The Bar-Ilan University
School of Medicine in the Galilee
Team Based Learning
Dr. Nomy Dickman
Head of Assessment and Teaching Development Unit
Education for the 21st century: Multiculturalism, children’s
rights and global citizenship
30.6.2015
October
2011
1949
February
The opening
2011
Old Hadassah
Hospital
3
The context
• Recognizing
, especially for medical students in the
periphery,
on understanding and promoting
• The role of physicians in reducing health gaps
• TBL, a method that promotes practical problemsolving in teams - was one of the approaches
used
Practical ideas for reducing the gap.
• .
Understanding the issue of inequality
in health
and developing social commitment
to reduction of gaps in health, using
Team Based Learning
The case of public health course at the
Faculty of Medicine in the Galilee, in
Israel.
Mary Rudolf
Professor of Public Health
Faculty of Medicine in the Galilee Bar Ilan University ISRAEL
Tsfat
What is TBL?
Team Based Learning
• Team Based Learning was developed in the 1970’s by
Dr. Michaelsen, a Professor of Management at the
University of Oklahoma
• His goal: to change the passive learning in his lectures
into active learning by testing and assigning students
to teams.
Team Based Learning
What is TBL?
It’s an active learning method that is learner centered
but instructor led (Koles et al. 2010).
Why use TBL?
It fosters individual and group accountability as groups of five to seven
students work together to solve clinical problems (Hrynchak & Batty, 2012)
. to do TBL?
In what setting to use TBL?
This method is used for large classes that are divided into smaller groups
(referred to as teams) that have maximal diversity within the teams but
relative evenness between the teams.
Team Based Learning
Active Learning
Active Learning
I hear and I forget.
I see and I remember.
I do and I understand.
(Confucius, 551 BC - 479 BC)
Professor Moshe Kaveh
President of Bar Ilan
University 2011
What is TBL?
Team-Baased Learning Process
Phase 1
Phase 2
Phase 3
Preparation
(Pre-class)
Readiness Assurance
(In-class)
Application of Course
Concepts
Individual Study
Instructor
Feedback
Small Group
Assignments
Group
Test
Team
Appeals
Individual
Test
Individual
Work
X
Small Group
Discussion
X
scratch card
Total Class
Discussion
=
Impact on
Learning
Duke School of Medicine embraces
Team-Based Learning
http://youtu.be/gW_M426V2E0
1.27 :‫סיום‬
2.16
What is TBL?
Team Based Learning
Team Based Learning is a
small learning group
method where individual
work is done outside the
class and team work is
completed in class.
What is TBL?
Team-Based Learning
Course Objectives
By the end of the course, the student will be able to:
•
Master the course subject matter
Similar to
•
Utilize the course concepts in thinking
lecturing
and problem-solving
•
Develop interpersonal and group interaction skills
•
Prepare for life-long learning
Meets LCME guidelines
http://www.amaassn.org/resources/doc
/council-on-med-ed/a08cmerpt3.pdf
Purpose of Team-based learning
*From Baylor College of Medicine, Team Learning in Medical Education, February 04 Workshops
Liaison Committee on Medical Education
What is TBL?
Team-Baased Learning Process
Phase 1
Phase 2
Phase 3
Preparation
(Pre-class)
Readiness Assurance
(In-class)
Application of Course
Concepts
Individual Study
Students read the
Israeli Medical
Association
document on
inequalities in health
Group
Test
?
Team
Appeals
Individual
Test
http://www.ima.org.il/Ima/FormSt
orage/Type1/epstein_report.pdf
Individual
Work
Small Group
Assignments
Instructor
Feedback
X
Small Group
Discussion
X
reconvene
AS BIG
GROUP
assignment
about "lack of
Groups
balance in
Diabetes" in four rapporteur
s
cultural groups
Total Class
Discussion
?
