Team-based learning increases active engagement and enhances development of teamwork and communication skills in a first-year course for veterinary and animal science undergraduates

Developing a model to promote caretaker confidence and communication in treatment decisions for dairy cattle through case studies

The significant role of dairy caretakers in maintaining animal welfare on dairy farms emphasizes the necessity of appropriate training and education to ensure the implementation of practices that promote good animal welfare. This study explored the potential of case-based learning as a novel approach to training for dairy caretakers by investigating dairy caretakers' perspectives on case study discussions. Additionally, this study sought to understand thoughts and feelings of caretakers during case study discussions to help identify information that caretakers use to evaluate cases and make decisions. Two case studies were developed and presented to participants, and thematic analysis of case study discussion transcripts was performed. Pre- and post-training questionnaires for 21 caretakers (n = 21) were summarized. The study found that caretaker reactions to case studies were generally positive. Thematic analysis revealed that caretakers use previous knowledge to make treatment decisions for cattle, and valued discussion with coworkers. The results of this study suggest the need for further investigation into the use of case studies and other activities that provide opportunities for critical thinking as training opportunities on dairy farms.

Design thinking for engaged learning in animal science: lessons from five semesters of a senior capstone course

This study presents a design-based research approach involving five iterations (semester) of implementing design thinking for engaged learning (DTEL) in an animal science capstone course. DTEL scaffolds design thinking into 10 stages for collaborative project-based learning to foster skills like problem solving and teamwork. Across five semesters (spring 2021 to spring 2023), student reflections (n = 276) were analyzed to identify aspects that worked well or were challenging. Network analysis visualized relationships (P < 0.05; Q > 0.4) between codes representing strengths, struggles, and alignment with principles from learning theories. Utilizing the relationships between strengths and theory-based principles to address struggles, resulted in changes to the design of the capstone course each iteration (time that the course was taught). The complexity of maps increased over iterations. Initially, struggles were prominent but decreased as responsive design refinements were made. Alignment of student experiences with principles from learning theories grew substantially from the first iteration to the last (theory-related nodes representing 11.4% vs. 24.4% in each network map, respectively), with learning theories also occupying more central positions in the last map (iteration five) compared to earlier ones (iterations one through four). These changes suggest student experiences increasingly aligned with principles of cognitive constructivism, social constructivism, constructionism, situated learning, and transformative learning. Design principles derived from the five-iteration study include: (1) allocating most time to hands-on lab work vs. lecture, (2) designating a coordinator faculty, (3) scaffolding for instructors unfamiliar with DTEL, (4) emphasizing consistency in processes over grades, and (5) intentionally developing teamwork skills. The study demonstrates the value of design-based research for iteratively refining and studying learning experiences to foster critical skills for undergraduate students in animal science.

Equivalent Performance of Exam Items Associated with Case-Based Learning, Flipped Classroom, and Lecture in a Pre-clerkship Medical Curriculum

The purpose of our study was to determine if knowledge acquisition, as measured by exam item performance, differed for active or passive learning activities in our medical curriculum. Additionally, we looked for differences in exam item performance in one second-year course that varies the method of an active learning activity, case-based collaborative learning (CBCL). Finally, we assessed whether item performance was impacted when small group activities were conducted online due to the COVID-19 pandemic. Exam item difficulty values were collected for several years of lectures, flipped classroom, and CBCL. Statistical analysis and modeling of data were performed to identify differences in difficulty of exam items that assess content delivered by different learning activities. Our analysis revealed no differences in difficulty of exam items that assess content delivered by different learning activities. Similarly, we determined that varying the execution of CBCL in one course did not impact exam item performance. Finally, moving CBCL small group sessions online did not impact exam item difficulty. However, we did detect a minor reduction in overall exam scores for the period of online instruction. Our results indicate that knowledge acquisition, as assessed by our multiple-choice summative exams, was equivalent regardless of learning activity modality.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01842-8.

A review of the application of active learning pedagogies in undergraduate animal science curricula

With most of the student attrition occurring early in undergraduate educational programs (Braunstein et al., 1997) it is necessary to interest and motivate students early on. The demographics of animal science students have shifted to students with minimal background in food producing animals. This presents a unique challenge as the current student population represents a diverse array of backgrounds and prior experiences. As a result, students enroll in undergraduate animal science programs with various expectations for their undergraduate degree and a focus primarily on careers in veterinary medicine. To engage all students, interest and motivation need to be generated. This review will use motivational frameworks as outlined by the self-determination theory, expectancy value theory, and interest, to explain the impact of the proposed solutions. Active learning classroom strategies are linked to increased knowledge compared with traditional, passive classrooms (Wells et al., 2019). Active learning shifts from a traditional teaching model to a student-centered model, which transitions instructors to facilitators of learning. This review summarizes current proposed pedagogies that have been researched in animal science classrooms such as experiential learning, flipped classrooms, hands-on animal experience, undergraduate research experiences, mentorship opportunities, capstone experiences, service-learning experiences, team-based learning, and cooperative learning. The limitations of these proposed pedagogies and the future research needed are also discussed.

