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2012 Reseach Abstract

Team-Based Learning and Internal Medicine Residency: a reasonable educational strategy?

Investigator: Steven Bishop, MD (AΩA, University of Virginia, 2010)
Mentor: Stephanie A. Call, MD, MSPH
Institution: Department of Internal Medicine, Virginia Commonwealth University

Project category: Teaching and education

Introduction: Team-Based Learning (TBL) is an active learning strategy that has the potential to solve many curriculum design problems in Graduate Medical Education (GME): the need for practices informed by adult learning theory; the requirement to deliver patient management content; the importance of teaching mastery of information management and critical thinking; and, the delivery of a unified curriculum across multiple work sites and rotations with disparate schedules. In order to determine if TBL is feasible for routine use at the GME level, we conducted a prospective cohort study using TBL in an internal medicine residency program with inpatient ward teams.

Methods: Residents were divided into three cohorts based on rotation: inpatient general medicine teams assigned to TBL, inpatient general medicine teams assigned to lecture, and all other residents assigned to lecture. Resident cohorts were formed for four-week blocks; the study was done for two consecutive blocks. At the beginning and end of each block, residents were asked to complete an online multiple-choice self-assessment test (SAT). Raw scores of the pre-SAT and post-SAT were compared, along with response rates and attendance rates.

Results: For block 1 attendance rates were highest in the TBL group. For both blocks, there were no significant differences in post-test scores when comparing across groups. The “all other residents” group assigned to lecture did have a statistically significant change in pre- to post-test scores; however, all lecture cohorts were given SAT answers by individual faculty members during lecture through audience response systems. TBL cohorts did not have this advantage.

Conclusions: Overall, TBL appears to be a feasible strategy for use in the context of an Internal Medicine curriculum and is a reasonable alternative to lecture. Given the testing advantage of the lecture-based cohorts in our study, it is unknown if TBL provides superior knowledge-based results compared with standard lecture in this context. Further areas of study include whether use of TBL using inpatient ward teams can improve the clinical outcomes of patients cared for by these teams.

Last Updated: 11/27/13

Updated on November 27, 2013.