A Modification of the Readiness Assurance Process of Team Based Learning
Janil Puthucheary MRCPCH, Doyle Graham MD, Sandy Cook PhD
Background: Conventional Team Based Learning (TBL) uses the Readiness Assurance Process (RAP) to ensure preparation of the participants for the Application Exercise, and conventionally consists of the Individual RAP, Team RAP (both closed book), and a discussion facilitated and led by an instructor. With this structure, we were struck by how students focused more on getting the “right” answer and not discussing the concepts or clearing up misunderstandings. We sought to develop and assess a RAP strategy that would increase the amount and depth of discussion around the questions and concepts. In addition we wanted our students to begin to address issues of certainty, confidence and the relevant source material.
Description: Our institution delivers almost all instruction in the first year of medical school through Team Based Learning. In one 20 week course (with a total of 40 RAP sessions) covering Pathology, Pharmacology, Immunology and Microbiology, the structure and delivery of the RAP was modified after 10 weeks. The modifications include the introduction of a limited number (2 per 25) questions students could choose to do open book in the Team RAP, and a Student driven discussion following the Team RAP. A survey was administered to the class of 48 MS1 students, who had experienced both approaches to assess their opinion of the differences and value of each approach.
Results: Most students reported the modified approach was more effective, more fun, resulted in more and deeper discussion of detail, and was better for their understanding of the material. Anecdotally, faculty reported an improved quality of discussion, a greater degree of student engagement and understanding, and less time spent in didactic delivery of material.
Conclusion: As a result of the student response the Modified Team Readiness Assurance Process (M-TRAP) has become our preferred method.
