Individual Readiness Assurance Test Scores Research Articles

Effectiveness of Team-based Learning Methodology in Improving Learning Outcomes Among 2nd-year Undergraduate Medical Students in Pathology

Abstract Introduction: Team-based learning (TBL) is a student-centric teaching–learning (TL) method and fosters active learning. TBL has an advantage over other small group TL methods for balancing teaching time and resources. Aim: The study aimed to determine the effectiveness of TBL methodology in improving learning outcomes among 2nd-year undergraduate medical students in pathology. Settings and Design: This was a quantitative interventional study involving 100 2nd-year MBBS students in pathology at AIMS, BG Nagara. Methodology: Two groups of 50 students were exposed to three TBL and case-based learning (CBL) sessions on similar topics. For the TBL session, individual readiness assurance test scores and team readiness assurance test scores were obtained. Statistical Analysis Used: For both the TBL and CBL sessions, retention test scores were obtained after 2 weeks and the effectiveness of two methods of learning was determined by comparing the retention test scores by independent Student’s t-test. Feedback on students’ perception of TBL was obtained using a five-point Likert scale. Results: The mean test score of the TBL session was significantly higher than that of CBL sessions (19.80 vs. 15.86, P < 0.0001). Similarly, it was also observed that the retention scores were higher among average performers after the TBL session (19.71 vs. 12.50, P < 0.0002). Conclusion: TBL is more effective than CBL in fostering learning and it selectively benefits average performers more than higher performers, evidenced in this study by better retention of knowledge.

Implementation of Team-Based Learning for a Clinical Module of the Ethiopian Undergraduate Anesthesia Curriculum and Students' Perspectives: A Pilot Cross-Sectional Study.

Team-based learning (TBL) is an active learning strategy that gives students the opportunity to apply conceptual information through a series of tasks that incorporate individual effort, team collaboration, and immediate feedback. This study aimed to report baseline TBL implementation in a clinical module of a fourth-year competency-based undergraduate anesthesia curriculum and explore the perspectives of students. In April 2023, 18 students participated in two TBL sessions over two weeks, and readiness assurance test results and post-TBL evaluations were analyzed. Week one TBL implementation scores were compared with week two, establishing a longitudinal analysis over two points in time. Students also participated in an online survey to assess their views on the advantages and design of TBL, their perceptions of its best and worst features, and their suggestions for its implementation. Of 18 students, 16 (89%) responded to the survey. Most students believed that TBL was an effective educational strategy but expressed concern about the amount of time required for TBL preparation and the need for student readiness. The individual readiness assurance test scores did not differ significantly between weeks 1 and 2 (mean difference [MD] = 0.39, P= 0.519, 95% CI: -0.824 to 1.60). However, the students' median [IQR] team readiness assurance test scores increased significantly from week one to week two, from 8 [2] to 10 [1] (p = 0.004). Peer evaluation scores also showed a significant increase in week 2 (MD = 2.4, P = 0.001, 95% CI: -3.760 to -0.996). TBL was successfully implemented for a clinical module at Dilla University-Ethiopia for the first time. Students perceived it positively, but some criticized its preparation time, workload, and minimal facilitator engagement. We suggest convenient and flexible scheduling personalized for each student's needs when TBL is applied for clinical modules.

The effectiveness of online team-based learning in introduction to medical ethics education for medical students at a medical college of Nepal: a pilot study

