Team-based learning in intensive course format for first-year medical students

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

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

The effect of modified team-based learning method on the knowledge and skills of medical emergency personnel: a clinical trial

Background

Trauma is one of the most important issues and problems considered in most countries in today's modern and industrial society. Since pre-hospital care is the first component of a trauma care system, if done properly, it can reduce the problems associated with long-term disability and death due to trauma. Therefore, the present study was conducted to determine the impact of training based on a modified team-based learning (TBL) method on the skills of medical emergency personnel in managing trauma patients in 2022.

Materials and methods

The present study was a two-group clinical before/after study in which 96 technicians were selected using a stratified random sampling method. The sample members were randomly divided into an intervention group and a control group. In the intervention group, skills for dealing with trauma patients were taught through a modified team-based learning method. The results were analyzed using SPSS software version 21.

Results

The results of the repeated measures analysis of variance showed a significant difference between the intervention and control groups in learning skills for dealing with trauma patients (P<0.001), which were determined by examining the effect of test repetition and the effect of interaction. The changes in the studied variables in the TBL groups were significantly greater than those in the control group (P<0.001).

Conclusion

The results indicate that training based on the modified team-based learning method is effective for the management of trauma patients by medical emergency personnel and improves the readiness of personnel in this field.

Evaluation of Student Engagement, Communication, and Collaboration During Online Group Work: Experiences of Fourth-Year Veterinary Medicine Students

Accelerated by the COVID-19 pandemic, online teaching has become widely established in higher education in recent years. However, little is known about the influence of the online environment on collaborative student activities, which are an integral part of veterinary education. This study explored engagement, collaboration, and communication among fourth-year veterinary students working in groups on online case-based learning (CBL) activities. Data were collected by questionnaire (93/135) and anonymous peer assessment (98/135) at the end of the trimester. While most students (67%) enjoyed group work and 75% considered it of benefit to their learning, the results indicated that the students' interaction was mainly limited to task management and collating individual answers on shared documents. Rather than meeting online, students communicated by chat and messenger apps. Agreement of roles, rules, and the group contract were largely treated as box-ticking exercises. Conflict was the only factor that affected group work satisfaction and was largely avoided rather than addressed. Interestingly lack of student engagement in group work was not related to overall academic performance and had no impact on their end-of-term exam results. This study highlights high student satisfaction and engagement with online group CBL activities even when collaboration and communication were limited. Achieving higher levels of collaborative learning involving co-regulation of learning and metacognitive processing of learning content may require more specific, formal training in relevant skill sets from an early stage of the veterinary curriculum.

Impact of Team-Based Learning Versus Lecture-Based Learning on Chinese Radiology Education: A Scoping Review and Meta-Analysis

This meta-analysis aimed to evaluate the effectiveness of team-based learning in radiology education. Data sources and selection criteria Databases were searched from inception up to August 2019 and included Pubmed, Medline, Embase, China National Knowledge Infrastructure (CNKI), Chinese Wanfang Database, and Chinese VIP. Randomized trials comparing teaching approaches for medical imaging of which provide the outcomes of theoretical scores and/or practical scores were included. Data were extracted independently by two authors and double-checked for accuracy. Outcomes included knowledge scores and practical scores. We pooled data using random-effects meta-analysis. Twelve trials involving 1,371 participants were included. Team-based learning teaching method had positive impacts on theoretical scores compared with the lecture-based learning or traditional teaching method (SMD = 1.07, 95% CI [0.50, 1.63]) and it positively improved skill scores (SMD = 0.68, 95% CI [0.19, 1.17]). Team-based learning could not only improve theoretical and skill scores in medical imaging courses but also encourage students to learn by themselves. Participants believed team-based learning raised their learning interest, team cooperation ability, and interpersonal communication skills. The heterogeneity of the included studies must be noticed and large well-designed and well-conducted trials are urgently needed.

Team-Based Learning Among Health Care Professionals: A Systematic Review

Introduced in the 1970s to meet the academic needs of a growing number of students with relatively stagnant faculty, team-based learning (TBL) has revolutionized the modern classroom structure. Contrary to the traditional didactic model where the teacher assumes the central role and students are passive listeners, TBL participants are actively involved in the learning process. Teachers act as facilitators while the TBL participants work in groups to solve problems through engagement with their peers. The objective of the article is to conduct a systematic review on team-based learning using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline.

The studies were searched in databases like PubMed®, Scopus®, Embase®, and PubMed Central® using appropriate keywords. Two authors screened the papers, and a third author resolved the conflicts. This was followed by a bibliographic review based on the references of the selected study and bias assessment using the Joanna Briggs Institute (JBI) critical appraisal tool.

The team-based learning model is increasingly being used by different institutions globally. TBL and traditional lecture-based teaching outcomes revealed that TBL participants performed better in academic, clinical, and communication domains. In addition, TBL enhanced learners' engagement, collaborative spirit, and satisfaction. Our study results are similar to the prior meta-analysis and systematic review. Nevertheless, this systematic review remains more comprehensive, up-to-date, and inclusive thus far.

Team-based learning is a pragmatic and superior approach to learning among health care professionals. It has resulted in better academic, clinical, and communication outcomes. This finding spans all the medical and allied professions studied in this systematic review.

Weekly team-based learning scores and participation are better predictors of successful course performance than case-based learning performance: role of assessment incentive structure

BACKGROUND

Incentives for preparation and participation in case-based (CBL) and team-based learning (TBL) differ by virtue of differences in assessment, allowing us to evaluate the role these incentives play in preparation and participation in these activities as well as overall course performance.

METHODS

Weekly TBL and CBL participation and performance as well as performance on the course final examination were recorded. Student participation was quantified and correlated with: (1) CBL preparation, participation, teamwork and completion of learning objectives scores, and (2) TBL individual readiness assurance test (iRAT) scores.

RESULTS

Student final examination scores (n = 95) were more strongly correlated with TBL than CBL performance. No significant correlation was found between iRAT and CBL scores. Student participation was measured in 3 CBL groups (8 students/group) and 4 TBL teams (6 students/team). TBL participation was more strongly correlated with final examination scores than CBL participation. TBL participation was also correlated with iRAT scores. CBL scores for preparation, participation, teamwork and completion of learning objectives did not significantly correlate with iRAT scores or TBL participation.

CONCLUSION

These results suggest that the assessment incentives and methods used in TBL result in student performance that better predicts performance on summative examinations.

