The Use of Team-Based Learning Strategies Combined with Simulation in Medical Education

Presenter: Tochi Iroku-Malize MD, MPH, FHM

Co-Presenters: Michael Delman MD,  Alice Fornari Ed.D, RD, Thomas Kwiatkowski MD

North-Shore Long Island Jewish Health System (NSLIJHS)

Background:

For several years, we had Family Medicine Residents and Medical Students participating in weekly scenarios (simulation) using PC-based interactive, digitally enhanced mannequins and at times live actors. The object was to promote learning in an environment without risk to real patients while allowing time for self-reflection via debriefing sessions. After debriefing (via playback of the videotaped scenario), a formal Power Point presentation was given by the instructor and then the participants were allowed to repeat the scenario. Over time we have evolved, and the scenario (patient interaction), which used to be individual based, is now team based. Recently, we have incorporated Team Based Learning into the sessions. This has allowed greater participation by the residents and students with greater enthusiasm for the sessions.

Description: The course consists of a pre-class reading of a topic, an individual readiness assurance test when they come to class followed by a group readiness assurance test. The TBL activity is then facilitated after which the teams take turns applying their knowledge in the scenario (patient interaction). Upon completion of the scenarios, the teams reconvene for debriefing, reflection (they watch themselves from the video) and further discussion of the topic. 

Evaluation: 55 residents and 50 students participated. At the end of each session participants completed an evaluation form.

A Classroom Engagement Survey has been distributed to the participants with four subscales: Learner Participation, Learner Enjoyment of Class, Patient Safety Elements and Team Work Awareness.

Analyses are currently ongoing comparing the difference in rating between the simulation sessions alone versus the simulation combined with TBL sessions.

Anecdotally, the preliminary evaluations from the participants in the simulation combined with TBL sessions have been more positive than those of simulation alone.

Conclusion: Of the two methods, students responded best to simulation combined with TBL, adding to the list of methods for teaching clinical topics to residents and medical students.