Team-based learning-adopted strategy in pharmacy education: pharmacology and medicinal chemistry students' perceptions

Background

Team-based learning (TBL) provides an advanced teaching method for healthcare education; it is characterised by being an interactive teaching session that allows groups of learners to work together in teams to discuss and apply what they have learnt to certain clinical scenarios. The following study aims to evaluate the impact of TBL strategy on the students' comprehension and acquired knowledge, to allow better application and integration of knowledge. The aim of the study was to improve pharmacy students' skills in achieving learning outcomes by adapting TBL pedagogy in the lectures. Students' feedbacks were collected via post-lecture survey.

Results

The study was applied to pharmacy students covering two courses: Pharmacology III (Level 4) and Medicinal Chemistry I (Level 3) in a period of two-week lectures through the first semester of the academic year 2021/2022 in Future University in Egypt. The selected topics-related preparation materials were previously available on each course moodle page prior to the actual lecture, for the students to get prepared including growth hormone, sex hormones and their associated diseases for the pharmacology course and COVID-19 management for the Medicinal Chemistry course. The TBL lecture was started by dividing the students into teams and then readiness assurance tests were given, as individual readiness assurance test and then team readiness assurance test conceptual test were applied. The assessment of the students' decision-making skills and problem solving was evaluated through solving-related clinical cases. All the learning outcomes were achieved with maximum participation and interaction via an open discussion between the lecturer and the students during the lecture. A total of 116 students answered the survey and confirmed their satisfaction, better understanding and more participation in TBL lectures compared to other topics taught with the ordinary methods. More than half of the students recommended the TBL method for better perception and participation.

Conclusion

The students felt great appreciation for the team-based lecturing. Also, recommendations and suggestions were directed towards increasing the percentage of TBL lectures in the curriculum, as it helped them to concentrate more with high participation levels.

Increasing Team Effectiveness through Experiential Team Training: An Explanatory Mixed-Methods Study of First-Year Veterinary Students' Team Experiences

This article explores the impact of experiential team communication training on student team effectiveness. First-year veterinary students were concurrently enrolled in the Group Communication in Veterinary Medicine course and applied their knowledge to their authentic team experiences in the Veterinary Anatomy and Introduction to Clinical Problem Solving courses. All students completed a modified team effectiveness instrument and a team self-reflection at the end of the semester. Results show that students experienced a high level of team effectiveness. Although students experienced challenges with respect to staying on task and distributing roles and responsibilities, team coordination and communication improved over time, due in part to the team activities associated with the team training intervention. This research provides support for the impact of experiential team training to the development of team process skills and team effectiveness.

The Student Engagement Effect of Team-Based Learning on Student Pharmacists

Objective. To expand our understanding of student engagement by qualitatively examining how student pharmacists experienced the psychological state of engagement when applying team-based learning (TBL) pedagogy.Methods. A qualitative case study was conducted. Data were obtained through semi-structured interviews with a purposeful and convenience sample of student pharmacists (n=14). Our initial data analysis identified common themes for student engagement in TBL. We then characterized each common theme by deductively coding the themes into predetermined focal concepts of engagement based upon Kearsley and Shneiderman's 1 previous characterization of student engagement as either relate, create, or donate components.Results. Seven common themes arose from this research: accountability, communication, conflict, learning, preparation, purpose, and teamwork. Results indicated that student pharmacists engaged in TBL pedagogy mostly experience the psychological state of student engagement through a relate (41%) component by drawing on team support and trust, followed by the donate (32%) and create (27%) components.Conclusion. Findings in this study are consistent with other research on TBL pedagogy which concluded that, at least in part, this type of learning was a conduit for building student pharmacists' engagement skills. The novelty of this research is that it deductively characterized how student pharmacists perceive, comprehend, and interpret the psychological state of engagement in TBL. Specifically, our findings concluded student pharmacists mostly identify with a relate component of engagement by drawing on team support and trust developed from TBL tenets that encourage communication, conflict resolution, and teamwork.

Implementation of team-based learning (TBL) in a second year medical school course: does prior experience with TBL improve the impact of this pedagogy?

BACKGROUND

We have shown that use of Team-based learning (TBL) in a first-year Infectious Diseases (ID) course improved final examination and course performance. Therefore, we implemented TBL in the second-year Women's Health (WH) course to improve acquisition of course content. We hypothesized that prior experience with TBL in the first-year of medical school would lead to a strong correlation between TBL performance in the first and second years.

METHODS

Our study is a retrospective review of student TBL and final examination performance in the ID and WH courses. The ID course has weekly TBL exercises that cover all course material, while the WH course has one TBL that covers a small portion of the course material. Final examination and TBL individual readiness assurance test (iRAT) scores in the ID and WH courses from three classes (n = 226) were obtained with institutional review board approval. Statistical analyses were performed including comparisons of means and correlation studies.

RESULTS

Average WH iRAT scores were significantly higher than ID iRAT scores (9.19 vs. 7.40,p < 0.01), and iRAT scores in both courses were highly correlated (r = 0.35,p < 0.01). When stratifying students based on WH course performance, in struggling students, iRAT but not final examination scores were higher in the WH course than the ID course (8.73 vs. 7.00,p < 0.01 and 82.45 vs. 80.51,p > 0.05, respectively).

CONCLUSIONS

Our results suggest that prior experience with TBL improves TBL iRAT scores, especially in struggling students. Prior TBL experience is also associated with consistent iRAT performance between first- and second-year courses in high performing students.

