Implementation of Team Based Learning in the Third Year Pediatric Clerkship
Nicole R. Frei, MD, Kavita S. Warrier MD, Jocelyn H. Schiller MD, Jennifer G. Christner, MD
The University of Michigan Department of Pediatrics, Ann Arbor, MI
Background
Team based learning (TBL) has been used in medical school primarily in the first two years. Few programs have implemented TBL in the third year clinical clerkships. Previously at our institution, the third year medical students had traditional didactic lectures twice weekly on a variety of core pediatric topics. We revised the core curriculum in order to add weekly TBL sessions.
Description
Our third year medical students rotate through the required pediatric clerkship in eight week blocks. We created six modules covering core pediatric topics using the TBL format. These are taught in two hour sessions once per week for six weeks. At each session, students complete an individual readiness assessment, followed by the group readiness test. Finally, they work on group application questions according to traditional TBL format.
Evaluation
Comparing the means of student responses before and after implementation of TBL, regarding the value of teams using a previously validated instrument from Baylor University, students felt “Collaborating with my peers will help me be a better student” (difference of 0.284, p=0.025). However, they did not believe “Group decisions are often better than individual decisions” and “Solving problems in groups leads to better decisions than solving problems alone.” (difference of -0.452, p=0.016, and -0.370, p=0.017).
Evaluating student engagement, students in the first group were significantly more likely to feel that they contributed meaningfully to the discussion during TBL than during lecture (difference of 1.348, p=0.00). They felt that they participated most of the time in TBL, as compared to lecture (difference of 1.220, p= 0.001). However, they seemed to enjoy the TBL sessions less than lecture (difference of 0.289, p=0.046).
In addition, we plan to analyze overall clinical performance on the metrics currently in place. (Pediatric clerkship grade, comprehensive clinical assessment scores, pediatric SHELF exam, required clinical case testing on fever)
Conclusion:
Based on our preliminary data, while the students contribute more to the discussion, and participate more in class, they do not seem as satisfied with TBL as with traditional lectures. While they do seem to value collaborating with their peers more after participating in TBL, they do not feel that groups can come to better solutions than individuals.
