Problem Based Learning In Comparison To Traditional Teaching As Perceived By ...iosrjce
Objectives: To compare lecture based learning (LBL) with problem based learning (PBL).
Methods: A cross sectional prospective study was carried out among 145 3rd year MBBS students in
Jawaharlal Nehru Medical College(JNMC), Aligarh. The study was performedfor a period of 60 days. Data was
collected by means of structured questionnaire.
Results: 65 (44.8%) students were girls while 80 (55.2%) were boys. 89 (61.4%) students liked only PBL
followed by both LBL and PBL by 104(71.7%) students. 59(40.7 %) students claimed that PBL has led to better
understanding of subject while 71(48.9%) respondents favored both LBL and PBL. 98(67.6%) respondents
admitted that PBL has led to more clarification of their concepts while 105(72.4%) students appreciated both.
Coverage of sufficient syllabus through PBL and both was claimed by 91(62.8%) and 105(72.4%) students
respectively. Majority 94(64.8%) was satisfied with training of the teacher for traditional teaching while
106(73.1%) were satisfied with training of facilitator for PBL. 69(47.5%) students were satisfied with
availability of resources for PBL while 71(48.9%) were for both methods combined together. 91(62.8%)
respondents preferred present scenario (LBL parallel with PBL)in JNMC.
Conclusion: LBL must be in symbiosis with PBL for better analytical approach and clarification of concepts.
There is need to improve the information resources for PBL and enhancement of practical knowledge of
students.
Portfolio - "Encouraging Better Employee Health Practices" - by Kim Mitchell,...Kim Elaine Mitchell
Portfolio containing entire research involved in preparing this assignment on "Encouraging Better Employee Health Practices." Includes: Bibliographies, Learning Needs Surveys, Evaluation Surveys, Brochure, and Journal.
Problem Based Learning In Comparison To Traditional Teaching As Perceived By ...iosrjce
Objectives: To compare lecture based learning (LBL) with problem based learning (PBL).
Methods: A cross sectional prospective study was carried out among 145 3rd year MBBS students in
Jawaharlal Nehru Medical College(JNMC), Aligarh. The study was performedfor a period of 60 days. Data was
collected by means of structured questionnaire.
Results: 65 (44.8%) students were girls while 80 (55.2%) were boys. 89 (61.4%) students liked only PBL
followed by both LBL and PBL by 104(71.7%) students. 59(40.7 %) students claimed that PBL has led to better
understanding of subject while 71(48.9%) respondents favored both LBL and PBL. 98(67.6%) respondents
admitted that PBL has led to more clarification of their concepts while 105(72.4%) students appreciated both.
Coverage of sufficient syllabus through PBL and both was claimed by 91(62.8%) and 105(72.4%) students
respectively. Majority 94(64.8%) was satisfied with training of the teacher for traditional teaching while
106(73.1%) were satisfied with training of facilitator for PBL. 69(47.5%) students were satisfied with
availability of resources for PBL while 71(48.9%) were for both methods combined together. 91(62.8%)
respondents preferred present scenario (LBL parallel with PBL)in JNMC.
Conclusion: LBL must be in symbiosis with PBL for better analytical approach and clarification of concepts.
There is need to improve the information resources for PBL and enhancement of practical knowledge of
students.
Portfolio - "Encouraging Better Employee Health Practices" - by Kim Mitchell,...Kim Elaine Mitchell
Portfolio containing entire research involved in preparing this assignment on "Encouraging Better Employee Health Practices." Includes: Bibliographies, Learning Needs Surveys, Evaluation Surveys, Brochure, and Journal.
Faculty Development Strategy is An Essential Element for Quality TeachingMatiaAhmed
Faculty Development Strategy is An Essential Element
for Quality Teaching
Quality teacher is an essential commodity for production of quality graduates, and quality
graduates contribute to health standard of a community as such of a country.
A Study to Evaluate the Effectiveness of Motivational Intervention on Anxiety...iosrjce
The objective of the study was to assess the mental To assess and compare the level anxiety of
unsuccessful B.Sc (N) students in university examination before and after the administration of motivational
intervention and to determine the association of level of anxiety with the selected personal variables.31
unsuccessful B.Sc(N)student were selected through purposive sampling technique. In view of the nature of the
problem and to accomplish the objectives of the study, structured Beck Anxiety Inventory was used to assess the
Anxiety level of the students. Validity was ensured in the field of Nursing and medical departments. Reliability of
the tools was tested by Cranach’s alpha, which was 0.92 Both descriptive and inferential statistics were used.
The findings of this study indicated that Motivational Intervention is effective in reducing Anxiety (t
value=3.027, p value = <0.05) among unsuccessful B.Sc (N) students. There was no significant association of
Anxiety with the selected sample characteristics after motivational intervention but before motivational
intervention it was significantly associated with age in year, passed higher secondary in how many attempts and
hobbies. The finding suggests that motivational intervention was effective in reducing level of Anxiety of
unsuccessful B.Sc (N) students.
Assessment of the Existing School Health Promotion Program in a Selected Educ...AnuragSingh1049
The health promotion school program was designed to promote the wellbeing of school students. This concept was introduced during the 1980s by the World Health Organization (WHO). In Sri Lanka; it was initiated and implemented in 2008 targeting all government schools. The aim of the study was to assess the existing school health promotion program. The cross-sectional study was implemented in May 2018 with all secondary schools in a selected education zone in Sri Lanka which represent three types of schools, 1AB, 1C and type 2. The study participants were students and teachers. The newly developed tool (Health Promoting School Assessment Tool) was used to assess the existing school health promotion program under six main criteria. The nominal group technique was followed to fill the assessment tool designed in the study where a team of teachers and a team of students separately took part in the assessment. The findings of the study show that the existing health promotion school program is partially unsuccessful in the selected educational zone. The existing situation of the school health promotion program, according to the main six criteria of the Health Promotion School Assessment Tool, was not at a satisfactory level of the implementation (38.2%). Only three schools (N=23) scored more than 50% while other schools (n=20, N=23) were scored less than 50%. According to the assessment, for each group of an individual school, there was a difference between teachers’ assessment and students’ assessment of the overall health promotion program. It is important to conduct continuous monitoring and have an evaluation plan for the school health promotion program to acquire effective changes in school settings.
