Team-based learning: A practical guide: AMEE Guide No. 65

BackgroundRecently, there has been a concerted effort within medical schools to depart from conventional lecture-based learning approaches to alternative teaching methods such as team-based learning (TBL) and problem-based learning (PBL), with the aim of enhancing both student engagement and instructional efficacy. Despite this shift, a comprehensive review that directly compares the impacts of PBL and TBL methods in medical education is lacking. This study seeks to address this gap by conducting a meta-analysis that compares the effects of TBL and PBL in the context of medical education.MethodsStudies from Embase, PubMed, Web of Science, China National Knowledge Infrastructure, and Chinese Wanfang Database were searched, from inception to July 11, 2023. A meta-analysis was performed using Stata 14.0, and a total of 10 studies (including 752 participants) were included. The standardized mean difference (SMD) was used to estimate pooled effects. Heterogeneity was detected using the I2 statistic and further explored using meta-regression analysis.ResultsCompared with PBL, TBL significantly increased the number of theoretical tests (SMD = 0.37, 95% CI: 0.02–0.73). Additionally, TBL greatly improved teamwork skills compared with PBL. However, there were no significant differences between the TBL and PBL groups concerning practical skill scores, learning interest, or understanding skills.ConclusionTBL in the theoretical aspects of medical education appears to be more effective than PBL in improving theoretical test scores and teamwork skills, providing evidence for the implementation of TBL in medical education.

A team-based learning (TBL) approach was used to facilitate student learning and performance in a sophomore preclinical endodontic course. TBL is based upon the division of a class into small groups of students using a problem-based learning approach. The purpose of this project was to improve student ability to diagnose diseases utilizing TBL combined with an audience response system (ARS). Three measures were used to assess the outcomes: 1) pre- and posttest scores, 2) a diagnostic skills assessment during the final examination, and 3) an attitudinal survey completed by the students. At the beginning of the course, second-year students (n=64) were evaluated to determine entry-level knowledge. Six groups of ten to eleven students each were pretested, followed by a parallel posttest following the implementation of the TBL experience. Students' performance on the posttest (63.4 percent) showed improved results when compared to the pretest (36.9 percent). Students also exhibited improved diagnostic skills with the final examination. The results of the students' attitudinal survey indicated an 80 percent agreement that TBL enhanced their powers of critical analysis.

Construct: We sought to evaluate the quality of Team-Based Learning facilitation in both large and small group settings. Background: Team Based Learning (TBL) is an increasingly popular small group instructional strategy in health science education. TBL facilitation skills are unique and differ from those needed to lecture or facilitate other types of small groups. Measuring facilitation skills and providing feedback to TBL instructors is important, yet to date no valid instrument has been developed and published for this purpose. Approach: We created an 11-item instrument (ratings of each item on a 7-point scale) designed to assess TBL facilitation skills, considering major sources of validity. Twelve experts in TBL facilitation and training developed the content of the FIT. To ensure response processes were valid, we used an immediate retrospective probing technique with 4th year medical students who were not part of the study. The Facilitator Instrument for Team-Based Learning (FIT) was piloted with 2,840 medical students in 7 schools in large (year 1 and 2) and small (year 3) courses. The internal structure of the FIT was analyzed. Results: In total, 1,559 and 1,281 medical students in large and small TBL classes, respectively (response rate 88%) rated 33 TBL facilitators. The composite mean score for the FIT was 6.19 (SD = 1.10). Exploratory factor analysis and Cronbach’s alpha indicated that all items loaded on 1 factor, accounting for 77% of the item variance. Cronbach’s alpha for the 11 items was 0.97. Analysis of facilitator variables and course context indicated that FIT scores were statistically significantly correlated with type of class (pre-clinical or clinical) and size of class as well as the facilitator enjoyment in using TBL as a method. Gender and the amount that facilitators used TBL each year was weakly correlated, with other factors not correlated (years facilitating TBL, confidence in facilitating TBL, and age). Conclusions: Analysis of FIT scores from 2,840 medical students across multiple institutions and teaching settings suggests the utility of the FIT in determining the quality of TBL facilitation across a range of medical education settings. Future research is needed to further analyze course contexts and facilitator variables that may influence FIT scores with additional facilitators. Additionally, FIT scores should be correlated with additional measures of TBL facilitator quality, such as direct observations, especially if these data are used for summative decision-making purposes.

