First year medical student performance on weekly team-based learning exercises in an infectious diseases course: insights from top performers and struggling students

Gonzalo A Carrasco,Osvaldo J Lopez,Kathryn C Behling

doi:10.1186/s12909-019-1608-9

Gonzalo A Carrasco, Osvaldo J Lopez + Show 1 more

Open Access

https://doi.org/10.1186/s12909-019-1608-9

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Abstract

BackgroundIn Team-Based Learning (TBL) preparation of relevant coursework during self-directed learning time is evaluated by the individual readiness assurance test (iRAT). We recently reported that student performance on iRATs is strongly correlated with final examination scores in an infectious diseases (ID) course. We now investigated how student preparation for each individual iRAT exercise relates to course performance.MethodsTwo-hundred and sixty medical students were enrolled in this three-year study. Student TBL iRAT scores were collected and correlated with final examination scores using Kruskal-Wallis One-Way ANOVA and Newman-Keul’s statistical methods.ResultsStudents performing in the upper and middle 33rd percentile on the final examination showed highly significant (p < 0.01) weekly improvements in their iRAT scores. However, students performing in the lower 33rd percentile did not show improvement in their iRAT scores until the last week of the course. Although there was a highly significant correlation between final examination and iRAT scores amongst all students participating in the study, this correlation was stronger in students performing in the lower 33rd percentile.ConclusionsOur data suggest that students who do not consistently prepare for TBL, as evidenced by low iRAT scores, exhibit poorer performance on the final examination. This lack of preparation likely interferes with the efficacy of this learning method. iRAT scores can also be used for early identification of struggling students in need of additional supports. Additionally, changes in TBL incentive structure may provide more tangible rewards for pre-class preparation in particular for struggling students.

Highlights

In Team-Based Learning (TBL) preparation of relevant coursework during self-directed learning time is evaluated by the individual readiness assurance test
We recently reported that implementation of TBL exercises in an Infectious Disease (ID) course at our institution resulted in improved performance on final examinations, in particular for more poorly performing students [6,7,8]
In students performing in the upper and middle 33rd percentiles, we only found a correlation between final examination and individual readiness assurance test (iRAT) scores in year 2 of the study (0.2236, p < 0.05 for the upper 33rd percentile) with no statistically significant correlation

Summary

Introduction

In Team-Based Learning (TBL) preparation of relevant coursework during self-directed learning time is evaluated by the individual readiness assurance test (iRAT). We recently reported that student performance on iRATs is strongly correlated with final examination scores in an infectious diseases (ID) course. We investigated how student preparation for each individual iRAT exercise relates to course performance. We and others have reported the beneficial effects of TBL in medical education [1, 6–9], where it improves the learning experience [10] and helps students to better understand complex subjects [1]. L. Michelsen, who developed TBL to address concerns regarding student engagement in a large class of undergraduate students, has suggested that properly formed teams, student accountability, frequent and timely feedback to students, and team assignments that promote learning and team development, are key to the success of the TBL experience [11, 12].

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