Effectiveness of a Team-Based Learning exercise in the learning outcomes of a medical pharmacology course: insight from struggling students

We have previously reported that multiple Team-Based Learning (TBL™) exercises in a 4-week pre-clinical medical school course improved final exam performance and significantly reduced the number of course failures. Here, we conducted a long-term study, with eight cohorts of first-year medical students, to determine whether the implementation of a single TBL individual readiness assessment test (iRAT) exercise in a 4-week medical school pharmacology course produces similar effects in overall course performance. We implemented a single TBL iRAT exercise that covered the subjects addressed during one week of the medical pharmacology course, with the four most recent cohorts of students matriculating at Cooper Medical School of Rowan University (n = 403). The first four cohorts matriculating at CMSRU did not participate in the TBL exercises (n = 266). Correlation of individual student TBL iRAT and final examination scores in the medical pharmacology course was compared to a second, unrelated first-year course (physiology) to control for variation in student performance between cohorts. We found that there was a significant moderate correlation between final examination and TBL iRAT scores (r = 0.49, p < 0.01, n = 403). Interestingly this moderate correlation was seen in students performing in the lower 25^th percentile on the course final examination (r = 0.41, p < 0.01, n = 101) and negligible in students performing in the upper 25^th percentile (r = 0.11, n = 101, p > 0.05). Implementation of the single TBL exercise also significantly reduced variance or range of student final examination performance compared to the group of the first four cohorts. These results suggest that implementation of a single TBL exercise, which covers only one week of content delivered in a 1-month medical pharmacology course, benefits first-year medical students by reducing the disparity in knowledge acquisition among them and providing a means to identify students who may struggle with course content.

Necessity is the mother of invention: how the COVID-19 pandemic could change medical student placements for the better

COVID-19 led to the widespread withdrawal of face-to-face hospital-based clinical placements, with many medical schools switching to online learning. This precipitated concern about potential negative impact on clinical and interprofessional skill acquisition. To overcome this problem, we piloted a 12-week COVID-19 safe face-to-face clinical placement for 16 medical students at the Hospital for Tropical Diseases, London, during the first wave of the COVID-19 pandemic. COVID-19 infection control measures necessitated that students remained in ‘social bubbles’ for placement duration. This facilitated an apprenticeship-style teaching approach, integrating students into the clinical team for placement duration. Team-based learning was adopted to develop and deliver content. Teaching comprised weekly seminars, experiential ward-based attachments and participation in quality improvement and research projects. The taught content was evaluated through qualitative feedback, reflective practice, and pre-apprenticeship and post-apprenticeship confidence questionnaires across 17 domains. Students’ confidence improved in 14 of 17 domains (p<0.05). Reflective practice indicated that students valued the apprenticeship model, preferring the longer clinical attachment to existent shorter, fragmented clinical placements. Students described improved critical thinking, group cohesion, teamwork, self-confidence, self-worth and communication skills. This article describes a framework for the safe and effective delivery of a longer face-to-face apprenticeship-based clinical placement during an infectious disease pandemic. Longer apprenticeship-style attachments have hidden benefits to general professional training, which should be explored by medical schools both during the COVID-19 pandemic and, possibly, for any future clinical placements.

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.

Classroom Response System in a Super-Blended Learning and Teaching Model: Individual or Team-Based Learning?

Building an interactive environment during learning experience is sometimes hindered by student numbers in class, their sociocultural differences and limited teaching time, which may reduce student engagement. In this study we provided a super blended teaching and learning model by hybridising Classroom Response System (CRS) with Flipped Classroom (FC) and Team-Based Learning (TBL). CRS allowed learners to use their smart devices (e.g., phones, tablets and laptops) to respond to a variety of numerical, multiple-choice, short-answer and open ended questions posed during live classes and encouraged them to engage with classroom activities. Our Flipped-CRS (F-CRS) approach required the students to preview the e-learning material and watch the recorded lectures before the sessions and apply their knowledge within the session, either individually or as teams, by answering questions using TurningPoint CRS software. Learners provided positive feedback regarding F-CRS and the application of super blended teaching and learning model demonstrated a substantial increase in student collaboration and enhanced their motivation, engagement, attendance and academic performance, especially while using F-CRS approach in teams. Our super blended approach enabled educators to monitor student engagement throughout the year, facilitated formative assessment and assisted teachers to create crude class performance prediction in summative assessments.

Engaging Pharmacy Students in Interactive Life-Based Situations as the Basis for Teaching a Biochemistry Course

Objectives

Undergraduate pharmacy students have neither sufficient training on analyzing the role of biochemistry in actual-life situations nor on its effect on both health and disease. Therefore, we conducted this study to link the biochemistry course with actual-life situations and to encourage students to search for biochemistry answers for the health problems they face.

Methods

Students were randomized into different groups of three to five students. Every week, a group was asked to search the Internet for the most prevalent disease in their area associated with the biochemistry title studied. The group was asked to have an open discussion was their colleagues about a hot topic in life that is related to this subject. Finally, the group was asked to dig into social media for a current event that grabbed their attention in relation to this subject and write a short paragraph beyond the details. This scenario was repeated weekly using different student groups. The students’ opinion was collected before the conduction of the course and the end of the semester.

Results

The post-course questionnaire showed good improvement in the students’ ability to communicate effectively, conduct independent work, participate in active discussion, and solve problems. Overall, the students’ satisfaction was significantly elevated.

Conclusions

We have promoted a method to engage undergraduate students in linking biochemistry theories with real-life situations instead of just memorizing them. The new method improves the students' perception of biochemistry courses. Finally, it provides a promise of a new active learning strategy for undergraduate pharmacy students, which can be used widely to motivate students.

Did Clinical Reasoning and Knowledge Questions During Team-Based Learning Enhance Dental Students' Performance in Esthetic Dentistry?

The aim of this study was to assess whether clinical reasoning and factual knowledge questions used in team-based learning (TBL) enhanced dental students' performance in esthetic dentistry. Ninety-seven third-year dental students enrolled in esthetic dentistry in a dental school in Korea in 2018 were assigned to 16 teams consisting of five or six students each. A four-step TBL sequence (pre-study, readiness assurance test, appeal/feedback, and final test) was designed to examine how clinical reasoning and knowledge questions affected academically high- and low-achieving students. The analysis was conducted with 87 students' data because ten students failed to answer some questions. The results showed that team performance in TBL was consistently better than individual performance. The TBL sessions enhanced students' critical thinking skills, though it did not affect their knowledge acquisition. The clinical reasoning questions especially benefited the academically low-achieving students. Overall, TBL was an effective method for teaching these dental students using small-group learning in esthetic dentistry. Team-based cooperative learning facilitated a deeper understanding of esthetic dentistry because students were motivated to think critically and solve problems rather than simply memorize factual knowledge.

