Robert P Drucker, MD - Duke University; James W Fox, MD - Duke University; Joseph A Jackson, MD - Duke University; Kathleen A McGann, MD - Duke University
Background: The lecture format used in clerkships to present a core curriculum is inconsistent with accepted adult learning principles. Team based learning (TBL) has been effective in undergraduate education and is being used increasingly in medical schools. Our clerkship is based on the COMSEP curriculum and students are required to work through the Computer-assisted Learning in Pediatrics Program (CLIPP) cases.
Objectives: 1) Use resources available through CLIPP to transition from student presentations to TBL sessions. 2) Compare student performances on objective examinations. 3) Review student satisfaction with learning techniques.
Methods: During the 2007-2009 academic years, each student (average 20 students/block with 5 blocks/year) presented a CLIPP case to classmates. For academic years 2009-2011, TBL was introduced using 3 CLIPP cases for the preparatory work for each of 5 weekly sessions. Questions from the CLIPP test bank were used for the readiness assessments for each TBL session. All students took 3 objective tests as part of this study: 1) pre-clerkship test, 2) post-clerkship test, and 3) CLIPP final exam. The pre- and post-clerkship tests consisted of additional questions from the CLIPP test bank. Performances on these three tests were compared for the time periods before and after the switch to TBL. In addition, student comments about the lecture series (2007-9) were compared to those for the TBL sessions (2009-11).
Results: There were no significant differences in pre-clerkship, post-clerkship, or final exam scores (47.5% vs. 48.2%, p=0.32; 72.9% vs. 71.6%, p=0.14; 78.8% vs. 78.1%, p=0.19, respectively) for the times before and after initiation of TBL. In the pre-TBL era, students found value in preparing their talks, but not in listening to classmates. Comments from the TBL period included appreciation for the interactive nature of the TBL sessions and the opportunity to practice CLIPP test questions.
Conclusions: The materials provided by CLIPP decreased the workload to transition to TBL. There were no objective changes in student performance with the switch to TBL, despite the decrease in number of CLIPP cases discussed formally. Students were more actively engaged during TBL than when listening to classmate presentations.