Board #233 - Program Innovation High-Fidelity Simulation as an Ideal Application Exercise for a Team-Based Learning Curriculum (Submission #10095)

Abstract

Objectives Team-based Learning (TBL) is a modern educational modality that uses an interactive, team-based approach to problem solving. It structures a curriculum that begins with knowledge acquisition and ends with application exercises. High-fidelity simulation is a well-established educational modality within healthcare and graduate medical education (GME); however, its use within a TBL curriculum has not been well described. According to TBL theory, for an application exercise to be successful, it must satisfy the 4 S’s: 1) Significant Problem: exercise must highlight a relevant problem that captures the learners’ interest; 2) Same Problem: By having all teams work on the same problem, it facilitates discussion within and between teams and it will force learners to defend their answer choices and examine each other’s thinking and problem solving processes; 3) Specific Choice: By being forced to make a specific choice, students must apply, analyze and evaluate all available data to create an answer and to defend their choice; and 4) Simultaneous reporting. By having groups report their answers simultaneously, it fosters discussion when groups choose different answers, forcing teams to critically evaluate the thought processes behind differing answer choices. Description We propose this curriculum to ideally incorporate high-fidelity simulation within a healthcare provider TBL curriculum, to optimize simulation’s utility as an application exercise: I. Acquisition phase: Students are given content-based assignments to be completed prior to class. II. Reinforcement phase: Students perform an Individual Readiness Assurance Test (iRAT) based on questions from the assignments. Next, students work together in teams on the Team Readiness Assurance Test (tRAT), which is the same test as the iRAT, to identify the best answer choice for each question. Faculty then explain concepts behind questions most teams have trouble with. III. Application phase: Students apply knowledge gained in the first two phases to manage significant problems by applying newly acquired content. To use simulation as an application exercise, all teams rotate through the same simulated scenarios, based on the same significant, relevant, content-based problem. After the simulation, teams are given a series of multiple choice questions to answer based upon the scenarios. Teams then select a specific answer and simultaneously report the answer to the group, by holding up a card with the answer choice. All teams then engage in discussion defending their answer choice. Conclusion We have piloted a TBL curriculum using medical simulation within this framework at our Emergency Medicine residency program of 30 residents, with good acceptance from our residents and faculty members. We surveyed our 30 residents, and out of three different application exercises (high-fidelity medical simulation, oral-board style case vignettes, and case-based problem-solving), high-fidelity simulation is the most popular amongst our residents (preferred by 50%). We believe that using this proposed curricular framework for GME and training of healthcare personnel, high-fidelity simulation positions itself as an ideal application exercise within a TBL curriculum. By satisfying the requirements of a TBL curriculum, high-fidelity simulation is poised to have its maximum impact on learning.