Oral Presentation Abstracts

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Research & Scholarship

Nutrition and Culinary Medicine TBL for Osteopathic Medical Students

Chris Burns, NYU School of Medicine
Emily Johnston, NYU School of Medicine

Poor nutrition is a leading cause of preventable death. Doctors of Osteopathic Medicine (DO) are trained in holistic care and health maintenance, but few DO schools offer adequate nutrition education. Physicians who make healthy lifestyle choices are more likely to recommend them to patients. Team-based learning (TBL) offers the potential advantage of providing effective instruction in fewer contact hours to improve nutrition knowledge among future health professionals.

Nutrition has been integrated into the curriculum at a new college of osteopathic medicine through TBL sessions, self-study activities, and interactive group-based culinary medicine (CM) workshops. We aimed to teach CM TBL sessions to first year students by adding a readiness assurance process (RAP) to workshops and by evaluating knowledge, attitudes, and personal dietary habits. RAP was assessed via InteDashboard, diet was assessed via online, visual food frequency questionnaire (FFQ, Vioscreen), diet quality was measured via Healthy Eating Index (HEI)-2015 score, a measure of adherence to the Dietary Guidelines for Americans. Surveys were administered via Qualtrics.

One hundred and ninety-five first year osteopathic medical students completed the initial FFQ, 75 students completed a second FFQ and 65 students completed the end of year survey. Mean baseline HEI-2015 score was 67.5, mean end of year 1 score was 69.6. Sodium intake was above and fiber intake was below dietary recommendations. More than half (55%) of respondents reported they were active to very active. Only 26% of respondents (17/65) reported taking a nutrition class prior to medical school. Nutrition knowledge scores ranged from 44-87% correct.

Team-based learning was effectively employed in CM workshops. Diet quality among osteopathic medical students was higher than the general population, but below recommended levels. Our findings suggest that TBL can be used to integrate nutrition into the crowded medical school curriculum and may improve osteopathic students' diet quality.

Improved Learning Outcomes and Teacher Experience: A Qualitative Study of Team-Based Learning in Secondary Schools

Stella Darby, University of Bradford
David O'Hanlon, University of Bradford
Simon Tweddell, University of Bradford

Based on the well-known benefits of Team-Based Learning (TBL) in higher education (Fatmi et al., 2013; Haidet, Kubitz and McCormack, 2014; Michaelsen, Davidson and Major, 2014; Swanson et al., 2019), the Erasmus+ funded TALENT project sought to study the possible benefits of using TBL in secondary schools. The project as a whole is investigating both teacher experience and student outcomes. The aspects of the research presented here focus on teacher experience and teachers' observations of student engagement and outcomes.

We conducted a year-long qualitative action research study with 13 teachers from Ireland, Spain and the UK. Data was collected using questionnaires, focus groups and individual interviews, and analysed using a grounded theory approach. Data collection took place using a 'before and after' approach, with teachers reflecting on their hopes and goals for using TBL directly after their initial training, then reflecting on their experiences and conclusions after using TBL for a year in their classes.

We found that, despite challenges, the benefits of using TBL in secondary schools make it worth teachers' time and effort. Overall, while teachers found preparation time, institutional requirements, and managing student team dynamics challenging, these challenges were outweighed by positive benefits including increased student engagement, quality of learning, skill development, and improved teacher job satisfaction. Almost all the teachers who took part in the initial training and first year of using TBL went on to undertake additional training to mentor others in their school to use TBL as well.

Teachers' choices to continue using TBL and their reports of their experiences demonstrate their assessment of TBL as a worthwhile use of lesson preparation and class teaching time. We recommend further training of TBL for secondary-level teachers and further research into this topic area.

Should We Have Confidence in Confidence Based Testing?

Neal Carter, Brigham Young University - Idaho

One popular iRAT variation is Confidence Based Testing (CBT), in which learners are given several points per MCQ and can spread these points out however they wish for that item. The idea is that this can serve to increase metacognition by having the learners gauge their levels of confidence in their responses through point allocation. This helps them weigh the relative appeal of the various alternatives, and could improve tRAT discussions.