Uncovering the 'messy details' of veterinary communication: An analysis of communication problems in cases of alleged professional negligence

BACKGROUND

Communication failure is reported as a cause of error in veterinary practice and has been associated with complaints and litigation. Evidence describing the types and nature of communication problems is lacking. This limits our ability to mitigate the risk poor communication poses.

METHODS

This study used a mixed methods approach to explore the frequency and types of communication problems present in settled cases of alleged veterinary professional negligence. Thematic analysis was conducted on written documents associated with 100 such cases involving canine patients. Interpretation was informed by human factors thinking and communication theory. Results were triangulated with findings from a focus group with the Veterinary Defence Society claims consultants and with healthcare literature on communication failures.

RESULTS

Communication problems played a contributory role in 80% of the cases examined. The analysis highlighted features of problematic communication in veterinary practice that are underrepresented in the current literature. These include the prominence of communication problems within veterinary teams, the impact of communication on the safety of care and also the interdependence of communication events with the context, system and environment in which they occur.

CONCLUSIONS

These results suggest that communication is a collective competency. Effective communication is something veterinary systems, rather than individuals alone, achieve. There is a need to consider the team and organisational contexts in which communication occurs to ensure individual communication skills can be translated into communication practices that support the delivery of high-quality, safe veterinary care for the benefits of clinicians, owners and patients.

Use of Team-Based Learning Pedagogy to Prepare for a Pharmacy School Accreditation Self-Study

Ensuring adequate engagement and preparation of all stakeholders in an accreditation self-study can be challenging for many reasons, including lack of motivation and inadequate understanding of expectations and procedures. The goal of this exploratory study was to determine whether using team-based learning (TBL) pedagogy to deliver an accreditation preparation workshop could effectively prepare and engage participants. A Likert-scale questionnaire was administered to workshop attendees (n = 52) to determine whether they found TBL-based training helpful and whether it promoted engagement. Twenty-four attendees completed the survey (46%). More than 80% of participants strongly agreed or agreed with 12 statements relating to perceptions of self and participant engagement within team activities and the usefulness of team activities. More than 65% of participants strongly agreed or agreed with statements relating to the helpfulness of the TBL approach in preparing for the self-study (five questions). Subgroup analysis showed no significant difference in responses based on whether on not participants had previously been involved in an accreditation self study. Our data indicate that a TBL approach can be an effective way to engage and prepare stakeholders for an accreditation self-study, and that TBL pedagogy has utility outside of the classroom setting.

The ubiquity of uncertainty: a scoping review on how undergraduate health professions' students engage with uncertainty

Although the evidence base around uncertainty and education has expanded in recent years, a lack of clarity around conceptual terms and a heterogeneity of study designs means that this landscape remains indistinct. This scoping review explores how undergraduate health professions' students learn to engage with uncertainty related to their academic practice. To our knowledge, this is the first scoping review which examines teaching and learning related to uncertainty across multiple health professions. The scoping review is underpinned by the five-stage framework of (Arksey and O'Malley in Scoping studies: Towards a methodological framework International Journal of Social Research Methodology 8(1) 19-32, 2005). We searched MEDLINE, Embase, PsychINFO, ISI Web of Science, and CINAHL and hand-searched selected health professions' education journals. The search strategy yielded a total of 5,017 articles, of which 97 were included in the final review. Four major themes were identified: "Learners' interactions with uncertainty"; "Factors that influence learner experiences"; "Educational outcomes"; and, "Teaching and learning approaches". Our findings highlight that uncertainty is a ubiquitous concern in health professions' education, with students experiencing different forms of uncertainty at many stages of their training. These experiences are influenced by both individual and system-related factors. Formal teaching strategies that directly support learning around uncertainty were infrequent, and included arts-based teaching, and clinical case presentations. Students also met with uncertainty indirectly through problem-based learning, clinical teaching, humanities teaching, simulation, team-based learning, small group learning, tactical games, online discussion of anatomy topics, and virtual patients. Reflection and reflective practice are also mentioned as strategies within the literature.

Development of Surgical Competence in Veterinary Students Using a Flipped Classroom Approach

Clinical skills laboratory (CSL) training was recently introduced in the renewed veterinary curriculum at Ghent University, using models and simulators for teaching practical skills. However, time in the CSL is restricted due to the large number of students combined with limited availability of personnel. Therefore, a flipped classroom (FC) model was introduced to maximize learning experiences. The goal of the present study was to evaluate the effect of flipped classroom CSL training on students' self-efficacy and practical surgical skills. Flipped classroom CSL training was implemented for the third-year pre-clinical students (n = 196) in the 6-year veterinary medicine program. Prior to CSL sessions, students studied online 'learning paths,' including text, pictures, videos of the skills, links to background information, a forum, and a compulsory pre-class quiz. A pre- and post-test were administered before and after flipped classroom CSL training. The tests consisted of a self-efficacy scale consisting of 20 items and an objective structured clinical examination (OSCE) test of surgical skills performance. Flipped classroom CSL training resulted in significantly higher self-efficacy (score/100, pre-test 55 ± 14 vs. post-test 83 ± 8, p< .001) and surgical skills performance (score/20, pre-test 5 ± 3 vs. post-test 17 ± 3, p< .001). In conclusion, this study demonstrated the feasibility and value of implementing a flipped classroom approach in combination with CSL training.

