Teaching critical appraisal to large classes of undergraduate medical students\xa0using\xa0team-based learning versus group discussions: a randomized controlled trial

Dayane Daou,Eman Sbaity,Marlene Chakhtoura,Ahmed El-Yazbi,Marwan M Refaat,Mona Nabulsi,Deborah Mukherji

doi:10.1186/s12909-022-03145-9

Abstract

BackgroundEvidence on the effectiveness of team-based learning in teaching critical appraisal to large classes of preclinical medical students is scarce. This study investigated whether team-based learning is effective in teaching critical appraisal to large classes of preclinical medical students.MethodsBetween April 2018 and May 2019, 107 first-year medical students were randomly allocated to receive instruction in critical appraisal using team-based learning or traditional group discussions as teaching methods. The primary outcome was students’ performance on the Berlin Questionnaire administered at the end of second year.ResultsStudents’ mean (SD) age was 22.0 (0.7) years. Baseline characteristics of the two groups were similar (all p values > 0.05). The mean (SD) Berlin scores of both groups were 80.4 (11.6) and 80.1 (12.1) for team-based learning and group discussions, respectively. Multivariate stepwise linear regression analysis revealed that the student’s academic achievement in medical school was the sole predictor of performance on the Berlin Questionnaire (ß = 1.079, p < 0.001), adjusting for gender, Medical College Admission Test score, student’s self-reported preferred teaching method, rank upon admission to medical school, score on the Epidemiology and Biostatistics course, and teaching method (team-based learning versus group discussions).ConclusionsTeam-based learning and group discussions were equally effective instructional strategies to teach critical appraisal to large classes of undergraduate medical students. Replication of our findings is needed in other educational settings.Trial RegistrationCurrent Controlled Trials ISRCTN15430424, retrospectively registered on December 30, 2021.

Highlights

Evidence on the effectiveness of team-based learning in teaching critical appraisal to large classes of preclinical medical students is scarce
In the first pre-clinical year, students are taught the principles of Epidemiology and Biostatistics in the Fundamentals of Medical Research (FMR) course, at the end of which they start the evidence-based medicine (EBM) course
Design We conducted this randomized open-label parallel group trial during the academic years 2018-2019 (April 2018 to May 2019) as an educational quality improvement project at the Faculty of Medicine of the American University of Beirut, Lebanon. This project was labelled as QI because the limited numbers of instructors was identified as an issue that may affect the quality of teaching critical appraisal, compromising achievement of the course learning objectives

Summary

Introduction

Evidence on the effectiveness of team-based learning in teaching critical appraisal to large classes of preclinical medical students is scarce. This study investigated whether team-based learning is effective in teaching critical appraisal to large classes of preclinical medical students. The Faculty of Medicine at the American University of Beirut (AUB) recently implemented a new curriculum, the Impact curriculum [3], which includes EBM as one of its competencies. In this curriculum, the teaching of EBM principles starts in first year medical school and continues vertically until graduation at the end of the fourth year. Each student is expected to present one of his/ her patients, generate a focused clinical question, search electronic databases for the evidence on this question, appraise the evidence, and discuss the application to the patient in terms of benefits, harms, cost, and patient preferences and values

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