Individual Readiness Assessment Test Research Articles

Hypertensive Emergency Team-Based Learning.

The target audiences for this team-based learning (TBL) activity are resident physicians and medical students. According to the Centers for Disease Control and Prevention (CDC), nearly half of the adults in the United States have hypertension,1 which is a leading cause of cardiovascular disease and premature death.2 In extreme cases, patients may present in hypertensive emergencies, defined as an acute, marked elevation of systolic blood pressure >180mmHg or diastolic blood pressure >120mmHg with evidence of organ dysfunction.3,4 Patients presenting to the emergency department (ED) with symptoms of hypertensive emergencies must be promptly diagnosed and treated to prevent further morbidity and mortality. This TBL utilizes four clinical cases to educate resident physicians and medical students not only on the recognition of hypertensive emergencies, but also on the workup, management, and disposition of patients who present to the ED with hypertension. By the end of this TBL session, learners should be able to: 1) define features of asymptomatic hypertension versus hypertensive emergency, 2) discuss which patients with elevated blood pressure may require further diagnostic workup and intervention, 3) identify a differential diagnosis for patients presenting with elevated blood pressures, 4) recognize the features of different types of end-organ damage, 5) review an algorithm for the pharmacologic management of hypertensive emergencies, 6) indicate dosing and routes of various anti-hypertensive medications, 7) choose the appropriate treatment for a patient who is hypertensive and presenting with flash pulmonary edema, 8) identify an aortic dissection on computed tomography (CT), 9) choose the appropriate treatment for a patient who is hypertensive and presenting with an aortic dissection, 10) identify intracranial hemorrhage on CT, 11) choose the appropriate treatment for a patient who is hypertensive and presenting with an intracranial hemorrhage, and 12) describe the intervention for warfarin reversal. This is a classic TBL that includes an individual readiness assessment test (iRAT), a multiple-choice group readiness assessment test (gRAT), and a group application exercise (GAE). Learners and instructors were given the opportunity to provide verbal feedback after completion of the TBL. Learners included senior medical students and first-, second-, and third-year emergency-medicine residents. Learners were specifically asked if they felt the cases were educational, relevant, and useful to their training. Six resident physicians and three medical students volunteered their verbal feedback, and agreed when they were specifically asked if the cases were educational, relevant, and useful to their training. The same learners also agreed when asked if they felt the TBL was a more enjoyable activity than a direct lecture to refresh their knowledge and skills. One instructor observed that interns and medical students were generally able to reach a correct diagnosis; however, they seemed to struggle more with describing appropriate pharmacologic interventions when compared to more senior learners. Hypertension is a common complaint and incidental finding in patients presenting to the ED. Given its non-specific value, it can be a difficult topic for the novice healthcare provider to master. The differential diagnosis for a patient presenting with hypertension is vast, ranging from benign to emergent, and can sometimes necessitate minimal to substantial workups. Thus, this TBL is a useful, relevant, and effective exercise for residents-in-training to review and understand the management of hypertension. Hypertension, hypertensive emergency, asymptomatic hypertension, flash pulmonary edema, aortic dissection, intracranial hemorrhage, warfarin reversal, team-based learning.

Application of lecture-and-team-based learning in stomatology: in-class and online

BackgroundThis study aimed to evaluate stomatological students’ learning efficacy and their attitude towards Lecture-Team-Based Learning (LTBL) on topics regarding the design of removable partial dentures via in-class, online, and both in combination.MethodsStudents from seven distinct grades participated in the course in their fourth academic year (Years 2015, 2016, 2017, 2018, 2019, 2020, and 2021). Students of Years 2015–2019 attended in-class LTBL, students of Year 2020 attended online LTBL, and students of Year 2021 attended the combination mode. The scores of three examinations were compared, namely, individual readiness assessment test, team readiness assurance test, and individual application test. Visual Analog Scales (VAS) were used for students to self-assess their mastery of prosthodontics knowledge before and after the course. Anonymous questionnaires were delivered to evaluate their satisfaction with LTBL via a Likert scale.ResultsIn each academic year, the three exam scores were significantly improved as the course progressed and VAS-post scores were significantly higher than VAS-pre scores. The three examination and VAS scores of students in Year 2020 were significantly lower than those in Years 2019 and 2021. Students were highly satisfied with the LTBL course based on the three parameters of knowledge acquisition, teamwork, and classroom atmosphere.ConclusionStudents were highly satisfied with the LTBL course and their learning performance was improved as the course progressed both in-class and online. Online LTBL could be adopted when students have to study online, while in-class LTBL could perform better when combined with video records of an online LTBL course.

