Three Weeks of Team-Based Leaning Do Not Overload Undergraduate Students

Overview

Journal Med Sci Educ

Publisher Springer

Specialty Medical Education

Date 2021 Aug 30

PMID 34457979

Citations 1

Authors

Alexandre Lafleur

Mathieu Rousseau-Gagnon

Marianne Cote-Maheux

Dave Tremblay-Laroche

Paul Rene De Cotret

Yves Caumartin

Affiliations

Soon will be listed here.

Abstract

Context: Team-based learning (TBL) is a flipped-classroom approach requiring students to study before class. Fully flipped curricula usually have fewer in-class hours. However, for practical reasons, several programs implement a few weeks of TBL without adjusting the semester timetable. Students fear that they will be overloaded by the individual and collaborative study hours needed to prepare for TBL.

Methods: We implemented three consecutive weeks of TBL in a 15-week lecture-based course on the renal system. In-class time and assessments were unchanged for all courses. Four hundred fifty-nine first-year undergraduate medical students (229 in 2018; 230 in 2019) were invited to complete weekly logs of their individual and collaborative study hours during lectures and TBL, along with questionnaires on cognitive load and perception of the course. Our program changed from grading in 2018 to grading in 2019.

Results: Participants ( = 324) spent a similar number of hours studying for TBL vs. lectures with a mean of 3.1 h/week. Collaborative study was minimal outside class (median 0.1 h/week). Results remained similar with grading. If in-class time were reduced, 18% of participants said they would have used freed-up time to study for TBL. Studying for TBL generated similar extraneous cognitive load and lower intrinsic load compared to studying for lectures; students were less stressed, and maintained high levels of motivation and self-perceived learning.

Conclusions: Three weeks of lectures were replaced by TBL without reducing in-class time. Students did not report overload in study hours or in cognitive load.

Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-021-01314-x.

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References

van Merrienboer J, Sweller J . Cognitive load theory in health professional education: design principles and strategies. Med Educ. 2010; 44(1):85-93. DOI: 10.1111/j.1365-2923.2009.03498.x. View

Parmelee D, Michaelsen L, Cook S, Hudes P . Team-based learning: a practical guide: AMEE guide no. 65. Med Teach. 2012; 34(5):e275-87. DOI: 10.3109/0142159X.2012.651179. View

White C, Fantone J . Pass-fail grading: laying the foundation for self-regulated learning. Adv Health Sci Educ Theory Pract. 2009; 15(4):469-77. DOI: 10.1007/s10459-009-9211-1. View

Prober C, Khan S . Medical education reimagined: a call to action. Acad Med. 2013; 88(10):1407-10. DOI: 10.1097/ACM.0b013e3182a368bd. View

Chen F, Lui A, Martinelli S . A systematic review of the effectiveness of flipped classrooms in medical education. Med Educ. 2017; 51(6):585-597. DOI: 10.1111/medu.13272. View

Koles P, Stolfi A, Borges N, Nelson S, Parmelee D . The impact of team-based learning on medical students' academic performance. Acad Med. 2010; 85(11):1739-45. DOI: 10.1097/ACM.0b013e3181f52bed. View

Barbosa J, Silva A, Ferreira M, Severo M . Do reciprocal relationships between academic workload and self-regulated learning predict medical freshmen's achievement? A longitudinal study on the educational transition from secondary school to medical school. Adv Health Sci Educ Theory Pract. 2018; 23(4):733-748. DOI: 10.1007/s10459-018-9825-2. View

Jessee W, Simon H . Time utilization by medical students on a pass-fail evaluation system. J Med Educ. 1971; 46(4):275-80. DOI: 10.1097/00001888-197104000-00003. View

Pluta W, Richards B, Mutnick A . PBL and beyond: trends in collaborative learning. Teach Learn Med. 2013; 25 Suppl 1:S9-16. DOI: 10.1080/10401334.2013.842917. View

10.

Reed D, Shanafelt T, Satele D, Power D, Eacker A, Harper W . Relationship of pass/fail grading and curriculum structure with well-being among preclinical medical students: a multi-institutional study. Acad Med. 2011; 86(11):1367-73. DOI: 10.1097/ACM.0b013e3182305d81. View

11.

Bloodgood R, Short J, Jackson J, Martindale J . A change to pass/fail grading in the first two years at one medical school results in improved psychological well-being. Acad Med. 2009; 84(5):655-62. DOI: 10.1097/ACM.0b013e31819f6d78. View

12.

Johanns B, Dinkens A, Moore J . A systematic review comparing open-book and closed-book examinations: Evaluating effects on development of critical thinking skills. Nurse Educ Pract. 2017; 27:89-94. DOI: 10.1016/j.nepr.2017.08.018. View

13.

Sharma N, Lau C, Doherty I, Harbutt D . How we flipped the medical classroom. Med Teach. 2014; 37(4):327-30. DOI: 10.3109/0142159X.2014.923821. View

14.

Robins L, Fantone J, Oh M, Alexander G, Shlafer M, Davis W . The effect of pass/fail grading and weekly quizzes on first-year students' performances and satisfaction. Acad Med. 1995; 70(4):327-9. DOI: 10.1097/00001888-199504000-00019. View

15.

Cilliers F, Schuwirth L, Herman N, Adendorff H, van der Vleuten C . A model of the pre-assessment learning effects of summative assessment in medical education. Adv Health Sci Educ Theory Pract. 2011; 17(1):39-53. PMC: 3274672. DOI: 10.1007/s10459-011-9292-5. View

16.

Rohe D, Barrier P, Clark M, Cook D, Vickers K, Decker P . The benefits of pass-fail grading on stress, mood, and group cohesion in medical students. Mayo Clin Proc. 2006; 81(11):1443-8. DOI: 10.4065/81.11.1443. View

17.

Parmelee D, Michaelsen L . Twelve tips for doing effective Team-Based Learning (TBL). Med Teach. 2010; 32(2):118-22. DOI: 10.3109/01421590903548562. View

18.

Cheng S, Kuo C, Lin K, Lee-Hsieh J . Development and preliminary testing of a self-rating instrument to measure self-directed learning ability of nursing students. Int J Nurs Stud. 2010; 47(9):1152-8. DOI: 10.1016/j.ijnurstu.2010.02.002. View

19.

M Thompson B, Schneider V, Haidet P, Levine R, McMahon K, Perkowski L . Team-based learning at ten medical schools: two years later. Med Educ. 2007; 41(3):250-7. DOI: 10.1111/j.1365-2929.2006.02684.x. View

20.

Haidet P, Levine R, Parmelee D, Crow S, Kennedy F, Kelly P . Perspective: Guidelines for reporting team-based learning activities in the medical and health sciences education literature. Acad Med. 2012; 87(3):292-9. DOI: 10.1097/ACM.0b013e318244759e. View