Animal sciences undergraduate education since the ASAS centennial: a national survey and scoping review

The rapid pace of advancement in animal sciences is drastically changing conditions for undergraduate teaching and learning in the discipline. Shortly after the American Society of Animal Science (ASAS) centennial, we conducted a national survey of 90 faculty instructors from 49 academic institutions to assess their perceptions of emerging teaching topics. Participants rated 18 learning outcomes (LO) and 16 types of courses and experiences (CE) with respect to their importance and the adequacy of available offerings. This study presents the results of the survey along with a scoping review of animal sciences teaching and learning publications since 2008 (n = 71). Results indicated that discipline-specific competencies and core experiential learning remain central to animal sciences teaching and identified several distinct needs for research. Namely, we suggest that future research in animal sciences teaching and learning 1) develop animal-science-specific expertise on a greater variety of pedagogies, 2) validate improved methods for assessing transferable skills, 3) expand pedagogical knowledge of emerging topics (e.g., sustainability, data science, welfare science, social science), and 4) deepen and broaden animal sciences’ teaching and learning identity through theory-building work and collaborations across instructors, disciplines, and institutions.

Evaluation of the effectiveness of student learning and teacher instruction on team-based learning during quality control of diagnostic imaging

Background: Team-Based Learning (TBL), which is a student-centered instructional approach, has been applied in various health-related courses, but research on the effectiveness of TBL in radiologic technology is limited. More research is needed to examine the effectiveness of TBL within the field of radiologic technology as well as to study teachers' reflective practices for instructional development in TBL.Objectives: This study examines the effectiveness of TBL on students' learning and course instructors' instructional development during quality control activities in diagnostic imaging.Design: This study employed an action research approach with mixed-methods. The study was categorized using four TBL modules as the topics: film/screen receptors and processors, radiography, mammography, and computed tomography. Quantitative data included pre-test scores on individual readiness assurance tests (IRAT-pre), group readiness assurance tests (GRAT), and post-test scores on individual readiness assurance tests (IRAT-post). Qualitative data included students' responses to open-ended questions about their experience with TBL and transcripts of instructors' interviews.Results: Forty junior college students participated in the study. A non-parametric test was conducted to compare the scores. The results showed that the GRAT score was significantly higher than the IRAT-pre-score, and the IRAT-post score was significantly higher than the IRAT-pre-score. The IRAT-post score was significantly higher than the GRAT score for the first and fourth modules, but IRAT-post score was significantly lower than the GRAT score on the second and third modules. Using direct content analysis, five themes were coded around instructional development, while 15 themes were coded to understand students' experiences with TBL.Conclusions: TBL can be an effective instructional approach to improve students' understanding of radiologic technology content. The results of this research can help instructors decide what action plan to implement to increase the effectiveness of TBL when further employing it for radiologic technology courses.

Evaluation of communication skills training programs at North American veterinary medical training institutions

OBJECTIVE

To describe how North American veterinary medical teaching institutions (VMTIs) provide communication skills training to students.

SAMPLE

Faculty coordinators of communication skills training programs (CSTPs) at 30 North American VMTIs.

PROCEDURES

An online survey instrument was designed and administered to each respondent followed by a telephone (n = 28) or in-person (2) interview. The survey and interview process were designed to evaluate all aspects of CSTPs, such as communication framework used, program format, number of student-contact hours, staffing models, outcome assessment, faculty background, program priorities, and challenges. Descriptive results were generated, and guidelines for future development of CSTPs were recommended.

RESULTS

27 US and 3 Canadian VMTIs were represented, and communication skills training was required at all. Twenty-five CSTPs used the Calgary-Cambridge Guide framework. Respondents provided a mean of 33 student-contact hours of training, primarily in the first 3 years of the veterinary curriculum in lecture (mean, 12 hours), communication laboratory (13 hours), and self-study (8 hours) formats with formative feedback. Communication skills training was integrated with other disciplines at 27 VMTIs. Most CSTPs were coordinated and taught by 1 faculty member with a < 0.50 full-time equivalent commitment and no administrative support. Stated priorities included acquisition of resources for CSTP faculty, administrative support, and video-equipped facilities; increasing integration of CSTPs into curricula; and assessment of educational outcomes.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that support for CSTPs and recognition of their value continue to grow, but a lack of resources, faculty expertise, validated methods for outcomes assessment, and leadership remain challenges.

Exploring Veterinary Medicine Students' Experiences with Team-Based Learning at the Universidad Andrés Bello

This study explored the use of team-based learning (TBL) in a Clinical Anatomy course taken by third-year veterinary medicine undergraduate students at the Universidad Andrés Bello in Chile. While research has shown that active learning methodologies yield improved student learning outcomes compared to lecture-based teaching, the incorporation of new pedagogical strategies is complex and its success depends on a range of contextual factors. This study sought to understand the strengths and weaknesses of using TBL in a specific subject (anatomy), discipline (veterinary medicine), and country (Chile). Students in the course had not been previously exposed to TBL. At the end of the semester during which TBL was used, the research team collected student satisfaction survey data and conducted a focus group in order to understand students' experiences with TBL in the course. We found that overall, students were satisfied with TBL and appreciated that it increased the amount of feedback they received, reinforced key concepts, and helped them to build skills they would need in their future professions. There was also a certain level of dissatisfaction, which may have been caused by negative experiences with team members and difficulties reading the preparatory material, which was in English. Given our findings, we discuss modifications that could be made in order to improve veterinary medicine students' experiences with TBL.