A question emerges, however, about students' test-taking strategies. While point-spreading might enable the learner to salvage partial credit for a second- or third- choice response, it simultaneously guarantees a loss of some credit for the correct answer. Learners' predilection for seeking gains or for avoiding loss might interfere with, or override, their use of points based on confidence in their responses. Testing strategy might lead some students to ignore the point-spreading strategy. This could pose some adverse results if iRAT grades are heavily weighted, especially if a gender gap exists in the frequency of employing point-spreading strategies when uncertain about the question.

For the last few years, I have used Qualtrics to conduct iRATS. In addition to Confidence Based Testing, I posed an addition Likert-scale question asking students to rate their confidence on each question. While it is clear that there is a strong correlation between confidence and allocating all points on one alternative (or spreading them out evenly among alternatives) this presentation will examine trends where confidence and point spreading don't fit together as neatly. This will help clarify the question of whether we should have confidence in CBT.

Back to the Classroom: Pedagogical Methods and Student Social Interactions After COVID-19 Restrictions

Richard Plunkett, University of British Columbia
Ossman Abuzukar, University of British Columbia
Ozren Petkovic, University of British Columbia

Educational systems are meant to empower learners with the skills and knowledge necessary to independently grow and learn, and contribute to society. How best to develop these skills is still a mystery. Collaborative peer-oriented pedagogies, like Team-Based Learning (TBL), have demonstrated academic and perceptual benefits. Other factors related to peer learning strategies, such as social interactions, are less well studied. Student social interactions influence science students' critical thinking, learning and mental well-being. These crucial aspects of a safe learning environment are impacted by pedagogies. The COVID-19 pandemic and transition to remote/online learning severely disrupted student learning and social context. Students were then expected to return from an isolating, individual learning context to an in-person environment that favours social learning interactions. We asked whether TBL can better create a social learning environment that allows students to prosper and readjust to in-person learning, compared with a conventional lecture-based environment. We used the Social Context and Learning Environment (SCALE) survey to compare social readjustment in third-year science students both within learning environments and between them. Over time, the TBL group showed consistent social growth, most noticeably in student-student interactions. On the contrary, the lecture-based learning group showed little to no social improvement over the semester, but scored higher in the instructor-centred social domains and experience. No correlation was observed between demographic groups and social interactions. This suggests that pedagogical methods are key for establishing socially safe learning environments. This may guide educators towards active learning practices that emphasize student social learning.

Innovations of TBL

How Does Team Based Learning Develop Skilled Collaborators?

John Chapman, Brigham Young University - Idaho

One of the assumptions of Team Based Learning is that individuals can learn to create high performing teams. At the core of what it means to become a high performing team is the skill of collaboration.

 One of the institutional learning outcomes of Brigham Young University-Idaho is to develop skilled collaborators. This learning outcome can be broken down into four areas or competencies:

  1.  Fulfill individual responsibilities
  2.  Facilitate the contributions of others
  3.  Foster productive group climates
  4.  Respond to conflicts in constructive ways

 The purpose of this presentation is a) to examine the overlap between these four competencies of skilled collaboration and TBL, b) to observe how the integration of these areas is key to developing skilled collaboration, and c) to offer suggestions regarding how to align course content closer to TBL to achieve the goal of learning to build high performing teams.

Using a Pre-class iRAT to Increase Accessibility in Readiness Assessment

Diana Langworthy, University of Minnesota College of Pharmacy

The traditional structure of the readiness assurance process (RAP) in a synchronous TBL module includes an in-class closed book iRAT, an in-class closed book tRAT and an in-class open book Applied Exercise. In the confines of the classroom, this limits the ability of instructors to grant varying time limits to students with time accommodation needs without disclosing the identify of those individuals. If instructors choose to grant additional time to all students in-class for inclusive design purposes, this may leave learners waiting for the entire class to finish their assessment in order to move on which could increase stress for learners still completing their iRAT.