Student Learning of Radiological Anatomy Through Team-Based Learning Modules: Early Successes and Qualitative Analysis

Knowledge of the anatomy of radiological images is an essential foundation from which medical students may begin to build clinical skills. This foundation can be laid within an anatomy course optimizing student opportunity to compare cadaveric structures with medical images, possibly improving a student's visual-spatial abilities. Strong visual-spatial abilities allow students to perform better on examinations in medical anatomy. Team-based learning has enhanced the opportunities for active student learning allowing the acquisition of more skills for medical students in a time-limited curriculum. Other less measurable contributions can also be expected from a pedagogy that encourages students to work in teams.

Team-based learning pedagogy enhances the quality of Chinese pharmacy education: a systematic review and meta-analysis

BACKGROUND

Recent years have witnessed the wide application of team-based learning(TBL) pedagogy in Chinese pharmacy education. However, the relevant systematic review evaluating the effects of such new pedagogical approach has not been established. The present study was designed to examine systematically the effect of using TBL approach in pharmacy education in China.

METHODS

Six databases were searched from the inception to January 2019. The studies reporting the performance of pharmacy students in Chinese university or college receiving TBL pedagogy compared to those receiving traditional lecture-based learning (LBL) were enrolled to be analyzed. Scores of the objective theoretical test were considered as the primary outcome, and the results from questionnaires about the number of students who approved the effects of TBL pedagogy on improving their learning enthusiasm, self-study ability, thinking ability, and communication skills were considered as the secondary outcome. A meta-analysis was conducted following the guidelines of the Cochrane Reviewer's Handbook and the Preferred Reporting Items for Systematic Reviews and Meta Analyses statement.

RESULTS

A total of 1271 students in 12 studies published from 2013 to 2018 were enrolled in present analysis. Compared with traditional LBL pedagogy, TBL pedagogy exhibited more effectiveness in developing the objective tests scores of pharmacy students from both universities (SMD = 1.69, 95% CI [1.10, 2.28], p < 0.00001) and colleges (SMD = 4.37, 95% CI [1.33, 7.40], p < 0.00001), and such pedagogy applied well in experiments-oriented courses (SMD = 2.14, 95% CI [0.86, 3.43], p < 0.00001) and theory-oriented courses (SMD = 2.77, 95% CI [1.41, 4.14], p < 0.00001). In addition, it developed students' learning enthusiasm, students' self-study ability, thinking ability, and enhanced students' communication skills.

CONCLUSIONS

TBL pedagogy has developed rapidly and applied widely in Chinese pharmacy education during the last decade. The results indicated that such novel pedagogy is compatible with the present situation of Chinese pharmacy education. And it could be considered as an effective method to enhance both the theoretical test scores and various abilities of Chinese pharmacy students.

The effect of team-based learning on public health students' educational outcomes

BACKGROUND

The educational environment has been confirmed as crucial factor for active learning. Team-based learning (TBL) is an interactive teaching method which improves students' perceptions and performance.

OBJECTIVES

The comparison of the team-based learning method through lecture-based approach on health education curriculum in public health students.

METHODS

A quasi-experimental study was conducted among 23 public health students of bachelor degree and 14 public health students of associate degree to teach communication and Health Education in Qom University of Medical Sciences from January 2015 to Jun 2016. Students of bachelor degree selected TBL and students of associate degree preferred the traditional lecture-based method. In the current study, educational outcomes were defined as educational environment and academic performance. At the last session of the semester, the educational environment and academic performance of both groups were evaluated. Data were analyzed by SPSS version 20.0 using Chi-square and Mann-Whitney test.

RESULTS

The mean and standard deviation of individual test score between the two groups showed significant difference based on Mann-Whitney results (P = 0.036). The mean of final examination score in TBL group was significantly higher than the traditional lecture group (P < 0.021, Mann-Whitney). Our findings showed that in TBL group, 78.3% of students' perceptions were in very favorable condition while it was only 28.6% for students of the traditional method.

CONCLUSIONS

TBL method improves students' perceptions about each area of educational atmosphere and also provides opportunities to innovate which lead to active teamwork among learners, and it can effectively enhance students' academic performance.

Team-Based Learning Activities for First-Year Medical Students: Perception of the Learners

OBJECTIVES

Team-based learning (TBL) is an active learning strategy that is used increasingly in medical education to promote critical thinking, knowledge application, teamwork, and collaboration. The aim of this study was to assess the students' perspective on the utility of TBL compared with traditional lectures.

METHODS

We used a validated TBL student assessment instrument comprising three subscales studying accountability, preference for lecture or TBL, and student satisfaction. First-year medical students enrolled at the University of Florida College of Medicine in spring semester 2016 were asked to complete the questionnaire.

RESULTS

The response rate was 50% (70/138). Although 81% of students reported that they had to prepare before TBL and believed they had to contribute to the learning of their team, only 52% believed that they were accountable for team learning. The majority believed that TBL activities are an effective approach to learning (74%), with 78% agreeing that TBL activities helped them recall information. Fewer than half (45%), however, believed that TBL helped improve their grades.

CONCLUSIONS

Students reported a preference and satisfaction with TBL over traditional lectures, but a mixed response was noted on the questions pertaining to accountability for team learning.

Team-based learning in an undergraduate pathology curriculum and its effects on student performance

Objectives

Team-based learning (TBL) is a student-centered learning modality in which high and low achievers are organized in groups where students learn from each other at their own pace. The purpose of this study was to explore the correlations between TBL scores and final examination scores and student perceptions of a TBL system.

Methods

A cross-sectional survey was conducted on a sample obtained using quota sampling of a population of second-year students enrolled in the College of Medicine, University of Sharjah, Sharjah, United Arab Emirates. A self-administered questionnaire was employed to collect data on the students’ perceptions and opinions, TBL scores, and final examination scores. The data were processed and analyzed using SPSS Version 22.

Results

A sample of 101 students participated in the study. The Team Readiness Assurance Test scores were consistently higher than the mean Individual Readiness Assurance Test (IRAT) scores. The results found a statistically significant correlation between the IRAT and the final examination scores (r = 0.46, p < 0.001). About 57% of the sample agreed that TBL increased the understanding of course content, 45% reported that TBL was a useful learning activity, and 67% indicated that TBL enhanced interpersonal and communication skills.

Conclusion

The findings imply that TBL is an effective tool to facilitate inter-professional and team-based learning outcomes. Collaborations among TBL group members help learners to develop communication and interpersonal skills and to gain knowledge.

Meta-analysis on the effectiveness of team-based learning on medical education in China

BACKGROUND

Team-based learning (TBL) has been adopted as a new medical pedagogical approach in China. However, there are no studies or reviews summarizing the effectiveness of TBL on medical education. This study aims to obtain an overall estimation of the effectiveness of TBL on outcomes of theoretical teaching of medical education in China.