Implementation of Team-Based Learning: a Tale of Two New Medical Schools

Team-based learning (TBL) is gaining popularity at medical schools transitioning from lecture-based to active learning curricula. Here, we review challenges and opportunities faced in implementing TBL at 2 new medical schools. We discuss the importance of using meaningful TBL grades as well as the role TBL plays in developing critical reasoning skills and in early identification of struggling students. We also discuss how the concurrent use of learning strategies with different incentive structures such as problem- and case-based learning could foster the development of well-rounded physicians. We hope this monograph helps and even inspires educators implementing TBL at their schools.

Training the next generation of Africa's doctors: why medical schools should embrace the team-based learning pedagogy

BACKGROUND

As far back as 1995, the Cape Town Declaration on training Africa's future doctor recognized the need for medical schools to adopt active-learning strategies in order to nurture holistic development of the doctor. However, medical education in Africa remains largely stuck with traditional pedagogies that emphasize the 'hard skills' such as knowledge and clinical acumen while doing little to develop 'soft skills' such as effective communication, teamwork, critical thinking or life-long learning skills. By reviewing literature on Africa's epidemiologic and demographic transitions, we establish the need for increasing the output of well-trained doctors in order to match the continent's complex current and future healthcare needs. Challenges that bedevil African medical education such as outdated curricula, limited educational infrastructure and chronic resource constraints are presented and discussed. Furthermore, increased student enrollments, a trend observed at many schools, coupled with chronic faculty shortages have inadvertently presented specific barriers against the success of small-group active-learning strategies such as Problem-Based and Case-Based Learning. We argue that Team-Based Learning (TBL) offers a robust alternative for delivering holistic medical education in the current setting. TBL is instructor-driven and embodies key attributes that foster development of both 'hard' and 'soft' skills. We elaborate on advantages that TBL is likely to bring to the African medical education landscape, including increased learner enthusiasm and creativity, accountability, peer mentorship, deep learning and better knowledge retention. As with all new pedagogical methods, challenges anticipated during initial implementation of TBL are discussed followed by the limited pilot experiences with TBL in Africa.

CONCLUSION

For its ability to enable a student-centered, active learning experience delivered at minimum cost, we encourage individual instructors and African medical schools at large, to adopt TBL as a complementary strategy towards realizing the goal of training Africa's fit-for-purpose doctor.

Flipped Classroom Use in Veterinary Education: A Multinational Survey of Faculty Experiences

Active teaching approaches such as the flipped classroom are linked to better quality student learning outcomes across health care disciplines, with the potential to support students' preparedness for practice. In the flipped classroom instructional approach, students engage in significant pre-class preparation to learn foundational knowledge and skills, then undertake instructional activities in the classroom that require them to integrate, apply and extend their learning to new contexts. This study reports the results of a multinational survey of flipped classroom use in veterinary education. Participants' ( n = 165) familiarity with and extent of use of the flipped classroom technique were investigated, together with the teaching strategies used and the perceived benefits and barriers to implementation. Relationships between respondent characteristics and flipped classroom use were also explored. The results indicated that 95% of participants were familiar with the flipped classroom technique, although fewer (64%) used it in their teaching. Pre-class activities included reviewing online and printed material, and engaging in preparatory learning activities such as quizzes, case analyses, reflective assignments and group activities. A variety of active learning strategies were used in class, including discussions, presentations, quizzes, group activities, problem solving and laboratory/practical exercises. Most participants perceived that the flipped classroom technique benefited student learning, with some also identifying benefits for the faculty involved. A range of student-, faculty- and institution-related barriers to implementing the flipped classroom technique were identified. These barriers need to be considered and addressed by teachers and administrators seeking to improve students' preparedness for practice by implementing flipped classrooms in veterinary education.

Peer Feedback on Collaborative Learning Activities in Veterinary Education

Collaborative learning activities are an increasingly prominent feature of veterinary curricula that have been redesigned to achieve competency-based graduate learning outcomes. This evolution challenges the traditional individualistic approach to veterinary education and necessitates revisions to assessment and feedback practices to ensure constructive alignment. Peer feedback has been widely reported in the medical education literature as a teaching intervention in collaborative learning settings, with learning gains reported for students who receive and provide peer feedback. In this setting, peer feedback has been demonstrated to provide valuable formative feedback on professional behaviors and skills. However, there are very few such reports in the veterinary education literature to date. Barriers to the introduction of this approach can include teacher and student perceptions, and concerns around validity and reliability. This review aimed to provide an overview of current evidence regarding peer feedback on collaborative learning activities in higher education, and to explore opportunities and challenges for the introduction of peer feedback in the context of veterinary education. We contend that early and repeated provision of formative peer feedback can provide an opportunity to scaffold the development of crucial core competencies within veterinary education, including the self-regulated learning skills required to work in collaborative teams, and interpret and act on feedback.

Educating the Future of Science and Medicine

For the past two decades, veterinary educators have been at the forefront of innovations in educational practices related to science and medicine. Many of the resulting methods have been translated and implemented as best practices across the breadth of disciplines in higher education. However, past World Organization for Animal Health (OIE) global conferences have highlighted the necessity for improving global harmonization of veterinary medical education. This underscores a growing need for even broader dissemination of best practices and assessment programs related to educating our veterinary workforce.

