Team Based Learning ( TBL )

Dr Shwesin MyintAssociate Professor

Department of Surgery University of Medicine 2

• Developed more than 20 years ago• By Dr Larry Michealsen• Used in business school at University of

Oklahoma • Now , more commonly applied during

the preclinical years

TEAM BASED LEARNING ( TBL ) AND PROBLEM BASED LEARNING ( PBL ) • Both learner centred approaches • Main difference is • TBL - One teacher • PBL - Each small group is run by one

teacher

• Over 11 months creation and running of 40 new TBL cases

• 660+ students • Approx 300 tutors (- clinicians and basic

scientists)

• 40 Clinical Cases + 400 MCQ• 40-60 case writers/reviewers • Content covered– basic science and clinical

medicine from 9 Blocks

• 3 IT support staff

• 2 academicso 1 lead author/content writer-editor

and project managero 1 tutor recruitment + research

• As an active learning and small group instructional strategy

• Provides opportunities to apply conceptual knowledge through a sequence of activities such as individual work, team work and immediate feedback .

• Can be applied to both large (>100 students ) and small (<25students ) classes

• Multiple groups of five to seven students • Range 4- 12 members • Random allocation • Mixed gender and experience

RESPIRATORY SYSTEM • TBL weekly , every Monday • Asthma • COPD• Interstitial lung disease • Sleep apnoea

TBL design elements • 1. Team formation • 2.Readiness assurance ( RA)• 3. immediate feedback • 4. sequencing of in – class problem

solving • 5. the four S • 6. incentive structure • 7. peer review

RA • Assess at both individual and team level • Individual readiness assurance tests (

iRAT ) and team readiness assurance test ( tRAT)

• 10-13 MCQ • Same questions for both tests • Testing the knowledge of individual and

teams , prepare before class , motivated by not wanting to let their team down

IMMEDIATE FEEDBACK • Class discussion • Addressed disagreement amongst

students and faculty or• scratch off answer sheath or• electronic audience response system

which displayed result directly on screen or

• scanner with print capability to score • Encourages competition

SEQUENCING OF IN-CLASS PROBLEM SOLVING • Students must interpret , analyze and

synthesize information to make a specific choice during activity and defend their choice to the class

4 S • 1. significant problem • 2. same problem • 3. specific choice • 4. simultaneous reporting – use colour

coded and lettered placards

INCENTIVE STRUCTURE • For example • iRAT -20% , t RAT -20%, tAPP-40%and

final examination -20%

PEER REVIEW • Some did not use peer review• Took place in the last day of the course

REVIEW ABOUT • Learning and understanding • Team members’ teamwork • Interpersonal skills / communication

skills • To develop professional competencies

and prepare for professional lives as clinicians

• CVS TBL • About congenital heart disease • Facilitators • 1paediatric cardiac surgeon PhD student • 1 cardiologist • 1 basic science teacher • 1 registrar

• 5 students in each table • Total 15 tables • Computer present in each table • t RAT • teacher can check the answers with

their computer

t RAT 15 minutes

Facilitator feedback and clarification 25 minutes

Problem solving activity 105 minutes

Trigger and cues 5 minutes

Discussion of basic science ( team ) 15 minutes

Patients data : H/O and P/E ( team ) 10 minutes

Patients data : H/O and P/E ( class ) 10 minutes

Hypothesis generation ( team ) 5 minutes

Review of investigation results( class ) 20 minutes

Diagnosis ( class ) 5 minutes

Mechanism ( team ) 25 minutes

Mechanism ( class ) 10 minutes

EXAMPLE - TBL of Cardiovascular science

• Prework for students to complete before TBL

• 1. Lectures , Seminars and practical • - development of heart and CVS • - circulatory changes at birth

• - pulmonary hypertension • - investigation of congenital cardiac

abnormalities • - identifying developmental delays • - CVS disease ,population medicine

perceptive

• Practical paediatrics• - suspected heart disease assessment • - heart diseases

• Complementary reading • - Lilly , Pathophysiology of heart disease :

collaborative project of medical students and faculty ,2016

• Robbin and Cotran – Pathologic basic of disease 9th edition , section on congenital heart disease

Thank you for kind attention