Team-based Learning: Lessons Learned from a TBL Conference

By Mike Petty

Having attended the 4^th Annual National Conference on Team-Based Learning (TBL) in Medical and Health Sciences Education this summer, I want to provide more background on TBL.  The use of TBL as a small group teaching method is expanding rapidly from one focused in the Texas health science community to one of national interest.  Attendees included educators in nursing, veterinary medicine, pharmacy, osteopathic medicine, and physical and occupational therapy, as well as those in undergraduate and graduate medical education, coming from nationally known universities, regional campuses, and local community hospitals.

TBL (formerly Team Learning) is a teacher-directed instructional method promoting student accountability, small group discussion, and large group interaction for the purpose of impacting learning by promoting the use of higher order thinking skills by students.  The TBL method can be used throughout a course, or at specific times during a course selected by the instructor, to move students beyond rote memorization of facts. Three components are involved in the process:

1.      Preparation – content delivery

2.      Readiness Assurance Test – testing of content knowledge (RAT)

3.      Application – questions requiring higher order thinking

Additional information is available in OED Notes, June 2004.  http://www.uams.edu/oed/newsletter/team_learning.asp

The conference focused on preparing educators to facilitate TBL sessions, developing RAT and application questions, and conducting scholarly research in TBL.  The major point emphasized by all faculty involved in TBL was that preparation is key.  In terms of facilitation, the most difficult obstacle for faculty members is remaining silent during the intra-group and inter-group discussions.  The role as facilitator is to guide questioning, not to respond to questions.  Offering your interpretation is saved for the closing moments of inter-group discussion.  As for developing RAT items, these are typically very straightforward questions designed to measure prior comprehension of content.  The difficult part is determining weighting of grades for the individual (IRAT), group (GRAT), and participation (peer evaluation).  The most successful approach was to set guidelines, but allow the students as a group to determine weights.  For example, if the Team Learning portion of a course were to count for 25% of the overall grade, stating that each of the three domains could be set between 5-10% allows input from the students to promote buy-in, especially needed for peer evaluation.  

For success in introducing TBL, devoting sufficient time to designing the application question(s) (15-25 hours) was deemed essential.  Every presenter at the conference emphasized this point.  Application questions formed with insufficient preparation time usually are seriously flawed.  Having other faculty read and re-read your application question(s) is integral to the process.  Your interpretation of a word may be very different than your colleagues.  On the other hand, one shouldn’t be surprised if errors in thinking are caught by the students even after having spent 25 hours on a question.  All of the presenters had experienced this as well.  They simply used the students’ input to modify the process the following year, even to the extent of leaving poorly written questions in the TBL session to emphasize a pertinent point of interest.

Finally, the concept of scholarly work in TBL was addressed.  Many times this came in the form of determining whether someone’s approach to TBL was adequately designed to be able to identify a causal relationship (not yet) or simply a correlational relationship (sometimes).  One researcher has demonstrated strong correlational data for a psychiatry clinical clerkship (significant increase in shelf exam scores 2001-2004) and has data from another clerkship at the same institution that follows a similar trend of improving scores over a 2 year period (2002-2004). 

Other researchers are showing similar results, but none correlating as strongly as this research. Identifying the many possible confounding variables present in educational research of this kind is a substantial problem.  Strong research design processes upfront will add to the value of scholarly teaching endeavors.

TBL researchers are starting to define when someone uses TBL legitimately and when they do not.  The focus is on “T” – developing team integrity.  A team cannot be formed and become a cohesive entity with only one or two exercises over the course of a semester.  The conference faculty stated that a minimum of 4 to 5 TBL sessions in the same course were required to start the process of developing team cohesiveness. 

Faculty at the conference recommended that participants not be afraid to attempt the TBL process for fear of failing, but learn from the mistakes everyone will inevitably make.  They freely offered their “words of wisdom,” but stated that implementation was a very idiosyncratic process.  An application exercise we performed in a TBL session involved identifying in which of several scenarios TBL was and was not successful.      

Agreement among seven group members (all teaching faculty) was difficult, but the outcome was even worse once we were told that most of us had chosen as an unsuccessful scenario one that was in fact a successful application, and our choice for success had failed. 

Next Article: Using an RSS Feed Aggregator for Professional Development

If you have questions or comments about this page please .