METHODS

We retrieved the studies from inception through December, 2015. Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Wanfang Database, Chinese Scientific Journal Database, PubMed, EMBASE and Cochrane Database were searched. The quality of included studies was assessed by the Newcastle-Ottawa scale. Standardized mean difference (SMD) was applied for the estimation of the pooled effects. Heterogeneity assumption was detected by I² statistics, and was further explored by meta-regression analysis.

RESULTS

A total of 13 articles including 1545 participants eventually entered into the meta-analysis. The quality scores of these studies ranged from 6 to 10. Altogether, TBL significantly increased students' theoretical examination scores when compared with lecture-based learning (LBL) (SMD = 2.46, 95% CI: 1.53-3.40). Additionally, TBL significantly increased students' learning attitude (SMD = 3.23, 95% CI: 2.27-4.20), and learning skill (SMD = 2.70, 95% CI: 1.33-4.07). The meta-regression results showed that randomization, education classification and gender diversity were the factors that caused heterogeneity.

CONCLUSIONS

TBL in theoretical teaching of medical education seems to be more effective than LBL in improving the knowledge, attitude and skill of students in China, providing evidence for the implement of TBL in medical education in China. The medical schools should implement TBL with the consideration on the practical teaching situations such as students' education level.

Evaluation of the role of incentive structure on student participation and performance in active learning strategies: A comparison of case-based and team-based learning

BACKGROUND

Student participation is important for the success of active learning strategies, but participation is often linked to the level of preparation. At our institution, we use two types of active learning activities, a modified case-based learning exercise called active learning groups (ALG) and team-based learning (TBL). These strategies have different assessment and incentive structures for participation. Non-cognitive skills are assessed in ALG using a subjective five-point Likert scale. In TBL, assessment of individual student preparation is based on a multiple choice quiz conducted at the beginning of each session.

METHODS

We studied first-year medical student participation and performance in ALG and TBL as well as performance on course final examinations.

RESULTS

Student performance in TBL, but not in ALG, was strongly correlated with final examination scores. Additionally, in students who performed in the upper 33rd percentile on the final examination, there was a positive correlation between final examination performance and participation in TBL and ALG. This correlation was not seen in students who performed in the lower 33rd percentile on the final examinations.

CONCLUSIONS

Our results suggest that assessments of medical knowledge during active learning exercises could supplement non-cognitive assessments and could be good predictors of performance on summative examinations.

The effects of team-based learning on learning outcomes in a course of rheumatology

INTRODUCTION

We evaluated the effects of implementing Team-Based Learning (TBL) on student engagement, accountability, satisfaction, and preference for lecture or team-based learning. Moreover, we assessed the effect of TBL on knowledge retention and application over time through short answer questions based on clinical scenarios addressing history taking and diagnosis skills in medical students.

METHODS

The study was conducted in a quasi-experimental design. The study population were all of the third-year medical students (n = 84) participating in a course of rheumatology in Shariati Hospital, which is a teaching hospital affiliated to Tehran University of Medical Sciences. We compared TBL with the conventional lecture-based method. The assessments were performed after implementation of TBL by the Classroom Engagement Survey (CES) and Team-Based Learning Student Assessment Instrument (TBL-SAI). The assessment for application of knowledge was conducted in 3 time-points through short answer questions on rheumatic diseases. The comparison of results was made by Student's t-test and repeated-measures analysis of variance (RM-ANOVA) using SPSS software, version 16.

RESULTS

The CES scores indicated a high level of engagement in TBL (Mean±SD=26.7±3.70, p=0.0001) but not in the lecture-based sessions (Mean±SD=23.80±4.35, p=0.09). The total mean score (SD) for TBL-SAI was 159.68 (14.14) for TBL sessions indicating a favorable outcome (p=0.0001). The student scores obtained from the short answer questions showed that over time the students' scores had declined significantly less for the TBL sessions in comparison to the lecture-based sessions, F (2, 166) = 4.624, p=0.011.

CONCLUSION

The results indicated higher student engagement, satisfaction and long term learning by TBL.

Effectiveness of the team-based learning (TBL) strategy on medical students' performance

Objectives

Team-based learning (TBL) represents a new and interesting educational strategy. It helps to enhance students' professional competencies and ideally works to prepare them in their pursuit of lifelong learning. The aim of this study is to evaluate the effectiveness of TBL as an educational strategy on medical students' performance in a problem-based learning (PBL) curriculum.

Methods

A cross-sectional study was conducted through a self-designed questionnaire. It was constructed to examine several aspects of TBL, including cognition, social skills, high school educational system, and personal development. A total of 112 students were invited to participate in the study and 100 completed the survey. Individual-readiness assurance test (IRAT) and group-readiness assurance test (GRAT) scores were collected and the data were analysed and compared to the results of the final assessment using Statistical Package for the Social Sciences (SPSS).

Results

A total of 52 students (52%) described TBL as fostering a cooperative learning environment and 64 students (64%) found the materials to be easier to understand when discussed among themselves as a group. Compared to final examination results, there was a significant correlation (p = 0.0001) between IRAT performance and final exam score. In addition, there was a significant correlation between high school education system and IRAT score, where the best performance was observed among students coming from schools using the British curriculum.

Conclusions

The overall perception and attitude of students toward the TBL system was positive and promising. Nevertheless, there are some notes and areas of concern that must be re-examined and remedied to improve TBL as an educational tool.

Team-based learning (TBL) in the medical curriculum: better than PBL?

BACKGROUND

Internationally, medical schools have long used a variety of approaches to develop hybrid Problem based learning (PBL) curricula. However, Team-based learning (TBL), has gained recent popularity in medical education. TBL maintains the advantages of small group teaching and learning, but in contrast to Problem-based learning (PBL), does not require large numbers of tutors. In 2016, TBL was introduced to Year 1 of the Sydney Medical Program (SMP).This study sought to compare students' perceptions of using TBL in place of PBL.

METHODS

Year 1 students (n = 169) completed three PBL and three TBL sessions during one of the following teaching blocks: Musculoskeletal (n = 56), Respiratory (n = 59) or Cardiovascular (n = 54). Student feedback following completion of each block of teaching was collected by questionnaire, using closed and open ended items. Data were analysed using descriptive statistics and thematic analysis.

RESULTS

In total, 144/169 (85%) of participants completed a questionnaire regarding PBL, and 152/169 (90%) completed a similar questionnaire regarding TBL. The students found positive aspects of their TBL experience to include the smaller group size, the use of readiness assurance tests, immediate feedback from senior clinicians, and time efficiency. In PBL, students reported that variable expertise of tutors; limited direction; and large group size hindered their learning.

CONCLUSIONS

Overwhelmingly, students preferred TBL over PBL, as the optimal teaching strategy. Students found the structure and format of the TBL sessions more conducive to learning, engagement and participation than PBL sessions. Although the use of TBL required an instructional approach, needing direction from the tutor, it remained student-centred, generating a range of positive outcomes. Study results provide confidence to change from PBL to TBL within Year 1 and Year 2 of the SMP in 2017.