The Suicidal Patient in the Emergency Department Team-Based Learning Activity.

Emergency medicine resident physicians, (PGY1-4), medical students rotating in the emergency department. Emergency physicians have a duty to recognize and provide care for patients who attempt to harm themselves or commit suicide. Mental health-related chief complaints account for 12.5% of emergency department (ED) visits.1 Additionally, patients with depressive symptoms who are discharged from the ED are at the highest risk for suicidal thoughts and behaviors.1 Therefore, evaluating and screening for suicide and determining appropriate dispositions for this patient population is extremely important. This team-based learning (TBL) activity will help prepare residents and medical students to evaluate, recognize, and disposition this at-risk patient population. By the end of the session, participants will be able to: 1) describe risk factors for suicide; 2) summarize the emergency physician's role in assessing patients with psychiatric emergencies; 3) assess a patient using a mental status evaluation; 4) identify the criteria for involuntary psychiatric hold placement; 5) develop a safe discharge plan for patients experiencing depression; and 6) Formulate a plan for evaluating a suicidal patient who is acutely intoxicated. This team-based learning activity is a classic TBL that includes learner responsible content (LRC), an individual readiness assessment test (iRAT), a multiple choice group readiness assessment test (gRAT) with immediate feedback assessment technique (IF/AT), and a group application exercise (GAE). A post-TBL survey was provided to each participant. A Likert scale was used for the survey questions to assess the relevance of the session to emergency medicine practice, learner perception of knowledge gained, learner perception of improvement of clinical practice, session engagement, and session delivery. The post-activity evaluation had a response rate of 33% (11/33). Overall, all the participants "strongly agreed" (Likert 5/5) or "agreed" (Likert 4/5) that the session improved their knowledge of caring for the suicidal patient in the ED with an average score of 4.6/5. All participants "strongly agreed" (Likert 5/5) or "agreed" (Likert 4/5) that the material presented was relevant to their clinical practice in the ED for an average score of 4.6/5. Constructive feedback included requesting learner responsible content (LRC) be sent earlier than one week prior to the activity. Depression and suicidal ideation are common ED complaints. However, it can be difficult to evaluate these patients and select an appropriate disposition because their symptoms can range from benign to life-threatening. The team-based learning (TBL) session allows for discussion of the complexities of the depressed and suicidal patient. Learners found this TBL to be beneficial in providing a diagnostic pathway and treatment algorithm to manage these complex, high-risk patients. Suicide, depression, substance abuse, disposition, team-based learning.

Online Team-Based Learning in Teaching Hyponatremia Among Medical Clerks of the University of Santo Tomas Faculty of Medicine and Surgery, Philippines