=
Impact on
Learning
Individual
Test
Good Scores
2012: N=65
AVG 82.24
2013: N= 60
AVG 84.00
Phase 2
Phase 2
Group Test
Teaching Assistant
• What was the uniqueness of the
TBL’s teaching method
• What was the TBL’s
contribution to understanding
inequality in health
Jumanah Essa - Hadad
• Jumanah1 (1).wmv
Team applied problem-solving exercise
Students perform an assignment
about "lack of balance in Diabetes"
Four cultural groups:
•
•
•
•
Arab
Haredi
Ethiopian immigrants
Jews living in poverty
The assignment
includes discussion in
teams about
 The social causes to
the phenomenon
 The doctor duty for
the patient
 The community and
the State liability for
reducing the gaps
20
Phase 3
Group
Application of Course Concepts
Why use TL?
The Student TBL Advantages
Motivated to Attend
Applies Knowledge
-Offered alternative to
large lecture classes
-Becomes part of a team
-Achieves higher-level cognitive skills
-Learns basic concepts and
experiences their application in
assignments
Participates Actively
in Education
Develops Interpersonal skills
-Acquires life-long skills
-Engages students who
prefer to work alone
-Assists “at risk” students
-Student learn about themselves in
collaborating with others on tasks
-Students learn to work as a team to
accomplish difficult intellectual tasks
The Student TBL Advantages
• TBL is effectively grounded in constructivist
learning theory.
Students apply their knowledge to solving
clinically relevant problems by working actively
in effective teams.
TBL contributes to develop skills that healthcare
professionals need:
critical thinking and teamwork skills.
HRYNCHAK & BATTY, 2012
24
Professional authenticity
A SIMPLE MODEL OF COMPETENCE
Does
Behaviour
Shows how
Knows how
Knows
Miller GE. The assessment of clinical skills/competence/performance.
Academic Medicine (Supplement) 1990; 65: S63-S7.
Cognition
How to do TBL?
Change Your Teaching Role
From “Sage on the Stage,”
and disseminating information
to “Guide on the Side,”
and asking open-ended questions
to prompt the team to find the information
Flipped
Classroom
L
L
L
Summary
What is TBL?
What makes TBL?
Why use TBL?
How to do TBL?
• Team Based Learning is a small learning group
method where individual work is done outside the
class and team work is completed in class.
• The four principles of TBL are (1) properly formed
and managed groups, (2) student accountability,
(3)team assignments that promote learning, group
interaction and team development, and (4) frequent
and immediate feedback to students.
• The rationale for using TBL is that it is a good
interactive alternative to passive lectures, requires no
extra facilities or faculty, develops interpersonal skills
and assists “at risk” students.
• Implementation of TBL involves planning before the
class, forming groups in the 1st class and reminding
the students of the learning objectives, content
application and team work near the end of the class.
Students’ Evaluation of the
Teaching/Learning Method
• A teaching survey, attitude
questionnaire and focus group
were held to evaluate the method.
• Data analysis was quantitative and
qualitative.
28
Results
Students rated the Group Facilitator very high:
4.80; 4.64; 4.60; 4.13
(2nd cohort; five-rank-scale).
29
Results and Conclusion
TBL was well received, particularly in the first
cohort of students.
Students rated the method as deepening their
understanding of written material
(1st cohort: 4; 2nd cohort: 3.7; five-rank-scale).
However they failed to see its value in contributing
to their skills as doctors
(1st cohort: 3.4; 2nd cohort: 2.3; five-rank-scale).
30
Results and Conclusion
Focus groups provided insights into how
the approach can be improved.
TBL has potential as a teaching method to
encourage students to read in depth, test
their knowledge and work in teams.
31
Group Facilitator
What was the TBL’s unique contribution to
• Understanding the doctor’s rule
• The team applied problem-solving
exercise?
