Implementation and Evaluation of a Team-Based Learning Approach Within a Hybrid Problem-Based Learning Medical Education Curriculum

Abstract

To potentially improve second-year medical students’ peer engagement and learning outcomes, we modified 2 weeks of an 8-week hybrid problem-based learning (PBL) curriculum to include team-based learning (TBL) strategies and a greater emphasis on discussion during PBL activities. Evaluation of this combined PBL–TBL 2-week curriculum (Study 1) included anonymous student and faculty ratings of their curricular experiences before, during, and after the new 2-week PBL–TBL activities and comparison of students’ end of block examination scores with a control group of students who did not have the PBL–TBL activities. Results were that students and faculty rated the 2 weeks in which the combined PBL–TBL was introduced as more positive on several items related to engagement, productivity, and skills development compared to the PBL-only weeks. Students’ scores on in-common multiple choice and clinical case essay examination questions were significantly higher than control cohorts’ scores regardless of academic class rank. In the following academic year (2011), we incorporated PBL–TBL into a full 8-week block. Anonymous student and faculty surveys at end of block were consistent with ratings in 2010. Analyses of students’ end of block examination scores compared to a 2009 control cohort found no overall significant differences for in-common questions; however, students in the lower third of class ranks in 2011 had significantly improved multiple choice examination scores compared to those from 2009. We conclude that incorporating TBL activities into PBL curricula that include student discussion is an effective strategy for improving second-year medical students’ engagement, self-perceived skill development and productivity, and performance outcomes for students with lower academic ranks.