Meta-analysis on the effectiveness of team-based learning on medical education in China.
ABSTRACT: Team-based learning (TBL) has been adopted as a new medical pedagogical approach in China. However, there are no studies or reviews summarizing the effectiveness of TBL on medical education. This study aims to obtain an overall estimation of the effectiveness of TBL on outcomes of theoretical teaching of medical education in China.We retrieved the studies from inception through December, 2015. Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Wanfang Database, Chinese Scientific Journal Database, PubMed, EMBASE and Cochrane Database were searched. The quality of included studies was assessed by the Newcastle-Ottawa scale. Standardized mean difference (SMD) was applied for the estimation of the pooled effects. Heterogeneity assumption was detected by I2 statistics, and was further explored by meta-regression analysis.A total of 13 articles including 1545 participants eventually entered into the meta-analysis. The quality scores of these studies ranged from 6 to 10. Altogether, TBL significantly increased students' theoretical examination scores when compared with lecture-based learning (LBL) (SMD?=?2.46, 95% CI: 1.53-3.40). Additionally, TBL significantly increased students' learning attitude (SMD?=?3.23, 95% CI: 2.27-4.20), and learning skill (SMD?=?2.70, 95% CI: 1.33-4.07). The meta-regression results showed that randomization, education classification and gender diversity were the factors that caused heterogeneity.TBL in theoretical teaching of medical education seems to be more effective than LBL in improving the knowledge, attitude and skill of students in China, providing evidence for the implement of TBL in medical education in China. The medical schools should implement TBL with the consideration on the practical teaching situations such as students' education level.
Project description:BACKGROUND:Recent years have witnessed the wide application of team-based learning(TBL) pedagogy in Chinese pharmacy education. However, the relevant systematic review evaluating the effects of such new pedagogical approach has not been established. The present study was designed to examine systematically the effect of using TBL approach in pharmacy education in China. METHODS:Six databases were searched from the inception to January 2019. The studies reporting the performance of pharmacy students in Chinese university or college receiving TBL pedagogy compared to those receiving traditional lecture-based learning (LBL) were enrolled to be analyzed. Scores of the objective theoretical test were considered as the primary outcome, and the results from questionnaires about the number of students who approved the effects of TBL pedagogy on improving their learning enthusiasm, self-study ability, thinking ability, and communication skills were considered as the secondary outcome. A meta-analysis was conducted following the guidelines of the Cochrane Reviewer's Handbook and the Preferred Reporting Items for Systematic Reviews and Meta Analyses statement. RESULTS:A total of 1271 students in 12 studies published from 2013 to 2018 were enrolled in present analysis. Compared with traditional LBL pedagogy, TBL pedagogy exhibited more effectiveness in developing the objective tests scores of pharmacy students from both universities (SMD = 1.69, 95% CI [1.10, 2.28], p < 0.00001) and colleges (SMD = 4.37, 95% CI [1.33, 7.40], p < 0.00001), and such pedagogy applied well in experiments-oriented courses (SMD = 2.14, 95% CI [0.86, 3.43], p < 0.00001) and theory-oriented courses (SMD = 2.77, 95% CI [1.41, 4.14], p < 0.00001). In addition, it developed students' learning enthusiasm, students' self-study ability, thinking ability, and enhanced students' communication skills. CONCLUSIONS:TBL pedagogy has developed rapidly and applied widely in Chinese pharmacy education during the last decade. The results indicated that such novel pedagogy is compatible with the present situation of Chinese pharmacy education. And it could be considered as an effective method to enhance both the theoretical test scores and various abilities of Chinese pharmacy students.