Objectives: To determine if online team-based learning (TBL) is effective in improving knowledge outcomes and confidence about hyponatremia in its clinical recognition, classification, diagnostic work up, and management among fourth year medical students Study design: A quantitative evaluative design. Population and Setting: Fourth year medical students (medical clerks) rotating in the Department of Medicine, Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines from July to December 2020. Methodology: A modified TBL workshop is adopted in teaching fourth year medical clerks about hyponatremia. The TBL session was held with a group of medical clerks weekly from July to December 2020. As a pre-workshop preparation, the medical clerks were assigned to read ahead of time the clinical practice guidelines on the diagnosis and treatment of hyponatremia developed by the European Renal Best Practice. After reading it, they were asked to answer an Individual Readiness Assessment Test (IRAT) composed of 20 case-based multiple-choice questions (MCQ). The group was thereafter divided into 4 subgroups and asked to discuss the same MCQ-based exam and present it as a Team Readiness Assessment Test (TRAT). As each subgroup presented their IRAT, the facilitator discussed the underlying concepts for each question and its application in actual cases of hyponatremia. The facilitator then summarized the learning outcomes at the end of the TBL workshop. For team application (TAPP), the students created a concept map and formulated admitting orders. The medical clerks were then surveyed on their confidence in hyponatremia diagnosis and management during pre-TBL workshop, after IRAT, after TRAT, and after discussion with the facilitator. Statistical Design: Descriptive statistics were used to summarize the study variables and included the mean, standard deviation, frequency, and percentage. Within-group comparisons of different outcomes across the different timeframes were conducted using one-way multivariate analysis of variance (one-way MANOVA). Cognizant that the study has multiple outcomes or dependent variables which were compared at four different timeframes, multivariate analysis was utilized to minimize the inflation of family-wise errors (FWE). Results: Comparative analysis indicated that the mean readiness scores of the respondents after TRAT was significantly higher (t=–91.61, p=0.001) compared to the mean readiness scores after IRAT. Comparative analysis using paired t-test indicated that the mean confidence scores of the respondents in the recognition, diagnosis, and treatment of hyponatremia were significantly higher among the respondents after the IRAT (t=–24.26, p=0.001), TRAT (t=–34.58, p=0.001), and facilitator discussion (t=–42.72, p=0.001) approaches compared to the mean pre-TBL confidence score. The mean knowledge score of the respondents on the creation of a concept map and the formulation of admission orders of patients with hyponatremia was 25.54±1.98 (95% CI 25.26-25.82). Conclusion: Findings of this study are not to be interpreted as demonstrating a causal relationship. Furthermore, the results are only hypothesis-generating at best. The study showed that online TBL has the potential to be an effective method in improving knowledge outcomes and confidence about hyponatremia in its clinical recognition, classification, diagnostic work-up, and management among fourth year medical students. As a preliminary evaluation of TBL, further studies can be conducted to determine its effectiveness as a teaching modality in the medical curricula in comparison to the traditional method before being adopted as a teaching-learning activity. Key words: team-based learning, online learning, COVID-19, hyponatremia, medical education

Online team based learning in teaching Biochemistry for first year MBBS students during COVID-19 pandemic.

The emergence of Corona Virus Disease-2019 (COVID-19) pandemic had unprecedented effects on medical education worldwide. Sustaining student engagement in virtual learning is an arduous task. Team based learning (TBL) is a learner-centered approach that can facilitate better student engagement. Adapting TBL to online platform may address the challenges faced in virtual learning. This study was conducted to implement and evaluate online TBL among first year MBBS students in Biochemistry. After obtaining informed consent, three online TBL sessions were planned. The Individual Readiness Assessment Test, Group Readiness Assessment Test, and team application were assigned in Google classroom. The students used online platforms for their team interactions. After submitting their assignments, they joined online discussion with facilitator. Peer evaluation was done via Google forms. At the end of all the sessions, the students' perceptions on the process were collected using a structured anonymous feedback with open comments. Analysis of their feedback showed that the students found the process useful and it helped in fostering their team skills. Five major themes emerged on content analysis of the open comments; 'Enriched team skills', 'Gain in knowledge', 'Impact on attitude', 'Interaction during pandemic', and 'Emotional responses'. Students perceived that the online TBL is effective in improving their engagement, learning, and team skills.

Effectiveness of a Team-Based Learning exercise in the learning outcomes of a medical pharmacology course: insight from struggling students.

