Team-based Learning Process Research Articles

Team-based learning with group awareness: impact on students with different self-regulated learning levels

ABSTRACT Team-Based Learning (TBL) has been widely applied in different fields (courses) and has been indicated to be efficient. Meanwhile, many studies have asserted that Group awareness (GA) information, which visually displays peers’ learning context and activities, can increase peer participation within an online collaborative learning environment. As the level of preparation by students before class affects their subsequent learning performance in the TBL process, this study incorporates GA information into the preparation stage of TBL process and further develops the online TBL + GA system in order to raise peer preparation level. Furthermore, self-regulated learning (SRL) levels of a student and online learning environment interactively influence learning effectiveness. Accordingly, this study further investigates how the TBL + GA environment influences students with different SRL levels. Two freshman classes were randomly chosen, with one as the control class (using the traditional TBL) and the other as the experimental class using the TBL + GA. Analytical results indicate that although the two classes do not reach significance overall on preparation level, TBL + GA can significantly enhance preparation levels for high-SRL students, but not low-SRL students.

Applying Creative Tools that Facilitate Online Team‐Based Learning

BackgroundOnline education jeopardizes many aspects of medical education. Online lecturing has the disadvantage of disengaging students, which leads to poor learning. Instructors can increase student engagement by incorporating active learning techniques into classroom discussions and interactions.Team Based Learning (TBL) has been shown to benefit students in a variety of settings. Ahead of COVID 19, TBL was used in classrooms and occasionally in blended learning environments combining online and classroom instruction.This study aims to introduce an innovative strategy for increasing student engagement through use of online TBL. We designed a TBL strategy using the Blackboard lockdown browser, breakout rooms, and Microsoft forms. The TBL framework of orientation, readiness assurance, and implementation exercises was maintained.MethodologyStudents were introduced to course material and held accountable for pre‐class instruction through the TBL Readiness Assurance tests. For the deployment of the iRAT, we used the lockdown browser in conjunction with the blackboard Respondus camera. The question type used was multiple‐choice without reporting the correct answers to the students. After submitting the iRAT, students were permitted to enter the blackboard session, where they were divided into groups for the tRAT, which took place in the breakout rooms that had been assigned in advance. The students' groups in their rooms were given a link to a Microsoft Form that was structured to look like the IF‐AT cards used by TBL, and they were instructed to use it. In order to construct the tRAT, point allocation and branching were used, and each question was entered three times into Forms and assigned a score of 4, 2, or 1 point. An automatic comment was triggered by selecting the correct response, praising the group for their effort, and awarding the required number of points. If the correct answer was not provided in the first three trials, the correct answer is provided before moving on to the next question in the series. When it was determined that all of the groups had submitted their tRAT answers, the breakout rooms were closed, and all of the students were moved to the main room with the blackboard where the session came to a close with a discussion of the answers with the instructor, who immediately provided feedback. Students' perceptions (N=203) were also evaluated using quantitative and qualitative tools, including a self‐administered questionnaire and a focus group discussion.ResultsBased on the data gathered during the readiness assurance process and the attendance of the students, it appears that the students were highly engaged in the online TBL process. The most significant themes identified by participants included increased commitment and preparedness, appropriately challenging questions, a deeper level of learning in the breakout rooms, and the ease with which technology could be used. Furthermore, students stated that participating in the online TBL enhanced their self‐confidence in order to face the examinations, offered an opportunity for a weaker student to cover learning objectives, and stimulated further motivation in them to attend these sessions.ConclusionOnline TBL is a valuable learning strategy that can be implemented to increase student engagement in online learning, provided the applications are used effectively.

Going virtual and going wide: comparing Team-Based Learning in-class versus online and across disciplines.

Team-based learning (TBL) is an active learning pedagogy developed for in-class sessions and based on the collaborative work of small groups of students. The increasing push to online and blended learning has enhanced the need to expand this pedagogy to a virtual environment, but little evidence has been produced on how students accept online synchronous sessions of TBL. The purpose of this study, that relies on 427 responses, is to present a comparative perspective of traditional in-class versus adapted fully synchronous online TBL and across different disciplinary fields. Students of two different academic years and different programs were surveyed for their acceptance of TBL. They were invited to answer closed-ended questions focused on their engagement in all TBL learning process and the final outcomes provided. Results obtained from this unique comparative study revealed a wide approval of TBL, regardless of the environment (online or in-class TBL sessions), scientific area of courses and student gender. The acceptance of fully online TBL sessions, in a similar way as traditional in-class sessions, could be a rationale for giving more use to the ‘virtual’ context. Other results corroborated previous researches on TBL, such the need of student awareness of TBL benefits to get more engaged in the process or the impact of student activities overload on the TBL process. Implications are informative for pedagogical practice.