Power Point presentation about the article written by: Simonsen, B. et al. (2008). Evidence-Based in Practises in Classroom Management: Considerations for Research to Practise. Education and treatment of children, v31 nº3, 351-380
This presentation session will outline how an online, self-directed, course titled ‘Diagnostic Reasoning and Care Planning’ was developed for undergraduate second year nursing students. The course was delivered in Semester 1 2014 and completed by 220 students. The course design successfully employed a range of tools in Blackboard to engage students in active, self-directed learning, supported by a series of scaffolded learning activities completed online in Blackboard, with students receiving timely, effective feedback via Grade Centre as activities were completed.
EFFECTIVENESS OF CO-OPERATIVE LEARNING METHOD IN LEARNING OF MATHEMATICS AMON...Thiyagu K
Co-operative learning is defined as students working together to “attain groups goals that cannot be obtained by working alone or competitively”. The main purpose of co-operative learning is to actively involve students in the learning process, a level of student empowerment which is not possible in a lecture format. The present study found out the effectiveness of co-operative learning in mathematics learning among the eighth standard students of Tirunelveli district. Two equivalent group experimental-designs are employed for this study. The investigator has selected 40 students studying VIII standard in High School, Tirunelveli Educational District. According to the scoring of pre-test, 20 students were chosen as control group and 20 students were chosen as experimental group in a cluster sampling techniques. Finally the investigator concludes that; (a) There was significant difference between control and experimental group students in their gain scores. That is the experimental group student is better than control group students in their gain scores. (b)There was significant difference between control and experimental group students in their gain scores for attainment of the knowledge, understanding, and application objectives.
Rethinking feedback practices: Keynote Med Ed Conference Taiwan 18Oct 2014r_ajjawi
Rethinking feedback practices: insights from research
We are seeing a shift in understandings of feedback from information telling towards social and cultural perspectives aimed at helping students to self-regulate their own learning. Our conceptions of feedback inform how feedback is practiced, e.g., if feedback is thought of as information transmission to ‘tell’ the learner about their performance then our feedback practices will tend to be unidirectional from tutor to learner with a focus on content and delivery. However, simply providing feedback does not ensure that students have read, understood or engaged and learned from it. The aim of this keynote is to synthesise key research evidence into feedback, including the persistent so called ‘feedback gap’, and to draw recommendations for how feedback could be practiced and embedded into curricula in order to optimise learning of students and staff.
Does the simulated learning environment provide the occupational therapy (OT) student with an increase in
self-efficacy, as compared to traditional hands-on peer
practice, in preparation for the fieldwork experience?
This paper provides an overview of evidence-based educational interventions (EBEIs) and associated practices in school psychology. The profession has, for some time, embraced scientific principles and procedures across areas of professional practice, including diagnosis and classification, assessment, prevention and intervention, consultation, and research and program evaluation. More recently, the profession has embraced evidence-based prevention and intervention practices, intending to implement them in schools. Source: https://ebookschoice.com/evidence-based-educational-interventions/
I was just looking for a better way to find jobs or catch peoples eye ,surfing and surfing surfing.Then had this idea to share what I learned.
INSPIRED BY Gary vaynerchuk
Faculty Development Strategy is An Essential Element for Quality TeachingMatiaAhmed
Faculty Development Strategy is An Essential Element
for Quality Teaching
Quality teacher is an essential commodity for production of quality graduates, and quality
graduates contribute to health standard of a community as such of a country.
A Study to Evaluate the Effectiveness of Motivational Intervention on Anxiety...iosrjce
The objective of the study was to assess the mental To assess and compare the level anxiety of
unsuccessful B.Sc (N) students in university examination before and after the administration of motivational
intervention and to determine the association of level of anxiety with the selected personal variables.31
unsuccessful B.Sc(N)student were selected through purposive sampling technique. In view of the nature of the
problem and to accomplish the objectives of the study, structured Beck Anxiety Inventory was used to assess the
Anxiety level of the students. Validity was ensured in the field of Nursing and medical departments. Reliability of
the tools was tested by Cranach’s alpha, which was 0.92 Both descriptive and inferential statistics were used.
The findings of this study indicated that Motivational Intervention is effective in reducing Anxiety (t
value=3.027, p value = <0.05) among unsuccessful B.Sc (N) students. There was no significant association of
Anxiety with the selected sample characteristics after motivational intervention but before motivational
intervention it was significantly associated with age in year, passed higher secondary in how many attempts and
hobbies. The finding suggests that motivational intervention was effective in reducing level of Anxiety of
unsuccessful B.Sc (N) students.
Assessment of the Existing School Health Promotion Program in a Selected Educ...AnuragSingh1049
The health promotion school program was designed to promote the wellbeing of school students. This concept was introduced during the 1980s by the World Health Organization (WHO). In Sri Lanka; it was initiated and implemented in 2008 targeting all government schools. The aim of the study was to assess the existing school health promotion program. The cross-sectional study was implemented in May 2018 with all secondary schools in a selected education zone in Sri Lanka which represent three types of schools, 1AB, 1C and type 2. The study participants were students and teachers. The newly developed tool (Health Promoting School Assessment Tool) was used to assess the existing school health promotion program under six main criteria. The nominal group technique was followed to fill the assessment tool designed in the study where a team of teachers and a team of students separately took part in the assessment. The findings of the study show that the existing health promotion school program is partially unsuccessful in the selected educational zone. The existing situation of the school health promotion program, according to the main six criteria of the Health Promotion School Assessment Tool, was not at a satisfactory level of the implementation (38.2%). Only three schools (N=23) scored more than 50% while other schools (n=20, N=23) were scored less than 50%. According to the assessment, for each group of an individual school, there was a difference between teachers’ assessment and students’ assessment of the overall health promotion program. It is important to conduct continuous monitoring and have an evaluation plan for the school health promotion program to acquire effective changes in school settings.