A systematic review of the published literature on team-based learning in health professions education

PURPOSE

Summarize the published literature on team-based learning (TBL) in health professions education (HPE) using the TBL conceptual framework to identify gaps that can guide future research Methods: PubMed, Web of Science, ERIC, and Google Scholar were searched through May 2016 for English-language articles regarding the use of TBL in HPE. Reviewers independently extracted data and coded for the seven elements in Michaelsen's Model of TBL.

RESULTS

A total of 118 articles met inclusion criteria. The number of articles published yearly on TBL has grown steadily, more than tripling between 2011 and 2016. Most studies (55; 47%) involved undergraduate medical students and took place in the US (72; 61%). The most commonly studied framework component was Teacher and Learner Attitudes (97; 82%). Other commonly studied elements included Learning Outcomes (85; 72%) and Team Characteristics (25; 21%). Contextual Factors affecting TBL was addressed in one study.

CONCLUSIONS

A substantial body of literature examines the effect that TBL has on traditional measures of achievement. However, many dimensions of TBL have not been well studied, including Teacher Decisions about TBL, Contextual Factors that affect TBL, Learners' Engagement, and Pattern of Engagement within Teams. Future research in these areas could determine the best use of TBL in HPE.

Group Problem Solving in Class Improves Undergraduate Learning

Developing methods for improving student learning is a long-standing goal in undergraduate science education. However, the extent to which students working on problems in small groups versus individually results in improved learning among undergraduate science students has not been evaluated in a randomized controlled trial. We have performed such a trial with 80 students in an undergraduate biochemistry class, in which students were randomized to either learning in groups or learning individually. All students participated in the same class, which consisted of a lecture with periodic breaks for students to solve problems using an audience response system. Students in the individual learning condition answered these questions on their own, but students in the group-based learning condition answered these questions in an assigned group of four students. At the end of the class, all students then took the same exam as individuals. The exam had two types of questions-recall questions, in which students had to simply recall information provided to them, and predict questions, in which students had to apply their new knowledge to a new context. Students in the individual and group-based learning conditions performed similarly well on recall questions. However, students who had been in the group-based learning condition performed significantly better as individuals on the predict questions. This suggests that learning in groups may be more effective than individual learning for undergraduate science students, particularly for applying their knowledge to new contexts; this highlights the potential need for pedagogical approaches in undergraduate science courses that incorporate learning in groups.

Applying team-based learning of diagnostics for undergraduate students: assessing teaching effectiveness by a randomized controlled trial study

Background

We aimed to introduce team-based learning (TBL) as one of the teaching methods for diagnostics and to compare its teaching effectiveness with that of the traditional teaching methods.

Methods

We conducted a randomized controlled trial on diagnostics teaching involving 111 third-year medical undergraduates, using TBL as the experimental intervention, compared with lecture-based learning as the control, for teaching the two topics of symptomatology. Individual Readiness Assurance Test (IRAT)-baseline and Group Readiness Assurance Test (GRAT) were performed in members of each TBL subgroup. The scores in Individual Terminal Test 1 (ITT1) immediately after class and Individual Terminal Test 2 (ITT2) 1 week later were compared between the two groups. The questionnaire and interview were also implemented to survey the attitude of students and teachers toward TBL.

Results

There was no significant difference between the two groups in ITT1 (19.85±4.20 vs 19.70±4.61), while the score of the TBL group was significantly higher than that of the control group in ITT2 (19.15±3.93 vs 17.46±4.65). In the TBL group, the scores of the two terminal tests after the teaching intervention were significantly higher than the baseline test score of individuals. IRAT-baseline, ITT1, and ITT2 scores of students at different academic levels in the TBL teaching exhibited significant differences, but the ITT1-IRAT-baseline and ITT2-IRAT-baseline indicated no significant differences among the three subgroups.

Conclusion

Our TBL in symptomatology approach was highly accepted by students in the improvement of interest and self-directed learning and resulted in an increase in knowledge acquirements, which significantly improved short-term test scores compared with lecture-based learning. TBL is regarded as an effective teaching method worthy of promoting.

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.

Team-Based Learning in a Graduate Nurse Residency Program

Nurse residency programs have become a standard of practice for transitioning nurses into the workforce. Resources and support determine the length and structure of these programs. New content and information is often delivered by the traditional lecture style. The organization described in this article implemented an innovative framework, derived from team-based learning, that facilitated learner engagement, interprofessional communication and patient care, enhanced critical thinking, problem solving, and knowledge development.

The Healer's Art (HART): Veterinary Students Connecting with Self, Peers, and the Profession

This case study sought to understand veterinary students' perceptions and experiences of the Healer's Art (HART) elective to support well-being and resilience. Students' "mindful attention" was assessed using the MAAS-State scale. Course evaluations and written materials for course exercises (artifacts) across the 2012-2015 cohorts of Colorado State University's HART veterinary students (n=99) were analyzed for themes using a grounded theory approach, followed by thematic comparison with analyses of HART medical student participants. HART veterinary students described identity/self-expression and spontaneity/freedom as being unwelcome in the veterinary curriculum, whereas HART medical students described spirituality as unwelcome. HART veterinary students identified issues of "competition" and "having no time," which were at odds with their descriptions of not competing and having the time to connect with self and peers within their HART small groups. HART veterinary students shared that the course practices of nonjudgment, generous listening, and presence (i.e., mindfulness practices) helped them build relationships with peers. Although not statistically significant, MAAS pre-/post-scores trended in the positive direction. HART provides opportunities for students to connect with self and foster bonds with peers and the profession, factors that are positively associated with resilience and wellness.

Team-based Learning Strategy in Biochemistry: Perceptions and Attitudes of Faculty and 1st-Year Medical Students

Background:

Team-based learning (TBL) strategy has been widely adapted by medical schools all over the world, but the reports regarding the perceptions and the attitudes of faculty and undergraduate medical students towards TBL approach have been conflicting.

Aim:

The study aimed to introduce TBL strategy in curriculum of Biochemistry after evaluating its effectiveness through perceptions and attitudes of faculty and 1^st-year medical students.

Materials and Methods:

One hundred and fifty students of first professional M.B.B.S and five faculty members participated in the study. Their responses regarding perceptions and attitudes towards TBL strategy were collected using structured questionnaires, focus group discussions, and in-depth interviews. Data were analyzed using Wilcoxon signed-rank test, paired sample t-test, and Mann–Whitney U-test.

Results:

Majority of the students expressed satisfaction with team approach and reported improvement in the academic scores, learning styles, and development of problem-solving, interpersonal, and professional skills. The faculty, however, recommended a modified TBL approach to benefit all sections of the students for the overall success of this intervention.

