an open comment period, panelists provided suggestions to help expand the indicator descriptions. Indicators were verified based on TBL and the education literature. Results. Twenty panelists (87% of those eligible) responded in round 1 and 17 (85% participation) in round 2. Sixteen quality indicators were identified in round 1, with 14 achieving consensus in round 2. "Uses authentic pharmacy challenges or situations" (88% strongly agree/agree) and "incorporates or provides effective feedback to groups" (88% strongly agree/agree) met consensus. However, "has multiple right answers" (76% strongly agree/agree) and "incorporates elements from school specific emphases (eg, faith, underserved)" (53% strongly agree/agree) did not reach consensus. Conclusions. These indicators can assist faculty members in designing application activities to provide high-quality TBL exercises that promote deep thinking and engaged classroom discussion. The indicators could also guide faculty development and quality improvement efforts, such as peer review of application activities.

A Small-Group Stratified-Learner Modification of Team-Based Learning (SGSL-TBL) for Resident Education

Providing learner-specific didactic instruction to a small group of residents can be a challenge in postdoctoral education programs. To date, no data has been published reporting Team-Based Learning (TBL) outcomes when modified for a small group of resident learners, nor on stratifying information presented to learners based on postgraduate year (PGY). Stratification of the advance assignment appears effective as each individual resident outperformed their peers on information assigned to their training level. The group performed significantly better on questions pertaining to their assigned reading than on questions from reading assigned to other residents (p = 0.02), due to the significant difference in PGY1 performance (p = 0.01). Overall performance is similar to traditional TBL, shown by a significantly better group Team Readiness Assurance Test (TRAT) score over Individual Readiness Assurance Test (IRAT) scores (p = 0.01). The Accreditation Council for Graduate Medical Education (ACGME) and Commission on Dental Accreditation (CODA) require evaluation of residents relative to their training level and to their peers. This Small-Group Stratified-Learner TBL (SGSL-TBL) may offer useful resident evaluation tools, providing quantitative data not previously available to small-group resident-training programs through application of TBL.

Students' Perceptions of Team-based Learning in an Undergraduate Nutrition School

This article was migrated. The article was marked as recommended. Introduction: Current challenges in the food and nutrition fields have required training nutritionists to develop teamwork skills, demanding the use of active methodologies. Methods: This qualitative descriptive study aimed at knowing Nutrition students' perceptions about the use of Team Based Learning (TBL) in a course. Focus groups were conducted and submitted to content analysis. Results: Categories were grouped into three axes: (1) principles of the method ( teamwork, individual preparation and teacher's role), (2) results of the experience ( knowledge acquisition, critical judgment and communication/argumentation) and (3) meanings of the experience ( engagement/motivation and preference for the method). Teamwork was the most frequent category (51 occurrences), followed by knowledge acquisition (44) and engagement/motivation (35). Axis 1 categories came out linked to each other and to at least one Axis 2 category, revealing the course's coherence with TBL principles, thus allowing better knowledge acquisition, communication skills, and development of critical judgment. Axis 3 was connected to the others, pointing out that both principles of the method and results of the experience contributed to students' engagement and preference for the method. Conclusion: According tostudents' perceptions, TBL can contribute to provide nutritionists with better technical training, critical judgment, and communication skills.

The Neuroscience Classroom Remodeled with Team-Based Learning

As neuroscience faculty we strive to have students be invested in their learning and be engaged in the process. However, these attributes are difficult to promote using a lecture-based format. Flipping the classroom so that students prepare before coming to class obliges them to take responsibility for their learning. This, combined with having them work in Teams with their classmates - across the entire semester - provides incentive and support. This article describes how I applied a method called Team-Based Learning (TBL) to my Neurobiology course. TBL requires that students read the assigned text before class and demonstrate their knowledge through quizzes called Readiness Assurance Tests (RATs) that are completed first individually (iRAT) then by each Team (tRAT). This process uncovers the most challenging material and identifies student misconceptions that the instructor addresses through mini-lectures. In subsequent classes, students work in Teams solving content-specific application questions (ungraded) and complete four written Team assignments (graded) that require critical thinking and collective decisions. Teams represent a safe space for students to share knowledge, ask questions, learn from and teach one another. Placing students in Teams promotes regular attendance and ensures preparation before class. Students report that working in Teams helps them to remember content and how to use the group's knowledge to solve problems. They also note the benefits of hearing multiple perspectives, diverse arguments, and different ways to reason. Scores on hourly exams and course grades show that TBL is an effective means for students to learn Neurobiology.

Multistation exercises: a combination of problem-based learning and team-based learning instructional design for large-enrollment classes

To introduce active learning session for a large group of 250 students, we combined the strengths of problem-based learning and team-based learning to promote a structured active learning strategy with less faculty involvement. For the implementation of this strategy, a case on anemia was selected based on the module already covered in classes. Structured exercises were preplanned on six different concepts that a student should possess for solving the problem. The large group of 250 students was divided into groups of 41 or 42 each. The groups were facilitated by one faculty member for one structured exercise. At the station, the group of 41 or 42 was further broken down into 6 smaller groups comprising 7 students each. After completion of the exercise, students cycled to the next exercise station facilitated by another faculty member. The case was solved in a plenary session. The effectiveness of the method was assessed by comparing the academic performance of the group with other similar groups from the previous year. The intervention group performed significantly better than the nonintervention group on the related item. Quartile subanalysis found that the effect was present in the performance of average and higher quartile groups, but not in the lower quartile group.

Is lecture dead? A preliminary study of medical students' evaluation of teaching methods in the preclinical curriculum

OBJECTIVES

To investigate medical students' perceptions of lecture and non-lecture-based instructional methods and compare preferences for use and quantity of each during preclinical training.

