Team-Based Learning as a Feasible, Acceptable, and Effective Educational Method for Internal Medicine Trainees - A Multi-phase Intervention and Cohort Comparison

Hannah Zane; Amanda Brunton; Patricia A Carney; Elizabeth Haney; Erin M Bonura

doi:10.1007/s11606-024-08891-8

Team-Based Learning as a Feasible, Acceptable, and Effective Educational Method for Internal Medicine Trainees - A Multi-phase Intervention and Cohort Comparison

J Gen Intern Med. 2024 Aug 6. doi: 10.1007/s11606-024-08891-8. Online ahead of print.

Authors

Hannah Zane¹, Amanda Brunton², Patricia A Carney³, Elizabeth Haney⁴, Erin M Bonura⁵

Affiliations

¹ Department of Medicine, Oregon Health & Science University, Portland, OR, USA.
² Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA.
³ Professor of Family Medicine and of Internal Medicine, Division of Hospital Medicine, Oregon Health & Science University, School of Medicine, Portland, OR, USA.
⁴ Associate Professor, Division of General Internal Medicine & Geriatrics, Oregon Health & Science University, Portland, OR, USA.
⁵ Associate Professor, Infectious Diseases, Oregon Health & Science University, Portland, OR, USA. Bonura@ohsu.edu.

PMID: 39105994
DOI: 10.1007/s11606-024-08891-8

Abstract

Background: Team-based learning (TBL) is an active learning strategy gaining traction in medical education. However, studies demonstrating successful incorporation into Graduate Medical Education (GME) curricula are limited.

Objective: To assess the feasibility, acceptability and efficacy of Infectious Disease (ID) TBL sessions within an Internal Medicine (IM) residency curriculum as part of a traditional 60-minute conference.

Design: We conducted a prospective cohort study of TBL implementation assessing acceptability and feasibility (Phase 1), and efficacy (Phase 2).

Participants: Phase 1 included 101 IM residents and eight TBL naïve faculty. Phase 2 included aggregate cohort IM In-Training Exam (ITE) data before (2008-2013) and after (2014-2019) TBL implementation.

Interventions: Eight TBL sessions were delivered once or twice weekly during 60-minute noon conferences.

Main measures: We assessed feasibility by measuring individual Readiness Assurance Test (iRAT) completion rates and inclusion of TBL elements in each session; acceptability through attendance, perceived effectiveness rating and attitudes about TBL; efficacy by comparing ITE data for the overall ID content and specific TBL associated learning objectives.

Key results: Seventy-five of 93 (80%) residents attended at least one session. All TBL elements were successfully incorporated each session. Of those surveyed, 86% rated the TBL sessions as facilitating their learning "very (4)" or "extremely (5)" well on a 5-point Likert scale (p<0.001). ITE mean percent correct scores of total ID content as well as TBL associated learning objective performance were both significantly higher for the post-TBL cohort among PGY-2 (76.2 vs 62.3; 76.2 vs 62.6) and PGY-3 (73 vs 64.5; 76.2 vs 64.5) IM residents (p<0.05; p<0.001 respectively).

Conclusions: Implementing a complete TBL pedagogy within the traditional noontime conference hour in GME is feasible, acceptable to residents and faculty, and associated with improved learning efficacy demonstrated through improved ITE scores.