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TEAM BASED LEARNING: AN ACTIVE LEARNING STRATEGY
FOR ALL LEVELS OF LEARNERS
APPD/COMSEP 2013 April 13, 2013
Facilitators
• Priya Garg-Tufts University
• Dorene Balmer- Baylor
• Andrew Mutnick- Columbia University
• Julia Aquino-Tufts University
• Linda Tewksbury- NYU
Drs. Aquino, Balmer, Garg, Mutnick and Tewksbury
have nothing to disclose
Objectives • Identify the essential elements of team based
learning
• Identify tools used in TBL to create an interactive learning environment
• Participate in a TBL session
• Review the evidence related to TBL
• Develop an implementation plan for home
TBL Overview
Active Learning E
ngag
emen
t with
co
nten
t
Engagement with others about content Borrowed from Boyd Richards, 2010
TEAM-BASED LEARNING: ONE OF SEVERAL “C-TYPE” ACTIVE LEARNING STRATEGIES
Strategies to promote active learning
Team-based Learning
Problem-Based Learning
Case Discussions Think-pair share
What is TBL?
• An instructional strategy designed to transform small groups into teams and impact learning through: • Ensuring preparation and provoking motivation • Replacing passive with active learning • Enhancing group problem solving skills • Maintaining optimal results even when student:faculty ratio
is high
Transformation
4 Essential Principles of TBL
Ø 1 - Groups must be properly formed and managed
Ø 2 - Students must be made accountable for their individual and group work
Ø 3 - Group assignments must promote both learning and team development, and
Ø 4 - Students must have frequent and timely feedback.
When these principles are in place, groups of students evolve into cohesive learning teams.
Team-based learning sequences learning experiences:
3. APPLICATION Learners solve and defend increasingly complex problems through INTRA- and INTER-group discussions
2. READINESS ASSURANCE: Learners demonstrate (individually and in small groups) readiness to use desired knowledge
1. PREPARATION: Learners acquire desired knowledge
TBL Structure
Phase 1
• Preparation • Compels teacher to have clear learning
objectives • Readings linked to those objectives • Assigned readings to be completed prior to class
Phase 2
• Readiness Assurance • Individual (IRAT)
• 10-15 MCQs • Group (GRAT)
• Repeat IRAT with Team • Immediate Feedback
• Challenges/Appeals/Clarifications
Immediate Feedback Readiness Phase
• Come to a group consensus answer for each question
• Scratch off the corresponding block – look for the STAR
• Scoring system
Readiness Assurance
• Encourages individual and group learner accountability
• Impresses outperformance of group over individual efforts
• Promotes teamwork and effective communication
Phase 3
• Application • Novel cases that stress core course/session concepts • Simultaneous reporting – Immediate Feedback
Immediate Feedback Application Phase
A B D E
Applications
• Develop critical, clinical reasoning skills
• Continue to hone adaptive teamwork skills
• Appreciate the ambiguity and variability of practice
• Cogently express challenges to accepted practice
TBL in action
Get to work!
• Can you recognize this picture?
Team Formation
TBL Learning Objectives
TBL session timeline Phase 1
• 1st video clip (3 min)
Phase 2
• Individual RAT (5 min)
• Group RAT (10 min)
• Review answers (Appeals process) (5 min)
Phase 3
• 2nd video clip (4 min)
• Application Exercise (5 min)
• Reporting back (5 min)
Preparation Phase
Readiness Assurance
Application Phase
Designing Readiness Assurance Test (RAT)
• Keep it brief
• Focused on key concepts (distinguish from application)
• Questions clear (don’t get caught in semantics) with clear choices
• Consider 1-2 controversial questions
Designing application exercise
Four S’s • Significant
• Important to clerkship • Consider using real cases
• Same • All teams working on same problem
• Specific • Narrow questions à deeper analysis • Addresses application, not factual recall
• Simultaneous report • Fosters healthy competition • Prevents boredom
Group Reflection
TBL Across the Continuum of Medical Education
Peds Clerkship- Columbia University
• 4 sessions, each 1-2 hrs long since January 2011
• Facility:
• Topics • Fever, Common Infections, GI (Emergencies, Vomiting, Diarrhea, Constipation),
Renal (Hematuria and Proteinuria)
• Facilitator: • Clerkship Director
• Specialists +/- (ID, GI, Nephrology)
• Evaluation: ~7% of total grade • 50% IRAT
• 50% GRAT
Residency Program Tufts Medical Center
• Monthly sessions, each 1hr long since July 2011
• Facility: Residency Conference Room
• Topics
• American Board of Pediatrics Board Certification Content
• Question Development
• AAP PREP Series
• Facilitator:
• 3rd year resident on teaching resident rotation
• Residency Director
• Evaluation: Based on attendance, scores reviewed semi annually
Faculty Development Workshop
Phase Three: Application
Group problem solving Report out and Discussion
Phase Two: Readiness Assurance
Individual readiness quiz Group readiness quiz Appeals and Discussion
Phase One: Pre-reading
Participants asked to peruse article, Qualitative Research in Medical Education
Questions
Any Evidence?
• Growing body of evidence in medical education
• Different learner groups
• Different levels of outcome
Academic Performance
• The Impact of Team-Based Learning on Medical Students’ Academic Performance. Koles, et al (2010) Acad Med • Students scored higher on preclinical exam
questions related to course content taught through TBL suggesting that TBL enhances mastery of course content.
• Students in the lowest academic quartile showed the greatest gains and may benefit more than highest quartile students from the TBL strategy.
Confidence & Behavior Change
• Applying team-based learning in primary care residency programs to increase patient alcohol screens and brief interventions. Shellenberger et al (2009) Acad Med • Residents reported high levels of confidence
in alcohol screening/intervention after 3 TBL booster sessions .
• The number of residents reporting alcohol screening/intervention behaviors increased over the 4 month training period.
Gain (or loss) based on comparing the score of each team to the score of its own BEST member.
Gain (or loss) based on comparing the score of each team to the score of its own BEST member.
Our Performance
Columbia TBL Performance Data
Tufts TBL Performance Data Topic Individual Avg
Performance Score
Group Avg Performance Score
IBD/GI Disorders 55% 75% Puberty and Short Staure
80% 80%
Toxicology 60% 100% Inborn Errors of Metabolism
68% 85%
Genetic syndromes 78% 85%
Immunology 74% 100% Nephrotic and Nephritic Syndrome
75% 85%
Meningitis 66% 90% Hematuria 71% 80% Opthamology 80% 100% Urology 85% 95% AVERAGE 72% 89%
Baylor Workshop Evaluation
1 2 3 4 5 6 7
Overall Education Event Specific TBL Session
Low High
Questions
Implementation : small group exercise
Successful curriculum
Obtain “stakeholder”
support
Determine topics
Establish question
development process
Design evaluation
process
Determine facilities logistics
Build an instructor pool
Feedback
THANK YOU!!
http://teambasedlearning.org
http://www.tblcollaborative.org