METHODS

We administered a survey to first- and second-year undergraduate medical students at the University of Alabama School of Medicine in Birmingham, Alabama, USA aimed to evaluate preferred instructional methods.  Using a cross-sectional study design, Likert scale ratings and student rankings were used to determine preferences among lecture, laboratory, team-based learning, simulation, small group case-based learning, large group case-based learning, patient presentation, and peer teaching. We calculated mean ratings for each instructional method and used chi-square tests to compare proportions of first- and second-year cohorts who ranked each in their top 5 preferred methods.

RESULTS

Among participating students, lecture (M=3.6, SD=1.0), team based learning (M=4.2, SD=1.0), simulation (M=4.0, SD=1.0), small group case-based learning (M=3.8, SD=1.0), laboratory (M=3.6, SD=1.0), and patient presentation (M=3.8, SD=0.9) received higher scores than other instructional methods. Overall, second-year students ranked lecture lower (χ²_{(1, N=120)} =16.33, p<0.0001) and patient presentation higher (χ²_{(1, N=120)} =3.75, p=0.05) than first-year students.

CONCLUSIONS

While clinically-oriented teaching methods were preferred by second-year medical students, lecture-based instruction was popular among first-year students. Results warrant further investigation to determine the ideal balance of didactic methods in undergraduate medical education, specifically curricula that employ patient-oriented instruction during the second preclinical year.

Understanding the early effects of team-based learning on student accountability and engagement using a three session TBL pilot

BACKGROUND AND PURPOSE

This study examined the early effects of a team based learning (TBL) pilot, including differences in student engagement with TBL compared to lectures, and student accountability, preferences, and satisfaction with TBL.

EDUCATIONAL ACTIVITY AND SETTING

Three TBL sessions were delivered in the nephrology section of pharmacotherapy and then students completed the team-based learning student assessment instrument (TBL-SAI), which assesses TBL relative to lecture on three subscales (i.e., student accountability, preferences, and satisfaction). Students also completed a modified engagement instrument for a lecture and again for a TBL session.

FINDINGS

All students (160) participated in the survey (100% response rate). When comparing TBL and lecture engagement, five of eight statements were statistically significantly different. In TBL, students reported the strongest agreement with statements related to contributions (i.e., contributing fair share [mean 3.97], contributing meaningfully [mean 3.96]). Using the TBL-SAI, the mean score for accountability (30.64) was higher than neutral (24) indicating a higher level of accountability with TBL. Student satisfaction with TBL was neutral (mean 26.62, neutral = 27).

DISCUSSION AND CONCLUSIONS

In a three-session pilot, TBL had positive effects on engagement and accountability. Early positive effects could aid programs in building and maintaining momentum with the TBL approach while working towards outcomes that may take longer to achieve, such as changes in professionalism or teamwork. Duration of exposure and perseverance through the transition to TBL may be important in developing preferences and satisfaction. This study provides insights to programs and instructors about student perceptions and attitudes as TBL is introduced.

A collaborative clinical simulation model for the development of competencies by medical students

Herein, we present a new collaborative clinical simulation (CCS) model for the development of medical competencies by medical students. The model is a comprehensive compendium of published considerations and recommendations on clinical simulation (CS) and computer-supported collaborative learning (CSCL). Currently, there are no educational models combining CS and CSCL. The CCS model was designed for the acquisition and assessment of clinical competencies; working collaboratively and supported by technology, small groups of medical students independently design and perform simulated cases. The model includes four phases in which the learning objectives, short case scenarios, materials, indices, and the clinical simulation are designed, monitored, rated and debriefed.

Team-based learning in large enrollment classes

The goal of this review is to highlight the key elements needed to successfully deploy team-based learning (TBL) in any class, but especially in large enrolment classes, where smooth logistics are essential. The text is based on a lecture and workshop given at the American Physiological Society's Institute on Teaching and Learning in Madison, WI, in June 2016. After a short overview of the TBL method, its underpinning in learning theory, and a summary of current evidence for its effectiveness, we present two case studies from our own teaching practices in a new medical school. The first case study explores critical elements of design and planning for a TBL module, and the second explores best practices in classroom management. As medical educators in the fields of physiology, pediatrics, nephrology, and family medicine, we present the objective views of subject matter experts who adopted TBL as one teaching method rather than TBL experts or advocates per se. The review is aimed primarily at faculty contemplating using TBL for the first time who are interested in exploring the significant benefits and challenges of TBL.

Implementation of a team-based learning course: Work required and perceptions of the teaching team

BACKGROUND

Team-based learning was selected as a strategy to help engage pre-registration undergraduate nursing students in a second-year evidence-informed decision making course.

OBJECTIVES

To detail the preparatory work required to deliver a team-based learning course; and to explore the perceptions of the teaching team of their first experience using team-based learning.

DESIGN

Descriptive evaluation.

METHODS

Information was extracted from a checklist and process document developed by the course leader to document the work required prior to and during implementation. Members of the teaching team were interviewed by a research assistant at the end of the course using a structured interview schedule to explore perceptions of first time implementation.

RESULTS

There were nine months between the time the decision was made to use team-based learning and the first day of the course. Approximately 60days were needed to reconfigure the course for team-based learning delivery, develop the knowledge and expertise of the teaching team, and develop and review the resources required for the students and the teaching team. This reduced to around 12days for the subsequent delivery. Interview data indicated that the teaching team were positive about team-based learning, felt prepared for the course delivery and did not identify any major problems during this first implementation.

CONCLUSIONS

Implementation of team-based learning required time and effort to prepare the course materials and the teaching team. The teaching team felt well prepared, were positive about using team-based learning and did not identify any major difficulties.