We have previously reported that multiple Team-Based Learning (TBL™) exercises in a 4-week pre-clinical medical school course improved final exam performance and significantly reduced the number of course failures. Here, we conducted a long-term study, with eight cohorts of first-year medical students, to determine whether the implementation of a single TBL individual readiness assessment test (iRAT) exercise in a 4-week medical school pharmacology course produces similar effects in overall course performance. We implemented a single TBL iRAT exercise that covered the subjects addressed during oneweek of the medical pharmacology course, with the four most recent cohorts of students matriculating at Cooper Medical School of Rowan University (n = 403). The first four cohorts matriculating at CMSRU did not participate in the TBL exercises (n = 266). Correlation of individual student TBL iRAT and final examination scores in the medical pharmacology course was compared to a second, unrelated first-year course (physiology) to control for variation in student performance between cohorts. We found that there was a significant moderate correlation between final examination and TBL iRAT scores (r = 0.49, p < 0.01, n = 403). Interestingly this moderate correlation was seen in students performing in the lower 25th percentile on the course final examination (r = 0.41, p < 0.01, n = 101) and negligible in students performing in the upper 25th percentile (r = 0.11, n = 101, p > 0.05). Implementation of the single TBL exercise also significantly reduced variance or range of student final examination performance compared to the group of the first four cohorts. These results suggest that implementation of a single TBL exercise, which covers only oneweek of content delivered in a 1-month medical pharmacology course, benefits first-year medical students by reducing the disparity in knowledge acquisition among them and providing a means to identify students who may struggle with course content.

Evaluation of Team-Based Learning to Increase Nurses' Knowledge of the Ventricular Assist Device.

Ventricular assist devices (VAD) are used to extend life expectancy for patients with advanced heart failure. Approximately 102 hospitals nationwide have a VAD program, but the majority implant only a small number of devices each year. This low-volume and high-acuity patient population can create concerns for maintaining nursing knowledge skill levels. Nursing staff from a step-down telemetry floor in a large urban hospital completed an Individual Readiness Assessment Test to assess their knowledge and accuracy in the care of mechanical circulatory support patients using the Immediate Feedback Assessment Technique. The nurses were then assigned to small groups and worked as a team to complete the same test known as the Group Readiness Assessment Test. Study results suggest that team-based learning was effective in increasing knowledge of mechanical circulatory support. [J Contin Educ Nurs. 2021;52(1):13-20.].

Pediatric Seizure Team-based Learning.

The target audiences for this team-based learning are emergency medicine and emergency medicine-pediatric resident physicians. Pediatric seizure is a common presenting complaint in the emergency department. It is said that over 470,000 children have a diagnosed seizure disorder1 and 2%-5% of children aged 6 months to five years will have a febrile seizure at some point during childhood.2 While there are many published educational materials related to pediatric seizure, they are simulation-based, and/or isolated to management of one underlying diagnosis.3,4,5,6 Therefore, this team-based learning uses four cases to provide an understanding of the possible causes of seizure in children, as well as the management, workup, and disposition for emergency medicine residents in training. By the end of this TBL session, learners should be able to:Define features of simple versus complex febrile seizureDiscuss which patients with seizure may require further diagnostic workupSummarize a discharge discussion for a patient with simple febrile seizuresIdentify a differential diagnosis for pediatric patients presenting with seizureDefine features of status epilepticusReview an algorithm for the pharmacologic management of status epilepticusIndicate medication dosing and routes of various benzodiazepine treatmentsObtain a thorough history in an infant patient with seizures to recognize hyponatremia due to improperly prepared formulaChoose the appropriate treatment for a patient with a hyponatremic seizureDescribe the anatomy of a ventriculoperitoneal (VP) shuntRelate a differential diagnosis of VP shunt malfunctionCompare and contrast the neuroimaging options for a patient with a VP shunt. This team-based learning is a classic TBL because it contains learner responsible content (LRC), an individual readiness assessment test (iRAT), a multiple-choice group RAT (gRAT) with immediate feedback assessment technique (IF/AT), and a group application exercise (GAE). We received formative feedback through conversations with learners afterwards, who stated they enjoyed the activity and felt it was highly useful for their learning; in addition, instructors discussed after the session and made changes accordingly. We collected verbal feedback from instructors and learners after the session. Learners and instructors felt that it was very successful with limited modifications, in particular, the need for more time to complete the activity. Therefore, we suggest a 90 minute rather than 60-minute timeframe to adequately cover all material. Pediatric seizure is a common complaint in the emergency department. It can be a difficult subject for the emergency medicine resident to master based on the variety of presentations. Indeed, the cause, management, and disposition may vary greatly; the etiology may range from benign to life-threatening, sometimes requiring minimal and at other times an extensive workup, with an ultimate disposition of either discharge home or admission to a pediatric intensive care unit. Therefore, team-based learning is well-suited to work through some of the complexities of such cases, and we found this educational session to be highly effective. Pediatric seizure, simple febrile seizure, complex febrile seizure, status epilepticus, hyponatremic seizure, ventriculoperitoneal (VP) shunt, team-based learning.

