Team-based learning versus interactive lecture in achieving learning outcomes and improving clinical reasoning skills: a randomized crossover study

Development and application of a learning enjoyment scale for pedagogical activities

The impact of learning enjoyment on motivation, enthusiasm, and overall learning experiences is significant. Previous studies, lacking an unbiased tool for measuring enjoyment and confronting various influencing factors, produced conflicting results regarding enjoyment levels in different instructional methods. Hence, we developed a learning enjoyment scale for evaluating both active and passive educational activities. We applied the developed scale to 112 first-year medical and dental students to assess their enjoyment during didactic physiology lectures and explored possible associated factors. Within this data note, we present students' responses to the developed LES. The LES encompasses six dimensions: knowledge, comprehension, application, analysis, concentration, and enjoyment. Students provided ratings for each dimension on a five-point Likert scale, spanning from 1 (strongly disagree) to 5 (strongly agree). The cumulative scores across the six dimensions range from a minimum of 6 to a maximum of 30. These total scores can be categorized as excellent (> 24), acceptable (18-24), or low (< 18). The second section of the dataset examines specific factors influencing overall enjoyment, such as teacher proficiency, topic difficulty, active student participation, objectives fulfillment, low stress levels, and self-perceived acquisition of skills. In addition to objective measurement of students' enjoyment level, the LES can be utilized for quantitative cross-comparisons between different teaching activities. By employing this dataset, we will undertake an analysis to determine the internal consistency of the Learning Enjoyment Scale (LES), with the anticipation that the outcomes will be published in another venue.

The outcomes of team-based learning vs small group interactive learning in the obstetrics and gynecology course for undergraduate students

INTRODUCTION

Team-based learning (TBL) is a well-established active teaching method which has been shown to have pedagogical advantages in some areas such as business education and preclinical disciplines in undergraduate medical education. Increasingly, it has been adapted to clinical disciplines. However, its superiority over conventional learning methods used in clinical years of medical school remains unclear. The aim of this study was to compare TBL with traditional seminars delivered in small group interactive learning (SIL) format in terms of knowledge acquisition and retention, satisfaction and engagement of undergraduate medical students during the 6-week obstetrics and gynecology clerkship.

MATERIAL AND METHODS

The study was conducted at Karolinska Institutet, a medical university in Sweden, and had a prospective, crossover design. All fifth-year medical students attending the obstetrics and gynecology clerkship, at four different teaching hospitals in Stockholm (approximately 40 students per site), in the Autumn semester of 2022 were invited to participate. Two seminars (one in obstetrics and one in gynecology) were designed and delivered in two different formats, ie TBL and SIL. The student:teacher ratio was approximately 10:1 in the traditional SIL seminars and 20:1 in the TBL. All TBL seminars were facilitated by a single teacher who had been trained and certified in TBL. Student knowledge acquisition and retention were assessed by final examination scores, and the engagement and satisfaction were assessed by questionnaires. For the TBL seminars, individual and team readiness assurance tests were also performed and evaluated.

RESULTS

Of 148 students participating in the classrooms, 132 answered the questionnaires. No statistically significant differences were observed between TBL and SIL methods with regard to student knowledge acquisition and retention, engagement and satisfaction.

CONCLUSIONS

We found no differences in student learning outcomes or satisfaction using TBL or SIL methods. However, as TBL had a double the student to teacher ratio as compared with SIL, in settings where teachers are scarce and suitable rooms are available for TBL sessions, the method may be beneficial in reducing faculty workload without compromising students' learning outcomes.

Training interprofessional teams in geriatric emergency medicine: A modified team-based learning approach

Background

Older adults deserve special healthcare provision in every branch of medicine. Turkey currently does not have geriatric emergency medicine (GEM) subspecialty training. Thus, interprofessional training for healthcare professionals involved in GEM services is required. Team-based learning (TBL) seems suitable to implement such training. We aimed to develop and implement a training program for healthcare professionals engaged with GEM services, and evaluate the program considering teacher and learner satisfaction and knowledge retention.