Jumanah Essa - Hadad
Jumanah (2).wmv
Sivan Spitzer Shohat
sivan (2).wmv
‫‪,‬‬
‫סה"כ‬
‫מידת שביעות רצוני מהלמידה מבוססת צוות‬
‫(‪)TBL‬‬
‫‪4.55‬‬
https://ipecollaborative.org/Recommended_Lin
ks.html
‫• מהו הערך המוסף שהייתה ללמידת הנושא‬
‫(מיומנויות לעבודה בצוות רב‪-‬מקצועי) בשיטת ‪TBL‬‬
‫על למידה מסורתית במליאה?‬
‫•‬
‫‪18.2.15‬‬
‫•‬
‫שיחת סיכום של ד"ר סרור עם הסטודנטים בסבב רפואת משפחה (סבב ‪)4‬‬
‫•‬
‫מה דעתכם על שיטת הלימוד ‪ ?TBL‬אחלה‬
‫•‬
‫בקשות‪:‬‬
‫•‬
‫רוצים מצגת סיכום הנושא הנלמד באותו היום‬
‫•‬
‫ייתרון – ייחודיות‬
‫•‬
‫כל הזמן מרוכזים במשימה‪ :‬קוראים‪ ,‬פותרים‪ ,‬מחייב להתרכז במשימה‬
‫•‬
‫הדגישו שבשיטה זו הם חייבים להכין וללמוד מקודם‪ .‬באים מוכנים‬
‫•‬
‫•‬
‫ד"ר סרור‪ :‬חוותדעתו על ההוראה והלמידה בשיטת ‪TBL‬‬
‫•‬
‫בהתחלה חששתי‪ ,‬בגלל שאף פעם לא היה לי ניסיון בלימוד ובהוראה בשיטה זו‪.‬‬
‫•‬
‫אחרי ניסיון של ‪ 4‬סבבים אני מעדיף את השיטה הזו‪.‬‬
‫•‬
‫חששות‪ :‬אי סדר בזמנים‪ ,‬חשש שיתפזרו ולא יתרכזו בנושא ויצא להיפך‪ :‬הם היו יותר מרוכזים‪.‬‬
‫•‬
‫יתרונות‪ :‬הכנה מוקדמת ליום הזה‪ ,‬הפעלה אקטיבית של הסטודנטים‪ ,‬המדריכים פעילים וגם צריכים להיות פסיביים‬
‫•‬
‫לא קל בהתחלה להיות פסיבי‪ ,‬בסבב הראשון התערבתי לא יכולתי לשתוק‪ ,‬אחר כך למדתי‬
‫•‬
‫אמרתי לסטודנטים שהשיטה שהם מופעלים ועושים הרוב היה לי מאד קשה לשתוק ולא להתערב אבל הרגשתי שאי‬
‫•‬
‫ההתערבות שלי תורמת להם להיות אקטיביים‬
‫תפקיד המנחה‪ :‬ארגון הזמן‪ ,‬ארגון הקבוצות הקטנות‪ ,‬בקרה של המליאה‬
‫•‬
‫כשהיו התלבטויות והם שאלו – נתתי להם שהם יהיו אקטיביים – עניתי כדי שיתקדמו‪ ,‬עזרתי‪ ,‬הדרכתי‪ ,‬הם הגיעו לבד לא‬
‫נתתי ממש תשובה‪.‬‬
How to do TBL?
Facilitating TBL
Getting Started
Phase 2
Phase 3
1st Class
Readiness Assurance
(In-class)
Application of
Course Concepts
1. Describe the TBL unit
2. Form the Teams
3. Set grading weights
4. Develop positive
group norms
1. Distribute RATS and collect
answers in Group folders
A.
IRAT B.
GRAT C Instructor
Feedback
2. Ask for GRAT answers and
provide feedback
Individual
Work
X
Small Group
Discussion
X
Total Class
Discussion
Small Group
Assignments
1. Distribute case
2. Time Teams
3. Facilitate team
discussions
4. Collect answers
5. Call for answers
6. Provide feedback
on team work
=
Impact on
Learning