Design of a disaster preparedness escape room for first and second-year pharmacy students

Background and purposeEducational escape rooms assist students with the development of teamwork, augmentation of problem-solving skills, and reinforcement of key course concepts. In this report, we examined the feasibility of creating a bioterror preparedness escape room in a small enrollment pharmacy public health elective course. Educational activity and settingA bioterror preparedness escape room was developed for pharmacy students in a health elective course. The instructional objectives of training students in disaster preparedness were assessed via group readiness assessment tests in the scenario and individual readiness assessment tests after the completion of the activity. FindingsTwenty-eight students participated in the escape room activity in groups of 6 to 8 students (n = 4 observations) and all groups escaped. Student performance was higher on the initial attempts of three group readiness assessment tests (88 ± 16.0%, 82 ± 7.1%, 78 ± 12.0%) than in the final individual readiness assessment test (73.4 ± 20.4%). Students indicated that they found the educational escape room to be enjoyable (95.7%) and felt that all members of the team were involved in solving the problems (86.9%). SummaryA disaster preparedness educational escape room was designed and implemented in a public health elective for pharmacy students. Findings indicate that the educational escape room format is an effective method for reinforcing course content, however additional improvements could be made to the instructional design to enhance individual student knowledge retention.

Patterns of medical student engagement in a second-year pathophysiology course: relationship to USMLE Step 1 performance.

Historically, attendance has been a marker of academic performance, but the current medical education literature has had mixed results. In addition, attendance is dropping in the preclinical curricula, whereas, at the same time, the focus on United States Medical Licensing Examination Step 1 performance is increasing. This present study is a mixed-method approach correlating student attendance and access to the formal curriculum in a second-year pathophysiology course to performance on Step 1. Additionally, survey and focus group data evaluated the usage and importance of both the formal curriculum and third-party resources. Out of 112 eligible students, 77 participated in the study. There was no correlation between attendance or access to the learning materials and Step 1 performance. There was a strong correlation between the performance on the final examination and that of Step 1 (r = 0.813; P < 0.001) and a moderate correlation between formative quiz (r = 0.321; P = 0.005) and individual readiness assessment test performance (r = 0.351; P = 0.002) and Step 1 performance. Survey and focus group data show that students place high importance on faculty-developed materials that they can use on their own, but not attendance. The third-party resources are highly used as an adjunct to the formal curriculum and to focus on Step 1 study. Attendance and access to the formal curriculum do not predict Step 1 performance, whereas performance on high- and low-stakes internal assessments do. Further study on how the lack of social interaction gained from attendance affects development of other competencies and the learning climate are warranted.