Conclusion:

TBL is an effective technique to enable the students to master the core concepts and develop professional and critical thinking skills; however, for the 1^st-year medical students, a modified TBL approach might be more appropriate for the effective outcomes.

Comparison of medical students' learning approaches between electronic and hard copy team-based learning

AIM

To compare the students' perception of team-based learning (TBL): The paper (hard copy) compared with the e-copy (electronic copy) in the family medicine course of the fifth year medical students, Qassim University College of Medicine.

METHODS

A cross-sectional study was conducted during the family medicine course in 2015-2016 to compare the hard copy and the e-copy TBL sessions. We used Google drive to distribute, collect and analyze the questionnaire. The results of the e-copy TBL are shown and displayed directly with each session to the students, which was not the same as practiced with hard copy. We used also SPSS (version 17 for Windows) for more statistical analysis.

RESULTS

The total number of respondents of students in each was 96; a phase of TBL phase 1 (hard copy) and phase 2 (e-copy). Male were 64 (66.7%) and females 32 (33.3%). The first three knowledge questions showed no difference between the mean score between paper and e-copy TBL, but of the perception questions showed a significant difference between the paper and e-copy TBL.

CONCLUSIONS

The results of the survey showed that the students prefer e-copy TBL as a course format, as it was an attraction for most of the students and making them even more successful in the key exam and e-copy TBL develop the skills needed to work productively in task-groups.

Modified Team-Based Learning in an Ophthalmology Clerkship in China

Objective

Team-based learning (TBL) is an increasingly popular teaching method in medical education. However, TBL hasn’t been well-studied in the ophthalmology clerkship context. This study was to examine the impact of modified TBL in such context and to assess the student evaluations of TBL.

Methods

Ninety-nine students of an 8-year clinical medicine program from Zhongshan Ophthalmic Centre, Sun Yat-sen University, were randomly divided into four sequential units and assigned to six teams with the same faculty. The one-week ophthalmology clerkship module included traditional lectures, gross anatomy and a TBL module. The effects of the TBL module on student performance were measured by the Individual Readiness Assurance Test (IRAT), the Group Readiness Assurance Test (GRAT), the Group Application Problem (GAP) and final examination scores (FESs). Students’ evaluations of TBL were measured by a 16-item questionnaire. IRAT and GRAT scores were compared using a paired t-test. One-way analysis of variance (ANOVA) and subgroup analysis compared the effects among quartiles that were stratified by the Basic Ophthalmology Levels (BOLs). The BOLs were evaluated before the ophthalmology clerkship.

Results

In TBL classes, the GRAT scores were significantly higher than the IRAT scores in both the full example and the BOL-stratified groups. It highlighted the advantages of TBL compared to the individual learning. Quartile-stratified ANOVA comparisons showed significant differences at FES scores (P < 0.01). In terms to IRAT, GRAT and GAP scores, there was no significant result. Moreover, IRAT scores only significantly differed between the first and fourth groups. The FES scores of the first three groups are significantly higher than the fourth group. Gender-specific differences were significant in FES but not the IRAT. Overall, 57.65% of student respondents agreed that TBL was helpful. Male students tended to rate TBL higher than female students.

Conclusion

The application of modified TBL to the ophthalmology clerkship curriculum improved students’ performance and increased students’ engagement and satisfaction. TBL should be further optimized and developed to enhance the educational outcomes among multi-BOLs medical students.

Incorporating Team-Based Learning Into a Physician Assistant Clinical Pharmacology Course

PURPOSE

To obtain student perceptions of team-based learning and compare the effectiveness of team-based learning and traditional lecture formats in a clinical pharmacology course for physician assistant (PA) students.

METHODS

Clinical pharmacology is a course offered to PA students in their first year of training at LIU Brooklyn, Brooklyn, NY. In spring 2014, half of the course was offered in a traditional lecture format and the remaining half was offered in a team-based learning format. The team-based learning format had 3 components: (1) prereading assignments, (2) individual readiness assessment tests, and (3) team readiness assessment tests. So that student perceptions of the integration of team-based learning activities into the course could be evaluated, presurveys and postsurveys were administered. The effectiveness of team-based learning was evaluated by comparing overall student performance with student performance in the preceding year.

RESULTS

Thirty-three students were enrolled in the course and completed the presurveys and postsurveys. The survey results are presented in Table 1. Comparison of student performance on examinations with performance from the previous year showed similar outcomes.

CONCLUSION

Incorporating a team-based learning pedagogical approach in the PA pharmacology course yielded similar examination results to those of traditional lecture formats. Presurvey and postsurvey questionnaires yielded various student perceptions of team-based learning.

Implementation of team-based learning in year 1 of a PBL based medical program: a pilot study

BACKGROUND

A traditional and effective form of teaching within medical education has been Problem Based Learning (PBL). However, this method of teaching is resource intensive, normally requiring one tutor for every ten students. Team-based learning (TBL) has gained recent popularity in medical education, and can be applied to large groups of up to 100 students. TBL makes use of the advantages of small group teaching and learning, but in contrast to PBL, does not need large numbers of teachers. This study sought to explore the efficacy of using TBL in place of PBL in Year 1 of a medical program.

METHODS

In Year 1 of the medical program, two iterations of TBL, with 20 students, were run following four iterations of PBL within the Cardiology teaching block. Student feedback following PBL and TBL was collected by questionnaire, using closed and open ended questions. Additionally, individual and team tests were held at the beginning of each TBL class, and results of each week were compared.

RESULTS

All students (n = 20) participated in the test in week 1, and 18/20 students participated in week 2. In total, 19/20 (95%) of students completed the questionnaires regarding their PBL and TBL experiences. The use of small groups, the readiness assurance tests, immediate feedback from an expert clinician, as well as time efficiency were all aspects of the TBL experience that students found positive. The clinical problem-solving activity, however, was considered to be less effective with TBL. There was a significant improvement (p = 0.004) in students' score from the week 1 assessment (median = 2) to the week 2 (median = 3.5) assessment. Interestingly, all teams but one (Team 1) achieved a lower score on their second week assessment than on their first. However, the lowest performing team in week 1 outperformed all other teams in week 2.

CONCLUSION

Students favoured many aspects of the TBL process, particularly motivation to do the pre-reading, and better engagement in the process. Additionally, the application of TBL principles meant the sessions were not reliant upon a large teacher to student ratio. Students, however, highlighted the need for more time within TBL for clinical problem-solving.

Reliability assessment of a peer evaluation instrument in a team-based learning course

OBJECTIVE

To evaluate the reliability of a peer evaluation instrument in a longitudinal team-based learning setting.