Status of Medical Education Reform at Saga Medical School 5 Years After Introducing PBL

Problem-based learning (PBL) represented a major and widespread change in educational practice within higher education when introduced into McMaster University and Case Western Reserve Medical Schools during the 1960s (Barrows 2007). The teaching and learning strategy spread during the 1970s into medical schools in Newcastle (Australia), Maastricht (Netherlands), and NewMexico Universities. Since then problem-based learning has spread across the world and is currently practiced intermittently across the United States, Canada, Europe, Singapore, and Australia. From beginnings in medical schools, problem-based learning has been introduced into all of the health sciences, engineering, business, science, and education. Increasing uptake of problem-based learning (which differs from problem solving) occurred because it was considered a means to engage students in deep rather than surface learning and was viewed as a successful strategy to align university courses with the real-life professional work students were expected to undertake on graduation. Problem-based learning is considered “problem-first learning” because it is the problem which defines the learning. Instructors design problems to represent authentic, real-world situations or issues likely to be addressed in the work place on graduation. Typically, students in small groups work through the problem to decide on the information and skills they will need to investigate the issues identified and strive to resolve the situation. Often the problem involves collaboration between disciplines so that students are required to build on current knowledge to synthesize then integrate new information. Instructors monitor group processes and facilitate student learning. However, students themselves are responsible for the learning that occurs within the group. Generally standard problems developed in education programs are well constructed so that all elements of the problem are clear from the outset and there is a preferred process to arrive at the correct conclusion. In a shift from this format, problems crafted for problem-based learning are ill structured and vague, where students define the elements of the problem and there are often alternative pathways to alternative solutions. Throughout this student-centered and self-directed process, students collaborate to share their knowledge and reflect on their learning and assessment (Azer 2008). Contemporary examples of ill-constructed problems suitable for problem-based learning include those centered on policy (fixing a price on carbon emissions), engineering design (processing gas onshore or offshore), and ethical dilemmas (levels of support to refugees). On beginning a problem-based learning task, students work in small groups of four to eight, which may be self-selected or allocated by the facilitator. Students often underestimate the importance of negotiating group protocols so this is the initial priority before identifying the learning outcomes and sharing their prior knowledge. They are then able to determine gaps in their collective knowledge and plan strategies to obtain further information they perceive as required. Regular group

INTRODUCTION: Problem based learning (PBL) has many benefits; however, research on PBL indicates that students are not quite good at integrating knowledge in basic sciences and clinical aspects. Case-based learning (CBL) might be an alternative method to enhance the integration of this knowledge. No research explored the way these two methods stimulate cognitive skills. This study aimed to explore the differences between PBL and CBL in stimulating cognitive skill by analyzing verbal interaction. MATERIALS AND METHODS: This descriptive research was performed at the Faculty of Medicine, Universitas Islam Indonesia (FM UII). Twenty-one undergraduate students contributed voluntarily to this study. The students were then split up randomly into a PBL Group (n=10) and a CBL group (n=11). Each group performed twice discussion meetings facilitated by an experienced tutor. The discussion processes were video recorded and analyzed using a coding scheme categorizing the verbal interaction into five types: cumulative reasoning, exploratory questioning, procedural interaction, handling conflict about knowledge, off-task/ irrelevant interactions. RESULTS: Students in both PBL and CBL groups spent most of their time-sharing cumulative reasoning and then asking exploratory question. Students in the PBL group were more frequently asking exploratory questions. Students in both groups rarely handled conflict about knowledge since it was a high order thinking skill. Students in the CBL group were more frequent than the PBL group in performing procedural interaction. CONCLUSIONS: Students performed various cognitive skills in both PBL and CBL. Each method has its own strengths in stimulating reasoning skills of students.