Background:The effectiveness of online classes is always a concern, and it can be overcome by opting for active learning strategies like team-based learning (TBL). This study was conducted to find out the effectiveness of online TBL as an active learning strategy. We also aimed to explore the satisfaction and perception of students toward TBL.Methods:This is a mixed-method study conducted among 29 third-year Bachelor of Medicine and Bachelor of Surgery (MBBS) students of Gandaki Medical College using purposive sampling method in the duration of January to September 2021. Three two hours online TBL sessions were used for teaching introduction to medical ethics. The individual readiness assurance test (IRAT) scores were compared to the group readiness assurance test (GRAT) scores to evaluate the effect of TBL through cooperative learning. Learner reactions and satisfaction of students towards TBL were assessed using a validated questionnaire comprising of a five-point Likert scale. An open-ended question asking the participants to describe their overall experience of the TBL sessions was also included to explore their perceptions towards TBL. The data were collected using Google form and exported to Microsoft Excel and the quantitative data were then analyzed using Statistical Package for Social Sciences (SPSS) version 16.0. To check the normal distribution of the data, Kolmogorov Smirnov and Shapiro-Wilk test were used. Non-parametric tests were used for the non-normally distributed data. P value of < 0.05 was regarded as significant. Thematic analysis was conducted for the qualitative data.Results:The median GRAT scores were significantly higher (p = 0.006 in TBL 1 and 0.001 in TBL 2) than IRAT scores. Learner reactions toward TBL sessions were positive as shown by the mean scores which were in the range of 3.59 to 4.66. Five themes were generated from the codes: “effective learning method”, “positive experience”, “gained knowledge”, “expression of gratitude” and “the way of conduction of the sessions”.Conclusion:Online TBL in medical ethics was effective as a teaching learning tool in our setting. The students were satisfied with the learning process and rated the learning strategy positively.

A meta-analysis of students\u2019 readiness assurance test performance with team-based learning

BackgroundTeam-based learning (TBL) is increasingly being utilized across medical fields by engaging students in small group discussions. The readiness assurance test (RAT) is an essential feature that differentiates TBL from problem-based learning (PBL) activity sequences. No publication has discussed differences in the RAT in TBL in medical schools. The purpose of this meta-analysis study was to examine the performance of learners in terms of group RAT (GRAT) and individual RAT (IRAT) scores in TBL for students of healthcare professions.MethodsDatabases, including PubMed and Cochrane were searched using several terms. We assessed the quality of included studies and conducted a meta-analysis.ResultsIn total, 11 studies with 1575 participants were identified. Quality assessment scores of these studies ranged 4 ~ 7. Mean GRAT scores were significantly higher than mean IRAT scores (standardized mean difference (SMD) = 2.027, 95% confidence interval (CI) = 1.657 ~ 2.486, p heterogeneity < 0.001). Although the test of subgroup differences was insignificant (p = 0.113), the nursing-only subgroup showed much better performance in the GRAT than the IRAT (SMD = 2.3CI: 95% CI = 2.0 ~ 2.6, I2 = 48.77%) compared to the others subgroup which included students from different majors. The subgroup analysis explained the heterogeneity in the overall analysis. Because of inadequate information from these 11 studies, a meta-regression could not explore the source of heterogeneity in terms of the mean age, duration of the intervention, preparation time before the RAT, and previous TBL experienced by students.ConclusionsStudents achieved significantly higher scores for the GRAT than for the IRAT, especially the group which only included nursing students, which implies excellent collaboration in the group of nursing students.

Peer‐Evaluation in a Team‐Based Learning Curriculum: Investigating the Relationship between Peer‐Evaluation Scores and Team Rank

