Vicki Park, PhD, FACMG University of Tennessee Health Science Center Memphis, TN

Transcription

1 Vicki Park, PhD, FACMG University of Tennessee Health Science Center Memphis, TN

2 UTHSC AT-A-GLANCE Class size ~ 170 Curriculum revision Conversion of a traditional curriculum to improve integration of content & active learning Implemented Fall, 2011 Team Based Learning (TBL) Introduced as one component within a multimodal curriculum

3 TBL IN MEDICAL EDUCATION P E D A G O G Y Active learning Collaborative Case-based Promotes competency development P R A C T I C A L C O N S I D E R A T I O N S Requires small number of faculty Minimal physical resources other than a large space National expertise available

4 IMPLEMENTATION AT UTHSC Context: One two-hour TBL session every 3 weeks All 3 concurrent courses participate with rotating responsibility Permanent teams: 28 teams of 6 (range 5-7 students per team) Readiness assurance: Lecture material & related application-specific readings Individual test & group (team) test Application exercises: Case-based with integration across course content 1-2 applications per two-hour session 4 S s (Same problem, Significant problem, Specific choice, Simultaneous reporting) Inter-team discussion with faculty facilitation irat: minutes grat: minutes Case 1: Minutes Case 2: Minutes Preparation (pre Class) Readiness Assurance Application Exercises Lecture review & reading assignment Instructor Feedback 5 10 minutes Inter team Discussion with Faculty Facilitation 15 minutes Inter team Discussion with Faculty Facilitation 15 minutes

5 ROLE OF TBL IN THE CURRICULUM Knowledge Acquisition Lecture, etc. Readings, self-study Selfassessment Knowledge Application TBL Readiness Assessment TBL Application Exercise Knowledge Assessment Objectivelinked Questions

6 TBL DEVELOPMENT AT UTHSC TBL topics matched to concurrent content Content expert assigned as lead author/facilitator for each TBL Assistance provided by other content experts and course directors Single individual organized the materials & coordinated the delivery of all sessions

7 FIRST SEMESTER TBLS: CONTENT FROM MOLECULAR, ANATOMY, & CLINICAL SKILLS 1. Sickle cell anemia (G. Onady, MedEdPortal) 2. Peripheral nerve injury 3. Genetic disease risk (Duchenne muscular dystrophy & Congenital hearing loss) 4. Type II diabetes 5. Hyperlipidemia 6. Osteogenesis imperfecta

8 GENETIC RISK TBL APPLICATION EXERCISE: DUCHENNE MUSCULAR DYSTROPHY Concept Application Mutation-selection balance: equilibrium between the occurrence of new mutations & selection against existing mutations Students began with a straightforward case scenario. More complex concepts were introduced with each application question. Assessment Ability to generalize and apply the concept on examination

9 A P P L I C A T I O N Q U E S T I O N # 1. C A L C U L A T E MENDELIAN RISK B A S E D O N F A M I L Y H I S T O R Y A P P L I C A T I O N Q U E S T I O N # 2. R E V I S E R I S K E S T I M A T E T O I N C L U D E P O S S I B L E N E W M U T A T I O N III-1 is an obligate carrier 67% probability III-1 is a carrier

10 IMPORTANCE OF MAKING A SINGLE CHOICE PROMOTES DEEPER DISCUSSION BY BOTH STUDENTS & FACULTY In families where a single individual is affected with DMD, choose the one concept most likely to introduce uncertainty in your ability to provide accurate risk information. A. Alternative splicing of the DMD transcript B. Germline mosaicism for a DMD mutation C. Allelic heterogeneity in DMD D. Reduced penetrance in DMD

11 OBSERVATIONS ABOUT EFFECTS ON LEARNING Evidence of student engagement & peer-peer instruction Readiness assessment irat average scores improved throughout the semester grat team scores consistent at ~99% Questions from teams reflected higher order learning Genetic scores improved on exam questions (for same questions used previously)

12 OBSERVATIONS ON IMPLEMENTATION PROCESS Value of external consultants for faculty development Promoted collaborative faculty interactions Single coordinator for all sessions gave consistency Student & faculty feedback valuable for troubleshooting (improvements to materials format, time management, grading) Limited problems with team dynamics, attendance, & student accountability

13 STUDENT SURVEY AFTER ONE SEMESTER For me, TBL provides a good opportunity to apply new knowledge Working in teams helps me to reach a higher level of knowledge Agree Neutral Disagree 67.3% 22.6% 10.1% 69.9% 22.3% 7.8% Working in teams helps me to be a better student 71.3% 19.5% 9.2% Integration of content from different courses in a single TBL is valuable to my learning 63.8% 25.8% 10.4% TBL helps me to prepare for assessments 36.4% 28.5% 35.2% n = range of

14 GOING FORWARD Formal implementation of peer evaluation Continue to streamline Readiness Assessment Quality assurance committee formed (development support) Improve alignment of TBLs with overall learning objectives and assessments Re-visit integration: too much, too early Continue implementation through curriculum

15 Co-authors: Bill Brescia Ken Nishimoto Russell Chesney Jewell Ward Eniko Pivnick Contact information: Vicki Park