A Unique Approach to Project-Based Learning (PjBL) in a Veterinary Anatomy Course

Project-based learning (PjBL) is a teaching methodology designed to engage students in solving real-world problems, acknowledging that students are active agents of their learning process. This methodology has historically been popular in architecture and industrial sciences; however, its use in teaching veterinary anatomy is scarcely published. Using information and communication technologies, the PjBL methodology was implemented in a first-year veterinary anatomy course. The methodology included teamwork and the selection of a routine object in the veterinary clinic at the beginning of the academic semester. The project's goal was to analyze the object and associate it with both a domestic animal species and an anatomical region, along with making and presenting a video or a simulation model about the object. More than 80% of students prefer active learning classes compared to traditional classes. In addition, 66% and 86% of students indicate that PjBL allowed them to improve their understanding of theoretical content for the first and second years of post-implementation, respectively. Students' self-assessment indicates that more than 80% of the students (first and second year post-implementation) felt they were responsible for the execution of the project, able to conduct research, and able to develop autonomous learning skills. After 2 years of PjBL implementation, failure rates in the course decreased by 21%. In general, PjBL results show that veterinary students prefer active learning activities that allow them to learn in a team-based learning process as well as to develop soft skills such as self-learning, responsibility, and teamwork. The online version contains supplementary material available at 10.1007/s40670-021-01205-1.

Interprofessional team-based learning (TBL): how do students engage?

BackgroundAlthough challenging to integrate within university curricula, evidence suggests that interprofessional education (IPE) positively impacts communication and teamwork skills in the workplace. The nature of Team-based learning (TBL) lends itself to interprofessional education, with the capacity to foster a culture of collaboration among health professional students. Our study was designed to pilot an interprofessional ‘back pain’ TBL module for physiotherapy and medical students, and to explore their experience of the TBL process, using the conceptual framework of ‘knowledge reconsolidation’ to discuss our finding.MethodsThree hundred and eleven students participated in the TBL session: 222/277 (80%) of Year 1 medical students and 89/89 (100%) of Year 2 physiotherapy students. Students completed one interprofessional Musculoskeletal Sciences TBL session on the topic of ‘back pain’. A questionnaire including closed and open-ended items, was distributed to students immediately following completion of the TBL session. Descriptive statistics were used to analyse the quantitative data. Thematic analysis was used to code and categorise qualitative data into themes. Pre-class quiz scores were compared between the groups using a one-way between groups Analysis of Variance (ANOVA) test with Tukeys Post Hoc test.ResultsIn total, 117/311 (38%) of participants completed the questionnaire. Both medicine and physiotherapy students appreciated the opportunity to learn about the curriculum of another healthcare discipline, and their scope of practice; gain multiple perspectives on a patient case from different disciplines; and recognised the importance of multidisciplinary teams in patient care. Students felt having an interprofessional team of facilitators who provided immediate feedback helped to consolidate student learning and promoted clinical reasoning. An analysis of variance revealed no difference between Physiotherapy and Medical students’ pre-class quiz scores.ConclusionOur study demonstrated that the small group and task-focused characteristics of TBL provided a student-centred teaching strategy to support the achievement of interprofessional learning goals. Students valued their interactions with other students from a different professional degree, the opportunity to problem solve together, and learn different perspectives on a patient case. The pre-class quiz results demonstrate that both groups of students had a comparative level of prior knowledge to be able to work together on the in-class activities.