BackgroundProblem-based learning (PBL) involves discussions among students who resolve loosely-structured problems to facilitate learning. In the PBL curriculum, faculty tutors are employed as facilitators for small groups of students. Because of lack of time and staff shortage, the effectiveness of tutorless PBL has been discussed as an alternate option.MethodsSessions in which tutored and tutorless PBL groups are mixed were presented by 1st-year medical students, who experienced both tutored and tutorless groups alternately in the two sessions of a year. To examine the effectiveness of tutored and tutorless PBL, written examination scores (WES) and self-contentment scores (SCS) were statistically analysed.ResultsWES averages did not significantly differ between the tutored and tutorless groups; however, a significantly greater variation was observed in WES in the tutorless group. SCS averages tended to be higher in the tutored PBL than in tutorless PBL groups.ConclusionsStudents in these tutorless PBL groups performed well in their written examinations, whereas those in the tutored PBL groups, achieved this and reported better self-contentment with their learning experience. Tutorless PBL sessions were considered to be comparable to tutored PBL sessions at least in the early stages.

Background: Medical teaching has evolved over the past few years, from traditional teaching methods such as lectures and practical classes using blackboard, slide projector to more student-centered activities such as self-directed learning, problem based learning (PBL) and team-based learning (TBL) Problem based learning is an integral part of our MBBS curriculum. We introduced TBL to 2nd year MBBS students in Pharmacology department, who are also practicing PBL in 2nd year. Aim: The aim of the study was to know student’s perception about TBL and PBL. Methods: Students were asked to fill the questionnaire regarding each teaching strategy anonymously using both, open and closed ended questions. The data was analyzed by using SPSS version 21. Results: A total of 120 students filled the questionnaire regarding their perception about TBL, and 94 students filled the questionnaire regarding PBL. Students found the readiness assurance tests and immediate feedback effective for their learning in TBL. While for PBL, students found that different point of views were respected by group members and there is better integration among different disciplines in PBL. Conclusion: It is the need of the hour to include new strategies in our curriculum which promotes team work and effective communication skills. Both PBL and TBL have advantages of their own and can provide better student learning if incorporated in a medical curriculum, keeping in view the students responses in our study.

This study investigated the comparative effectiveness of Problem-Based Learning (PBL) and Lecture-Based Learning (LBL) in the teaching of redox reactions to Senior High School students in Ghana. The central objective was to examine which of the two pedagogical approaches yields better achievement outcomes, as measured by students’ mean scores in knowledge, comprehension, and application of redox concepts. The study was designed to provide evidence for determining which method is more suitable and effective for enhancing learning in chemistry classrooms, particularly for abstract and challenging concepts such as redox reactions. A pure experimental design was adopted, involving 36 Senior High School chemistry students who were randomly assigned to two groups: the PBL group (experimental) and the LBL group (control). Both groups were assessed through a series of pre-tests, immediate post-tests, and delayed post-tests. These assessments were carefully structured to capture three levels of learning outcomes: knowledge recall, conceptual comprehension, and application of redox principles. The use of the t-test helped establish the level of equivalence between the groups and to determine the statistical significance of observed differences in performance. While both groups demonstrated similar prior knowledge, students taught through PBL consistently achieved higher performance across knowledge, comprehension, and application of redox principles in both immediate and delayed assessments. These results indicate that PBL promotes deeper understanding and longer-lasting learning compared to the traditional lecture approach. These findings provide robust evidence that PBL enhances not only short-term learning gains but also long-term retention of redox concepts. By engaging students in problem-solving activities and encouraging active participation, PBL allows learners to develop a more meaningful understanding of abstract chemical processes compared to the traditional lecture approach, which often emphasizes rote memorization. Educationally, the findings highlight the value of learner-centered strategies in improving students’ mastery of abstract chemistry concepts. By actively engaging students in problem-solving and critical thinking, PBL supports meaningful learning rather than rote memorization. The study therefore underscores the need for chemistry teachers and curriculum developers to adopt PBL approaches to enhance conceptual understanding, retention, and problem-solving skills at the Senior High School level.

Team-Based Learning (TBL) is a cooperative learning strategy blending elements of flipped learning, inquiry-based learning, and problem-based learning. Although used quite frequently in other disciplines, use of this strategy in mathematics has been limited. In this article, we describe how TBL can be implemented in math courses with adherence to essential elements of TBL and introduce modifications specific to mathematics instruction. In particular, we introduce a particular style of TBL, which we term Team-Based Inquiry Learning, that satisfies the defining pillars of inquiry-based learning.

