The document describes a librarian's experience piloting team-based, case-based, and critical pedagogy approaches in one-shot health sciences library instruction sessions. The librarian developed cases focused on real-world public health issues and adapted them for class discussions and literature searches. Student survey results were mixed, but reflections with colleagues affirmed the value of active learning approaches and using the instructor's experience as an evaluation measure. Going forward, the librarian will develop online modules to supplement in-class activities and refine survey methods to better capture the impact of the instructional methods.

1. TBL CBL Crit Ped paper
Title: Good afternoon everyone, it is great to see you all here.
Acknowledgement: First I’d like to acknowledge the Council of Three Fires, the Ojibwe,
Potawatomi, and Odawa nations that originally lived on the land in Chicago and the
Viejas Band of the Kumeyaay Indians who lived on the land where San Diego State
University is now.
Title and objectives: From my presentation title and objectives, it might seem like I just
mashed-up some current trends, so I would like use authoethnography to explain how I
decided to use team-based and case-based learning and critical pedagogy and give
some context to my results.
Library photo: I started at SDSU Library in September 2017 as the temporary part-time
health sciences librarian because the full-time position had yet to be posted (anyone
working in a state university will probably understand this). I jumped right into teaching
nursing, public health, and exercise and nutrition science course-based library classes
and doing consultations with the students.
Active Learning Class photo : There was a fairly new team-based learning classroom,
called the Active Learning Classroom, in the library, and I was excited because I had
used a similar class for teaching at my previous place of work. I already had experience
with the class format of giving enough instruction to get students going with a database
or web site, giving groups questions to work on, and finally having teams present their
work to the class. I still had some classes where specific information needed to be
presented, and faculty expected step by step instruction, but I was flexible.
Office photo: During the consultations, I was doing at the same time, I noticed that many
of the upper level students were doing projects out in the community that involved a
specific population with a particular condition, and when they started looking for
evidence to support their work, it was hard to find in the literature. They were often
frustrated and I realized that the basic PubMed topics I was using for class instruction,
weren’t really helping these students, who had more complex problems to figure out
than just finding the latest RCTs of a diabetes medication.

2. Paper titles: So I started researching and found that there was a large body of literature
on using team-based and/or case-based methods to teach health sciences students.
While I couldn’t do an intensive case in a one shot lecture, I figured I could at least find
some cases and adapt them to make less complex problems that would give students a
real world question to answer when they practiced searching.
Critical Pedagogy: While searching for team and case based teaching articles, I came
across a few articles dealing with critical pedagogy in health sciences teaching, and this
converged with several mentions of​ Pedagogy of the Oppressed​ by Paulo Freire in
conversations and presentations. As much as I had always considered ethics in my
teaching and work, because of patient confidentiality or animal care and use committee
deliberations on experiments or privacy concerns related to data, I had not run into
critical pedagogy until I started learning more about critical and feminist librarianship.
And I became committed to figuring out how to develop classes that had sociocultural
perspective. Critical pedagogy is useful in public health classes because the relevant
evidence won’t always be a peer-reviewed trial with lots of participants. It could be a
report from a grant recipient who tried a diabetes program in a low-income area of a
large city. Because critical pedagogy includes an anti-authoritarian approach to examine
issues, it questions some of the usual ways information literacy defines authority.
Elaine’s Lecture: Elaine Martin’s Janet Doe Lecture was one of those mentions of
Freire’s book. Her lecture was titled Social Justice and the Medical Librarian, I was
taken with this quote “Social justice librarianship involves the development of a personal
and professional approach in which the practice of medical librarianship puts the
library’s users health information interests and needs front and center. Similar to US
medicine, we have been slow to realize our social responsibility to those we serve.” This
confirmed my decision to use critical pedagogy because social justice and a global
approach are applications of critical theory.
Definitions: Before I go any further, let me make sure we are all on the same page
about these terms. Because these were one shot classes, my definition for TBL doesn’t
include the pre-class work or the peer-evaluation components you usually see
mentioned.
CBL uses real life, messy prompts, rather than the carefully designed scenarios used in
problem based learning. Note that it is has Guided inquiry during class, an instructor
making suggestions as students work.

3. METHODS: My idea was to start the class covering the basics of searching in the
Library catalog and PubMed, stressing the idea that depending on their topic, there
might be nothing. I asked them to think about the crucial part or concept of their
question, the part that must be in the article, versus the parts that were not set in stone,
for example the searching for the exact city, when any large city, low-income community
might be fine. Then I would give the students the cases and let them search.
Western MPH website: I had multiple Public Health classes scheduled, so I started by
looking for cases related to public health. There are multiple places to find medicine or
business cases for class use, but I had to dig a bit deeper to find public health, and
eventually found some cases, with their study reports, that were openly available from
my alma mater! Western University in London, Ontario (used to be UWO when I
received my degrees there) has a great collection of cases their public health students
have worked on over the years. And most dealt with social justice issues.
Case 2 Maternity care: The cases are all far too complex to use as is for a one shot
class, but I worked to distill them down to something a little less complex, but still
something that is a little harder to find literature for. I tried not to start with a lot of case
information because that would give the students some flexibility in how they decided to
view the case, and it worked because in a couple of cases, like this one, a member of
the team was doing something similar for the Southern California area and was able to
flesh out the questions with their experience. I also taught classes in Nursing and
Exercise and Nutrition Science as well as the public health classes and when
applicable, I worked with professors to develop cases that would reflect real life.
Computer class photo: So I had a class plan in place using TBL CBL crit ped and I had
the usual format of showing PubMed and other library resources when required by the
instructor or classroom design Note: while it is possible to do group activities in a
regular computer classroom, the logistics make it more difficult, so it was the method I
chose to have both types of classes for testing.
LibGuide: Whenever time allowed, for Master’s classes in public health, after finding
articles, books, or chapters to help with the case using Library tools, I showed them
some grey literature tools and had them look for preprints and gov or org report.
Survey start: I sent around surveys later in the term, when reports had been handed in,
because I wanted to see if the students actually used what they learned. I sent link to a
Google form to all the faculty I worked with and asked them to share it with the students
from the class.