Project description:BACKGROUND:Problem-based learning (PBL) combined lecture based learning (LBL) has been a trend adopted as a new medical pedagogical approach in Chinese medical teaching. This study aims to evaluate the impacts of hybrid PBL and LBL pedagogy compared with LBL teaching method on the learning achievements of clinical curriculum for Chinese medicine students. METHODS:Randomized controlled trials (RCTs) were identified through a systematic literature search of electronic databases and article references up to June 2019. PubMed, EBSCO, Web of Science, Cochrane Library, Wanfang Database, CNKI, and China Biology Medicine database (CBM) were searched. End points included knowledge scores, skill scores, medical writing scores, comprehensive ability scores and teaching satisfaction. RESULTS:Totally 20 randomized controlled studies were finally included and all Chinese literatures, involving 1817 patients. Compared with traditional LBL pedagogy, hybrid PBL and LBL pedagogy significantly increased the clinical theoretical knowledge assessment score (RR?=?4.84, 95% CI: 2.92?6.76, P?<?.00001), clinical skills assessment score (RR?=?1.60, 95% CI: 1.39?1.81, P?<?.00001), comprehensive ability score (RR?=?9.13, 95% CI: 8.42?9.84, P?<?.00001) and teaching satisfaction (RR?=?2.58, 95% CI: 1.84?3.62, P?<?.00001), The meta-regression results showed that expertise-level of students and course type were the factors that caused heterogeneity. CONCLUSIONS:Hybrid PBL and LBL pedagogy integrates the advantages of conventional teaching methods and novel teaching methods, remarkably improves the teaching efficacy, demonstrates easy acceptance by students, and meets the demand of modern medical education, so it is an effective approach to cultivate the medical talents with an ability of innovative thinking and can be advocated and popularized as a teaching means.
Project description:OBJECTIVE:At present, current didactic teaching delivery method help nursing students apply theory to clinical situations in an inefficient way. The flipped classroom (FC), a novel teaching mode emphasizing self-study and critical thinking, has generated interest in nursing education in China. However, there are a gap in the literature and no consistent outcomes of current studies which compared FC and lecture-based learning (LBL), and no systematic review has comprehensively compared theoretical scores as an affected outcome in FC versus LBL modes. METHODS:In this review, we analyze flipped-learning nursing students' scores, and aim to assess the efficacy and provide a deeper understanding of the FC in nursing education. Following the inclusion criteria, articles were obtained by searching PubMed, Embase and Chinese data, including the China National Knowledge Infrastructure, Wanfang Data, and VIP database until 3 January 2020. Data were extracted from eligible articles and quality was assessed. A meta-analysis was then performed using a random effects model with a standardized mean value (SMD) and a 95% confidence interval (CI).32 studies were included after reviewing 2,439 citations. All studies were randomized controlled trials (RCTs). The FC theoretical knowledge scores in FC were significantly positively affected compared to those of the traditional classroom (SMD = 1.33, 95% CI: 1.02-1.64; P < 0.001). In addition, 23 studies reported skill scores, indicating significant difference between the FC mode and LBL mode (SMD = 1.58, 95%CI: 1.23-1.93; P < 0.001). CONCLUSIONS:The results of this meta-analysis suggest that compared to the LBL teaching method, the FC mode dose significantly improve Chinese nursing students' theoretical scores. However, the problems of heterogeneity and publication bias in this study need to be remedied high-quality future studies.
Project description:BACKGROUND:The educational environment has been confirmed as crucial factor for active learning. Team-based learning (TBL) is an interactive teaching method which improves students' perceptions and performance. OBJECTIVES:The comparison of the team-based learning method through lecture-based approach on health education curriculum in public health students. METHODS:A quasi-experimental study was conducted among 23 public health students of bachelor degree and 14 public health students of associate degree to teach communication and Health Education in Qom University of Medical Sciences from January 2015 to Jun 2016. Students of bachelor degree selected TBL and students of associate degree preferred the traditional lecture-based method. In the current study, educational outcomes were defined as educational environment and academic performance. At the last session of the semester, the educational environment and academic performance of both groups were evaluated. Data were analyzed by SPSS version 20.0 using Chi-square and Mann-Whitney test. RESULTS:The mean and standard deviation of individual test score between the two groups showed significant difference based on Mann-Whitney results (P = 0.036). The mean of final examination score in TBL group was significantly higher than the traditional lecture group (P < 0.021, Mann-Whitney). Our findings showed that in TBL group, 78.3% of students' perceptions were in very favorable condition while it was only 28.6% for students of the traditional method. CONCLUSIONS:TBL method improves students' perceptions about each area of educational atmosphere and also provides opportunities to innovate which lead to active teamwork among learners, and it can effectively enhance students' academic performance.
