When we talk about team learning, we are talking about a variety of approaches, all of which attempt to get the greatest benefit from gettling learners into groups to work out problems together. 

 

When we use the term, "Team-Based Learning" (TBL) we are referring to a specific and highly structured approach that has been developed by--and actually copyrighted by--Team-Based Learning.  For a succinct definition and more information, refer to this web link:  http://www.teambasedlearning.org/definition/

 

We use the formal TBL process in our curriculum, but we also use several other effective team learning approaches, too. It is a simple truth:

 

                                             We learn better when we learn with others.

 

According to Michaelson and Sweet (2008), effective team learning has four elements:

1. Small groups. Relatively permanent small groups formed at the beginning of the class experience.

2. Accountability. Individuals must be accountable for both individual and group work.

3. Feedback. Students must receive frequent and timely feedback.

4. Assignment Design. Group assignments must promote both learning and team development.

 

We have found several team learning approaches to be profitable. 

 

THE MOST SUCCESSFUL TEAM EXPERIENCES FOLLOW THIS PATTERN:

1. Students are given a relevant pre-class assignment so that they can apply what they learned in clinical cases.

2. At the beginning of the class period, a quick 2 - 4 question clicker quiz is administered to get the 'cognitive juices' flowing. The questions should help students consider the pre-class assignment information. 

3. Teams (usually using the ITP teams that were developed early in the school year), are then presented with realistic (preferably REAL) cases that push the students to apply the information they have learned in solving clinical problems.    [On a practical level, it is good to tell the students as they enter the room that they will be in their teams, and you should place some kind of identifier on the tables to facilitate orderly gathering.]  NOTE: Sometimes we allow students to pick their teams on the fly.  This is less formal, and perhaps less rigorous, but the students appear to enjoy the flexibility.   

4. Give the teams about three cases to deal with, and with each one, have 3 - 5 practical clinical problems to solve.   

5. Work with an instructional designer or experienced teacher to develop a web-based form for teams to submit answers.    Remember, you want the teams to solve open-ended problems, so giving the multiple-choice questions is not ideal.   Have the students produce differential diagnoses and defend them. 

6. In the most successful team experiences, the instructor will have one (or maybe two) of the teams share their solutions to the problems.  In medical school, this is a golden opportunity to reinforce clinical reasoning.   Here, the instructor can ask questions about the thought process and provide feedback.  This is a great opportunity for interaction.   

7. After the students have interacted with the cases, you may want to give another short quiz (perhaps 2 questions) and use that for attendance, as well.   

8. If you care to capture the clicker responses from the first or last quiz, the instructional design team can help you.   

 

 

SPECIFIC ELEMENTS OF TEAM LEARNING IN MEDICAL SCHOOL

Small Groups.  In many schools, small groups are formed for clinical skills training and these groups throughout the program. This means that groups theoretically work through the group dynamics and are most productive. there are 24 groups of 6-8 student each. Of course, there are usually 1 or 2 groups (of the 24) that are dysfunctional . In these cases, please contact the instructional design team for advice. Team learning is not very valuable to those students who--for whatever reason--are on dysfunctional teams. We will attempt to design an intervention in those cases. The 24+/- teams are numbered and because we use team approaches in several classes, they know their team. We use numbered cards set throughout a classroom to identify where the team should meet. If you put the cards out prior to the students entering the classroom, they will gather as teams.

 

Accountability. Michaelson and Sweet (2008) emphasize the importance of accountability for both individual and group work.  Be careful with this...    We have motivated students.   We do not have to emphasize accountability as much as regular undergraduate college programs where team-based learning was developed. We recommend that students come into team learning experiences with relevent preparatory assignments.   Don't worry too much about accountability in our setting...   concentrate on the team problem solving in the context of cases. 

 

Assignments. We typically present team challenges in class in the form of a clinical case vignette with 3-5 questions associated with it.  In the best case, this vignette will represent a problem that is prevalent in eastern ‌Virginia, or is a top 100 medical issue nationwide. We want to present students with cases they might see in practice. The vignette is presented either through a slide presentation, a video, as a print hand-out, or on the Google Docs site. The groups will discuss and research the solution. Ideally, they will draw on their pre-team expeience assignment knowledge, as well. They will then answer the questions in a Google Doc questionnaire in class. The answers may be presented and projected, and then the professor may ask a group to explain their answer, or discuss the group answers that are displayed.

 

Feedback. Feedback is provided several ways. First, as the group spokesperson presents the group's answers, the instructor can provide feedback. Second, since all the problem solutions are projected, the instructor can address the various strengths and weaknesses of each solution approach. This type of feedback is very powerful: it is immediate and it is complete. Again, you may choose to provide individual feedback on pre-team experience assignments.

 

Reference:

 

Michealson, L. K., & Sweet, M. (2008). The essential elements of team-based learning. New Directions for Teaching and Learning(116), 7-27.