Abstract

Background:
Team-based learning (TBL) is a distinctive form of collaborative, small group learning that has been shown to
improve students’ engagement with course material, increase their capacity for problem-solving and develop their
team working skills (1-4). These attributes are important in medicine and other healthcare professions, and TBL is
already in use in such programmes overseas (5) and in the UK (6). First year undergraduate medical students took
part in a pilot of TBL, with the aim of assessing whether TBL might have benefits as an adjunct to existing teaching
methods, and to explore whether students’ individual and team performances in TBL activities correlate with their
performance in summative written knowledge examinations.
Methodology:
The TBL activities consisted of 3 distinct stages: 1) Guided independent learning, where students were provided
with a ‘reading pack’ to enable them to achieve specific learning objectives, outside of class, 2) Readiness assurance
tests (RATs), completed in the classroom, consisting of a 10 question multiple choice test initially sat individually
(iRAT) then in teams (tRAT); each team consisted of 6 or 7 students, and 3) Application exercises, undertaken in
teams, allowing students to apply their knowledge in real-world clinical scenarios. Three TBL sessions were held
during the academic year, with 87 of 98 students attending all three activities and 11 students attending at least
two activities. Following each TBL activity, students were asked to provide anonymous peer evaluation on all other
members of their team, where they had to allocate a range of scores from 0.6 to 1.0, according to the peer’s
contribution to the work of the team. This permitted calculation of a team score for each student (the tRAT score
multiplied by their average peer evaluation score) and an ‘overall mark’ for each student (a weighted average
consisting of the student’s iRAT score and team score in a 1:2 ratio). The relationships between students’ summative
written Knowledge examination marks at several points in the academic year and (a) iRAT scores, (b) team scores
and (c) ‘overall marks’ were explored using correlation analysis.
Results:
iRAT scores ranged between 10 and 100% (average of three TBL sessions 30 - 80%). Team scores ranged between
54.3 and 95% (average of three TBL sessions 53.1 - 90.3%). ‘Overall marks’ ranged between 44.7 and 96.7% (average
of three TBL sessions 52.0 - 84.2%). Students’ written Knowledge exam scores at several points in the year
correlated with their iRAT scores, team scores and ‘overall marks’ in TBL activities that had been completed before
the exams. For example, the students’ end of year written Knowledge exam marks significantly correlated with
average iRAT scores (Spearman’s rho = 0.460, P
Discussion:
Formative assessment of individual and team performance in TBL readiness assurance tests significantly correlate,
with medium to large effect sizes, with summative written knowledge examinations, in first year undergraduate
medical students. These results may support reports in the literature that TBLimproves students’ engagement with
course material and increases their capacity for problem-solving (1-4).

References:
1. Levine RE, O’Boyle M, Haidet P, Lynne DJ, Stone MM, Wolf DV, Paniagua EA. Transforming a clinical clerkship with team learning. Teaching and Learning in
Medicine, 2004, 16(3): 270-275.
2. Kelly PA, Haidet P, Schneider V, Searle N, Seidel CL, Richards BE. A comparison of in-class learner engagement across lecture, problem-based learning, and
team-based learning using the STROBE classroom observation tool. Teaching and Learning in Medicine, 2005, 172(2): 112-118.
3. Clark MC, Nguyen HC, Bray C, Levine RE. Team-based learning in an undergraduate nursing course. Journal of Nursing Education, 2008, 47(3): 111-117.
4. Chung EK, Rhee JA, Baik YH, Oh-Sun A. The effect of team-based learning in medical ethics education. Medical Teacher, 2009, 31(11): 1013-1017.
5. Michaelsen LK, Parmelee DX, McMahon KK, Levine RE. Team-based learning for health professions education, 2008, Sterling, VA: Stylus Publishing, LLC.
6. Tweddell S, Clark D, Nelson M. Team-based learning in pharmacy: The faculty experience. Currents in Pharmacy Teaching and Learning, 2016, 8(1): 7-17.