Modified team‐based learning as a weekly formative review

Team‐Based Learning is an evidence‐based collaborative learning strategy designed around units of instruction, known as “modules,” that are taught in a three‐step cycle: preparation, in‐class readiness assurance testing, and application‐focused exercise. The Anatomy, Histology and Embryology course at the University of New Mexico School of Medicine modified TBL for use as both summative and formative weekly assessment, ending each week with a TBL module. The individual readiness assessment test (IRAT) served as a weekly “summative” quiz, while the group readiness assessment test (GRAT) served a formative role, allowing students to debrief and learn from each other following the IRAT. The application exercises were clinical cases focused on application of the anatomy, histology and embryology. Instead of additional multiple choice questions, questions were posed in short and long answer formats, giving the students an opportunity to generate their own answers for deeper learning. An addition specific to anatomy, were weekly mini‐practical exams to prepare students for summative lab practical exams. This modified TBL method was well‐received by students and prepared them for summative exams. One drawback was that scores from the GRAT, application exercise, and mini‐practical contributed to passing of some students that did not have a strong enough grasp on the concepts. This method was abandoned when the course was integrated as a thread into the existing organ blocks of the preclinical curriculum. Recently, this form of TBL was modified again to serve a purely formative role in weekly review and consolidation of concepts in the Musculoskeletal, Skin, and Connective Tissue Block of the integrated curriculum. Student feedback and scores strongly support use of this method as a formative review of the weekly material to prepare students for weekly graded quizzes and a summative NBME exam.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

The effect of interprofessional team-based learning among nursing students: A quasi-experimental study

BackgroundAlthough interprofessional education has received attention in recent years as a means of providing opportunities for health-care professionals to learn with, from and about other disciplines and enhance the quality of patient care, evidence of its effectiveness is limited. Interprofessional team-based learning was introduced to make it possible for students in different healthcare disciplines to interact with each other, and to prepare them to function effectively within a team in their future career. ObjectivesTo examine the effects of interprofessional team-based learning for undergraduate nursing students in terms of knowledge level, readiness for interprofessional learning, attitude towards various aspects of team learning, and perceived collective efficacy. DesignThe study employed a one-group pretest-posttest quasi-experimental design. MethodsAn interprofessional education program was given to students from two universities in Hong Kong who were in different healthcare disciplines including medicine, nursing, pharmacy, biomedical science, and Chinese medicine programs. The program was based on four phases of student learning— individual readiness assessment test, ice breaking session, team readiness assessment test, and application exercise. Nursing students involved in the program were invited to complete anonymous questionnaires to evaluate their interprofessional team experience. ResultsA total of 40 nursing students (9 male, 31 female) participated in the study. A statistically significant improvement was identified in their knowledge level (p<0.001), attitude towards readiness for interprofessional learning, team learning, and perceived collective efficacy (p<0.001). ConclusionThis study suggests that interprofessional team-based learning can enhance cross-disciplinary learning and outcomes resulting from team efforts.

Team-Based Learning Improves Staff Nurses' Knowledge of Open- and Closed-Chest Cardiac Surgical Resuscitation.

There are few reports of the use of 1-session team-based learning (TBL) in hospital settings and none to teach cardiac surgical resuscitation (CSR). The aim of this study was to investigate whether 1-session TBL is an effective method to increase nursing knowledge of CSR. The participating subjects viewed a PowerPoint presentation about CSR prior to the learning session. Participants completed a 16-item individual readiness assessment test. Immediately after, participants in groups of 3 completed the same 16-item test as a team using the Immediate Feedback Assessment Technique form. Participants were asked open-ended questions about their concerns with CSR, which were analyzed with a grounded theory approach. The sample consisted of 60 subjects (54 completing all phases). Team-based learning significantly increased scores from 36.93 (SD, 8.49) to 50.89 (SD, 5.29), t53 = -13.05, P < .001. There was a significant increase in scores (t46 = 2.13, P = .04) among the noncohesive groups from baseline (52.88 [SD, 3.29]) versus the cohesive groups (50.38 [SD, 4.73]). The qualitative data indicated that the subjects had worries/concerns and lack of self-confidence around CSR. Team-based learning is a feasible method to use for single-session education where team building is also required. Noncohesive groups may benefit from TBL, from discussing divergent viewpoints to reach a consensus. Additional studies are needed to compare preferences for TBL with other teaching methods.

