Team Based Learning ( TBL )
Dr Shwesin MyintAssociate Professor
Department of Surgery University of Medicine 2
• Developed more than 20 years ago• By Dr Larry Michealsen• Used in business school at University of
Oklahoma • Now , more commonly applied during
the preclinical years
TEAM BASED LEARNING ( TBL ) AND PROBLEM BASED LEARNING ( PBL ) • Both learner centred approaches • Main difference is • TBL - One teacher • PBL - Each small group is run by one
teacher
• Over 11 months creation and running of 40 new TBL cases
• 660+ students • Approx 300 tutors (- clinicians and basic
scientists)
• 40 Clinical Cases + 400 MCQ• 40-60 case writers/reviewers • Content covered– basic science and clinical
medicine from 9 Blocks
• 3 IT support staff
• 2 academicso 1 lead author/content writer-editor
and project managero 1 tutor recruitment + research
• As an active learning and small group instructional strategy
• Provides opportunities to apply conceptual knowledge through a sequence of activities such as individual work, team work and immediate feedback .
• Can be applied to both large (>100 students ) and small (<25students ) classes
• Multiple groups of five to seven students • Range 4- 12 members • Random allocation • Mixed gender and experience
RESPIRATORY SYSTEM • TBL weekly , every Monday • Asthma • COPD• Interstitial lung disease • Sleep apnoea
TBL design elements • 1. Team formation • 2.Readiness assurance ( RA)• 3. immediate feedback • 4. sequencing of in – class problem
solving • 5. the four S • 6. incentive structure • 7. peer review
RA • Assess at both individual and team level • Individual readiness assurance tests (
iRAT ) and team readiness assurance test ( tRAT)
• 10-13 MCQ • Same questions for both tests • Testing the knowledge of individual and
teams , prepare before class , motivated by not wanting to let their team down
IMMEDIATE FEEDBACK • Class discussion • Addressed disagreement amongst
students and faculty or• scratch off answer sheath or• electronic audience response system
which displayed result directly on screen or
• scanner with print capability to score • Encourages competition
SEQUENCING OF IN-CLASS PROBLEM SOLVING • Students must interpret , analyze and
synthesize information to make a specific choice during activity and defend their choice to the class
4 S • 1. significant problem • 2. same problem • 3. specific choice • 4. simultaneous reporting – use colour
coded and lettered placards
INCENTIVE STRUCTURE • For example • iRAT -20% , t RAT -20%, tAPP-40%and
final examination -20%
PEER REVIEW • Some did not use peer review• Took place in the last day of the course
REVIEW ABOUT • Learning and understanding • Team members’ teamwork • Interpersonal skills / communication
skills • To develop professional competencies
and prepare for professional lives as clinicians
• CVS TBL • About congenital heart disease • Facilitators • 1paediatric cardiac surgeon PhD student • 1 cardiologist • 1 basic science teacher • 1 registrar
• 5 students in each table • Total 15 tables • Computer present in each table • t RAT • teacher can check the answers with
their computer
t RAT 15 minutes
Facilitator feedback and clarification 25 minutes
Problem solving activity 105 minutes
Trigger and cues 5 minutes
Discussion of basic science ( team ) 15 minutes
Patients data : H/O and P/E ( team ) 10 minutes
Patients data : H/O and P/E ( class ) 10 minutes
Hypothesis generation ( team ) 5 minutes
Review of investigation results( class ) 20 minutes
Diagnosis ( class ) 5 minutes
Mechanism ( team ) 25 minutes
Mechanism ( class ) 10 minutes
EXAMPLE - TBL of Cardiovascular science
• Prework for students to complete before TBL
• 1. Lectures , Seminars and practical • - development of heart and CVS • - circulatory changes at birth
• - pulmonary hypertension • - investigation of congenital cardiac
abnormalities • - identifying developmental delays • - CVS disease ,population medicine
perceptive
• Practical paediatrics• - suspected heart disease assessment • - heart diseases
• Complementary reading • - Lilly , Pathophysiology of heart disease :
collaborative project of medical students and faculty ,2016
• Robbin and Cotran – Pathologic basic of disease 9th edition , section on congenital heart disease
Thank you for kind attention