Evidence Based Practice is a 15 week course for third year pharmacy students that uses TBL for about 40% of course sessions. The course has historically offered all components of the TBL module (iRAT, tRAT, and AE) inside of a 2 hour class period. In the past, iRATs have been designed to take 6 minutes but course faculty have allowed 12 minutes to account for all time needs for learners (up to double time accommodations). In the Fall of 2022, course faculty have modified the TBL process to move the iRAT to a pre-class open book, timed assessment to increase accessibility for individual learners.

InteDashboard is prepared with an asynchronous iRAT that opens 24 hours before the TBL module date and time and students must complete the iRAT individually before class starts. Students with time accommodations take the assessment with their respective time needs. A survey is prepared and will be conducted at midpoint and endpoint of the course to assess student perceptions of this novel process and results will be available at the March conference.

Applying Flipped Classroom in Team-Based Learning Approach for College Nursing Education: A Pilot Study

Mei-Chun Lin, Cardinal Tien Junior College of Healthcare and Management

Team-based learning is a dialectics learning strategy involving the application of adult learning theory and the cooperative learning approach. The core principle of the flipped classroom is that responsibility for learning returns to the students, the role of teachers changing from that of the leader to that of provider. However, the application of the flipped classroom in the team-based learning method in nursing education literature is insufficient, and there is a lack of clarity as to the process of implementation process students' learning outcomes.

The purpose of this study was to explore the effectiveness of team-based learning within the flipped classroom on learning outcomes in nursing education.

Using an experimental study design, structured questionnaires were used for data collection. A non-random, purposive sampling method was applied and recruited 50 participants, who were then randomly divided into an experimental group and a control group. Two kinds of course intervention (traditional lecture and online-based flipped classroom) were delivered to both groups.

The results of the study showed that there was statistically significant difference in the post-test scores between the two groups following different interventions identified by an independent sample t test (t = 13.24, p > .001). Both groups improved following the interventions as indicated by a paired sample t test (t = 15.89/4.07, p > .001). There was evidence that the post-test performance of the experimental group was better than that the control group. The experimental group had satisfied in three areas, which included "Learning achievements€ (M = 3.94, SD = 0.21), "Learning materials" (M = 3.93, SD = 0.20) and "Knowledge application" (M = 3.93, SD = 0.21) by questionnaires.

Team-based learning within a flipped classroom in the nursing class teaching improved student learning motivation and learning effectiveness.

Creating and Delivering Effective Oral Presentations for the SURE2021 and 2022 Conference via Online Team-Based Learning (TBL)

Anne Marie O'Brien, Technological University of the Shannon

This paper presents the experience of staff who developed and delivered an oral presentation workshop via online TBL. We look at the experience of the attendees from varied STEM disciplines and different Higher Education Institutes across Ireland. We examine the learning curve and collaboration of the staff delivering the workshop. The participants were presenting the results of their undergraduate research at the SURE network conference 2021/22, this takes place simultaneously across three HE institutes. The team of five lecturers from different institutes devised an oral presentation workshop that could be delivered online or face to face. In advance of the session, pre-reading material was collated and curated, and made available to participants via a specially designed sway. MCQ and application tasks were carefully and specifically devised for the target participants. Participants pre-registered for the workshop via a link supplied by Lams international and the workshop platform used was zoom. We hoped that participants would come to the session and that we would provide a unique multidisciplinary workshop where they shared and learned from each other. This was a new experience for the lecturers and the participants The workshop exceeded our expectations, 32 out of 44 presenters came to the workshops. Students said they found the workshop "engaging, fun, informative, helpful, efficient and excellent€ they felt that discussion questions and engaging with other presenters worked well. This paper reflects on this experience from the lecturer's and the participant's points of view. We explore what worked well and what needs to be improved. We also look at how this has impacted the lecturers who prepared this and if they then went on to use TBL in their own teaching.

When Team-Based Learning Met the Two-Stage Exam - A Marriage Made in Heaven?