Implementation of team-based learning on a large scale: Three factors to keep in mind*

Team-based learning (TBL) is a structured form of small group learning that can be scaled up for delivery in large classes. The principles of successful TBL implementation are well established. TBL has become widely practiced in medical schools, but its use is typically limited to certain courses or parts of courses. Implementing TBL on a large scale, across different courses and disciplines, is the next logical step. The Lee Kong Chian School of Medicine (LKCMedicine), a partnership between Nanyang Technological University, Singapore and Imperial College London, admitted its first students in 2013. This new undergraduate medical program, developed collaboratively by faculty at both institutions, uses TBL as its main learning and teaching strategy, replacing all face-to-face lectures. TBL accounts for over 60% of the curriculum in the first two years, and there is continued learning through TBL during campus teaching in the remaining years. This paper describes our experience of rolling out TBL across all years of the medical curriculum, focusing on three success factors: (1) “team-centric” learning spaces, to foster active, collaborative learning; (2) an e-learning ecosystem, seamlessly integrated to support all phases of the TBL process and (3) teaching teams in which experts in pedagogical process (TBL Facilitators) co-teach with experts in subject matter (Content Experts).

The effectiveness of TBL with real patients in neurology education in terms of knowledge retention, in-class engagement, and learner reactions

In our medical school, we changed from a lecture-based method to a team-based learning (TBL) method to teach "polyneuropathies" in the neurology clerkship starting from the 2014 to 2015 academic year. Real patients were used instead of written scenarios in TBL sessions. This study aimed to compare former lecture-based and the current TBL methods in terms of knowledge retention, in-class learner engagement, and learner reactions. First, we determined in-class engagement and satisfaction of the students for the lectures given in the 2013-2014 academic year. The following year, besides the same criteria, we also determined individual (IRAT) and group readiness test (GRAT) scores in the TBL group. End-of-clerkship exam scores for both groups were recorded. Additionally, opinions of patients about their experiences throughout the TBL process were determined. One year later (2015 for lecture and 2016 for TBL), both groups sat for an MCQ test to determine their knowledge retention levels. We found no difference between groups regarding end-of-clerkship exam scores. The mean knowledge retention test score of the TBL group was significantly higher than that of the lecture group (5.85 ± 1.74 vs. 3.28 ± 1.70). The differences between IRAT, GRAT, and retention test scores in the TBL group were significant. The mean student satisfaction score on a five-point scale was 3.01 ± 0.9 (median = 3) in the lecture group and 4.11 ± 1.1 (median = 4) in the TBL group. Our results seem encouraging for use of TBL performed with real patients in neurology education to achieve better long-term knowledge retention and higher in-class engagement and student satisfaction.

Evaluating the Use of Second Life™ for Virtual Team-Based Learning in an Online Undergraduate Anatomy Course

Team-based learning (TBL) is one strategy for improving team-work and critical thinking skills. It has proven to be an engaging teaching pedagogy in face-to-face classes; however, to our knowledge, it has never been implemented online in a 3-D virtual world. We implemented virtual TBLs in an online undergraduate anatomy course using Second Life™, and evaluated whether it engaged students. This study was conducted over two semesters with 39 total students. Surveys and content analysis of transcripts were used to evaluate student engagement. Our results indicate virtual TBLs were engaging for most students. The average engagement score was 7.8 out of 10 with 89.2% of students reporting a score of 6 or above. Students exhibited high levels of cognitive engagement during the clinical application portion of the TBL process. Males felt more emotionally engaged than females; however, most measures of engagement indicated no differences between groups of students (mode of communication, previous technology experience, gender, and performance); therefore, virtual TBLs may be engaging for a broad range of students. Ninety-five percent of students agreed that this was a worthwhile experience. In light of this evidence, we feel that virtual TBL sessions are valuable, and could be implemented in other online courses.

Implementation of team-based learning in year 1 of a PBL based medical program: a pilot study.

BackgroundA traditional and effective form of teaching within medical education has been Problem Based Learning (PBL). However, this method of teaching is resource intensive, normally requiring one tutor for every ten students. Team-based learning (TBL) has gained recent popularity in medical education, and can be applied to large groups of up to 100 students. TBL makes use of the advantages of small group teaching and learning, but in contrast to PBL, does not need large numbers of teachers. This study sought to explore the efficacy of using TBL in place of PBL in Year 1 of a medical program.MethodsIn Year 1 of the medical program, two iterations of TBL, with 20 students, were run following four iterations of PBL within the Cardiology teaching block. Student feedback following PBL and TBL was collected by questionnaire, using closed and open ended questions. Additionally, individual and team tests were held at the beginning of each TBL class, and results of each week were compared.ResultsAll students (n = 20) participated in the test in week 1, and 18/20 students participated in week 2. In total, 19/20 (95 %) of students completed the questionnaires regarding their PBL and TBL experiences. The use of small groups, the readiness assurance tests, immediate feedback from an expert clinician, as well as time efficiency were all aspects of the TBL experience that students found positive. The clinical problem-solving activity, however, was considered to be less effective with TBL. There was a significant improvement (p = 0.004) in students’ score from the week 1 assessment (median = 2) to the week 2 (median = 3.5) assessment. Interestingly, all teams but one (Team 1) achieved a lower score on their second week assessment than on their first. However, the lowest performing team in week 1 outperformed all other teams in week 2.ConclusionStudents favoured many aspects of the TBL process, particularly motivation to do the pre-reading, and better engagement in the process. Additionally, the application of TBL principles meant the sessions were not reliant upon a large teacher to student ratio. Students, however, highlighted the need for more time within TBL for clinical problem-solving.