IntroductionMany medical school and health care professional curricula are incorporating teaching methods along with learning and assessment approaches, which aim to foster communication skills, professionalism, teamwork, and leadership skills. Team‐based learning (TBL) is a commonly used pedagogical approach to accomplish the flipped classroom and to foster professionalism, teamwork, and communication skills. Two components of TBL curriculum are 1) the utilization of peer evaluations for assessment purposes and 2) a team competition as an incentive structure. No standardized instrument exists for TBL peer evaluation and some studies have questioned the reliability and validity of the instruments for assessment purposes. Therefore, the objective of this study was to evaluate the relationship between averaged peer‐evaluation scores and rank in the team competition.MethodsTeams (n=5) within a TBL graduate histology course during the fall semester of 2018 were ranked weekly in a team competition following each of the 10 TBL sessions. Rank was calculated based on averaged individual readiness assurance test scores (iRAT), group readiness assurance test scores (gRAT), and group activity scores for each TBL and was updated throughout the semester. Students (n=31) conducted peer‐evaluations of their team members at two different points (mid‐ and end‐of‐semester). The instrument for the peer‐evaluation contained 10 items that assessed professionalism and team engagement (e.g., is well‐prepared for team activities) on a four‐point scale from never to always. This tool was developed based on recommendations for TBL peer evaluations in the literature. Spearman correlations were used to determine the relationship between peer‐evaluation scores and team rank at each time point. Alpha was set at p≤0.05.ResultsThere was a statistically significant (p=0.037) negative correlation between peer‐evaluation scores and TBL team rank at mid‐semester (r=−0.375) and stronger negative correlation existed at the end‐of‐semester (r=−.591, p&lt;0.001). In other words, students on teams with a lower rank tended to give their peers lower evaluation scores.Discussion and ConclusionThe relationship between the peer‐evaluation scores and the TBL team rank demonstrate a negative relationship. Thus, within this graduate level histology course utilizing the peer‐evaluation as a summative assessment may not be warranted as it may be unduly penalizing poor performing teams. Other courses utilizing team rank incentives may consider evaluating the use of peer evaluations as summative assessments. Furthermore, this study demonstrates a need for a standardized and reliable instrument for peer evaluations in a TBL curriculum.

Application of Modified Team-Based Learning Approach for Enhancing Undergraduate Medical Educational Seminars.

Team-Based Learning (TBL) is an instructor-led, structured form of cooperative learning that promotes self-directed learning and teamwork while equipping students with the problem-solving and collaborative skills needed to meet the demands of their future professions. This study examines the impact of applying a modified TBL approach to enhance educational seminars in a PBL-adopted curriculum. A total of 300 students participated in the study. Students' Individual Readiness Assurance Test (IRAT) mean scores were compared with mean scores of the same students' Group Readiness Assurance Test (GRAT). Student satisfaction was determined on a scale with 6 options in response to 13 questions to compare different aspects of traditional and TBL educational seminars. Comparison between IRAT and GRAT scores showed consistently higher GRAT scores. The majority of students expressed their overall satisfaction in favor of the TBL seminar, especially regarding seminar organization, knowledge acquisition, and team work skills. Application of the TBL approach in educational seminars increased second- and third-year medical students' engagement and satisfaction and improved their test performance.

Comparison of Lecture Based and Modified Team Based Learning in Achieving Cognitive Skills in Medical Education

Current study was designed to compare effectiveness of lecture-based and modified team-based learning in achieving cognitive skills in resident doctors.Methodology: This comparative cross sectional study was conducted on medical floor in Mayo Hospital, Lahore. Resident doctors (RDs) including house officers (HOs) and postgraduate residents (PGRs) were divided into two groups for lecture based learning (LBL) and modified team based learning (mTBL) on the topic of “health promotion and disease prevention”. All RDs undertook individual readiness assurance test (IRAT) and final (FT) tests where FT pertained to six cognitive domains. Statistical testing for IRAT and FT scores and performance in early and advanced domains were performed taking p-value &lt; 0.05 as significant.Results: A total of 53 RDs including 58.49% HOs and 41.51% PGRs participated in the study with similar distribution among mTBL and LBL groups. The mean IRAT scores for LBL and mTBL groups were 41.03±17.79&amp;44.17±19.54, respectively (p-value 0.272). The overall FT scores were 40.26±15.17 &amp;48.02±17.57 for LBL and mTBL respectively (p-value 0.045). The FT scores in early domains were 34.81±14.93&amp;56.12±15.1 for LBL and mTBL groups (p-value 0.000). The scores of advanced domains were 35.53±12.65 and 30.56±14.73 for LBL and mTBL (p-value 0.301). PGRs performed better than HOs in early domains (p-value 0.043) but not in advanced domains. There was no difference in performance of male and female RDs. Conclusion: After a single session, mTBL significantly improved performance in early cognitive domains but not in advanced cognitive domains.

Effectiveness of the team-based learning (TBL) strategy on medical students' performance.