Implementing Team Based Learning in an Information Literacy Course

Introduction: Motivating students to improve their Information Literacy (IL) skills can be a challenge. As a pilot, we implemented Team Based Learning (TBL) in our IL lessons. TBL is an interactive learning approach based on the “flipped classroom” concept, offering students opportunities to gather skills via immediate feedback during individual and team activities. Moreover, TBL promises to be an attractive and activating way of learning. We were interested if TBL, A) indeed activates students and B) improves their IL skills more than with lectures and self-tuition.Methods: TBL was implemented in a first year bachelor IL course in the year 2015-2016. Student were asked to study three IL e-learning modules before class. The obtained knowledge was assessed individually during an Individual Readiness Assessment test (IRAT) and in a team via a Team Readiness Assessment test (TRAT) using “scratch and win cards”. After this, teams were given an IL case and the members had to come to a consensus about the best solution out of a couple options provided. Finally, students took a written exam, which was the same as used in this course in the year 2014-2015, when TBL was not applied yet.We compared the grades of the written exam between the two academic years using a Mann Whitney U test (P&lt;0.05). Students’ opinion about TBL was polled using a 34 question student survey.Results: The mean written exam grades were significantly higher in the TBL year than in the preceding year without TBL (respectively, 7.6 ± 1.42 vs 6.5 ± 1.31, P&lt;0.001). The student survey showed that students were positive about the IRATs and TRATs, but neutral about other TBL parts.Conclusion: TBL seems to be a good didactical method to motivate students and enhance their IL skills.

Use of Live-Stream and Pre-recorded Simulation in the Individual Readiness Assessment Test During TBL, a Novel Approach

At the Alabama College of Osteopathic Medicine (ACOM), the use of medical simulation helps to teach basic pharmacology in a manner that can more easily integrate with clinical sciences. Our novel use of simulation involved using both pre-recorded and live streaming simulated scenes in a clinical vignette format during the independent readiness assurance test (iRAT) of team-based learning (TBL). The incorporation of simulation helped bridge basic science and clinical sciences in a manner that had basic and clinical faculty work together, leading to positive student feedback. Our results indicate that more students were satisfied than dissatisfied with this method and more agreed that this was a valuable use of their time. This paper describes our experience in developing these simulated cases and student satisfaction data on this method.

Post-Partum Depression: Diagnosis, Screening, and Treatment

Abstract This is a team-based learning (TBL) module aimed to help medical students identify and treat post-partum depression (PPD). In the 10-item individual readiness assessment test (IRAT) and gr...

A Comparison of Team‐Based Learning Formats: Can We Minimize Stress While Maximizing Results

Team‐Based Learning (TBL) is used at the University of Louisville School of Medicine as a collaborative teaching method in which students solve challenging physiology problems. Students take an Individual Readiness Assessment Test (iRAT), Team Readiness Assessment Test (tRAT), and Individual Summative Assessment Test (iSAT). While educational gains of TBL have been shown, some student evaluations negatively assessed the teaching method with complaints regarding question difficulty and stress levels. Thus, during implementation of TBL in the School of Dentistry, two changes were made: (1) TBL questions were cognitively aligned with unit exam questions (2) Scratch‐off, lottery response cards were used to create a fun, game‐like environment. This revised TBL format, compared to the original TBL format, resulted in similar student performance during iRAT and tRAT sessions. However, the revised, low‐stress format had significantly higher scores on the iSAT (n=119‐161, p&lt;.05). Furthermore, on Likert‐scale surveys, students participating in the revised TBL format subjectively reported higher effectiveness of the learning format, higher levels of perceived fairness, and lower stress levels. These results suggest that the qualitative experience of students, when using a new teaching format such as TBL, may be an important consideration that should be carefully evaluated during implementation.