4. Results
When I finally went through the survey results, I realized I had some problems. One
professor, who had been very excited when I showed him how to do TBL since he’d
been given a TBL classroom and had never used it, let me know that he gave his
students credit for filling out the survey. None of the other faculty contacted me, but I
had responses from a few other classes, but they were all from TBL classes and there
were too few to use. (total of 57 responses)
Bar Graph: So I had one class with no control, but they seemed to like the class given
the results to the first 6 questions that were on a Strongly Agree - Strongly Disagree
scale. Oddly, one person checked all Strongly Disagree, and nobody checked Disagree
Question 7: Then looked at the comments people had made for the last 2 questions.
And this is where things get interesting, because no matter what scores people give on
scales, the text answers are something they feel strongly enough to write about.
Comment on responses
I included the last response to give you an idea of the range of experience in this 4th
year Public Health class. One student still didn’t know that they could get articles from
home with their student ID.
Question 8: The answers to the next question were also interesting.
These are all really compliments in a way, so I was pleased.
But compare these with the ones that were negative
SIGN So I was left with the old saying, you can’t please all of the people all of the time.
(By the way, I searched for attribution, etc. but this saying has too many forms, so I’m
going with this sign)
https://www.etsy.com/sg-en/listing/596184768/you-cant-please-everyone-sign

5. 4 question survey: I had one professor of a PhD level class do a short questionnaire
with his students about what was helpful, what could be omitted and what else could be
added to the lecture. I thought these responses might help since that class was held in
the regular computer lab, not the TBL classroom. But the results from that class were
similar to the likes and dislikes in the other class. But one student gave me an
interesting bit of information, which I hadn’t know since I was new - the students in the
program had been given library instruction in several other classes by me or a previous
librarian or the faculty member teaching. This indicated to me that once students hit the
master’s level, they were more likely to get library instruction and it would be helpful to
coordinate library instruction.
First year results: Because I didn’t get the survey response I had hoped for, I had to
rethink how to present my results, so I had a lovely chat with a colleague, Zoe Jarocki,
who is testing team based teaching in first year info lit classes. As we discussed the fact
that her first test of team based vs regular classes showed no difference in results, we
thought about the questions we were using and the questions other instructors were
using, and what we were trying to accomplish.
Compared to me: I was only able to compare her results to a couple of my questions,
but the results aren’t significantly different. But beyond the numbers, we both preferred
the active classroom and felt that the students were more excited by the class. I had
especially noticed that the students who had real-world case examples were more
excited about finding resources. Luckily, Zoe reminded me that in critical pedagogy, the
standard survey should never be the only measure. The lived experience of the
instructor is another measure that should be considered. And if we feel better about the
teaching style and student response, that is a valid measure of the success of the class.
Reflection Survey: Discussions with another colleague and her evaluation methods led
me to another aspect of critical pedagogy. Giving the students a chance to reflect on
what they have learned. Rebecca Nowicki had a different student survey with built in
reflection for the student.
For Rebecca, the first and fourth questions act as repetition of learning, which should
help with retention, but it is also a way for them to give context to what they have
learned. While the other questions help her adjust her teaching.

6. Conclusions
SPH slide: After teaching these classes, but before starting to analyze results, a couple
of things happened to shift my thinking about how to move forward. First, I went to
APHA thanks to a Sewell stipend and learned about JHU online modules. Then I
attended a SPH faculty meeting and they were all enthusiastic about having a set of
basic modules with some sort of completion certificate, that would allow more advanced
searching in class. So I will be developing modules and updating my class plans but I
will still use cases and tbl. The faculty were enthusiastic about the case based learning
idea - using real world examples.
Lessons Learned and changes moving forward.
I’m still confident in my hypothesis that TBL CBL and crit ped are important, and still
think my teaching plan is good, but I’m going to refine my survey methods for the fall.
I’m not ready to call my experiment a failure or an unsuccess, a term I’ve recently heard
used. Instead, this is a learning experience and I’ve learned there is more to the story
than the survey results.
Notes
SPH has:
MPH – Biometry
MPH – Environmental Health
MPH – Epidemiology
MPH – Health Management & Policy
MPH – Health Promotion & Behavioral Science
MPH – Health Promotion & Behavioral Science ONLINE
For a health management class on the high performing healthcare org I used these
scenarios:
1. Quality of care differences when there is universal health insurance.
2. EHR security for prehospital care - person in group was EMS
3. Hospital accreditation and use of guidelines.