ObjectivesTeam-based learning (TBL) represents a new and interesting educational strategy. It helps to enhance students' professional competencies and ideally works to prepare them in their pursuit of lifelong learning. The aim of this study is to evaluate the effectiveness of TBL as an educational strategy on medical students' performance in a problem-based learning (PBL) curriculum.MethodsA cross-sectional study was conducted through a self-designed questionnaire. It was constructed to examine several aspects of TBL, including cognition, social skills, high school educational system, and personal development. A total of 112 students were invited to participate in the study and 100 completed the survey. Individual-readiness assurance test (IRAT) and group-readiness assurance test (GRAT) scores were collected and the data were analysed and compared to the results of the final assessment using Statistical Package for the Social Sciences (SPSS).ResultsA total of 52 students (52%) described TBL as fostering a cooperative learning environment and 64 students (64%) found the materials to be easier to understand when discussed among themselves as a group. Compared to final examination results, there was a significant correlation (p = 0.0001) between IRAT performance and final exam score. In addition, there was a significant correlation between high school education system and IRAT score, where the best performance was observed among students coming from schools using the British curriculum.ConclusionsThe overall perception and attitude of students toward the TBL system was positive and promising. Nevertheless, there are some notes and areas of concern that must be re-examined and remedied to improve TBL as an educational tool.

Teaching Patient Safety Using an Interprofessional Team-Based Learning Simulation Model in Residency Training.

Teaching and learning patient safety require demonstration of competencies such as teamwork, communication skills, and recognition of systems error. This patient safety TBL simulation-training program was developed to fulfill core patient safety objectives outlined by the ACGME and ACGME Clinical Learning Environment Review Program. The goal of the program is to enhance patient safety and quality care concepts and facilitate hands-on teamwork skills and core attitudes towards patient safety. This program served as a mandatory part of the residency core curriculum. It was delivered as a 3-hour workshop session during medicine resident orientation. The workshop included an introductory presentation, one TBL activity, and three 1-hour interprofessional simulated application cases using either high-fidelity mannequins or standardized patients. Following each application case activity, trainees participated in a postcase scenario debriefing moderated by faculty facilitators. A total of 76 trainees participated, and 20 interprofessional teams were created. An independent-samples t test revealed that the Group Readiness Assurance Test scores were significantly higher than the Individual Readiness Assurance Test scores. Although the Readiness for Interprofessional Learning Survey's Teamwork and Professional Identity subscale scores were higher postworkshop compared to preworkshop, the differences were not statistically significant. Over 90% of the participants agreed that the safety concepts they learned would likely improve the quality of care they provide to future patients. A simulation model centered on an interprofessional team can be used as an important training technique to teach health care professionals realistic, hands-on principles of patient safety.

Modified Team-Based Learning in an Ophthalmology Clerkship in China.

ObjectiveTeam-based learning (TBL) is an increasingly popular teaching method in medical education. However, TBL hasn’t been well-studied in the ophthalmology clerkship context. This study was to examine the impact of modified TBL in such context and to assess the student evaluations of TBL.MethodsNinety-nine students of an 8-year clinical medicine program from Zhongshan Ophthalmic Centre, Sun Yat-sen University, were randomly divided into four sequential units and assigned to six teams with the same faculty. The one-week ophthalmology clerkship module included traditional lectures, gross anatomy and a TBL module. The effects of the TBL module on student performance were measured by the Individual Readiness Assurance Test (IRAT), the Group Readiness Assurance Test (GRAT), the Group Application Problem (GAP) and final examination scores (FESs). Students’ evaluations of TBL were measured by a 16-item questionnaire. IRAT and GRAT scores were compared using a paired t-test. One-way analysis of variance (ANOVA) and subgroup analysis compared the effects among quartiles that were stratified by the Basic Ophthalmology Levels (BOLs). The BOLs were evaluated before the ophthalmology clerkship.ResultsIn TBL classes, the GRAT scores were significantly higher than the IRAT scores in both the full example and the BOL-stratified groups. It highlighted the advantages of TBL compared to the individual learning. Quartile-stratified ANOVA comparisons showed significant differences at FES scores (P < 0.01). In terms to IRAT, GRAT and GAP scores, there was no significant result. Moreover, IRAT scores only significantly differed between the first and fourth groups. The FES scores of the first three groups are significantly higher than the fourth group. Gender-specific differences were significant in FES but not the IRAT. Overall, 57.65% of student respondents agreed that TBL was helpful. Male students tended to rate TBL higher than female students.ConclusionThe application of modified TBL to the ophthalmology clerkship curriculum improved students’ performance and increased students’ engagement and satisfaction. TBL should be further optimized and developed to enhance the educational outcomes among multi-BOLs medical students.