METHODS

Student pharmacists were instructed to evaluate the contributions of their peers. Evaluations were analyzed for the variance of the scores by identifying low, medium, and high scores. Agreement between performance ratings within each group of students was assessed via intra-class correlation coefficient (ICC).

RESULTS

We found little variation in the standard deviation (SD) based on the score means among the high, medium, and low scores within each group. The lack of variation in SD of results between groups suggests that the peer evaluation instrument produces precise results. The ICC showed strong concordance among raters.

CONCLUSIONS

Findings suggest that our student peer evaluation instrument provides a reliable method for peer assessment in team-based learning settings.

A Rapid Review of the Factors Affecting Healthcare Students' Satisfaction with Small-Group, Active Learning Methods

PHENOMENON: Problem-based learning (PBL) and other small-group, active learning methodologies have been widely adopted into undergraduate and postgraduate healthcare curricula across the world. Although much research has examined student perceptions of these innovative teaching pedagogies, there are still questions over which factors influence these views. This article aims to identify these key elements that affect healthcare student satisfaction with PBL and other small-group learning methods, including case-based and team-based learning.

APPROACH

A systematic rapid review method was used to identify high-quality original research papers from the healthcare education literature from between 2009 and 2014. All papers were critically appraised before inclusion in line with published guidelines. Narrative synthesis was achieved using an inductively developed, thematic framework approach.

FINDINGS

Fifty-four papers were included in the narrative synthesis. The evidence suggests that, despite an initial period of negative emotion and anxiety, the perspectives of healthcare students toward small-group, active learning methods are generally positive. The key factors influencing this satisfaction level include (a) the facilitator role, (b) tutorial structure, (c) individual student factors, (d) case authenticity, (e) increased feedback, (f) group harmony, and (g) resource availability. Insights: Student satisfaction is an important determinant of healthcare education quality, and the findings of this review may be of value in future curriculum design. The evidence described here suggests that an ideal curriculum may be based on an expert-led, hybrid PBL model.

The Impact of Team-Based Learning on Nervous System Examination Knowledge of Nursing Students

INTRODUCTION

Team-based learning is one of the active learning approaches in which independent learning is combined with small group discussion in the class. This study aimed to determine the impact of team-based learning in nervous system examination knowledge of nursing students.

METHODS

This quasi-experimental study was conducted on 3(rd) grade nursing students, including 5th semester (intervention group) and 6(th) semester (control group). The traditional lecture method and the team-based learning method were used for educating the examination of the nervous system for intervention and control groups, respectively. The data were collected by a test covering 40-questions (multiple choice, matching, gap-filling and descriptive questions) before and after intervention in both groups. Individual Readiness Assurance Test (RAT) and Group Readiness Assurance Test (GRAT) used to collect data in the intervention group. In the end, the collected data were analyzed by SPSS ver. 13 using descriptive and inferential statistical tests.

RESULTS

In team-based learning group, mean and standard deviation was 13.39 (4.52) before the intervention, which had been increased to 31.07 (3.20) after the intervention and this increase was statistically significant. Also, there was a statistically significant difference between the scores of RAT and GRAT in team-based learning group.

CONCLUSION

Using team-based learning approach resulted in much better improvement and stability in the nervous system examination knowledge of nursing students compared to traditional lecture method; therefore, this method could be efficiently used as an effective educational approach in nursing education.

Student Perceptions of Team-based Learning vs Traditional Lecture-based Learning

OBJECTIVE

To evaluate pharmacy student perceptions of team-based learning (TBL) vs traditional lecture-based learning formats.

METHODS

First professional year pharmacy students (N=111) at two universities used TBL in different courses during different semesters (fall vs spring). Students completed a 22-item team perceptions instrument before and after the fall semester. A 14-item teaching style preference instrument was completed at the end of the spring semester. Data were analyzed using Wilcoxon signed rank test and Mann-Whitney U test.

RESULTS

Students who experienced TBL in the fall and went back to traditional format in the spring reported improved perceptions of teams and preferred TBL format over a traditional format more than students who experienced a traditional format followed by TBL. Students at both universities agreed that the TBL format assists with critical-thinking, problem-solving, and examination preparation. Students also agreed that teams should consist of individuals with different personalities and learning styles.

CONCLUSION

When building teams, faculty members should consider ways to diversify teams by considering different views, perspectives, and strengths. Offering TBL early in the curriculum prior to traditional lecture-based formats is better received by students, as evidenced by anecdotal reports from students possibly because it allows students time to realize the benefits and assist them in building teamwork-related skills.

Effects of Team-Based Learning on short-term and long-term retention of factual knowledge

PURPOSE

We investigated the effect of Team-Based Learning (TBL) on long-term retention of knowledge in comparison to a traditional curriculum.

METHODS

As TBL was incorporated into our curriculum in the 2008-2009 academic year, students were compared with those who received the traditional curriculum the year prior. Students in both the groups completed multiple-choice knowledge test at four time points spanning two years. Test performance was compared at each time point to assess changes in knowledge retention as a function of time.

RESULTS

Baseline knowledge did not differ significantly between the TBL and control groups [51% versus 46%; t(84) = 0.91, p = 0.37, d = 0.20]. Performance improved after the course for both the groups, but was significantly higher in the TBL group [79% versus 59%; t(84) = 4.96, p = 0.000004, d = 0.95]. However, when assessed prior to the pediatrics clerkship, learning gains from TBL had largely disappeared and the small difference in performance was not significant [57% versus 51%; t(84) = 1.51, p = 0.14, d = 0.32].

CONCLUSION

Incorporating TBL into the pre-clinical pediatrics curriculum led to large gains in knowledge over the short-term, but these gains did not persist. Further research should focus on extending the impact of TBL on long-term knowledge retention.

Team cohesiveness, team size and team performance in team-based learning teams

OBJECTIVES

The purpose of this study was to explore the relationships among variables associated with teams in team-based learning (TBL) settings and team outcomes.

METHODS

We administered the National Board of Medical Examiners (NBME) Psychiatry Subject Test first to individuals and then to teams of Year three students at four medical schools that used TBL in their psychiatry core clerkships. Team cohesion was analysed using the Team Performance Scale (TPS). Bivariate correlation and linear regression analysis were used to analyse the relationships among team-level variables (mean individual TPS scores for each team, mean individual NBME scores of teams, team size, rotation and gender make-up) and team NBME test scores. A hierarchical linear model was used to test the effects of individual TPS and individual NBME test scores within each team, as well as the effects of the team-level variables of team size, team rotation and gender on team NBME test scores. Individual NBME test and TPS scores were nested within teams and treated as subsampling units.

RESULTS

Individual NBME test scores and individual TPS scores were positively and statistically significantly (p < 0.01) associated with team NBME test scores, when team rotation, team size and gender make-up were controlled for. Higher team NBME test scores were associated with teams rotating later in the year and larger teams (p < 0.01). Gender make-up was not significantly associated.

