Professor Danny McLaughlin and Dr Andrew Chaytor
School of Medical Education
What did you do?
Introduced Team-Based Learning (TBL) into the MBBS curriculum.
Who is involved?
We introduced TBL and carried out the evaluation with Phase I MBBS students at Durham University when that programme was running. These students then went on to complete their degree here at Newcastle University.
Since the team of staff from Durham joined Newcastle University, we have continued to use TBL with Newcastle University MBBS students. Other course leads are now involved with the delivery of TBL.
How did you do it?
Team-based learning is a method of collaborative learning using a flipped classroom approach. It promotes both individual and team accountability.
Students are put into permanent teams of ideally 5-7 students and the aim of the teams is to encourage participation and engagement. This approach develops teamwork skills and provides a forum for meaningful discussion. The principle includes removing some elements of teaching and introducing guided independent learning.
The first stage is the readiness assurance process where students are provided with a reading pack. In this instance this mainly involved providing students with links to websites and relevant documents. They then attend a session and the first thing they do is take an individual MCQ test, the Individual Readiness Assurance Test (iRAT) based on this reading. They then work with their team to complete the same MCQ test (the Team Readiness Assurance Test or tRAT) using an IFAT scratch card. The team discusses what they think the correct answer is and then they scratch off that option on the scratch card. If they are wrong they have to work together as a team to decide what the right answer is. Teams get 4 points if they get the answer right first time then 2, then 1 and finally 0.
The next step is the application exercises where teams are given real world examples of clinical scenarios and asked what they think the best course of action is. These examples must comply with the ‘4S’ approach: Significant problem, same problem, specific answer, and simultaneous reveal.
The person leading the session will then select one of the teams to justify their answer and invite other teams to join in the discussion.
Following the session, students also have to complete peer evaluation. Initially we tried a paper based approach to this asking students to essentially rank each other as well as provide qualitative feedback. A number of students expressed dissatisfaction with this approach so the following year we started using WebPA and students could give any score 1-5 to their peers, again including some qualitative feedback. This was much better received by the students.
Why did you do it?
Students have asked for more self-directed learning time, probably due to the high levels of staff contact time in the MBBS course. They also seem to enjoy interactive sessions with a flipped classroom approach.
Using TBL also ensures students engage with the material as well as offering a way of incorporating peer evaluation, with students giving feedback to their peers.
Does it work?
We carried out an evaluation following the introduction of TBL in 2015-16 and then again in 2016-17. We listened carefully to the student feedback from the first evaluation and acted on this by changing the peer evaluation element and moving to an electronic submission system (WebPA). For the 2016-17 cohort we also made sure that we explained TBL to the students more fully before they started the sessions.
There were increased satisfaction levels in the evaluation that was carried out in 2016-17, with a big improvement in the percentage of students who found the reading packs useful. There was also some nice individual feedback including a comment about the positive impact TBL had in other aspects of their study.
Although there were inevitable differences of opinion the evaluation suggests that TBL can be a useful adjunct to the undergraduate curriculum.
Even though we used TBL in medical education there are a number of examples of this approach being used successfully in other disciplines including Business, Geography and English Literature.
Interested in finding out more?
www.teambasedlearning.org gives a comprehensive overview of Team Based Learning with a range of useful resources.
If you are interested in finding out more about WebPA you can sign up to a workshop here You will need to log in to view the workshops.
Dr Andrew Chaytor, School of Medical Education