Implementing the Flipped Classroom in a Veterinary Pre-clinical Science Course: Student Engagement, Performance, and Satisfaction

There has been a recent move toward active learning pedagogies in veterinary education, with increasing use of a blended approach that incorporates both online resources and live classroom sessions. In this study, an established veterinary pre-clinical course in introductory animal health was transitioned from a traditional didactic lecture delivery mode to a flipped classroom approach with core content delivered online. This study compared the experiences of two cohorts of students who studied the same course in the different formats in consecutive years. Online learning resources included short video segments and a variety of short problems and activities. Online materials were complemented with weekly small-group case-based learning classes facilitated by academic staff. A mixed methods evaluation strategy was applied using student grades, surveys, and focus groups to compare student academic performance, satisfaction, and engagement between the two cohorts. The flipped classroom cohort achieved significantly higher grades in the written answer section of the final examination. Student satisfaction with learning resources was also higher in this cohort. However, satisfaction with other aspects of the course was largely the same for both cohorts. This study revealed some of the challenges associated with achieving adequate student preparation for class using online resources. The outcomes of this study have implications for veterinary educators considering the design and development of new online learning resources.

Comparison of lecture and team-based learning in medical ethics education

BACKGROUND

Medical education literature suggests that ethics education should be learner-centered and problem-based rather than theory-based. Team-based learning is an appropriate method for this suggestion. However, its effectiveness was not investigated enough in medical ethics education.

RESEARCH QUESTION

Is team-based learning effective in medical ethics education in terms of knowledge retention, in-class learner engagement, and learner reactions?

RESEARCH DESIGN

This was a prospective controlled follow-up study. We changed lecture with team-based learning method to teach four topics in a 2-week medical ethics clerkship, while the remaining topics were taught by lectures. For comparison, we formed team-based learning and lecture groups, in which the students and instructor are the same, but the topics and teaching methodologies are different. We determined in-class learner engagement by direct observation and student satisfaction by feedback forms. Student success for team-based learning and lecture topics in the end-of-clerkship exam and two retention tests performed 1 year and 2 years later were compared.

ETHICAL CONSIDERATIONS

Ethical approval for the study was granted by Akdeniz University Board of Ethics on Noninvasive Clinical Human Studies Ethics committee.

FINDINGS

Short-term knowledge retention did not differ; however, team-based learning was found superior to lecture at long-term retention tests. Student satisfaction was high with team-based learning and in-class engagement was better in team-based learning sessions.

DISCUSSION

Our results on learner engagement and satisfaction with team-based learning were similar to those of previous reports. However, knowledge retention results in our study were contrary to literature. The reason might be the fact that students prepared for the end-of-clerkship pass/fail exam (short term) regardless of the teaching method. But, at long-term retention tests, they did not prepare for the exam and answered the questions just using the knowledge retained in their memories.

CONCLUSION

Our findings suggest that team-based learning is a better alternative to lecture to teach ethics in medical education.

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.

Nurses' perceptions of the impact of Team-Based Learning participation on learning style, team behaviours and clinical performance: An exploration of written reflections

Team-Based Learning (TBL) is a teaching strategy designed to promote problem solving, critical thinking and effective teamwork and communication skills; attributes essential for safe healthcare. The aim was to explore postgraduate student perceptions of the role of TBL in shaping learning style, team skills, and professional and clinical behaviours. An exploratory descriptive approach was selected. Critical care students were invited to provide consent for the use for research purposes of written reflections submitted for course work requirements. Reflections of whether and how TBL influenced their learning style, teamwork skills and professional behaviours during classroom learning and clinical practice were analysed for content and themes. Of 174 students, 159 participated. Analysis revealed three themes: Deep Learning, the adaptations students made to their learning that resulted in mastery of specialist knowledge; Confidence, in knowledge, problem solving and rationales for practice decisions; and Professional and Clinical Behaviours, including positive changes in their interactions with colleagues and patients described as patient advocacy, multidisciplinary communication skills and peer mentorship. TBL facilitated a virtuous cycle of feedback encouraging deep learning that increased confidence. Increased confidence improved deep learning that, in turn, led to the development of professional and clinical behaviours characteristic of high quality practice.

Does team-based learning improve performance in an infectious diseases course in a preclinical curriculum?

OBJECTIVES

To examine whether introduction of Team-based Learning (TBL) improves student learning resulting in improved performance on final examination questions and decreased failures in an infectious diseases course.

METHODS

To improve mastery of course content, we designed an intervention, which provided weekly TBL exercises in study years 2 and 3 to review concepts presented during didactic lectures and laboratory exercises.  The remaining course structure and content was essentially unchanged. All students taking the course (n=50 in year 1, n=64 in year 2, and n=72 in year 3) participated in this study. Student final examination performance and performance on individual final examination questions were collected and analyzed for changes in response to the study intervention.

RESULTS

Addition of weekly TBL exercises improved student performance on the course final examination as demonstrated by a statistically significant increase in the distribution of correct answer percentages for questions in common between the final examinations in years 1 and 2 and between years 1 and 3 (t₍₉₉₎ = 3.1454, p<0.05 and t₍₉₉₎ = 4.1268, p<0.01, respectively; Student-Newman-Keuls).  There was no statistical difference (t₍₉₇₎ = 0.9814, p> 0.05; Student-Newman-Keuls) in the distribution of correct answer percentages between years two and three. There was also a decrease in final examination failures in years two and three.