Project description:BACKGROUND:Recently, flipped classrooms (FCs) have gradually been used in Chinese higher education settings. However, few studies have focused on the effects of FCs on interdisciplinary curricula. The purpose of this study was to examine the impact of an FC on the engagement, performance, and perceptions of students and on teacher-student interaction in a pharmaceutical marketing course. DESIGN:A clustered randomized controlled study was conducted, with 137 junior-year pharmacy undergraduates using an FC serving as the intervention group, in contrast to students using lecture-based learning (LBL) as the control group. Flanders' interaction analysis system (FIAS) was used to measure teacher-student interaction, and questionnaires regarding attitudes toward and satisfaction with the teaching model were administered. RESULTS:The students in the FC group scored significantly higher than those in the LBL group (88.21±5.95 vs. 80.05±5.59, t = -8.08, p = 0.000) on pharmaceutical marketing. The multiple linear regression results showed that the FC model had a significant impact on student performance (? = 8.16, p<0.0001). The percentages of teacher talk in the FC and LBL groups were 21% and 96%, respectively (?2 = 2170.274, p = 0.000); however, the percentages of student talk in the FC and LBL groups were 75% and 2.6%, respectively (?2 = 2012.483, p = 0.000). Compared with the LBL group, most students in the FC group held more positive attitudes toward the teaching model; the mean scores for the 8 attitude attributes in the FC group were significantly higher than those in the LBL group (p = 0.000). There were significant differences in the ratings of satisfaction with teacher-student interaction (p = 0.000), the students' learning attitude (p = 0.000), the teacher's preparatory work (p = 0.000), the teaching objective (p = 0.000), and the teaching effect (p = 0.000) between the two groups. CONCLUSION:Compared with LBL methods, implementing the FC model improved student performance, increased teacher-student interaction and generated positive student attitudes toward the experience. As an effective pedagogical model, it can also stimulate pharmacy students' learning interest and improve their self-learning abilities.
Project description:Team-based learning (TBL) is used in undergraduate medical education to facilitate higher-order content learning, promote learner engagement and collaboration, and foster positive learner attitudes. There is a paucity of data on the use of TBL in graduate medical education. Our aim was to assess resident engagement, learning, and faculty/resident satisfaction with TBL in internal medicine residency ambulatory education.Survey and nominal group technique methodologies were used to assess learner engagement and faculty/resident satisfaction. We assessed medical learning using individual (IRAT) and group (GRAT) readiness assurance tests.Residents (N = 111) involved in TBL sessions reported contributing to group discussions and actively discussing the subject material with other residents. Faculty echoed similar responses, and residents and faculty reported a preference for future teaching sessions to be offered using the TBL pedagogy. The average GRAT score was significantly higher than the average IRAT score by 22%. Feedback from our nominal group technique rank ordered the following TBL strengths by both residents and faculty: (1) interactive format, (2) content of sessions, and (3) competitive nature of sessions.We successfully implemented TBL pedagogy in the internal medicine ambulatory residency curriculum, with learning focused on the care of patients in the ambulatory setting. TBL resulted in active resident engagement, facilitated group learning, and increased satisfaction by residents and faculty. To our knowledge this is the first study that implemented a TBL program in an internal medicine residency curriculum.
Project description:Introduction:Current medical education promotes enhanced integration of various disciplines and early exposure to clinically relevant topics. Against this background, we have developed a team-based learning (TBL) module for medical students in the preclerkship period that integrates embryology, anatomy, and radiology of the head and neck region. Methods:The module, which includes prereading assignments, readiness assurance tests, and an application exercise, focuses on the development of the head and neck region. Students were asked to consolidate their knowledge of the topic-acquired as part of their regular curriculum-and to apply this knowledge to cases of cervical cysts and cleft lip/palate. Results:The TBL module was developed for a class of 234 students. The students performed well in the TBL module. Although many students perceived the session as time-consuming, the majority of students evaluated it as relevant for their understanding of the course material and a valuable adjunct to their course. Discussion:To our knowledge, as of this writing, no TBL modules have been published that focus on the integration of complex embryological topics with anatomy and radiology and that are suitable for medical students at the beginning of their education. Therefore, the presented TBL module fills a gap in material available to educators in the field.