Power Point presentation about the article written by: Simonsen, B. et al. (2008). Evidence-Based in Practises in Classroom Management: Considerations for Research to Practise. Education and treatment of children, v31 nº3, 351-380
This presentation session will outline how an online, self-directed, course titled ‘Diagnostic Reasoning and Care Planning’ was developed for undergraduate second year nursing students. The course was delivered in Semester 1 2014 and completed by 220 students. The course design successfully employed a range of tools in Blackboard to engage students in active, self-directed learning, supported by a series of scaffolded learning activities completed online in Blackboard, with students receiving timely, effective feedback via Grade Centre as activities were completed.
EFFECTIVENESS OF CO-OPERATIVE LEARNING METHOD IN LEARNING OF MATHEMATICS AMON...Thiyagu K
Co-operative learning is defined as students working together to “attain groups goals that cannot be obtained by working alone or competitively”. The main purpose of co-operative learning is to actively involve students in the learning process, a level of student empowerment which is not possible in a lecture format. The present study found out the effectiveness of co-operative learning in mathematics learning among the eighth standard students of Tirunelveli district. Two equivalent group experimental-designs are employed for this study. The investigator has selected 40 students studying VIII standard in High School, Tirunelveli Educational District. According to the scoring of pre-test, 20 students were chosen as control group and 20 students were chosen as experimental group in a cluster sampling techniques. Finally the investigator concludes that; (a) There was significant difference between control and experimental group students in their gain scores. That is the experimental group student is better than control group students in their gain scores. (b)There was significant difference between control and experimental group students in their gain scores for attainment of the knowledge, understanding, and application objectives.
Rethinking feedback practices: Keynote Med Ed Conference Taiwan 18Oct 2014r_ajjawi
Rethinking feedback practices: insights from research
We are seeing a shift in understandings of feedback from information telling towards social and cultural perspectives aimed at helping students to self-regulate their own learning. Our conceptions of feedback inform how feedback is practiced, e.g., if feedback is thought of as information transmission to ‘tell’ the learner about their performance then our feedback practices will tend to be unidirectional from tutor to learner with a focus on content and delivery. However, simply providing feedback does not ensure that students have read, understood or engaged and learned from it. The aim of this keynote is to synthesise key research evidence into feedback, including the persistent so called ‘feedback gap’, and to draw recommendations for how feedback could be practiced and embedded into curricula in order to optimise learning of students and staff.
Does the simulated learning environment provide the occupational therapy (OT) student with an increase in
self-efficacy, as compared to traditional hands-on peer
practice, in preparation for the fieldwork experience?
This paper provides an overview of evidence-based educational interventions (EBEIs) and associated practices in school psychology. The profession has, for some time, embraced scientific principles and procedures across areas of professional practice, including diagnosis and classification, assessment, prevention and intervention, consultation, and research and program evaluation. More recently, the profession has embraced evidence-based prevention and intervention practices, intending to implement them in schools. Source: https://ebookschoice.com/evidence-based-educational-interventions/
I was just looking for a better way to find jobs or catch peoples eye ,surfing and surfing surfing.Then had this idea to share what I learned.
INSPIRED BY Gary vaynerchuk
We provide strategic and tactical advisory and consulting services to the pharmaceutical, biotechnology, chemical, and other industries.
We also are positioned to provide interim staffing support for companies needing General Manager, COO, Sales and Sales Leadership roles.
We provide a broad suite of QlikView licensing and documentation services including scoping, design, development, integration, training and labor management services.
Host Analytics & Inside Info's Unflagging Commitment To Australia With New Da...Inside Info Pty Ltd
Host Analytics and Inside Info are committed towards helping business organizations in optimizing their commercial potential. They aim to offer support in business planning, financial consolidation and other processes.
Team-based learning (TBL) as a teaching modality in Pharmacologyiosrjce
Team-based learning (TBL) is a student-centered teaching approach that requires both individual
and group accountability to ensure a fruitful teaching/learning experience. We adopted TBL in teaching second
year Pharmacy students Pharmacology course in Dubai Pharmacy College (DPC), Dubai, UAE. The present
study assessed students’ perception to TBL as a teaching/learning method. Second year students were divided
into 10 groups 7-8 students each. The three phases of the TBL technique were implemented. Students were
requested to respond to a questionnaire to assess their perception to the TBL experience. A significant
proportion of the students felt that TBL provides an enjoyable teaching/learning experience that enhances their
active learning, self-directed learning (SDL), critical thinking and ability to solve clinical problems
Spotting and Supporting Eating Disorders in School - Recommendations from Sch...Pooky Knightsmith
Eating disorders have a high rate of onset in school-aged children. School staff are in an excellent position to spot the early warning signs and offer support during recovery. This paper explores the findings from focus groups conducted with 63 members of staff from 29 UK schools with the aims of (a) understanding whether they are in a good position to support students with eating disorders and (b) to generate recommendations regarding school staff’s training needs for spotting and supporting eating disorders. Participants took part in semi-structured focus groups. These were transcribed and analysed using content analysis principles. Five key themes emerged: 1. Many staff don’t have a basic understanding of eating disorders; 2. Eating disorders are taboo in the staffroom; 3. Staff don’t feel comfortable talking to students about eating disorders; 4. Support is needed to ensure the teacher-parent relationship is a positive one; 5. School staff would welcome practical ideas for how they can best support students during the recovery period. The findings show that school staff currently feel ill-equipped to support students with eating disorders and endorse a need for focused training for school staff to better enable them to support students with eating disorders.
Toth-Cohen, S., Miller, C., Muhlenhaupt, M., Zapletal, A. Strategies for Integrating health lIteracy into entry-level OT curricula: A comprehensive approach. American Occupational Therapy Association Annual Conference and Expo, Chicago, IL, April 9, 2016.
MR. BHUSHAN R JOSHI (IV B. BSc. NSG
The curriculum must reflect the needs of patients and be immediately relevant and applicable to the central role of nurses: caring for patients.”
Accessing professional development activities: a survey of health sciences ac...Brenda Leibowitz
This is a presentation of data from a survey sent to health sciences academics in the Western Cape, South Africa, regarding their participation in professional development activities and their attitudes towards academic development
PICO QUESTION 2
PICO QUESTION 3
Pico Question
NRS-441V
August 28, 2015
Running head: PICO QUESTION 1
Pico Question
PICOT Question Components in relation to breastfeeding success rates
Population: Among pregnant women who plan to breast feed
Intervention: How does prenatal breastfeeding education
Comparison: Compared to no prenatal breastfeeding education.
