Team-based Learning in Therapeutics Workshop Sessions

Objectives

To implement team-based learning in the workshop portion of a pathophysiology and therapeutics sequence of courses to promote integration of concepts across the pharmacy curriculum, provide a consistent problem-solving approach to patient care, and determine the impact on student perceptions of professionalism and teamwork.

Design

Team-based learning was incorporated into the workshop portion of 3 of 6 pathophysiology and therapeutics courses. Assignments that promoted team-building and application of key concepts were created.

Assessment

Readiness assurance tests were used to assess individual and team understanding of course materials. Students consistently scored 20% higher on team assessments compared with individual assessments. Mean professionalism and teamwork scores were significantly higher after implementation of team-based learning; however, this improvement was not considered educationally significant. Approximately 91% of students felt team-based learning improved understanding of course materials and 93% of students felt teamwork should continue in workshops.

Conclusion

Team-based learning is an effective teaching method to ensure a consistent approach to problem-solving and curriculum integration in workshop sessions for a pathophysiology and therapeutics course sequence.     

Student Perceptions of Team-based Learning vs Traditional Lecture-based Learning

Objective. To evaluate pharmacy student perceptions of team-based learning (TBL) vs traditional lecture-based learning formats.Methods. First professional year pharmacy students (N=111) at two universities used TBL in different courses during different semesters (fall vs spring). Students completed a 22-item team perceptions instrument before and after the fall semester. A 14-item teaching style preference instrument was completed at the end of the spring semester. Data were analyzed using Wilcoxon signed rank test and Mann-Whitney U test.Results. Students who experienced TBL in the fall and went back to traditional format in the spring reported improved perceptions of teams and preferred TBL format over a traditional format more than students who experienced a traditional format followed by TBL. Students at both universities agreed that the TBL format assists with critical-thinking, problem-solving, and examination preparation. Students also agreed that teams should consist of individuals with different personalities and learning styles.Conclusion. When building teams, faculty members should consider ways to diversify teams by considering different views, perspectives, and strengths. Offering TBL early in the curriculum prior to traditional lecture-based formats is better received by students, as evidenced by anecdotal reports from students possibly because it allows students time to realize the benefits and assist them in building teamwork-related skills.     

Comparison of Answer-Until-Correct and Full-Credit Assessments in a Team-based Learning Course

Objective. To assess the impact of awarding partial credit to team assessments on team performance and on quality of team interactions using an answer-until-correct method compared to traditional methods of grading (multiple-choice, full-credit).Methods. Subjects were students from 3 different offerings of an ambulatory care elective course, taught using team-based learning. The control group (full-credit) consisted of those enrolled in the course when traditional methods of assessment were used (2 course offerings). The intervention group consisted of those enrolled in the course when answer-until-correct method was used for team assessments (1 course offering). Study outcomes included student performance on individual and team readiness assurance tests (iRATs and tRATs), individual and team final examinations, and student assessment of quality of team interactions using the Team Performance Scale.Results. Eighty-four students enrolled in the courses were included in the analysis (full-credit, n=54; answer-until-correct, n=30). Students who used traditional methods of assessment performed better on iRATs (full-credit mean 88.7 (5.9), answer-until-correct mean 82.8 (10.7), p<0.001). Students who used answer-until-correct method of assessment performed better on the team final examination (full-credit mean 45.8 (1.5), answer-until-correct 47.8 (1.4), p<0.001). There was no significant difference in performance on tRATs and the individual final examination. Students who used the answer-until-correct method had higher quality of team interaction ratings (full-credit 97.1 (9.1), answer-until-correct 103.0 (7.8), p=0.004).Conclusion. Answer-until-correct assessment method compared to traditional, full-credit methods resulted in significantly lower scores for iRATs, similar scores on tRATs and individual final examinations, improved scores on team final examinations, and improved perceptions of the quality of team interactions.     