Preparing nursing students to be competent for future professional practice: applying the team-based learning-teaching strategy.

Team-based learning (TBL) has been used for many years in business and science, but little research has focused on its application in nursing education. This quasi-experimental study was to apply the TBL in four nursing courses at a university in Taiwan and to evaluate its effect on students' learning outcomes and behaviors. Adult health nursing, maternal-child nursing, community health nursing, and medical-surgical nursing were the 4 designated courses for this study. Three hundred ninety-nine students in 2-year registered nurse-bachelor of science in nursing, and regular 4-year nursing programs enrolled in the designated courses were contacted. Three hundred eighty-seven students agreed to participate in the data collection. Results showed that the TBL significantly improved the learning behaviors of students in both programs, including class engagement (p < .001) and self-directed learning (p < .001). The group readiness assurance test score was significantly higher than the mean individual readiness assurance test (IRAT) score. The final examination score was significantly higher than the IRAT score, which means that TBL is effective in improving students' academic performance. The study revealed that TBL generally improves students' learning behaviors and academic performance. These learning behaviors are important and beneficial for the students' future professional development. The TBL method can be considered for broader application in nursing education.

간호교육에서 팀 기반학습(Team-based Learning)의 적용에 관한 연구

Purpose: This study is to assess the level of student perceptions, academic achievement, satisfaction, and their relationships in a medical-surgical nursing course using team-based learning (TBL). Method: Four-hour TBL sessions were given in a structured three-phase sequence in a cohort of 261 second year nursing students. Results: Mean perceptions of TBL was <TEX>$6.64{\pm}5.11$</TEX>, and <TEX>$8.30{\pm}4.11$</TEX> for perceptions of teamwork. On a 7-point scale, the mean satisfaction score was <TEX>$4.85{\pm}1.41$</TEX>, and 64.0% of nursing students were satisfied with TBL compared to lecture. Group readiness assurance test score was significantly higher than individual readiness assurance test score (t=-16.76, p<.001). Perceptions of TBL (F=1.40, p=.245), perceptions of team work (F=1.55, p=.202) and satisfaction (F=0.81, p=.489) was not different by the level of students' academic achievement on items related TBL. Conclusion: Results indicates that TBL was an effective instructional strategy including favorable perceptions and satisfaction for nursing students. TBL could be an adjunct educational strategy for undergraduate nursing education.

Methods of effective team-based learning administration and expected effects on medical education.

The aim of this study was to analyze the results of quantitative and qualitative student evaluations of team-based learning (TBL) and student achievement evaluations during TBL. Questionnaires that evaluated medical student perception and self-assessment of the TBL experience included 38 questions on the TBL process. Also, we used scores from the TBL session to investigate student academic achievement. Our results showed that the more proper the educational environments were, the more focused students were on team learning. According to the distribution period for preliminary assignments, there was a difference in self-directed learning. In addition, team members had the opportunity to learn new knowledge by interacting with each other, and when they had the experience of feedback, they understood the instruction topics through team learning better. With regard to peer evaluation, the students who recognized the importance of assessment studied more sincerely and honestly. By experiencing the TBL process, every team showed a high significance in the group readiness assurance test score compared with the individual readiness assurance test score, and student satisfaction with the TBL and expectation levels about capacity strengthening increased as well. TBL is an effective teaching and learning method and has positive impacts on student academic achievement. A study on student academic achievement and perception of TBL is expected to provide medical educators with suggestions on planning teaching strategies for effective TBL administration.