Does Participation in Team-Based Learning Affect Medical Students’ Longer-Term Learning?

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PURPOSE Several studies have evaluated learning outcomes of students who participate in team-based learning (TBL) in health professions curricula, focusing primarily on short-term effects on academic performance in single disciplines (anatomy, pathology, pharmacology, psychiatry). 1-4 Evidence of longer-term learning outcomes associated with TBL in integrated curricula is needed.

METHODS The performance of 22 second-year medical students (11 males, 11 females) on two examinations was evaluated. The pre-test consisted of 100 questions in 9 domains: physiology, pathology, and pharmacology of cardiovascular (n=34), respiratory (n=34) and renal (n=32) systems. Students took the pre-test before a 10-week block of integrated courses in these 3 systems. Seven interdisciplinary TBL modules were included in this block. A post-test, consisting of the same 100 questions, was administered 8 weeks after the end of the 10-week block. Pre-test vs. post-test performance was compared for subsets of 50 questions related to TBL module content (TR) vs. 50 questions unrelated to TBL module content (TU).

RESULTS There was no significant difference in pre-test mean scores for TR vs. TU questions (32.9% vs. 34.7%, p=0.319). Comparison of post-test vs. pre-test mean scores showed significant improvement for both TR and TU questions (TR: 32.9% vs. 59.9%, p<0.001; TU: 34.7% vs. 52.1%, p<0.001. Improvement between pre-test and post-test mean scores for TR questions was significantly greater than for TU questions (TR: +27.0% vs. TU: +17.4%; p<0.001).

CONCLUSIONS 1. Pre-test difficulty of TR vs. TU questions was similar (no inherent differences in item difficulty). 2. Students’ improvement in performance on both TR and TU questions at 8 weeks after the cardiovascular-respiratory-renal course block suggests both gain and retention of knowledge. 3. The larger improvement in post-test scores for TR vs. TU questions suggests a learning benefit associated with TBL that persists at least 8 weeks after courses in which TBL was used