Outcome: increase breastfeeding initiation and continuation rates
Time Frame: from birth to six months of life?
PICOT Question/Statement
P-Among pregnant women who plan to breast feed, I- does prenatal education contribute their O-successful breastfeeding initiation and continuation, C- compared to mothers who did not receive prenatal education, T- during hospitalization at birth up to six months of life?
Clinical Problem
Most women in the United States are aware that breastfeeding is the best source of nutrition for most infants, but they seem to lack knowledge about its specific benefits and are unable to cite the risks associated with not breastfeeding. Mothers are also uncertain about what to expect with breastfeeding and how to actually carry it out. Even though breastfeeding is often described as “natural,” it is also an art that has to be learned by both the mother and the newborn. Skills in how to hold and position a baby at the breast, how to achieve an effective latch, and other breastfeeding techniques may need to be taught. Not surprisingly, some women expect breastfeeding to be easy, but then find themselves faced with challenges. Unfortunately, education about breastfeeding is not always readily available to mothers nor easily understood by them. The goals for educating mothers include increasing their knowledge and skills relative to breastfeeding and positively influencing their attitudes about it. (NCBI, 2014)
References
National Center for Biotechnology Information (NCBI). (2014, July 15). Barriers to Breastfeeding in the United States. Retrieved from http://www.ncbi.nlm.nih.gov/
Developing an Implementation Plan
Professor 2013
Due Date: Sep 11, 2015 23:59:59 Max Points: 150
Details:
Consider the population in which the solution is intended, the staff that will participate, and the key contributors that must provide approval and/or support for your project to be implemented. These stakeholders are considered your audience.
Develop an implementation plan (1,500-2,000 words) using the "Topic 3: Checklist" resource. The elements that should be included in your plan are listed below:
1. Method of obtaining necessary approval(s) and securing support from your organization's leadership and fellow staff.
2. Description of current problem, issue, or deficit requiring a change. Hint: If you are proposing a change in current policy, process, or procedure(s) when delivering patient care, describe first the current policy, process, or procedure as a baseline for comparison.
3. Detailed explanation of proposed solution (new policy, process, procedure, or e.
research articles in the fields of special education andor intern.docxrgladys1
research articles in the fields of special education and/or internationally underserved populations and select one article to write about using APA citation of the article, a summary of the purpose of the research, analysis of the research, a personal reflection on the research. The article must be from research-based journal. Topics include but are not limited to national and international special education policies, practices, Response to intervention (RtI), Positive behavioral interventions and supports (PBiS), American with disabilities act (ADA), Parental Rights. Technology, technology implementation limitations, Assessment, Special Education Students, Instructional Strategies, At-Risk Students, International Issues, and English Language Learners (ELL).
The “I” in RTI Research-Based Factors
Name
Marymount University
ED-541
Dr. Hauth
2/13/2017
The “I” in RTI Research-Based Factors
In the research article, The “I” in RTI Research-Based Factors for Intensifying Instruction, Harlacher, Walker, and Sanford (2010) address the changes in the
2004 Individuals with Disabilities Improvement Act (IDEA), that widened the use of response to intervention (RTI). As a model for identifying students with learning disabilities, the legislative changes coincided with school wide reforms, which implemented research-based instruction and promoted the response for students who needed support (Harlacher, Walker, & Sanford, 2010). With a new way students’ difficulties are viewed, this called for new skills for educators in improving student outcomes. The purpose of their research is stated in the following question, “What research-based instructional factors can educators modify to intensify students’ instructional support? (Harlacher, Walker, & Sanford, 2010 p. 30).”
RTI: Background and Description
Response to Intervention (RTI) is a multi-tiered approach in providing services to students that match the students’ level of academic need to corresponding level of instruction (Harlacher, Walker, & Sanford, 2010). With the RTI model, schools create a range of levels in instructional support and teachers place students into these levels based off of screenings and progress monitoring data. Within the three tiers, all students receive Tier 1 with base core curriculum and in Tier 2, students who have mild skill deficits and need more instructional time each day. Tier 3 support, is the most intensive level of support. Students in Tier 3, receive instructional groups of three or four students. RTI is that all students receive research-based instruction that matches their need for support and continuously monitoring students' progress toward their goals.
Running head: THE “I” IN RESPONSE TO INTERVENTION 3
THE “I” IN RESPONSE TO INTERVENTION 6
The Effects of RTI in Special Education
For students who receive additional support, RTI is essentially important to intensify instruction. Teachers must ensure research-based instruction be.
Each student is required to complete and turn in the evolution oAlyciaGold776
Each student is required to complete and turn in the evolution of the course prior to sitting for the final exam. This is a portfolio requirement that must be completed at the end of each course. You will not be allowed to sit for the final without having completed the evolution for this course.
Rubric
NURS_307 - Nursing Evolution Rubric
NURS_307 - Nursing Evolution Rubric
Criteria
Ratings
Pts
This criterion is linked to a Learning OutcomeReflects on current theory and clinical class with concepts and theories using the Program Learning Outcomes and BSN Essentials listed in the syllabus
3.3 pts
Meets Expectations
1. Reflects on current theory class and clinical and how courses support each other (transfer of knowledge to apply to clinical)- Focused to Current Term. 2. Synthesizes theories and concepts from liberal education to build an understanding of the human experience. 3. Uses skills of inquiry and analysis to address practice issues 4. Applies knowledge of social and cultural factors in the care of populations encountered in this course.
2.51 pts
Approaches Expectations
1. Limited reflection on current theory class and clinical and how courses support each other (transfer of knowledge to apply to clinical)- Focused to Current Term. 2. Limited synthesis of theories and concepts from liberal education to build an understanding of the human experience 3. Use limited skills of inquiry and analysis to address practice issues 4. Applies limited knowledge of social and cultural factors in the care of populations encountered in this course.