CONCLUSIONS

The results suggest that TBL could be used to improve mastery and retention of course content in a preclinical infectious diseases course. Weekly exercises allow students to identify and ameliorate weaknesses in understanding and make adjustments early in the course.

Approaches and Study Skills of Veterinary Medical Students: Effects of a Curricular Revision

The objective of this study was to determine if a revised, recently implemented curriculum, embracing an integrated block design with a focus on student-centered, inquiry-based learning, had a different effect on veterinary medical students' approaches to studying than the previous curriculum. A total of 577 students completed a questionnaire consisting of the short version of the Approaches and Study Skills Inventory for Students (ASSIST). It included questions relating to conceptions about learning, approaches to studying, and preferences for different types of courses and teaching. In addition, students were asked to respond to general questions regarding the design of the revised curriculum. The scores for the deep and strategic learning approaches were higher for students studying under the previous curriculum compared to the revised curriculum, despite the fact that the revised curriculum was specifically designed to foster deep learning. The scores for the surface learning approach were lower in the students studying the revised curriculum compared to students studying under the previous curriculum. We identified the following factors affecting student learning: alteration of learning activities, such as problem-based learning, from the recommended models; a lack of instructor support for the revised curriculum; assessments that were not aligned to encourage critical thinking; and directed self-learning activities that were too comprehensive to complete in the allotted time. The results of this study can be used to improve the implementation of student-centered and inquiry-based curricula by identifying potential problems that could prevent a deep learning approach in veterinary medical students.

Evaluation of team-based learning in a doctor of physical therapy curriculum in the United States

PURPOSE

The purpose of this retrospective study was to evaluate students' academic outcomes after implementation of the team-based learning (TBL) approach in patient/client management courses in an entry-level doctor of physical therapy (DPT) curriculum.

METHODS

The research design of this study involved comparing written and practical exam scores from DPT student cohorts taught with the traditional instructional methods (lecture-based) to those of students from subsequent cohorts taught using the TBL approach in two patient/client management courses: basic skills and cardiopulmonary. For this comparison, the exams used, the number of contact hours and labs, and the instructors who taught these courses remained the same during the transition between these two instructional methods (traditional vs. TBL). The average of all individual course exam scores was used for data analysis.

RESULTS

In both courses, there were no meaningful differences in the mean exam scores among students across years of cohorts receiving the same instructional method, which allowed clustering students from different years of cohorts in each course receiving the same instructional method into one group. For both courses, the mean exam score was significantly higher in the TBL group than in the traditional instruction group: basic skills course (P<0.001) and cardiopulmonary course (P<0.001).

CONCLUSION

Student cohorts taught using the TBL approach academically outperformed those who received the traditional instructional method in both entry-level DPT patient/client management courses.

The First Shared Online Curriculum Resources for Veterinary Undergraduate Learning and Teaching in Animal Welfare and Ethics in Australia and New Zealand

Simple Summary

There is a need for teaching Animal Welfare and Ethics in veterinary schools and we are developing online resources to meet this need. In this paper we describe how we prioritized the development of these resources by polling experts in the field.

Abstract

The need for undergraduate teaching of Animal Welfare and Ethics (AWE) in Australian and New Zealand veterinary courses reflects increasing community concerns and expectations about AWE; global pressures regarding food security and sustainability; the demands of veterinary accreditation; and fears that, unless students encounter AWE as part of their formal education, as veterinarians they will be relatively unaware of the discipline of animal welfare science. To address this need we are developing online resources to ensure Australian and New Zealand veterinary graduates have the knowledge, and the research, communication and critical reasoning skills, to fulfill the AWE role demanded of them by contemporary society. To prioritize development of these resources we assembled leaders in the field of AWE education from the eight veterinary schools in Australia and New Zealand and used modified deliberative polling. This paper describes the role of the poll in developing the first shared online curriculum resource for veterinary undergraduate learning and teaching in AWE in Australia and New Zealand. The learning and teaching strategies that ranked highest in the exercise were: scenario-based learning; a quality of animal life assessment tool; the so-called ‘Human Continuum’ discussion platform; and a negotiated curriculum.

Integration of gross anatomy in an organ system-based medical curriculum: strategies and challenges

The University of Alabama School of Medicine (UASOM) instituted a fully integrated, organ system-based preclinical curriculum in 2007. Gross anatomy and embryology were integrated with other basic science disciplines throughout the first two years of undergraduate medical education. Here we describe the methods of instruction and integration of gross anatomy and embryology in this curriculum as well as challenges faced along the way. Gross anatomy and embryology are taught through a combination of didactic lectures, team-based learning activities, and cadaveric dissection laboratories. Vertical integration occurs through third- and fourth-year anatomy and embryology elective courses. Radiology is integrated with anatomy instruction through self-study modules and hands-on ultrasound sessions. Our model of anatomy instruction is time efficient, clinically relevant, and effective as demonstrated by student performance on the United States Medical Licensing Examination(®) (USMLE(®) ) Step 1 examination. We recommend that medical schools considering full integration of gross anatomy and embryology (1) carefully consider the sequencing of organ system modules, (2) be willing to sacrifice anatomical detail for clinical application, (3) provide additional electives to third- and fourth-year students, and (4) integrate radiology with anatomical education.

