Team-based Learning:  An Effective Method for Teaching Pharmacology?

Amy L. Wilson-Delfosse1 and Daniel. R. Wolpaw2,3,

Departments of  1Pharmacology and  2Medicine,  CASE  School of Medicine,

CASE Western Reserve University, Cleveland, OH and 3Cleveland VA Medical Center

Introduction

The CASE School of Medicine is poised to enter an exciting period of curriculum transformation.  The new curriculum will include an enhanced appreciation and need for more interactive teaching methods. Currently, the first year medical Pharmacology committee, Fundamentals of Therapeutic Agents (FTA),  includes a mix of lectures and small group conferences.  Consistency in small group facilitation is achieved by having the same faculty teach the same small group conference at six different times to six different groups of 25 medical students. The problem with generalizing this method to other committees is that it requires an extraordinary amount of faculty time and also requires that the order in which small groups are taught does not matter.  In an attempt to develop a more efficient yet interactive teaching strategy, it is proposed that team-based learning (TBL) strategies be developed for use within the FTA committee.

Team based learning is an educational technique that has gained popularity at a number of medical schools across the United States [1-3].  This is an approach that requires a single expert facilitator for groups as large as the current medical school class at CASE yet fosters an active and collaborative learning environment (Fig. 1). The active learning environment and more efficient use of faculty time will benefit both students and faculty.   It is anticipated that the experience gained through implementing such methods during the FTA committee can be disseminated to other basic science course directors. 

Statement of the problem and program objectives

The teaching of fundamental principles of pharmacology at CASE School of Medicine is accomplished utilizing a combination of large group and small group methods.  The necessity to utilize expert facilitators in the small group conferences dictates that the class be divided into not more than 6 groups, resulting in 25 students per group.  This rather large number of students per group does not optimally promote a productive and active learning environment

Question

Does the introduction of team-based learning into the Fundamentals of Therapeutic Agents curriculum:

            promote self-directed learning,

            improve retention and ability to apply concepts learned, and

            increase student satisfaction with regard to

            learning experience?

Description of the project/intervention

A team based learning approach was introduced into the first year, Fundamentals of Therapeutic Agents subject committee.  Specifically, half of the class studied pharmacodynamic principles by means of a traditional small group approach, while the other half of the class was exposed to the same cases and principles utilizing a team learning approach.

Outline of TBL Approach

Fig. 3. Team-based learning begins by assessing students knowledge with a quiz and then progresses into application exercises that require students to struggle with and apply their knowledge.

Syllabus:  Students in both the team-based learning and small group conference classes were provided with syllabus materials that included required preparatory readings and learning objectives.  The syllabus for all students also included a presentation of cases and discussion questions that were suitable for conducting a traditional small group conference.  Case vignettes considered during these exercises were the same.  Small group discussion questions, however, were converted to team-based learning application exercises that were revealed at the time of the team-based learning sessions.

Quizzes:  Both the traditional small group conferences and the team-based learning sessions will be initiated with a short (5-question) multiple choice quiz to assess adequate student preparation accomplished by studying the assigned readings.

Participation:  Assessment of “informed participation” took place in both the small group conference and team-based learning sessions.

Findings to date/Evaluation to date

The methods used to evaluate this project are outlined in Figure 4.  The first two steps (Student Survey and Interim Exam) have been completed.  Delayed assessment of knowledge will take place in March of 2006.

Evaluation Strategy

Comparison of TBL and control (SGC) outcomes

Fig. 4.  Team-based learning is being evaluated utilizing a student survey and knowledge assessments.

 

 

Student Perception Survey Results

 

                                          Student Exam Results

                                        

                                             

Raw Scores                                    Descriptive

 

	N	Mean	Std Deviation	Std. Error	95% confidence Interval for Mean		Min	Max
					Upper bound	Lower bound
Team Learning Small Group Total	58  57 115	9.95 10.16 10.05	1.05 0.70 0.90	0.14 0.09 0.08	9.67 9.97 9.89	10.22 10.34 10.22	6.00 9.00 6.00	11.0 11.0 11.0

 

 

Raw Scores                                    Anova

	Sum of Squares	df	Mean Square	F	Sig
Between Groups Within Groups Total	1.26 90.42 91.38	1 113 114	1.26 0.80	1.58	.21

 

 

Key lessons learned so far and next steps

There are no differences with regard to student perceptions or exam performance when the team-based learning approach is compared to the current small group conference approach.

 

While it is relatively easy to learn how to implement team-based learning in the classroom, it is not at all trivial to write application exercises that will foster successful discussion during the team-based learning exercises. 

 

Questions

Does team learning improve retention of pharmacodynamic concepts?  Why is there no difference in perception or performance when team-based learning and small group conference approaches are compared?  Are there instructor advantages to utilizing one approach versus another?

 

  

Literature cited

1.Haidet P., O’Malley, KJ, Richards, B. (2002) An initial experience with “team learning” in medical education. Acad. Med. 77:40-4.

2.Hunt, D.P., Haidet, P., Coverdale, J.H., Richards, B. (2003) The effect of using team learning in an evidence-based medicine course for medical students. Teach. Learn. Med. 15:131-9.

3.Searle, N.S., Haidet, P., Kelly, P.A., Schneider, V.F., Seidel, C.L., Richards, B.F. (2003) Team learning in medical education: initial experiences at ten institutions. Acad. Med. 78:S55-8.