1.65 pts
Does Not Meet Expectations
1.No reflection on current theory class and clinical and how courses support each other 2. Does not synthesize theories and concepts from liberal education to build an understanding of the human experience 3. Does not use skills of inquiry and analysis to address practice issues 4. Does not apply knowledge of social and cultural factors in the care of populations encountered in this course.
3.3 pts
This criterion is linked to a Learning OutcomeDevelops an effective communication style for interacting with current patients, families, and the interdisciplinary health team when providing holistic, patient centered nursing care to populations encountered in this course.
3.4 pts
Meets Expectations
1. Reflects on providing holistic patient care to populations encountered in this course. 2. Describes inter-collaborative involvement (i.e. Interprofessional rounds; consultations and interaction with PT/OT; Respiratory Therapy, Pharmacist consultation---describe their role/ contribution.)
2.58 pts
Approaches Expectations
1. A limited reflection on providing holistic patient care to populations encountered in this course. 2. Describes limited inter-collaborative involvement
1.7 pts
Does Not Meet Expectations
1. No reflection on providing holistic patient care to populations encountered in this course. 2. Does not describes inter-collaborative involvement
3.4 pts
This criterion is ...
1. This article was downloaded by: [UPSTATE Medical University Health Sciences Library]
On: 10 February 2015, At: 04:36
Publisher: Routledge
Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House,
37-41 Mortimer Street, London W1T 3JH, UK
Teaching and Learning in Medicine: An International
Journal
Publication details, including instructions for authors and subscription information:
http://www.tandfonline.com/loi/htlm20
Long-Term Gain After Team-Based Learning Experience
in a Pediatric Clerkship
Kavita S. Warrier
a
, Jocelyn H. Schiller
a
, Nicole R. Frei
a
, Hilary M. Haftel
a
& Jennifer G.
Christner
a
a
Department of Pediatrics , University of Michigan Medical School , Ann Arbor , Michigan ,
USA
Published online: 10 Oct 2013.
To cite this article: Kavita S. Warrier , Jocelyn H. Schiller , Nicole R. Frei , Hilary M. Haftel & Jennifer G. Christner (2013)
Long-Term Gain After Team-Based Learning Experience in a Pediatric Clerkship, Teaching and Learning in Medicine: An
International Journal, 25:4, 300-305, DOI: 10.1080/10401334.2013.827975
To link to this article: http://dx.doi.org/10.1080/10401334.2013.827975
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2. Teaching and Learning in Medicine, 25(4), 300–305
Copyright C 2013, Taylor & Francis Group, LLC
ISSN: 1040-1334 print / 1532-8015 online
DOI: 10.1080/10401334.2013.827975
Long-Term Gain After Team-Based Learning Experience
in a Pediatric Clerkship
Kavita S. Warrier, Jocelyn H. Schiller, Nicole R. Frei, Hilary M. Haftel,
and Jennifer G. Christner
Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
Background: Team-based learning (TBL) increases student en-
gagement, value of teamwork, and performance on standardized
evaluations. Purpose: The authors implemented a 3rd-year pedi-
atric TBL curriculum, evaluating its effect on satisfaction, engage-
ment, value of teamwork, and short-term and long-term academic
performance. Method: Students evaluated the TBL curriculum
and core lectures through satisfaction, engagement and value of
team surveys. Scores on short-term and long-term examinations
were compared to historical data. Results: The first implementa-
tion year, students were less likely to enjoy TBL sessions com-
pared to lectures. The 2nd year, this difference lessened. Through
both years, students reported dramatic increases in classroom en-
gagement during TBL compared to lecture. Students developed a
greater value for teams after participating in TBL. Short-term and
long-term examination scores improved significantly. Conclusions:
Both short-term and long-term performance improved with imple-
mentation of TBL, emphasizing the benefits of a curriculum that
allows students to critically engage with material.
Keywords team based learning, medical student, pediatrics, active
learning
A teacher-centric perspective has traditionally been the most
common orientation to teaching in medical education. Little
evidence supports dissemination-only strategies if the goal is
to improve professional practice.1
A growing body of medical
education research has demonstrated that active learning is more
effective than passive learning.2,3
A review of educational theory suggests that learners actively
contribute to the educational process, practice skills accompa-
nied by constructive feedback from teachers and peers, and re-
late learning to understanding and solving real-life problems.4
Indeed, the Liaison Committee for Medical Education has incor-
We thank Drs. Mary Hernandez and Laura Hopson for their assis-
tance in data collection. We also acknowledge Drs. Kenneth Pituch,
Terrance Murphy, Patricia Keefer, Kerry Mychaliska, and Francis
McBee-Orzulak for their help developing and implementing the TBL
curriculum.
Correspondence may be sent to Jocelyn H. Schiller, 12-525 Mott,
1540 East Hospital Drive, SPC 4280, Ann Arbor, MI 48109-4280,
USA. E-mail: johuang@umich.edu
porated active learning into its expected standards.5
Although
education reform emphasizes altering the pedagogical approach
to curriculum, such as switching from lecture format to case
studies,6
generational issues also need consideration. A recent
meta-analysis on generational changes indicates that students
born after 1980 prefer learning by doing rather than by listening
to lectures. This generation of students is also more likely to be
overconfident and thus may require more feedback.7
Team-based learning (TBL) is an innovative instructional
method that fosters active learning and has been adopted by
some medical schools, particularly in the preclinical years.8–13
TBL utilizes active small-group discussion facilitated by an in-
structor. Teams solve clinical problems and receive immediate
feedback on performance. Student performance is graded, with
an assessment of individual knowledge, evaluation of group
performance, and peer feedback making up the incentive struc-
ture of the method. TBL has been shown to improve learning
outcomes and examination scores,11,14–18
communication pro-
cesses, teamwork skills, and the value students place on these
skills,10.11,13,15
and student engagement in class settings.11,19–21
This correlates both with student satisfaction and student
achievement, especially when the subject matter is difficult.
TBL in the clinical setting has been previously described
for psychiatry and internal medicine clerkships11,14,22,23
but uti-
lizing TBL to deliver core curriculum in a pediatric clerkship
has not been reported. Long-term clinical knowledge gains have
also not been reported. In our clerkships’ transition from didac-
tic lectures to TBL, we had four objectives: (a) compare student
evaluations of TBL teaching sessions to core didactic lectures,
(b) analyze the students’ perspectives of the value of teams
before and after experiencing TBL, (c) analyze classroom en-
gagement during TBL, and (d) compare academic performance
between students prior to and after implementation of TBL ses-
sions, including long-term gains.