Team-based learning in the gross anatomy laboratory improves academic performance and students' attitudes toward teamwork

As the healthcare climate shifts toward increased interdisciplinary patient care, it is essential that students become accomplished at group problem solving and develop positive attitudes toward teamwork. Team-based learning (TBL) has become a popular approach to medical education because of its ability to promote active learning, problem-solving skills, communication, and teamwork. However, its documented use in the laboratory setting and physical therapy education is limited. We used TBL as a substitute for one-third of cadaveric dissections in the gross anatomy laboratories at two Doctor of Physical Therapy programs to study its effect on both students' perceptions and academic performance. We surveyed students at the beginning and completion of their anatomy course as well as students who had previously completed a traditional anatomy course to measure the impact of TBL on students' perceptions of teamwork. We found that the inclusion of TBL in the anatomy laboratory improves students' attitudes toward working with peers (P < 0.01). Non-TBL students had significantly lower attitudes toward teamwork (P < 0.01). Comparison of academic performance between TBL and non-TBL students revealed that students who participated in TBL scored significantly higher on their first anatomy practical examination and on their head/neck written examination (P < 0.001). When asked to rate their role in a team, a 10.5% increase in the mean rank score for Problem Solver resulted after the completion of the TBL-based anatomy course. Our data indicate that TBL is an effective supplement to cadaveric dissection in the laboratory portion of gross anatomy, improving both students' grades and perceptions of teamwork.

Twelve tips for facilitating team-based learning

BACKGROUND

Team-based learning (TBL) has become a more commonly recognized and implemented pedagogical approach in curricula of numerous disciplines. The desire to place more autonomy on the student and spend less in-class time delivering content has resulted in complete or partial adoption of this style of learning in many educational settings.

AIM

Provide faculty with tools that foster a well facilitated and interactive TBL learning environment.

METHODS

We examined the published literature in the area of facilitation - specifically in TBL environments, and explored learning theories associated with team learning and our own experiences to create these facilitation tips.

RESULTS

We created 12 tips for TBL facilitation designed to assist faculty to achieve an effective and engaging TBL learning environment.

CONCLUSIONS

Applying these twelve tips while facilitating a TBL classroom session will help to ensure maximal participation and optimal learning in a safe yet stimulating environment.

Team-based learning as a teaching strategy for first-year medical students

BACKGROUND

Teaching programmes in medical education are now routinely employing active learning strategies to enhance the learning process and engage students in higher levels of learning. Team-based learning (TBL) is one active learning strategy that builds on individuals' strengths by allowing them to collaborate and work as a team to achieve a common learning objective.

AIMS

The present study aims to evaluate the impact of TBL on student performance. It also aims to assess students' attitudes towards TBL and the feasibility of its incorporation into the course curriculum.

METHODS

From a class of 241 students, 128 who agreed to participate in the study underwent two sessions of TBL each consisting of Individual and Group Readiness Assurance Tests (IRATs and GRATs). The readiness assurance tests each had 13 multiple choice questions (MCQ). To analyse the impact of TBL supplementation, the median sessional MCQ scores of students who underwent TBL supplementation (group 1) were compared with those who did not undergo the session (group 2). Students' experiences with TBL and their attitudes towards incorporation of TBL into the course curriculum were analysed using a feedback questionnaire that was given to students who underwent TBL.

RESULTS

Students belonging to the TBL group performed significantly better than the students who did not undergo TBL (p<0.001). The median sessional MCQ score of the TBL group was seven and non-TBL group was six. The overall mean attitude score obtained from feedback questionnaires was 3.57, which indicates a positive attitude towards TBL.

CONCLUSION

The team-based learning session improved student engagement with course content. The majority of the students felt that TBL supplementation enhanced their understanding of course content and believe that it will help them perform better in their exams.

Feasibility and sustainability of an interactive team-based learning method for medical education during a severe faculty shortage in Zimbabwe

BACKGROUND

In 2010, in the midst of the human immunodeficiency virus (HIV) epidemic in Zimbabwe, 69% of faculty positions in the Department of Medicine of the University of Zimbabwe College of Health Sciences (UZ-CHS) were vacant. To address the ongoing need to train highly skilled HIV clinicians with only a limited number of faculty, we developed and implemented a course for final-year medical students focused on HIV care using team-based learning (TBL) methods.

METHODS

A competency-based HIV curriculum was developed and delivered to final-year medical students in 10 TBL sessions as part of a 12 week clinical medicine attachment. A questionnaire was administered to the students after completion of the course to assess their perception of TBL and self-perceived knowledge gained in HIV care. Two cohorts of students completed the survey in separate academic years, 2011 and 2012. Descriptive analysis of survey results was performed.

RESULTS

Ninety-six of 120 students (80%) completed surveys. One hundred percent of respondents agreed that TBL was an effective way to learn about HIV and 66% strongly agreed. The majority of respondents agreed that TBL was more stimulating than a lecture course (94%), fostered enthusiasm for the course material (91%), and improved teamwork (96%). Students perceived improvements in knowledge gained across all of the HIV subjects covered, especially in challenging applied clinical topics, such as management of HIV antiretroviral failure (88% with at least a "large improvement") and HIV-tuberculosis co-infection (80% with at least a "large improvement").

CONCLUSIONS

TBL is feasible as part of medical education in an African setting. TBL is a promising way to teach challenging clinical topics in a stimulating and interactive learning environment in a low-income country setting with a high ratio of students to teachers.