Ready to learn physics: a team-based learning model for first year university

Team-based learning (TBL) is an established model of group work which aims to improve studentsʼ ability to apply discipline-related content. TBL consists of a readiness assurance process (RAP), student groups and application activities. While TBL has not been implemented widely in science, technology, engineering and mathematics disciplines, it has been effective in improving student learning in other disciplines. This paper describes the incorporation of TBL activities into a non-calculus based introductory level physics topic—Physics for the Modern World. Students were given pre-class preparation materials and an individual RAP online test before the workshops. The pre-workshop individual RAP test ensured that all students were exposed to concept‐based questions before their workshops and motivated them to use the preparatory materials in readiness for the workshop. The students were placed into random teams and during the first part of the workshop, the teams went through a subset of the quiz questions (team RAP test) and in the remaining time, teams completed an in-class assignment. After the workshop students were allowed another attempt at the individual RAP test to see if their knowledge had improved. The ability of TBL to promote student learning of key concepts was evaluated by experiment using pre- and post- testing. The students’ perception of TBL was monitored by discussion posts and survey responses. Finally, the ability of TBL to support peer–peer interaction was evaluated by video analysis of the class. We found that the TBL process improved student learning; students did interact with each other in class; and the students had a positive view of TBL. To assess the transferability of this model to other topics, we conducted a comparison study with an environmental science topic which produced similar results. Our study supports the use of this TBL model in science topics.

Tackling student neurophobia in neurosciences block with team-based learning

IntroductionTraditionally, neurosciences is perceived as a difficult course in undergraduate medical education with literature suggesting use of the term “Neurophobia” (fear of neurology among medical students). Instructional strategies employed for the teaching of neurosciences in undergraduate curricula traditionally include a combination of lectures, demonstrations, practical classes, problem-based learning and clinico-pathological conferences. Recently, team-based learning (TBL), a student-centered instructional strategy, has increasingly been regarded by many undergraduate medical courses as an effective method to assist student learning.MethodsIn this study, 156 students of year-three neuroscience block were divided into seven male and seven female groups, comprising 11–12 students in each group. TBL was introduced during the 6 weeks of this block, and a total of eight TBL sessions were conducted during this duration. We evaluated the effect of TBL on student learning and correlated it with the student's performance in summative assessment. Moreover, the students’ perceptions regarding the process of TBL was assessed by online survey.ResultsWe found that students who attended TBL sessions performed better in the summative examinations as compared to those who did not. Furthermore, students performed better in team activities compared to individual testing, with male students performing better with a more favorable impact on their grades in the summative examination. There was an increase in the number of students achieving higher grades (grade B and above) in this block when compared to the previous block (51.7% vs. 25%). Moreover, the number of students at risk for lower grades (Grade B- and below) decreased in this block when compared to the previous block (30.6% vs. 55%). Students generally elicited a favorable response regarding the TBL process, as well as expressed satisfaction with the content covered and felt that such activities led to improvement in communication and interpersonal skills.ConclusionWe conclude that implementing TBL strategy increased students’ responsibility for their own learning and helped the students in bridging the gap in their cognitive knowledge to tackle ‘neurophobia’ in a difficult neurosciences block evidenced by their improved performance in the summative assessment.