METHODS
Educational Intervention
At the University of Michigan Medical School, all 3rd-year
medical (M3) students rotate through an 8-week pediatric clerk-
ship with approximately 25 to 32 students in each cohort. In the
300
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3. LONG-TERM GAINS AFTER TBL IN PEDIATRIC CLERKSHIP 301
past, 21 hours were set aside for core pediatric teaching in the
form of didactic lectures. Beginning with the 2009–10 academic
year (2009 AY), six 90-minute TBL sessions replaced 12 of the
core teaching hours.
The 10 pediatric faculty members involved in the develop-
ment, implementation, and facilitation of TBL modules attended
a TBL workshop in 2008. Three core faculty members also at-
tended the TBL Collaborative Annual Conference. Module top-
ics were chosen by reviewing institutional objectives and the
national Council on Medical Student Education in Pediatrics
Curriculum to identify core pediatric topics.24
The modules
were piloted and reviewed prior to implementation and have
since been published on MedEd Portal.25–30
Because the students had no prior TBL experience, they were
given information about TBL during the clerkship orientation.
Reading assignments were provided for each module. The in-
structors randomly divided students into teams of five to six at
the first TBL session. The students remained in the same teams
for all six TBL sessions. Each block of six TBL sessions was
facilitated by a team of two faculty members to allow students
to develop rapport with the faculty and to provide a variety of
faculty perspectives.
Each session consisted of readiness assurance tests (RATs)
taken individually (IRATs) and as a group (GRATs), followed by
application exercises (see Table 1). Students were not allowed
to use reading materials during the RATs. Immediate feedback
was provided during the GRAT with scratch-off answer sheets
denoting the correct answer with a star. Faculty facilitators re-
viewed the answers to the RATs and clarified key points before
students started the application exercises. For 24 hours after
the session, any team was allowed to appeal RAT questions by
showing a credible source that supported an alternative answer.
The application exercises consisted of more complex clinical
scenarios, which required synthesis of information, often focus-
ing on diagnosis or treatment. Most questions had one “most
right” answer with other “right” answer choices. Each team dis-
cussed the questions and came to a consensus on the answers.
After the intra-team discussion was complete, the teams came
together for inter-team dialogue. Each team simultaneously dis-
played their answer; the facilitators then required teams to ex-
plain their reasoning and defend their answer choice.
TABLE 1
Time spent on Readiness Assurance Tests (RAT) and
application questions
Exercise Time Spent No. and Type of Questions
Individual RAT 15 min 9 to 12 multiple choice
questions based on readings
Group RAT 30 min Same as IRAT
Application 45 min 2 to 5 complex clinical
scenarios
At the final session, students gave written peer feedback
adapted from the Koles method,31
which was reviewed by the
associate clerkship director and assigned a grade. Twenty-five
percent of the TBL grade was based on the IRAT and 65% of
the TBL grade was based on the GRAT; the other 10% of the
TBL grade came from peer feedback. These distributions were
assigned by the course director. The TBL grade was worth 5%
of the total clerkship grade, which was in line with amounts
assigned to other clerkship assessments such as written notes,
assignments, and professionalism.
Objectives and Data Collection
During the 2009 AY, we gathered student evaluations of the
core didactic lectures and TBL sessions. These evaluations were
not anonymous. We also collected data on student engagement
during the didactic and TBL sessions using the Classroom En-
gagement Survey, a tool from Baylor College of Medicine that
asked questions relating to engagement in the lecture or TBL
session.11,32
Students’ perception of the value of teamwork was
measured at the beginning and end of the clerkship using a nine-
item “Value of Teams” survey developed at Baylor College of
Medicine.11,33
All items were scored on a 5-point Likert scale
anchored by 1 (strongly disagree) and 5 (strongly agree).
Academic performance was assessed with three measures.
National Board of Medical Examiners (NBME) Pediatric Shelf
scores for the 2009 AY and 2010 AY were compared to scores
from the 4 years prior. We also analyzed scores on our M4 Com-
prehensive Clinical Assessment (CCA), a high-stakes Objective
Structured Clinical Examination all 4th-year students must pass.
The CCA included several stations, one of which entailed ob-
taining a pediatric history from a standardized patient parent.
Students are randomly assigned to either the pediatric fever or
asthma standardized patient parent. Scores from this pediatric
station were compared between the students who completed the
clerkship in AY 2009 to students from the 4 years prior. Our
last performance measure was an examination taken during the
required M4 Emergency Medicine (EM) clerkship. AY 2009
student scores on two clinical questions about fever in neonates
and toddlers were compared with those from the 2 years prior.
The CCA stations and EM examination questions were chosen
because both fever and asthma were previously taught during
the M3 year by didactic lecture, but in 2009 AY became TBL
topics. These M4 CCA assessments were done between 1 and
10 months after the M3 pediatric clerkship and the EM exam
was taken between 1 and 22 months after completion of the M3
pediatric clerkship. Other than the implementation of TBL, no
other changes were made to the curriculum during these study
years.
This study was reviewed by the University of Michigan In-
stitutional Review Board and granted exempt status.
Statistical Analysis
Mean response to each survey item for overall evaluation,
student classroom engagement, and value of teams were
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4. 302 K. S. WARRIER ET AL.
calculated and compared by independent samples t tests. The
Value of Teams Survey analyzes two different learner perceived
dimensions of learning in groups, the Value of Working with
Peers and the Value of Group Work,34
which were calculated
and compared by independent samples t test. Independent
samples t tests were used to compare means for NBME scores,
CCA performance, and EM exam scores. Cohen’s d was
calculated to show effect size. Data were analyzed using SAS
9.2 Statistical Software.
RESULTS
One hundred seventy-nine students completed the pediatric
clerkship in 2009 AY and 160 students completed the clerkship
in 2010 AY.