A Multiyear Analysis of Team-Based Learning in a Pharmacotherapeutics Course

To evaluate the impact of team-based learning (TBL) in a pharmacotherapeutics course on pharmacy students' ratings of faculty instructors and the course, and to assess students' performance after implementation of team-taught TBL. Teaching methodology in a pharmacotherapeutics course was changed from a lecture with recitation approach in 2 semesters of a 6 credit-hour course to a TBL framework in a 3-semester 3+4+5 credit hour course. The distribution of faculty of instruction was changed from 4 faculty members per week to 1 faculty per 1-credit-hour module. TBL consisted of preclass study preparation, readiness assurance (Individual Readiness Assessment Test and Group Readiness Assessment Test), and in-class application exercises requiring simultaneous team responses. Retrospective analysis of student ratings of faculty and instructional methods was conducted for the 2 years pre-TBL and 4 years during TBL. Final course grades were evaluated during the same time period. Student ratings showed progressive improvements over 4 years after the introduction of team-based learning. When aggregated, ratings in the "excellent teacher" category were unchanged with TBL compared to pre-TBL. Improvements in faculty instructor approaches to teaching were noted during TBL. Group grades were consistently higher than individual grades, and aggregate course grades were similar to those prior to TBL implementation. Implementation of TBL in a pharmacotherapeutics course series demonstrated the value of team performance over individual performance, indicated positive student perceptions of teaching approaches by course faculty, and resulted in comparable student performance in final course grades compared to the previous teaching method.

The Effectiveness of Team-based Learning (TBL) as a New Teaching Approach for Pharmaceutical Care Education

The concept of Team-Based Learning (TBL) was developed in the late 1970s by Larry Michaelsen, who wanted students to enjoy the benefits of small group learning within large classes in the business school environment. In contrast to problem-based learning (PBL), which is student centered, TBL is typically instructor centered. Recently, TBL is being used as a teaching method in over 60 health science professional schools in the US and other countries. In the present study, the impact of adopting TBL in teaching pharmaceutical care practices to students was evaluated. Students were required to answer a set of multiple-choice questions individually in individual readiness assessment test (IRAT) before the TBL sessions to assess their level of preparation. The same set of questions was then reattempted by the group readiness assessment test (GRAT) during TBL. Comparing the scores obtained in the GRAT and IRAT before the first TBL session, the scores from the GRAT were always higher than those of the IRAT, indicating that TBL has encouraged active learning. In addition, students were surveyed about their level of satisfaction with TBL and written comments about TBL were solicited. The results of the questionnaire showed that 87.3±9.3% of the students were satisfied. Moreover, no student commented that TBL was in any way inferior to the PBL. Implementation of a TBL approach was successfully integrated into the pharmaceutical care education course. In order to further improve the usefulness of TBL in teaching pharmaceutical care, a hybrid teaching approach that also comprises PBL and a lecture-based course is desirable.

Can a multisensory teaching approach impart the necessary knowledge, skills, and confidence in final year medical students to manage epistaxis?

ObjectiveThe purpose of this study is to evaluate the efficacy of a multisensory teaching approach in imparting the knowledge, skills, and confidence to manage epistaxis in a cohort of fourth year medical students.MethodsOne hundred and thirty four fourth year medical students were recruited into the study from Aug 2011 to February 2012 in four groups. Students listened to an audio presentation (PODcast) about epistaxis and viewed a video presentation on the technical skills (VODcast). Following this, students completed a 5-minute Individual Readiness Assessment Test (IRAT) to test knowledge accrued from the PODcast and VODcast. Next, students observed a 10-minute expert demonstration of the technical skills on a human cadaver and spent half an hour practicing these techniques on cadaver simulators with expert guidance. The students’ confidence was assessed with Confidence Level Questionnaires (CLQs) before and after their laboratory session. The skill level of a subset of students was also assessed with a pre- and post-laboratory Objective Structured Assessment of Technical Skills (OSATS).ResultsEighty two percent of the participants achieved a score of at least 80% on the IRAT. The CLQ instrument was validated in the study. There was a statistically significant improvement between the pre- and post-laboratory CLQ scores (p<0.01) and also between pre- and post-laboratory OSATS scores (p<0.01). Qualitative feedback suggested a student preference for this teaching approach.ConclusionsThis study provides further evidence that a multisensory teaching intervention effectively imparts the necessary knowledge, skill and confidence in fourth year medical students to manage epistaxis.