Optimizing Clinical Reasoning Using Team-based Learning
Purpose
This session will describe a very specific version of the flipped classroom: Team-based Learning, which is the perfect classroom vehicle for giving students the opportunity to apply and develop their clinical reasoning skills. By actively applying these skills, students will more effectively translate knowledge of factual content into meaningful application in clinical settings. Participants will become familiar with the specific design components of Team-based Learning and will be introduced to physical therapy classroom application examples. They will also be familiarized with published effectiveness research on this method and other significant advantages of this approach to classroom instruction.
Methods and/or Description of Project
Team-based Learning was used to reconfigure the clinical reasoning component of a second semester physical therapist education course in basic orthopedic content in response to increased class size. Another active learning approach was needed because previous approaches to active learning did not translate to a class of 36 as well as they had in a class of 20. Multiple principles of effective educational design are incorporated into the Team-based Learning approach and these will be described, including how they increase student preparation, engagement, and thus longer-term learning.
Results/Outcomes
While the initial transition to Team-based Learning was time-consuming, the effort was worthwhile, as students achieved several important benefits. Content knowledge was achieved, and the ability to apply this knowledge to simulated written clinical scenarios was demonstrated. Active engagement was demonstrated by virtually every student throughout each extended format class session. Students prepared for class sessions by reading assigned material and demonstrated their preparation on individual reading assessment tests at the beginning of each module. They then worked in a student team to enhance their understanding of the preparatory material before application of information began. Student teams were formed to maximize heterogeneity on various student characteristics and these teams were maintained for the entire semester. Several important aspects of team member effectiveness were formatively evaluated by each other team member at mid-term, and then summatively evaluated at the end of the semester. These peer evaluations and anonymous student comments suggest that very meaningful improvement in individual team member behaviors occurred as a result. Students, who admitted being apprehensive at the beginning of the semester about being required to work in teams, ended the semester as enthusiastic supporters of the effectiveness of this approach, and the superiority over other traditional methods for facilitating meaningful student learning.
Conclusions/Relevance to the conference theme: The Pursuit of Excellence in Physical Therapy Education
This presentation focuses on the use of Team-based Learning in a physical therapist education program, but the method is equally applicable to physical therapist assistant education. Students at all levels of physical therapy education need the opportunity to self-assess and improve their ability to translate curricular content into understanding and application in safe and effective ways. This method has other significant benefits that are important to the physical therapy faculty member, including increased student preparation for classroom activities, consistent and meaningful student engagement in learning, enhanced ability to verbalize and apply clinical reasoning, as well as improved team and individual behaviors and effectiveness. Because they were required to almost continually self-assess their own knowledge deficits, students were more active participants in remediating these deficits and were thus much more active participants in the learning process. All of these benefits support the pursuit of excellence in physical therapy education.
References
Hawkins D. A Team-based Learning Guide for Faculty in the Health Professions. AuthorHouse LLC, 2014
Sibley J, Ostafichuk P. Getting Started With Team-based Learning. Stylus, 2014
Chung E, Rhee J, Baik Y, Oh-Sun A. The Effect of Team-based Learning in Medical Ethics Education. Medical Teacher, 2009
Haidet, P, Kubitz K, McCormack W. Analysis of the Team-based Learning LIterature. Journal of Excellence in College Teaching
Koles P, Stolfi A, Borges N. The Impact of Teacm=based Learning on Medical Students' Academic Performance. Academic Medicine, 2010
Course Objectives
Participants will
- be familiar with the components of team-based learning
- briefly describe evidence of effectiveness and advantages of team-based learning
- describe how team-based learning enhances clinical reasoning over more traditional classroom teaching approaches
- have a better appreciation of the usefulness of teamwork and peer assessment of team behaviors
Instructional Methods
Lecture and demonstration of team-based learning research, components and student outcomes. Audience participation will also be facilitated.
Tentative Outline/Schedule
10 mins: overview of the problems that prompted the course redesign
20 mins: overview of TBL, including some sample items from physical therapy classroom
10 mins: summarize effectiveness research on team-based learning
10 mins: overview of team formulation and peer assessment
15 mins: perceived advantages and outcomes, including those for specific sub-types of students
10 mins: questions and discussion