Satisfaction
Students reported lower satisfaction with team-based learn-
ing as compared to lectures for almost all features in both years
(see Table 2). However, the mean differences in satisfaction be-
tween lecture and TBL dropped in the 2nd year of study. The
differences between these means were statistically significant
for six of the seven questions in the 1st year, and five of the
seven questions in the 2nd year. The only change between years
was the question of whether the topic was of importance.
Value of Teams
For all items on the Value of Team survey, students demon-
strated a greater appreciation for teamwork after the completion
of the term, but this was only statistically significant for three of
the items: “Working in teams in class is productive and efficient,”
“Group decisions are often better than individual decisions,” and
“Solving problems in groups leads to better decisions than solv-
ing problems alone” (see Table 3). Although the other six items
were not statistically significant, all items trended in a positive
direction after students experienced TBL. The Value of Teams
Survey analyzes two different learner perceived dimensions of
learning in groups; there was no significant difference in the
overall Value of Working with Peers. There was, however, a sig-
nificant difference in student assessment of the Value of Group
Work (0.24; p <.01, d = .38) after completion of the team-based
learning curriculum.
Classroom Engagement
Students reported higher levels of personal contribution and
participation, as well as fellow student involvement, in TBL
TABLE 2
Student satisfaction and classroom engagement: Comparing lecture to TBL sessions
2010 2011
Lecture Lecture
Question Ma
TBL Mb
Diff p d Mc
TBL Md
Diff p d
Standard Evaluation
Achieved Objectives 4.60 4.24 0.36 <.01 0.41 4.63 4.45 0.18 <.01 0.24
Session Effective 4.55 4.28 0.26 <.01 0.32 4.57 4.46 0.11 <.01 0.13
Topic Important 4.65 4.57 0.08 <.01 0.12 4.67 4.65 0.02 .43 0.04
Level of Discussion Appropriate 4.46 4.43 0.03 .48 0.03 4.50 4.56 0.06 .16 0.06
Organized 4.64 4.31 0.33 <.01 0.42 4.67 4.46 0.21 <.01 0.30
Session Appropriate 4.61 4.44 0.17 <.01 0.23 4.66 4.57 0.09 <.01 0.12
Engagement
I Contributed 3.04 4.34 1.30 <.01 0.94 3.36 4.37 1.01 <.01 0.75
I Did Not Have Fun 1.62 1.95
∗
n = 1,030
0.33 <.01 0.32 1.53 1.70 0.17 <.01 0.19
I Had Fun 4.03 3.90 0.13 <.01 0.12 4.10 4.17 0.07 .14 0.07
I Paid Attention 4.45
∗
n = 878
4.43 0.02 .63 0.02 4.45 4.42 0.03 .40 0.04
I Would Like More Like This 4.12 3.94 0.18 <.01 0.18 4.20 4.12 0.08 .10 0.08
Most Students Involved 3.85 4.33 0.48 <.01 0.45 4.00 4.39 0.39 <.01 0.22
Most Students Did Not Pay Attention 1.73 1.84 0.11 .03 0.10 1.69 1.70 0.01 .84 0.01
I Participated 3.52 4.45 0.93 <.01 0.62 3.77 4.47 0.70 <.01 0.58
Average 3.96
∗
n = 878
4.20
∗
n = 1,030
0.24 <.01 0.34 4.08 4.32 0.24 <.01 0.32
Note. TBL = team-based learning.
a
N = 879. b
N = 1,033. c
N = 943. d
N = 916.
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5. LONG-TERM GAINS AFTER TBL IN PEDIATRIC CLERKSHIP 303
TABLE 3
Value of teams survey
Pre-TBL Post-TBL
Item Question Meana
Meanb
p
1 The ability to collaborate with my peers will be necessary if
I am to be successful as a student.
4.61 4.65 .61
2 It is a waste of time to work in groups. 1.80 1.69 .20
3c
The ability to work with my peers is a valuable skill. 4.70 4.72 .71
4 Collaborating with my peers will help me be a better student. 4.40 4.52 .07
5 Solving problems in a group is an effective way to practice
what I have learned.
4.19 4.25 .50
6 Solving problems in a group is an effective way to learn. 4.11 4.21 .25
7c
Working in teams in class is productive and efficient. 3.54 3.78 .02
8 Group decisions are often better than individual decisions. 3.91 4.26 <.01
9c
Solving problems in groups leads to better decisions than
solving problems alone.
3.99 4.31 <.01
Note. TBL = team-based learning.
a
n = 171. b
n = 170. c
Post-TBL n = 169.
sessions as compared to lecture, noted by the higher ratings for
TBL in the items “I contributed to class,” “Most students were
involved in class,” and “I participated in class” (see Table 2).
However, similar to the data from the evaluations, students re-
ported higher agreement with statements such as “I did not have
fun” for TBL sessions and did not want more sessions like TBL.
Again, similar to the data from the evaluations, we noted im-
provements in the 2nd year with students enjoying TBL more
the 2nd year. Overall, the cumulative Classroom Engagement
score showed a significant increase between TBL sessions as
compared to lecture in both years.
The effect size for these mean differences was notable partic-
ularly for student agreement with statements about their personal
contribution and participation across both years.
Academic Performance
NBME SHELF Exam. For 4 years prior to the initiation of
TBL, the mean on the Pediatric Shelf was 79.46 (n = 614; see
Table 4). The mean on the Pediatric Shelf for the 2 years after
the initiation of TBL was 82.50 (n = 311). This is an increase
of 3.04 points ( p <.0001, d = .36). Shelf data were unavailable
for 31 students in 2009 AY.
M4 CCA. For the 4 years prior to initiation of TBL, the
student mean on the CCA Pediatric Station was 73.02 (n = 668;
see Table 4). The student mean on the CCA for the 1st year after
TBL was introduced was 75.55 (n = 149). The increase of 2.53
points was statistically significant (p = .0109, d = .24). Data for
22 students were unavailable, as several students took a leave of
absence between M3 and M4 year to pursue academic interests.
