21st Century Learning in Medicine: Traditional Teaching versus Team-based Learning

Abstract

The learning strategy developed by Duke-NUS educators, called TeamLEAD, incorporates Team-Based Learning principles. Lectures, readings and e-learning on a given topic are completed before class; in-class activity focuses on assuring understanding, applying principles, and solving problems within student teams facilitated by faculty. The study compared Duke-NUS students’ results on the National Board of Medical Examiners Comprehensive Basic Science Examination (CBSE) and United States Medical Licensing Examination (USMLE) Step 1 with those of US medical students. The Duke and Duke-NUS curriculum is unique in that the basic science foundation is taught in one year, typically half the time devoted at other US medical schools. At the end of their basic science instruction, the first three student cohorts from Duke-NUS performed comparably to US students on the CBSE At the end of their second year (devoted to clinical work), the Duke-NUS students scored significantly higher than the US students (66.5±7.8 vs. 61.0±11.0) (p<.0.05; 95% CI [65.1 to 67.9]). The first two years of Duke-NUS student also scored significantly higher than US students on the USMLE Step 1 (228.4±20.7 vs. 222±24) (p<.028; 95% CI [223.5 to 233.3]). In less curricular time, Duke-NUS students achieved the standards of basic science knowledge achieved by US medical students. Duke-NUS students at the end of their second (clinical) year, performed significantly higher than the US students.