Project description:As part of an undergraduate pipeline program at our institution for students from underrepresented minorities in medicine backgrounds, we created an intensive four-week medical microbiology course. Team-based learning (TBL) was implemented in this course to enhance student learning of course content. Three different student cohorts participated in the study, and there were no significant differences in their prior academic achievement based on their undergraduate grade point average (GPA) and pre-course examination scores. Teaching techniques included engaged lectures using an audience response system, TBL, and guided self-directed learning. We hypothesized that more active learning exercises, irrespective of the amount of lecture time, would help students master course content. In year 2 as compared with year 1, TBL exercises were decreased from six to three with a concomitant increase in lecture time, while in year 3, TBL exercises were increased from three to six while maintaining the same amount of lecture time as in year 2. As we hypothesized, there was significant (p < 0.01) improvement in performance on the post-course examination in years 1 and 3 compared with year 2, when only three TBL exercises were used. In contrast to the students' perceptions that more lecture time enhances learning of course content, our findings suggest that active learning strategies, such as TBL, are more effective than engaged lectures in improving student understanding of course content, as measured by post-course examination performance. Introduction of TBL in pipeline program courses may help achieve better student learning outcomes.
Project description:BACKGROUND: Medical education curricula in developing countries should emphasize training in health research. This study compares the knowledge and attitudes towards health research between undergraduate medical students undertaking Problem Based Learning (PBL) versus conventional Lecture Based Learning (LBL). METHODS: Two groups comprising 66 (LBL) and 84 (PBL) 4(th) and 5(th) year students from the medical college of Aga Khan University were administered a structured and validated questionnaire. Knowledge and attitudes of the two groups were recorded on a scale (graduated in percentages) and compared for statistical difference. RESULTS: PBL students scored 54.0% while LBL students scored 55.5% on the knowledge scale [p-value; 0.63]. On the attitudes scale, PBL students scored 75.5% against a 66.7% score of LBL students [p-value; 0.021]. A higher proportion of PBL students (89%) had participated in research activities compared to LBL students (74%) and thus felt more confident in conducting research and writing a scientific paper. CONCLUSION: The PBL students showed slightly healthier attitudes towards health research compared to LBL students. Both groups demonstrated a similar level of knowledge about health research. The positive impact of the PBL curriculum on attitudes of medical students towards health research may help in improving research output from developing countries in future.
Project description:PURPOSE: Previous studies on team-based learning (TBL) in medical education demonstrated improved learner engagement, learner satisfaction, and academic performance; however, a paucity of information exists on modifications of the incentive structure of "traditional" TBL practices. The current study investigates the impact of modification to conventional Group Application exercises by examining student preference and student perceptions of TBL outcomes when Group Application exercises are excluded from TBL grades. METHODS: During the 2009-2010 and 2010-2011 academic years, 175 students (95.6% response rate) completed a 22-item multiple choice survey followed by 3 open response questions at the end of their second year of medical school. These students had participated in a TBL supplemented preclinical curriculum with graded Group Application exercises during year one and ungraded Group Application exercises during year two of medical school. RESULTS: Chi-square analyses showed significant differences between grading categories for general assessment of TBL, participation and communication, intra-team discussion, inter-team discussion, student perceptions of their own effort and development of teamwork skills. Furthermore, 83.8% of students polled prefer ungraded Group Application exercises with only 7.2% preferring graded and 9.0% indicating no preference. CONCLUSION: The use of ungraded Group Application exercises appears to be a successful modification of TBL, making it more "student-friendly" while maintaining the goals of active learning and development of teamwork skills.