CONCLUSIONS

The results of an NBME Psychiatry Subject Test administered to TBL teams at four medical schools suggest that larger teams on later rotations score higher on a team NBME test. Individual NBME test scores and team cohesion were positively and significantly associated with team NBME test scores. These results suggest the need for additional studies focusing on team outcomes, team cohesion, team size, rotation and other factors as they relate to the effective and efficient performance of TBL teams in health science 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.

Tackling student neurophobia in neurosciences block with team-based learning

INTRODUCTION

Traditionally, neurosciences is perceived as a difficult course in undergraduate medical education with literature suggesting use of the term "Neurophobia" (fear of neurology among medical students). Instructional strategies employed for the teaching of neurosciences in undergraduate curricula traditionally include a combination of lectures, demonstrations, practical classes, problem-based learning and clinico-pathological conferences. Recently, team-based learning (TBL), a student-centered instructional strategy, has increasingly been regarded by many undergraduate medical courses as an effective method to assist student learning.

METHODS

In this study, 156 students of year-three neuroscience block were divided into seven male and seven female groups, comprising 11-12 students in each group. TBL was introduced during the 6 weeks of this block, and a total of eight TBL sessions were conducted during this duration. We evaluated the effect of TBL on student learning and correlated it with the student's performance in summative assessment. Moreover, the students' perceptions regarding the process of TBL was assessed by online survey.

RESULTS

We found that students who attended TBL sessions performed better in the summative examinations as compared to those who did not. Furthermore, students performed better in team activities compared to individual testing, with male students performing better with a more favorable impact on their grades in the summative examination. There was an increase in the number of students achieving higher grades (grade B and above) in this block when compared to the previous block (51.7% vs. 25%). Moreover, the number of students at risk for lower grades (Grade B- and below) decreased in this block when compared to the previous block (30.6% vs. 55%). Students generally elicited a favorable response regarding the TBL process, as well as expressed satisfaction with the content covered and felt that such activities led to improvement in communication and interpersonal skills.

CONCLUSION

We conclude that implementing TBL strategy increased students' responsibility for their own learning and helped the students in bridging the gap in their cognitive knowledge to tackle 'neurophobia' in a difficult neurosciences block evidenced by their improved performance in the summative assessment.

Applying established guidelines to team-based learning programs in medical schools: a systematic review

PURPOSE

Team-based learning (TBL), a structured form of small-group learning, has gained popularity in medical education in recent years. A growing number of medical schools have adopted TBL in a variety of combinations and permutations across a diversity of settings, learners, and content areas. The authors conducted this systematic review to establish the extent, design, and practice of TBL programs within medical schools to inform curriculum planners and education designers.

METHOD

The authors searched the MEDLINE, PubMed, Web of Knowledge, and ERIC databases for articles on TBL in undergraduate medical education published between 2002 and 2012. They selected and reviewed articles that included original research on TBL programs and assessed the articles according to the seven core TBL design elements (team formation, readiness assurance, immediate feedback, sequencing of in-class problem solving, the four S's [significant problem, same problem, specific choice, and simultaneous reporting], incentive structure, and peer review) described in established guidelines.

RESULTS

The authors identified 20 articles that satisfied the inclusion criteria. They found significant variability across the articles in terms of the application of the seven core design elements and the depth with which they were described. The majority of the articles, however, reported that TBL provided a positive learning experience for students.

CONCLUSIONS

In the future, faculty should adhere to a standardized TBL framework to better understand the impact and relative merits of each feature of their program.

A comparison of conventional lecture and team-based learning methods in terms of student learning and teaching satisfaction

BACKGROUND

Team-based learning (TBL) is a structured type of cooperative learning that has growing application in medical education. This study compares levels of student learning and teaching satisfaction for a neurology course between conventional lecture and team-based learning.

METHODS

The study incorporated 70 students aged 19 to 22 years at the school of rehabilitation. One half of the 16 sessions of the neurology course was taught by lectures and the second half with team-based learning. Teaching satisfaction for the teaching methods was determined on a scale with 5 options in response to 20 questions.

RESULTS

Significant difference was found between lecture-based and team-based learning in final scores (p<0.001). Content validity index of the scale of student satisfaction was 94%, and external and internal consistencies of the scale were 0.954 and 0.921 orderly (p<0.001). The degree of satisfaction from TBL compared to the lecture method was 81.3%.

CONCLUSION

RESULTS revealed more success and student satisfaction from team-based learning compared to conventional lectures in teaching neurology to undergraduate students. It seems that application of new teaching methods such as team-based learning could be effectively introduced to improve levels of education and student learning.

Team-based learning to improve learning outcomes in a therapeutics course sequence

OBJECTIVE

To compare the effectiveness of team-based learning (TBL) to that of traditional lectures on learning outcomes in a therapeutics course sequence.

DESIGN

A revised TBL curriculum was implemented in a therapeutic course sequence. Multiple choice and essay questions identical to those used to test third-year students (P3) taught using a traditional lecture format were administered to the second-year pharmacy students (P2) taught using the new TBL format.

ASSESSMENT

One hundred thirty-one multiple-choice questions were evaluated; 79 tested recall of knowledge and 52 tested higher level, application of knowledge. For the recall questions, students taught through traditional lectures scored significantly higher compared to the TBL students (88%±12% vs. 82%±16%, p=0.01). For the questions assessing application of knowledge, no differences were seen between teaching pedagogies (81%±16% vs. 77%±20%, p=0.24). Scores on essay questions and the number of students who achieved 100% were also similar between groups.

CONCLUSION

Transition to a TBL format from a traditional lecture-based pedagogy allowed P2 students to perform at a similar level as students with an additional year of pharmacy education on application of knowledge type questions. However, P3 students outperformed P2 students regarding recall type questions and overall. Further assessment of long-term learning outcomes is needed to determine if TBL produces more persistent learning and improved application in clinical settings.

Analysis of the Team-Based Learning Literature: TBL Comes of Age

Team-based learning, or TBL, is an application-oriented teaching method that combines small- and large-group learning by incorporating multiple small groups into a large group setting. It has been increasingly used in postsecondary and professional education over the past two decades. Given this increasing usage, many faculty wonder about the effects TBL has on learning outcomes. The authors performed a review and synthesis on the educational literature with respect to TBL to examine the quality of their descriptions of core TBL elements, then constructed narrative summaries of these selected articles. Their analysis demonstrated early evidence of positive educational outcomes in terms of knowledge acquisition, participation and engagement, and team performance. The authors conclude that the TBL literature is at an important maturation point, where more rigorous testing and study of additional questions relating to the method are needed, as well as more accurate reporting of TBL implementation.