Methods

This was a design-based study in which a one-day GEM training program was developed based on the literature and expert opinions. The program was applied to 54 physicians, 98 nurses, 70 health officers, and 102 paramedics using a modified version of TBL. Teams included at least one representative from each profession. TBL was modified by adding a 1-h lecture and eliminating peer evaluation. Feedback forms, individual and group tests of TBL, and a retention test conducted six months later were used for program evaluation.

Results

The mean group test score was higher than that of individual tests in all professions. Physicians' individual test scores were higher than those of other professions, but this difference disappeared in the group test. The retention test mean score was higher than the individual test mean score but lower than that of the group test. Teacher and learner satisfaction was high.

Conclusion

We implemented a training program using a modified TBL approach to teach GEM to relevant healthcare professionals; it yielded promising results regarding knowledge gain and retention, as well as teacher and learner satisfaction. The instruction design and method used in this study can be applied to multidisciplinary team training.

Team-based learning (TBL) in clinical disciplines for undergraduate medical students-a scoping review

BACKGROUND

Team-based learning (TBL) is an evidence-based pedagogical method that has been used in undergraduate medical education since 2001. However, its use in clinical disciplines is rarely reported, and the impact of its implementation is not known. The aim of this study was to explore and map the published literature on the impact of implementing TBL in clinical disciplines in undergraduate medical education.

METHODS

A comprehensive search of Medline, Education Resources Information Center (ERIC), and Web of Science databases was performed on November 24, 2021 and updated April 6, 2023, using relevant Medical Subject Headings (MeSH) and free-text terms. Original research studies reporting on the implementation of TBL in clinical disciplines in undergraduate medical education published in peer-reviewed English language journals were included irrespective of their methodological design.

RESULTS

The initial search identified 2,383 records. Of these, 49 met the inclusion criteria. Most of the studies (n = 44, 90%) described the implementation of a modified version of TBL in which one or more TBL steps were missing, and one study had undefined protocol for the implementation. The most reported outcomes were knowledge acquisition (n = 38, 78%) and students' satisfaction or attitudes toward TBL (n = 34, 69%). Despite some differences in their results, the studies found that implementing TBL is associated with increased knowledge acquisition (n = 19, 39%), student engagement (n = 6, 12%), and student satisfaction (n = 31, 63%).

CONCLUSIONS

Most of the studies reported positive results in students' satisfaction and students' engagement, whilst the results on knowledge acquisition and retention were more contradictory. In most of the studies, TBL was implemented in a modified form and diverse comparators were used. The methodological quality also varied. Thus, no unequivocal conclusions could be drawn regarding the value of implementing TBL in clinical disciplines. More studies with rigorous methodologies are needed in this field.

Learning Collaborative Clinical Reasoning in Healthcare Education: An Integrative Review

BACKGROUND

Collaborative clinical reasoning (CCR) occurs when two or more healthcare professionals reflect and negotiate an issue regarding patient's situation or care. This represents a crucial learning goal that needs to be achieved during healthcare education.

PURPOSE

To describe the characteristics of and the pre-conditions for learning collaborative clinical reasoning in healthcare education.

METHOD

An integrative review was conducted. A systematic search was carried out in May 2020 (updated in August 2022) in four databases (CINAHL, Pubmed/Medline, Scopus and Eric/EBSCO). Thirty-three peer-reviewed research articles met the inclusion criteria and were included into a data quality appraisal and analysis. The data was analysed with inductive content analysis.

RESULTS

The characteristics of learning collaborative clinical reasoning were described using the following categories: 1) the collaborative clinical reasoning learning method 2) the collaborative clinical reasoning learning environment and 3) the collaborative clinical reasoning learners. The pre-conditions for learning collaborative clinical reasoning were described using the following categories: 1) the learning situation when learning collaborative clinical reasoning, 2) interaction when learning collaborative clinical reasoning and 3) clinical context when learning collaborative clinical reasoning. The learning situation includes the pedagogical preparation before the learning of collaborative clinical reasoning. The interaction consists of facilitation, feedback and peer communication during the learning of collaborative clinical reasoning. The clinical context utilized in the learning of collaborative clinical reasoning needs to be realistic and familiar for the students.

CONCLUSIONS

The results indicate that interventions enhancing collaboration and clinical reasoning apply a variety of learning methods, however there are certain characteristics of and pre-conditions for learning collaborative clinical reasoning to be considered.