TBL Trends
January 2015
Vol 5 Issue 1

TBL Users From Around the World to Meet in Sunny South Florida!

Wayne McCormack, PhD
University of Florida

Just when you might need a break from winter, here is your chance to get away from it all and spend a few days immersed in team-based learning with your teaching colleagues from around the world at the TBL Collaborative! Please join us in St. Petersburg, Florida for our 14th Annual TBL Conference, which will be held Thursday through Saturday, March 5-7, 2015. Pre-meeting workshops will be held on March 5th, followed by two days of TBL workshops, posters, oral presentations, and plenary sessions. Three tracks will run throughout the program - Fundamentals of TBL, Innovations in TBL, and Research & Scholarship of TBL - so there will be new information for both TBL newcomers and experienced practitioners.

We are pleased to announce our plenary speakers, Eric Mazur and Misty Loughry. Dr. Eric Mazur, professor of physics at Harvard University and developer of the Peer Instruction interactive teaching methodology, will provide an exciting start to our conference with a presentation entitled "Flat Surface, Deep Learning". Dr. Misty Loughry, professor of management at Georgia Southern University and co-developer of the CATME system of web-based tools, will get us thinking about how we can assess the impact of TBL in our classrooms with the closing plenary entitled "Using the CATME SMARTER Teamwork System to Support Team-Based Learning".

During registration, you'll have a lot of options to tailor the annual meeting experience to your TBL needs and goals. Choose from 14 TBL workshops in three concurrent sessions, and explore the latest findings in TBL implementation and research at the poster session! Three "Best Poster" awards will be presented at the business meeting on Saturday.
We look forward to seeing you in St. Petersburg in March!

Click here to visit tblcmeeting.org

Wayne McCormack
University of Florida
President, TBLC

International Interest in TBL

Larry Michaelsen, PhD

TBL is growing worldwide at a rate that is quite remarkable. Educators and administrators are realising the tremendous benefits that TBL offers in terms of student engagement and proven learning outcomes. As a result, since I officially retired last May, I have been travelling very widely delivering TBL workshops around the world. In just the last 6 months I've worked with faculty in the US, Chile, Colombia, Netherlands, Denmark, Norway, Singapore, UK and Australia. During these visits, I have delivered workshops to mixed-discipline faculty groups as well as specific faculties including engineering, pharmacy, medicine and education and even to the national training staff of the Boy Scouts of America, and to primary and secondary teachers at the Singapore Ministry for Education.

One of the memorable experiences from my visits to all these countries was to observe the implementation of TBL in a Singapore normal school seventh grade math class. What struck me in particular was to see a student with ADHD in that TBL class who became engaged with math to the point where he was able to tutor other students. Another example of the power of the TBL process was the observation by Bradford University (UK) that after the school-wide introduction of TBL, student requests for two different kinds of support had been dramatically reduced. One was that requests for support from the disability office for special accommodations (e.g. extra time for exams, a quiet test-taking environment, etc.) had almost completely disappeared; students with disabilities didn't need extra help. The other was that student requests for individual tutoring support in relation to their coursework had almost vanished altogether.

Another very interesting project that I have been working on is the introduction of TBL across the University of South Alabama. This is being done as a very well-planned and well-implemented change process that started in 2011, and is progressing well in meeting the objectives of improving student retention and improved learning. This process and the outcomes are being well documented in a paper that will soon be available. For example, dropout rates in the over 150 classes taught with TBL were less than half of the rates in comparable non-TBL courses and there were 38% fewer D's and F's and higher critical thinking scores. I think that the experience documented in the paper will provide a very good model for other institutions that want to address the very universal challenges in improving student learning and classroom experience.


A Process for Providing Feedback to Faculty About TBL Modules

Amy Lin, MD
Abbas Hyderi, MD, MPH
Janet Riddle, MD
University of Illinois College of Medicine at Chicago

At the University of Illinois College of Medicine at Chicago, we first introduced Team-based learning (TBL) into the preclinical curriculum in academic year 2011-2012. We started with two modules generously provided by Wright State University Boonshoft School of Medicine. As course directors and faculty became more familiar with and willing to try TBL, the number of modules delivered markedly increased to 22 in academic year 2013-14. Some modules were homegrown, and others, adapted from existing modules. As novice practitioners of TBL, the quality of our modules was variable, so we developed a process for providing feedback to faculty about module quality.

