Medical Students’ Attitudes about Team-Based Learning in a Pre-Clinical Curriculum

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Abstract

Background:

Team-Based Learning is relatively new in medical education. Team-Based Learning was integrated into one medical school's pre-clinical curriculum in 2002. Purpose: This study compared how medical students’ attitudes about the Team-Based Learning process changed between the first and second year of medical school.

Method:

180 students responded to 19 statements regarding their attitudes about Team-Based Learning during their first and second year of medical school. Data were analyzed using a Mann-Whitney U test. Results: Significant changes in attitudes occurred in the areas of Professional Development, Satisfaction with Team Experience, and Satisfaction with Peer Evaluation but not in the areas of Team Impact on Quality of Learning and Team Impact on Clinical Reasoning Ability.

Conclusion:

This study demonstrates that students’ attitudes about working within teams, their sense of professional development, and comfort and satisfaction with peer evaluation change in a curriculum using Team-Based Learning.

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Most cited references 35

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Problem-based learning: a review of literature on its outcomes and implementation issues.

M. Albanese, Jonathan Mitchell (1992)

The effects of problem-based learning (PBL) were examined by conducting a meta-analysis-type review of the English-language international literature from 1972 to 1992. Compared with conventional instruction, PBL, as suggested by the findings, is more nurturing and enjoyable; PBL graduates perform as well, and sometimes better, on clinical examinations and faculty evaluations; and they are more likely to enter family medicine. Further, faculty tend to enjoy teaching using PBL. However, PBL students in a few instances scored lower on basic sciences examinations and viewed themselves as less well prepared in the basic sciences than were their conventionally trained counterparts. PBL graduates tended to engage in backward reasoning rather than the forward reasoning experts engage in, and there appeared to be gaps in their cognitive knowledge base that could affect practice outcomes. The costs of PBL may slow its implementation in schools with class sizes larger than 100. While weaknesses in the criteria used to assess the outcomes of PBL and general weaknesses in study design limit the confidence one can give conclusions drawn from the literature, the authors recommend that caution be exercised in making comprehensive, curriculum-wide conversions to PBL until more is learned about (1) the extent to which faculty should direct students throughout medical training, (2) PBL methods that are less costly, (3) cognitive-processing weaknesses shown by PBL students, and (4) the apparent high resource utilization by PBL graduates.

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Team-based learning in a medical gross anatomy and embryology course.

Gary L Nieder, Dean X. Parmelee, Adrienne Stolfi … (2005)

The application of team-based learning (TBL) as a major component of a medical gross anatomy course was evaluated. TBL is a method of small group instruction that addresses some of the shortcomings of other small-group teaching approaches. The core components of TBL were instituted in 12 small group sessions in the course. Each session included objective-oriented assignments, an individual readiness assurance test, a group readiness assurance test and a group application problem. Peer evaluation was carried out on a regular basis. Scores from TBL session activities and course examinations were analyzed and compared to previous years' course performance. Student course evaluation data and faculty feedback were also collected. Student evaluation data and faculty response indicated strong support for the TBL method as it was implemented in the course. Faculty noted improvements in students' day-to-day preparedness and group problem solving skills. Students' mean scores on exams were not significantly different from those of previous years. There was, however, a significantly smaller variance in examination scores that was reflected in a lower course failure rate compared to previous years. Correlation analyses of TBL and examination performance suggested that individual readiness assurance test performance is a good predictor of examination performance. TBL proved to be a superior method for small group learning in our anatomy course. Student performance suggested that TBL may most benefit academically at-risk students who are forced to study more consistently, are provided regular feedback on their preparedness and given the opportunity to develop higher reasoning skills.

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Problem-based learning: why curricula are likely to show little effect on knowledge and clinical skills.

M. Albanese (2000)

A recent review of problem-based learning's effect on knowledge and clinical skills updated findings reported in 1993. The author argues that effect sizes (ES) seen with PBL have not lived up to expectations (0.8-1.0) and the theoretical basis for PBL, contextual learning theory, is weak. The purposes of this study were to analyse what constitutes reasonable ES in terms of the impacts on individuals and published reports, and to elaborate upon various theories pertaining to PBL. Normal theory is used to demonstrate what various ESs would mean for individual change and a large meta-analysis of over 10 000 studies is referred to in identifying typical ESs. Additional theories bearing upon PBL are presented. Effect sizes of 0.8-1.0 would require some students to move from the bottom quartile to the top half of the class or more. The average ES reported in the literature was 0.50 and many commonly used and accepted medical procedures and therapies are based upon studies with ESs below 0.50. Effect sizes of 0.8-1.0 are an unreasonable expectation from PBL because, firstly, the degree of changes that would be required of individuals would be excessive, secondly, leading up to medical school, students are groomed and selected for success in a traditional curriculum, expecting them to do better in a PBL curriculum than a traditional curriculum is an unreasonable expectation, and, thirdly, the average study reported in the literature and many commonly used and accepted medical procedures and therapies are based upon studies having lesser ESs. Information-processing theory, Cooperative learning, Self-determination theory and Control theory are suggested as providing better theoretical support for PBL than Contextual learning theory. Even if knowledge acquisition and clinical skills are not improved by PBL, the enhanced work environment for students and faculty that has been consistently found with PBL is a worthwhile goal.

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Author and article information

Journal

Journal ID (nlm-ta): Med Educ Online

Journal ID (publisher-id): MEO

Title: Medical Education Online

Publisher: Medical Education Online

ISSN (Electronic): 1087-2981

Publication date (Electronic): 07 January 2009

Publication date Collection: 2009

Volume: 14

Electronic Location Identifier: 1

Affiliations

[* ]Departments of Psychiatry and Pediatrics

[† ]Academic Affairs, Boonshoft School of Medicine Wright State University, Dayton, OH, USA

[‡ ]Department of Communication

[§ ]Center for Teaching and Learning, Wright State University, Dayton, OH, USA

[¶ ]Department of Community Health, Academic Affairs, Boonshoft School of Medicine Wright State University, Dayton, OH, USA

Author notes

Correspondence: Nicole J. Borges, Boonshoft School of Medicine Wright State University, Academic Affairs, 3640 Colonel Glenn Highway, Dayton, OH 45435-0001, Phone: 937-775-3196, nicole.borges@ 123456wright.edu

Article

Publisher ID: MEO-14-0280

DOI: 10.3885/meo.2009.Res00280

PMC ID: 2779620

PubMed ID: 20165515

SO-VID: f12a18ee-4e47-4d21-9318-61a87871f5ca

License:

Material in Medical Education Online is licensed under a Creative Commons Attribution-Share Alike 3.0 United States License.

Medical Students’ Attitudes about Team-Based Learning in a Pre-Clinical Curriculum

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Abstract

Background:

Method:

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Most cited references 35

Problem-based learning: a review of literature on its outcomes and implementation issues.

Team-based learning in a medical gross anatomy and embryology course.

Problem-based learning: why curricula are likely to show little effect on knowledge and clinical skills.

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