C. Babbitt1, A. Kaminski1, M. C. McCarthy1, M. Roelle1, R. Markert1, P. P. Parikh1 1Wright State University,Dayton, OH, USA
Introduction: Team-based learning (TBL) has been studied in several preclinical and a few clinical settings, but there is less evidence for its effectiveness in specialties, such as Surgery. We developed and instituted TBLs in a 3rd year surgery clerkship and compared Surgery Subject Exam scores before and after implementation. We also analyzed students’ feedback for their perception of TBLs.
Methods: The study was approved by Wright State University’s IRB. The TBLs were transitioned into the curriculum during the 2013-2014 academic year. Thus, the before implementation period was the two academic years prior (2011-2013), and the after implementation period was 2014-2016. NBME Subject Examination scores at our institution and nationally were compared using the independent samples t-test. Satisfaction with the clerkship was assessed with AAMC Graduation Questionnaire data. Student feedback regarding TBLs was gathered at the end of each surgery rotation (six per year) and were analyzed for themes, both positive and negative, using constant comparative method.
Results: Table 1 shows that NBME Surgery Subject Exam mean score was higher at our institution than nationally, both before (77.10±8.75 vs. 75.20±8.95, p=0.032) and after (74.65±8.0 vs. 73.10±8.55, p=0.071) TBL implementation. The NBME Subject Exam mean was lower following TBL implementation at our medical school (77.10±8.75 vs. 74.65±8.00, p=0.039), but the mean was also lower at the latter period on a national basis (75.20±8.95 vs. 73.10±8.55, p<0.001). Further, students at our medical school were more likely to rate the surgery clerkship good or excellent after TBL implementation (84.6% vs. 73.7%). Overall, qualitative assessment perceived our TBLs to be educationally effective. Learners stated that TBLs were informative, helpful in studying for the shelf exam, and viewed them as an opportunity for interactive learning. Some students also requested more TBLs. Areas for improvement included reading materials, TBL instructions, and organization of sessions. Some students viewed TBLs as more time-consuming than traditional instruction.
Conclusion: Team-based learning has been found to be an effective collaborative learning strategy in medical education. Since introducing TBL into our surgery clerkship, student perception of TBL has been both positive and provided feedback for improvement. In addition, our medical school graduates have continued to assess their surgery experience as good/excellent by large majorities. Concurrently, our NBME Subject Exam scores remain one-half to one standard deviation above the national mean. In summary, we believe our medical students benefit from a well-organized TBL and its active approach to learning during surgery clerkship with no loss of fundamental surgery knowledge.