Method: In AY2013-14, all TBL modules in the preclinical curriculum were submitted for peer review to two individuals at least three weeks prior to the scheduled TBL date. Reviewers provided narrative feedback using track changes about: quality of learning objectives, readiness assurance test (RAT) questions, and application exercises; nature of the preparatory material; and alignment of all components with one another. Reviewers had one week to complete their review, giving faculty one week to respond and make changes, so the module could be finalized for printing one week prior to the scheduled date.  

Lessons learned:
  1. When starting TBL in your program, one should have a process for providing feedback to faculty about module quality. A skilled facilitator cannot make up for a poorly constructed module. The feedback process provides a means for faculty development not only in TBL construction, but also for writing learning objectives and multiple-choice items, and constructing independent learning assignments.
  2. It takes a team of people to complete the task of providing feedback because the workload is significant. It took us an average of 6-10 hours to complete one review, so having two individuals each reviewing 22 modules was not sustainable.
  3. Hold faculty accountable for review submission deadlines or consider a longer time frame to review. When faculty were told to submit three weeks prior to the scheduled TBL date, they actually submitted their modules 1-2 weeks in advance, which was insufficient time for an adequate review.
  4. Having the entire module in one document with explanatory notes is helpful for reviewers. We developed a template for faculty to fill in that includes a lesson plan, advance assignment, learning objectives, RAT, and application exercises. In addition, we provide spaces for faculty to indicate the linked learning objective(s) and explain key concepts for each RAT question and application exercise.

Future directions: We continue to modify our process for providing feedback on module quality, and are currently working with the Educational Development Committee (EDC) and other members of the TBLC to develop a rubric for assessing module quality. Another major pitfall in TBL implementation is poor facilitation. We are developing a process for providing feedback to faculty on facilitation of the session, which also involves working with the EDC and other TBLC members to develop a rubric for facilitation.



Team-Based Learning and Undergraduate Anatomy: A Good Match

Sarah Leupen, PhD
University of Maryland

Team-Based Learning has often been used to teach anatomy and physiology courses in medical school and at other graduate schools in the health professions, but these courses are still uncommon in undergraduate programs. I have found TBL to be a perfect fit for this topic and level.

The Anatomy and Physiology courses at UMBC, like at many institutions, are a two-semester, sophomore-level biology courses taken primarily by pre-health students. The 100 or so students that enroll each semester are equally distributed among those planning careers in nursing, physical therapy, pharmacy and medicine. The TBL version of the course is divided into seven units, each of which begins with a Readiness Assessment Test (IRAT and TRAT) and ends with an application exercise. Teams are fixed and students are given required readings before class which are the basis for the RAT.

Application activities, an integral part of each module, are structured using "4S" principles and emphasize the most challenging goals for each unit. Each application activity is projected on slides to be reviewed by the teams. I have learned the following lessons about designing effective application activities which may be helpful to other faculty teaching undergraduate TBL courses:

  1. Use relatively simple clinical applications to provide significant, specific-choice problems. For example: You're in the dentist's chair, awaiting your root canal. The dentist pauses, needle in hand. "Which cranial nerve should I block?" she asks.

  2. After teams use voting cards to indicate their choices, have them place the cards on stands (such as seating places at a wedding might be marked) so everyone can see and remember each team's choice.

  3. When facilitating team discussions choose individuals randomly during facilitation to report their team's reasoning. This prevents one or two students from becoming the team's spokesperson or spokespeople, and forces weaker or less focused students to work to understand the team's answer and reasoning.

  4. Application exercises should be kept short. A long, complex problem can be broken up into smaller pieces. This keeps the teams on track and minimizes chatter about their weekends, as students usually have only 2-3 minutes for each problem or piece of the problem.

  5. "Significant" doesn't always mean "Realistic." Some of my best applications-meaning, those that produce the best within-team and between-team discussion-are my "Alien Ray Gun" questions, in which a pictured cartoon alien threatens to vaporize one of various cell types within a tissue, tissues within an organ, or organs within an organ system, but kindly allows the victim to choose which. Choosing between types of T lymphocytes, for example, or whether to vaporize their stomach or colon, teams become highly invested in their answers while at the same time learning the nitty gritty functional relevance of each cell type or organ - which is, of course, the point!