2007 Leadership Academy for Educators

University of Missouri—Kansas City School of Medicine

This research aims to develop learning media in the form of electronic student worksheets based on the Problem-based Learning in trigonometry material for class X Senior High School. This learning media can be used in class or independently. The method used in this study is the research and development method or Research and Development (RnD) which refers to the ADDIE model (Analyze, Design, Development, Implementation, Evaluation). After being tested, the researcher entered the evaluation stage, namely processing the data obtained from the results of the expert validation and trials. The material and language expert validation test scores were 83.33%, media validation tests were 93.48%, teacher validation tests were 99.31%, trials on students in small groups were 91.1%, and trials on students in large groups were 84.2 %. Based on these results obtained an average percentage of 90,284%. From the results of the effectiveness test obtained an average value of 98.27. It can be concluded that Problem-based Learning on trigonometry material can be interpreted as very feasible to be used as learning media for teachers and students.

Problem based learning (PBL) has been used for many years and it is one of the effective educational methodologies applicable for distinguished engineering disciplines. It is a widely used student-centric approach through which students get engaged to solve real world problems by research, continuous study, and regular practices along with knowledge utilization during implementation. This study explores the PBL with an advanced computer engineering course of pre-final year students. This study centers around the implementation of a system to solve one of the real-life problems and distinguishes a portion of the difficulties that lie ahead for PBL. Here, to examine the impact of PBL approach for the specified subject, the result of B.Tech. (CE and IT branches) sixth semester students (A.Y. 2019-20 and 2020-21) are considered with various known parameters. Students' feedback is taken at the end of course study. Problem title, hook of the problem, background or history of the problem, clarifying/providing constraints, list of deliverables, strategy to solve the problem, assessment criteria/rubric etc. are provided well in advance to the students to be comprehensible for the problem. Learning sequence sessions are also arranged on a regular basis during problem solving by the facilitator to fill out the gap. As a result, the PBL approach is found to be intended more strongly for engineering students than for other students; in contrast, with traditional MCQ based examination students mostly focus on mug up of concepts rather than implementation and critical thinking. Engineering students are able to work smartly along with hard work, and as a result students have developed their technical skills, collaborative skills, self-learning approach with advanced computer engineering courses. Assessment pattern has changed into advancement with the proposed PBL approach over a traditional MCQ based approach. Continuous assessment is performed on covering all segments of the exam. Results found with traditional approach are contrasted with results found with PBL approach and tracked down that a more prominent number of students had secured more than over average score (>=60%) with the proposed PBL approach and statistically proven for the same. This correlation shows that students are more noticeable and curious about the PBL approach as opposed to robbing up hypothetical ideas and choosing the appropriate answers with a traditional MCQ based approach. In Addition, student’s feedback is observed to be very satisfactory. It has been seen that through PBL, students' retaining level has extremely increased and their learning abilities and understanding level too has improved altogether. PBL plays out a fundamental role for achieving the student's involvement and commitment towardslearning. Logical, critical thinking, teamwork, technical etc. skills for engineering students can be developed effectively with the PBL approach. Keywords— Problem-based learning, Continuous assessment, PBL, self-regulated learning, self-directed learning

Research has shown that coaches learn through reflective practice (Trudel & Gilbert, 2006), that communities of practice can assist the reflective process (Culver & Trudel, 2008), and that problem-based learning can increase critical thought by coaches (Jones & Turner, 2006). To help coaches develop reflective practice skills in an online course, the authors designed and implemented a novel assignment combining the principles of a community of practice with problem-based learning. Small groups of students were presented with a problem scenario and then met synchronously online using a low bandwidth group chat application (EtherPad) to diagnose the problem, strategize, and outline a solution. Students were able to conduct group meetings with only minor technical diffculties, and their written work demonstrated that a moderate level of refection had occurred. Future assignment redesigns should allow more opportunities for student-instructor interaction to facilitate greater development of student reflective practice skills.