Team Based Learning

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Team Based Learning

• Sidney S. Murphree, M.D.

University of Louisville School of Medicine
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• Why We Chose to Use Team Based Learning
• Overview of Team Based Learning as a Pedagogical
  Method
• Team Based Learning At The University of
  Louisville
• Team Based Learning at Other Institutions

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Why We Chose to Use Team Based Learning
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Sophomore Pathology Course

• Traditional Pathology Department Based Course
• Lectures
• Laboratory
• Other Assignments
• Autopsy / Death Certificate
• Patient Centered Response
• Others

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Laboratory Component prior to TBL intervention

• Small Groups of 12 to 15 students
• Groups Led By Preceptors

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Laboratory Component prior to TBL intervention

• Case Based Small Group Discussion
• Cases on CD
• Saunders Companion CD
• Clinical History with some Laboratory
• Annotated Gross and Micro
• Some Embedded Questions
• Sessions began with short quiz

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Preceptors

• Small Groups of 12 to 15 students led by
  preceptors which included
• Pathology Faculty
• Anatomic gtgt Clinical gtgtgt Research Pathology
• Community Pathologists
• Pathology Residents

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Preceptors Time committment

• Needed 12 Preceptors each week
• 3 hours each week
• One hour prep session
• 2 hours in lab with students
• 18 weeks
• 648 hours if they spent no
  additional time preparing

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Problems

• Difficult to obtain and train preceptors on a
  weekly basis Weekly One hour Prep sessions
• TREMENDOUS VARIATION IN
• Preceptor Preparation
• General Teaching Skills
• Small Group Teaching Skills
• Knowledge of Subject Matter
• Enthusiasm .HIGHLY VARIABLE
• Most preceptors
• not subject experts
• Average to poor small group instructors

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Problems

• Persistent Student Complaints of variation in the
  quality of small group experience
• Typical Small Group Approach
• Passive Mini-lecture
• Preceptor read summaries and captions provided in
  the cases
• No actual case discussion
• Few incentives for individual student preparation
  or group participation

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Problems

• Typical student comments from course evaluations
  lab was often a waste of time with no
  value added beyond the opportunity to ask the
  preceptor questions, which, if you were luck,
  they occasionally could answer many
  students in my group often went next door to the
  sessions run by Dr. XXXX, who ran a great small
  group and consistently generated enthusiasm about
  the content with challenging questions and lively
  discussion that took them beyond the material we
  had already studied for each lab. I usually
  stayed behind in the group I was assigned and
  felt cheated

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What We Wanted

• Active learning with active group discussion
• Wanted to keep the group dynamic
• Active discussion with an exchange of questions
  and ideas
• between preceptor and group members
• students in a group ( students teaching
  students)

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What We Wanted

• Wanted all groups have real time access to
  subject experts and quality teachers
• Wanted students motivated to spend time / effort
  preparing for laboratory sessions
• Wanted students motivated to help each other
  learn

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Overview of Team Based Learning as a Pedagogical
Method
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Team Based Learning

• Larry Michaelson gt
• Business School
• Problem solving
• Multiple small groups solving the same problem
  simultaneously in a large lecture hall with
  guidance from a content expert.

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Basic Components of Team Based Learning

• Learning objectives and assignments structure
  preclass preparation
• Students are assigned to specific small groups
• Instead of multiple small groups scattered in
  several small rooms, TBL sessions are conducted
  in a large lecture hall
• Small group members are clustered together and
  solve problems as a group

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Team Based LearningTBL PHASES
INDEPENDENT STUDY and GROUP STUDY PRIOR TO
SESSION DRIVEN BY WELL WRITTEN LEARNING
OBJECTIVES, SPECIFIC STUDY
ASSIGNMENTS
INDIVIDUAL PRETEST
GROUP PRETEST
ADDITIONAL GROUP WORK POST TEST PROBLEM SOLVING
During session
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Team Based Learning

• Demands Active Learning and Pre-Class
  Preparation
• Individual Preparation DRIVEN BY
• Well written learning objectives
• assigned reading
• assigned cases
• individual pretest
• PEER PRESSURE group pretest
• Independent Study Prior to Group Sessions is
  Encouraged and Rewarded

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Pre-Class Preparation / Individual Study
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Readiness Assurance Testing
Same Short Multiple Choice Test Taken
Twice
Individual PreTest
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Group Discussion / PreTest
Instructor Feedback
Application of Concepts
Post Test Group Activity Small Group Assigment
3
Group Application Activity
Instructor Feedback
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The Teamwork TBL

• Small Groups of 6 to 7 Students
• Groups must be carefully constructed and
  maintained intact
• Group Process is Important
• Small Group Discussion during Class
• Group Pretest
• Post Test // Group Activity
• Individual student grades determined by team
  performance (group pretest) and personal
  performance (individual pretest)

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Efficient Use of Student and Faculty Time in
Team Based Learning

• Single Preceptor for Session
• Groups Generate Questions gtgt Dealt with by
  Preceptor(s)
• Preceptor Generates Questions gtgt Questions by are
  heard and considered by all groups
• All Groups have Identical Experience /
  Identical Exposure/Access to Faculty
• Added Value

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What is was like before team learning.
Robbins CD LINK Cardiac Case 1
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Team Based Learning At The University of
Louisville
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Companion CD

• Learning Objectives
• Case History
• Annotated Images
• - Guiding Questions

Two hours each week are set aside on the student
calendar for TBL preparation
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1
Companion CD Content Learning Objectives
Annotated Images Guiding Questions
Readiness Assurance Testing
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Discussion of Pretest Question and Answer
Exchange Instructor Questions Group Questions
Instructor Feedback
Post Test Group Activity MCQ based on
Similar but different Cases
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Additional Instructor Feedback
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What a team learning session is like.
. TBL Discussion Powerpoint
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Results Two Years Experience

• No change in student performance (? improvement)
  on Pathology Shelf and NBME I.
• 10 fold decrease in faculty time devoted to
  laboratory content 750 hours vs 75 to 80
  hours
• Consistently Positive Response from Students and
  Faculty

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Pathology Team Based Learning

• Mercer Medical School Sebastian Alston
• Univ of Oklahoma John Holliman
• Wright State Paul Koles
• Meharry George Breaux
• Univ of Cincinnatti Paul Biddinger
• Other Medical Schools ??

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TBL in Medicine

• Full Spectrum of Courses in Basic and Clinical
  Sciences
• Integrated and non-integrated curricula
• Both Lecture and Laboratory

Medical Team Based Learning Cooperative www.tlcol
laborative.org
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• Why We Chose to Use Team Based Learning
• Overview of Team Based Learning as a Pedagogical
  Method
• Team Based Learning At The University of
  Louisville
• Team Based Learning at Other Institutions

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Conclusions

• Team Based Learning is a new pedagogical approach
  that emphasizes Individual and Small Group Work
• Widely used in Pathology and Other Medical
  Disciplines
• Active learning
• Benefits of Small Group Dynamic
• Compared to traditional faculty lead small group
  sessions TBL..
• Fewer Faculty resources needed (10 fold decrease)
• All groups exposed to content experts

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Questions?
Bright Star Regulus near the Leo 1 Dwarf Galaxy
Astronomy Picture of the Day at .
http//antwrp.gsfc.nasa.gov/apod/image/0606/leoreg
ulus_croman_big.jpg
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