Jonathan Branney, Bournemouth University, UK
Ryan Muldoon, Bournemouth University, UK

A new policy was introduced in our institution, Bournemouth University, UK, that meant the combined grading of multiple components of assessment towards one overall grade for a module of study was prohibited. This presented a problem for our full implementation of Team-based Learning (TBL) as the teaching and learning strategy for an applied pathophysiology unit (module) for student nurses. With TBL, students' grades are typically calculated either from TBL components alone (individual and team readiness assurance tests, peer evaluation, sometimes also application exercises), or they might account for a lesser percentage (for example, 25% of final grade, usually without grading of application exercises) in combination with a more traditional assignment (for example, 75% of final grade) such as a final examination. However, our new institutional policy prevented either approach, presenting our unit team with a dilemma of how we could maintain the principles of TBL while also adhering to institutional policy. Our module was included in several nursing degree programmes which are regulated by the Nursing and Midwifery Council (NMC). Further compounding the situation, the NMC introduced a requirement that student nurses must achieve the minimum pass mark in each component of assessment contributing to an overall grade, not just achieve a pass mark on the combined grade. Thus, having more than one component of assessment presented a risk of increasing the failure rate. The solution that seemed to meet the needs of both institutional and professional regulatory body policies was a two-stage exam to provide the final grade. A two-stage exam consists of individual and team stages thus commensurate with the ethos of TBL, while being considered one assessment. We wish to describe our first implementation of the two-stage exam, the evaluation by students and staff, and the practicalities of making this happen alongside institutional and professional body constraints.

A Five-Hour TBL Series for Establishing Foundational Immunology in Medical Education

Nicholas Wohlgemuth, Kansas College of Osteopathic Medicine
Sarah Evans, Kansas College of Osteopathic Medicine
Stacy Jones, Kansas College of Osteopathic Medicine

Most incoming osteopathic medical students have not taken a dedicated course in immunology since it is not a prerequisite for admission into medical school. Therefore, we designed a five-contact hour Team-Based Learning (TBL) series in immunology to ensure that all first-year students at the Kansas College of Osteopathic Medicine had the necessary knowledge for understanding the pathophysiology of disease. The series consisted of two two-hour TBL sessions, one on each branch of the immune system, innate and adaptive. The remaining one-hour session contained a summative evaluation and an additional activity involving the integration of innate and adaptive immunity. Each two-hour TBL session included seven or eight question iRAT/tRATs and two application activities. One to two-minute minilectures were used for summarizing the key discussion points for each question during the debrief. InteDashboad was used to facilitate all iRAT/tRATs and application exercises. Students scored an average of 51.6% on the in-class iRATs, with scores improving to 88.3% for the tRATs. Most notably, during the summative assessment, students scored 30% greater on average than their iRAT scores. Faculty observation of students during the TBL activities revealed a high degree of student buy-in with nearly one hundred percent participation. TBL is a powerful and efficient pedagogical method for comprehensively covering a large amount of material. Choosing application activities that integrate immunological concepts made it feasible to provide students with a comprehensive foundation in immunology and evaluate their understanding of the critical concepts in only five hours of instruction.

TBL in Executive Education: Innovating Medical English Training for Doctors in Vietnam

Daniel Ruelle, VinUniversity

TBL has long been used in medical education with countless positive effects on learners' mastery of content and skills. However, outside of the higher education classroom environment, TBL has not seen as much implementation in non-traditional educational settings.

This presentation outlines how the author implemented TBL in an innovative setting, namely an executive education course to help doctors in Vietnam improve their medical English language and communicative competence. The course was a blended design with doctors spending some time during the week on guided independent learning and coming together in a synchronous live online workshop held in TBL mode. The workshops utilized LAMS and Microsoft Teams and offered doctors a chance to consolidate independently-learned medical English and apply it in a variety of different communicative application exercises.

This presentation will outline how this innovative program was developed, the unique challenges that participants and instructor faced, lessons learned from the course, and an exploration of how innovations like this course can expand the reach of TBL into non-traditional educational settings such as executive education. Attendees will leave the talk with a better understanding of the unique challenges and opportunities for TBL in online executive education and how non-traditional learners grapple with TBL in their first experience of it.