TABLE 4
Measures of academic performance
Test M Score SD Difference p Cohen’s d
NBME Shelf Examination
Pre-TBLa
79.46 8.14 3.04 <.01 0.36
Post-TBLb
82.50 8.72
Clinical Skills Examination
Pre-TBLc
73.05 12.42 2.89 <.01 0.24
Post-TBLd
75.94 11.00
EM Score (Toddler)
Pre-TBLe
2.21 1.04 0.28 <.01 0.28
Post-TBLf
2.49 0.84
EM Score (Neonate)
Pre-TBLe
6.00 1.51 0.45 <.01 0.32
Post-TBLf
6.45 1.17
Note. NBME = National Board of Medical Examiners; TBL = team-based learning; EM = Emergency Medicine.
a
n = 614. b
n = 311. c
n = 668. d
n = 149. e
n = 281. f
n = 151.
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6. 304 K. S. WARRIER ET AL.
EM Clinical Skills Exam. The student mean score on the
question addressing fever in toddlers increased by 0.28 (p =
.0032) after the introduction of TBL sessions, a 9% increase in
the score out of a maximum score of 3 points. The student mean
score on the question addressing fever in neonates increased
by 0.45 (p = .0006, d = .32), an increase of 6.4% out of the
maximum score of 7 points.
DISCUSSION
To the best of our knowledge, this is the first study demon-
strating that 3rd-year students participating in TBL had sus-
tained improved in examination performance. Active discussion
in the context of clinical scenarios may lead to longer retention
of knowledge than that learned through rote memorization. Our
findings support our hypothesis that TBL has a positive im-
pact on students’ learning as demonstrated by improved test
scores the following academic year. These results are likely
multifactorial. Students must read preparatory materials prior
to the TBL session, which may increase the amount of reading
during the clerkship on subject matter that is directly linked to
clerkship and institutional learning objectives, improving their
preparation for examinations. The peer interactions during TBL
sessions require students to choose best answers within teams
and educate each other, which likely enhances personal under-
standing of the material.17
The increased accountability to the
group due to peer evaluation may have encouraged students to
engage in more independent study.17
Across both years of study, students reported an increase in
classroom engagement during TBL sessions as compared to lec-
tures. This may also help explain the improvement in academic
performance. As students critically examine clinical questions,
they become invested in learning why certain choices are most
appropriate, which likely invests them in learning.17
Because
faculty can assess student knowledge from the IRAT and group
discussion, faculty can then direct the ensuing discussion toward
clarifying difficult concepts that were not well understood.
Despite the positive effect on learning, students did not rate
TBL as highly as didactic lectures. This confirms the results of
another study which showed that although learners were more
engaged during TBL, the perceived value of didactic sessions
was higher.21
In that study, however, student performance was
the same between TBL and didactic lectures, whereas our stu-
dents had improved performance after TBL. We chose to keep
only the most highly rated didactic lectures in our curriculum,
which may have influenced our findings. In addition, our stu-
dents have minimal exposure to TBL; introduction of a novel
instructional method that requires more work on the part of
the student may have affected student satisfaction. Orienting
the students to TBL may be important in fostering acceptance.
Overall, we are encouraged that the evaluations of TBL im-
proved in the 2nd year. Another study has also demonstrated
improvement in student perceptions of the merit of TBL teach-
ing over a 3-year time span.35
Although faculty data were not
formally collected, our faculty report increased comfort with
the material and teaching style over time, which is supported
by a qualitative study by Thompson et al. reporting that faculty
needed time to become comfortable with the TBL method and
faculty expertise was vital to successful TBL implementation.36
Faculty indicated that initial use of TBL was of limited success
but that repeated use of TBL was essential to success.13
Our
experience reminds us that creating the conditions for effective
change require time, experience, and a shifting of attitudes for
both students and faculty.
The students involved in this study were primarily students
from “Generation Me” who often require support when try-
ing something new. It has been noted that this generation likes
to know exactly what to do to get good grades and finds am-
biguous instruction stressful.7
Our students may need additional
preparation in order to accept TBL.23
We have created a more
extensive orientation to TBL illustrating not only the process
but the perceived benefits of this type of instruction, hoping to
give students clearer expectations and improve their view of the
process. The fact that medical decision making can yield mul-
tiple correct yet different paths is also an intrinsic part of TBL,
and one that may be difficult for junior students to accept. Even
experienced clinicians may be uncomfortable with diagnostic
uncertainty, despite it being part of clinical medicine. Although
it may be uncomfortable for students—and may lead to low
evaluations—it does not change the fact that this is important
exposure for students and may be something they value in the
long run—if not now.
Our results support the findings of previous studies indicating
that TBL can teach students to value teamwork. Students were
more likely to appreciate using teamwork in class and, more
important, see the value that comes from shared decision mak-
ing. This promotes a collaborative decision-making process, an
important value in this age of patient- and family-centered care.
More research will be necessary to determine whether expo-
sure to team learning impacts future views of teamwork in the
clinical setting or ultimately impacts clinical care.
This study has some limitations. Because TBL is a graded
component of the 3rd-year curriculum, we were unable to cre-
ate a control group for comparison; the entire class participated.
This necessitated the use of historical controls for the analy-
sis of academic performance. The yearly differences between
classes in the medical school could explain the variation in Shelf,
CCA, and ED clinical examination scores. Our mean student
Shelf scores prior to the intervention, however, were constant.
Demographic data that influence standardized test-taking ability
were not included in the statistical analysis and could influence
the scores. We have only 1 year of ED clinical exam data, as the
examination was changed after that year, so we are unable to see
if this improvement was sustained in the next academic year. All
students were required to turn in the surveys, and so response or
nonresponse bias was not a factor; however, the student surveys
were not anonymous, which could have affected the students’
report on all measures.
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7. LONG-TERM GAINS AFTER TBL IN PEDIATRIC CLERKSHIP 305
CONCLUSIONS
This study adds to the growing body of evidence suggest-
ing the effectiveness of TBL in achievement of knowledge ob-
jectives for medical students and is the first to demonstrate
knowledge gains extending into the next academic year. TBL
addressed the needs of this generation of learners to be more
actively involved in their education while allowing the fac-
ulty member to provide “real-time” feedback as students work
through clinical cases. Faculty need time to adapt to a differ-
ent pedagogical method, but once practiced, the gains in ac-
tive learning, teamwork, and increase in long-term performance
seem well worth the investment.
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