Presented By: Barbara Warner, Bowling Green State University
Co-Authors: Ariel Cascio, Michigan State University College of Human Medicine
Julia Knopes, Case Western Reserve University School of Medicine
Ed McKee, Central Michigan University College of Medicine

Purpose 
In our educational program, team-based learning (TBL) is used to assess and extend small group Case-Based-Learning (CBL), which is considered the pre-work for the TBL. In this intervention, students were assigned to either work with the same "static" group for TBL CBL or work with a "hybrid" group comprised of members from 6-7 different CBL groups. The primary aim was to compare outcomes and experiences of students on hybrid versus static teams. The secondary aim is to understand student perspectives on these curricular choices. 

Methods 
Data were collected over three years. In years 1 and 3, students engaged in this intervention during two course blocks. Each group was "static" for one course and "hybrid" for the other. TBL scores (IRAT, GRAT, and GAE) and exam scores for questions mapped to TBL sessions were compared between static and hybrid conditions using a two-tailed t-test. Pandemic circumstances prohibited the intervention in Year 2; those data are analyzed as control. Students completed surveys (n = 96) and focus groups (n = 7) on their experiences. Responses were analyzed thematically. 

Results 
There were no significant differences in exam scores between static and hybrid groups. Across all years, in course 1, hybrid groups performed significantly better on IRAT and static in GRAT. In Course 2, hybrid groups performed significantly better in GRAT and static in GAE. In year 1, the same groups scored significantly higher in GRAT regardless of being static or hybrid. In Year 3, Course 2, static groups performed significantly better in GAE. In surveys, many respondents expressing a preference for static groups. Qualitative results demonstrated mixed sentiments about hybrid groups.

Conclusions
Multiple peer-based learning groups do not consistently impact academic outcomes. Students recognize advantages and disadvantages of each condition. Educators could pursue either condition based on their mission and goals.