  6. Direct competition among teams is a useful tool. Often, the times of highest enthusiasm and participation in my classroom are the ten-question "For the Pie" competitions, usually held shortly before individual exams, in which student teams compete on a series of short, tough questions to win homemade pie baked by the instructor. Although the "For The Pie" times are not advertised, students learn to predict them and often seem to study harder for them than for the actual test!

  7. This approach has, over three years, been highly successful. The DFW rate (percent of students receiving Ds or Fs or withdraw from the course) is very low since TBL was implemented, less than 5% per year, versus 15-30% before using TBL. Student satisfaction is high, based on both official student evaluations and mid-course anonymous surveys. When compared to lecture, students give the TBL course significantly higher ratings for both how much they learned as well as the instructor's overall teaching effectiveness.

A pre-posttest is given in each semester for the TBL course. Results reveal that students more than double their knowledge each semester. Additionally, students retain more material from A&P 1 than students who took the course the same year in a lecture format.

The major benefit that TBL provides is the time to explore complex and interesting problems in class with your students. By keeping the organization and flow tight and focused while allowing for misconceptions and messiness to flow freely during facilitation, the course allows students to get confused (a state that is all too lacking in lectures) in an environment that facilitates the transformation of that confusion into new understanding - learning!



TBL vs. Lecture: An Exploration of Student Test Data

Coral Wayland
Angie Ferrara
Lisa Walker

University of North Carolina at Charlotte

In Fall 2012 the first author converted a large (100-150 student) general education course from a lecture based class to a TBL formatted course. This shift entailed restructuring how class time was used and content was delivered, but the content remained the same. Students in both the lecture and TBL classes were assigned the same readings. Additionally, material that had been covered during class in the lecture format (lectures and videos) was delivered outside of class in the TBL format using podcasts, lessons in Moodle, and online access to videos. Students in both formats took the same exams with the same objective (multiple choice, true/false) questions. The TBL sections followed best practices: students were placed on permanent teams; the readiness assessment process was completed for each unit; this was followed by application exercises; and peer feedback was given throughout the semester.

A comparison of test question data after 3 TBL semesters revealed that students in lecture sections got 78% of questions correct while students in TBL sections got 81% of questions correct (this difference was significant). The first author was interested in exploring where this improvement came from and wondered what methods of content delivery in lecture based classes were more or less effective than in a TBL class? For example, did students in TBL sections have a better grasp of material that had previously only been assigned outside of class (e.g. a reading not covered in lecture)? Did they fare worse on material that used to be delivered via lecture because they now reviewed it on their own?

Working with two colleagues, Lisa Walker and Angela Ferrara, we explored this issue by comparing the percentage of students who correctly answered objective (multiple choice/TF) exam questions in these two learning environments (lecture vs. TBL). We analyzed student exam data collected over five semesters. Two of these semesters were lecture based (340 students total). Three semesters were taught using TBL (356 students total). One hundred and one test questions remained constant over these 5 semesters and these were included in our analysis. The first author determined the correct answers and developed a key that was used to machine score the questions.

Questions were categorized based on how students in the lecture based course received the information contained in the question. A test question was categorized as:

  • "In-class content delivery" if students were only exposed to the information during face-to-face class time.

  • "Self-directed/outside of class" if students were only exposed to the information outside of class.

  • "Both" if the information in the test question was covered during face-to-face class time and in a resource students were expected to review outside of class.

Note, questions were not classified based on how content was delivered in TBL sections because all content was initially delivered outside of class. Class time was then spent engaging in the Readiness Assessment Process and application exercises.

The analysis revealed that regardless of how content was delivered in the lecture section, TBL students had higher scores. All differences were statistically significant. Students exposed to TBL scored higher (81%) on the in-class content delivery questions than students in lecture (79%) (t = 1.819, p = 0.035). Students exposed to TBL got 78% of the self-directed/outside of class questions correct, while students in the lecture sections got 72% correct (t = 5.749, p<0.001). Finally, TBL students scored higher (86%) than lecture students (83%) on questions categorized as both (t = 2.261, p = 0.012). These results suggest TBL can be as effective, if not more effective, than lecture based pedagogy.



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1) innovative ideas that have been applied to TBL, and
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