Correlation of Student Performance on Team Based Learning (TBL) with Exams in Systems Based First Year Medical School Courses

TCOM Basic Sciences curriculum uses a two‐pass systems based approach. Students are introduced to normal anatomy, physiology, and biochemistry in the first year and then progress through an introduction to immunology and microbiology, pathology and pharmacology. As course directors, we implemented TBL in the Musculoskeletal System 1 and Nervous System 1 courses as a substitute for the pre‐exam reviews. The TBLs carried points towards the final course grade. Lecturers submitted questions that were mainly in the USMLE or COMLEX format, i.e. the question was based on a clinical vignette and the stem asked the students to determine which anatomical structure, mechanism or process was involved. A total of 20 questions were presented initially as an individual quiz and then they were repeated as a group quiz. For the group quiz, students went into their groups and then discussed each question whereupon a group leader would submit an answer based on a consensus of their knowledge. We are correlating student performance on the individual quiz and total TBL score with exam scores to determine the effectiveness of using TBL. We are also presenting a survey to determine student enthusiasm for the TBL process.

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.

Computer-supported team-based learning: The impact of motivation, enjoyment and team contributions on learning outcomes

The benefits of teamwork and collaboration have long been advocated by many educational theories, such as constructivist and social learning models. Among the various applications of collaborative learning, the iterative team-based learning (TBL) process proposed by Michaelsen, Fink, and Knight (2002) has been successfully used in the classroom without computer support. This paper describes the implementation and evaluation results of a classroom application of the TBL process, which was modified to include computer mediation. We call this process computer-supported team-based learning (CS-TBL). This work extends learning in small teams from the traditional classroom to the hybrid classroom where students meet both face-to-face and online by emphasizing the importance of online team interactions. The outcomes are assessed through an evaluation model that considers the impact of motivation, enjoyment and team contributions on learning outcomes. The study results indicate that motivation influences the relationship between team interactions and perceived learning. Enjoyment is affected by motivation and perceptions of team members’ contributions, with the implication that students who perceive that the team interactions are adding value to their education will better enjoy learning and will experience higher-level learning outcomes.

Team-based learning: a strategy for interprofessional collaboration

Context and setting Team-based learning is content-grounded and allows for problem solving and mastery of concepts for large groups within a small-group setting. We developed an innovative method of expert-presented content followed by collaborative team-based learning, to teach health-care leaders in the National Academies of Practice (NAP) skills for effective interprofessional patient care. The NAP, an honorific, national group comprised of elected members in 10 academies representing medicine and 9 other health care professions, serves as a distinguished policy forum that advises governmental bodies on interprofessional approaches to problems in health care. Our objective was to create an interactive team-based learning experience for a large group of interprofessional health care leaders that provided them with the opportunity to: (a) examine the process of creating a patient interprofessional care plan and (b) collaborate with interprofessional colleagues to develop effective ways to co-ordinate patient care. Why the idea was necessary The ability of health care providers to work effectively in interprofessional teams is a key component of quality health care. The Institute of Medicine reports that health care team communication failures cause mistakes that endanger patient safety. Interprofessional communication, taught rarely in traditional health care settings, is learned usually through a hidden curriculum of experiences. While there is growing interest in team-teaching for specific content areas, few programmes utilise team-teaching to teach the process of interprofessional care. We describe an efficient team-teaching strategy to teach skills for interprofessional care of patients. What was done We developed a 3-h interactive session, presented at the 2004 NAP National Forum, to address interprofessional issues with leaders from 10 health-care professions. Participants (n = 98) studied the case of a diabetic woman with medical and psychosocial issues. Experts from each discipline gave short presentations (8 min each) relevant to their discipline's contribution to the patient's care. Participants were then divided into 8 interprofessional groups and asked to discuss the process of creating a co-ordinated care plan (rather than actually creating one) from their diverse perspectives. Each group answered one of the following two questions: (1) how might this patient be helped through the current system to receive comprehensive and co-ordinated care by all these disciplines? And (2) what are the benefits and barriers to an interprofessional approach to this patient's needs? All groups answered a third question: (3) what policy recommendations should NAP make to governing bodies to promote a more effective means for interprofessional care? Each small group reported to the larger group, which then discussed the process of effective interprofessional collaboration. Evaluation of the results and impact Participants were enthusiastic about the opportunity to participate in a team-based learning process. They identified lack of training in the skills necessary for effective collaboration as a common barrier to interprofessional practice, and improving communication among diverse providers as the key to optimising interprofessional care. Participants were uniformly positive in their support of this interdisciplinary team-learning model as an efficient and effective way to gain exposure to the perspectives and knowledge of those in related professions, and to learn important skills for interprofessional collaboration.