Team-based and Relationship-centered Learning in Biochemistry
Lon J. Van Winkle, Ph.D. Midwestern University, Chicago College of Osteopathic Medicine
Background: Team-based learning (TBL) increases student productivity, creativity and learning. We measured individual and team development during TBL versus an instructor-centered format over 26 weeks of learning biochemistry by first-year osteopathic medical students. Because TBL is inherently relationship-centered, teams also discussed humanism and professionalism in medicine, and we tested whether TBL increases patient-centeredness in our students.
Description: Our students learn biochemistry in a sequence of three courses of four (Biochemistry 1500), eleven (Biochemistry 1501) and eleven (Biochemistry 1502) weeks duration. Multiple-choice, index questions were used to compare individual student mastery of information presented by instructors (2007-2008 school-year) versus learned on their own in TBL (2008-2009 school-year). Team academic development during the 2008-2009 school-year was assessed by following changes in individual versus team test performance during the sequence of courses. Changes in relationship-centeredness were measured using two instruments; Tasks of Medicine (TOMS) and Patient-Practitioner Orientation Scale (PPOS).
Results: Individual student performance on index questions increased using TBL as the sequence of courses progressed from 8% lower than for the instructor-based format in Biochemistry 1500 (p<0.001) to 7% higher than for the instructor-based format in Biochemistry 1502 (p<0.005). Teams increased their ability to out-perform their academically strongest member two-fold between Biochemistry 1500 and Biochemistry 1501 (p<0.001). Furthermore, teams appeared to use a greater proportion of their membership to take team tests as they progressed from Biochemistry 1500 through Biochemistry 1502 (p<0.01). Finally, students became more patient-centered (TOMS, p<0.0001) and caring (PPOS, p<0.0001) using TBL, whereas no change (TOMS) or the reverse (PPOS, p<0.01) were observed for the instructor-based format.
Conclusion: In a series of biochemistry courses for first-year medical students, TBL fostered not only greater academic development, but also increased patient-centeredness and caring.
