Modified Team-Based Learning in an Ophthalmology Clerkship in China

PLoS One. 2016 Apr 21;11(4):e0154250. doi: 10.1371/journal.pone.0154250. eCollection 2016.

Abstract

Objective: Team-based learning (TBL) is an increasingly popular teaching method in medical education. However, TBL hasn't been well-studied in the ophthalmology clerkship context. This study was to examine the impact of modified TBL in such context and to assess the student evaluations of TBL.

Methods: Ninety-nine students of an 8-year clinical medicine program from Zhongshan Ophthalmic Centre, Sun Yat-sen University, were randomly divided into four sequential units and assigned to six teams with the same faculty. The one-week ophthalmology clerkship module included traditional lectures, gross anatomy and a TBL module. The effects of the TBL module on student performance were measured by the Individual Readiness Assurance Test (IRAT), the Group Readiness Assurance Test (GRAT), the Group Application Problem (GAP) and final examination scores (FESs). Students' evaluations of TBL were measured by a 16-item questionnaire. IRAT and GRAT scores were compared using a paired t-test. One-way analysis of variance (ANOVA) and subgroup analysis compared the effects among quartiles that were stratified by the Basic Ophthalmology Levels (BOLs). The BOLs were evaluated before the ophthalmology clerkship.

Results: In TBL classes, the GRAT scores were significantly higher than the IRAT scores in both the full example and the BOL-stratified groups. It highlighted the advantages of TBL compared to the individual learning. Quartile-stratified ANOVA comparisons showed significant differences at FES scores (P < 0.01). In terms to IRAT, GRAT and GAP scores, there was no significant result. Moreover, IRAT scores only significantly differed between the first and fourth groups. The FES scores of the first three groups are significantly higher than the fourth group. Gender-specific differences were significant in FES but not the IRAT. Overall, 57.65% of student respondents agreed that TBL was helpful. Male students tended to rate TBL higher than female students.

Conclusion: The application of modified TBL to the ophthalmology clerkship curriculum improved students' performance and increased students' engagement and satisfaction. TBL should be further optimized and developed to enhance the educational outcomes among multi-BOLs medical students.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • China
  • Curriculum*
  • Education, Medical / methods*
  • Educational Measurement
  • Female
  • Group Processes
  • Humans
  • Male
  • Ophthalmology / education*
  • Problem-Based Learning / methods*
  • Students, Medical / statistics & numerical data
  • Surveys and Questionnaires
  • Young Adult

Grants and funding

This study was supported by the Undergraduate Teaching Reform Research Program of Sun Yat-sen University (2014-33-Haotian Lin, 2015-16-Yong Ao), the Outstanding Young Teacher Cultivation Projects in Guangdong Province(No.YQ2015006), the Guangdong Provincial Natural Science Foundation for Distinguished Young Scholars of China (Grant No. 2014A030306030), Youth Science and Technology Innovation Talents Funds in Special Support Plan for High Level Talents in Guangdong Province (Grant No. 2014TQ01R573), the Cultivation Projects (12ykpy61) and Intensive Cultivation Projects (2015ykzd11) for Young Teaching Staff at Sun Yat-sen University from the Fundamental Research Funds for the Central Universities, and the Fundamental Research Funds of the State Key Laboratory of Ophthalmology (Grant No. 2015QN01). The sponsors of the study played no role in the study protocol design, data collection, data analysis, data interpretation, manuscript preparation, or the decision to submit the manuscript for publication.