Pharmacy Students’ Ability to Think About Thinking

Objective. To investigate students’ metacognitive skills to distinguish what they know from what they do not know, to assess students’ prediction of performance on a summative examination, and to compare student-identified incorrect questions with actual examination performance in order to improve exam quality.Methods. Students completed a test-taking questionnaire identifying items perceived to be incorrect and rating their test-taking ability.Results. Higher performing students evidenced better metacognitive skills by more accurately identifying incorrect items on the exam. Most students (86%) underpredicted their performance on the summative examination (actual=73.6 ± 7.1 versus predicted=63.7 ± 10.5, p<0.05). Student responses helped refine items and resulted in examination changes.Conclusion. Metacognition is important to the development of life-long learning in pharmacy students. Students able to monitor what they know and what they do not know can improve their performance.     

Using Team-based Learning in an Endocrine Module Taught Across Two Campuses

Objectives

To implement a team-based learning (TBL) format in an endocrine module to promote students'' active learning in a course delivered to 2 campuses.

Methods

Course lectures were transformed into 13 TBL sessions consisting of content pre-assignments (self-directed learning), in-class readiness assurance tests (accountability), and team problem solving of patient cases and faculty-led class discussion (knowledge application). Student performance was evaluated through multiple assessments during the TBL sessions and on unit examinations. Students evaluated each individual TBL session and the course as a whole.

Results

Course grades were higher using the TBL method compared to the traditional lecture-based method that was used previously. Individual readiness assurance tests and team contribution scores significantly predicted overall course grades (p<0.001). Students accepted the change in course format as indicated by course evaluation results.

Conclusions

TBL is an effective active-learning, instructional strategy for courses with large student-to-faculty ratios and distance education environments.     

Developing Entrepreneurial Skills in Pharmacy Students

Objective. To create, implement, and evaluate a workshop that teaches undergraduate pharmacy students about entrepreneurship.Design. Workshops with 3 hours of contact time and 2 hours of self-study time were developed for final-year students. Faculty members and students evaluated peer assessment, peer development, communication, critical evaluation, creative thinking, problem solving, and numeracy skills, as well as topic understanding. Student evaluation of the workshops was done primarily via a self-administered, 9-item questionnaire.Assessment. One hundred thirty-four students completed the workshops. The mean score was 50.9 out of 65. Scores ranged from 45.9 to 54.1. The questionnaire had a 100% response rate. Many students agreed that workshops about entrepreneurship were a useful teaching method and that key skills were fostered.Conclusion. Workshops effectively delivered course content about entrepreneurship and helped develop relevant skills. This work suggests students value instruction on entrepreneurship.     

Team-Based Learning in Pharmacy Education

Instructors wanting to engage students in the classroom seek methods to augment the delivery of factual information and help students move from being passive recipients to active participants in their own learning. One such method that has gained interest is team-based learning. This method encourages students to be prepared before class and has students work in teams while in the classroom. Key benefits to this pedagogy are student engagement, improved communication skills, and enhanced critical-thinking abilities. In most cases, student satisfaction and academic performance are also noted. This paper reviews the fundamentals of team-based learning in pharmacy education and its implementation in the classroom. Literature reports from medical, nursing, and pharmacy programs are also discussed.     

Using Debate to Teach Pharmacy Students About Ethical Issues

Objective. To create, implement, and evaluate debate as a method of teaching pharmacy undergraduate students about ethical issues.Design. Debate workshops with 5 hours of contact with student peers and facilitators and 5 hours of self-study were developed for second-year pharmacy students. Student development of various skills and understanding of the topic were assessed by staff members and student peers.Assessment. One hundred fifty students completed the workshops. The mean score for debating was 25.9 out of 30, with scores ranging from 23.2 to 28.7. Seventy percent of students agreed that the debates were a useful teaching method in the degree program.Conclusion. A series of workshops using debates effectively delivered course content on ethical issues and resulted in pharmacy students developing skills such as teamwork, peer assessment, communication, and critical evaluation. These findings suggest that pharmacy students respond favorably to a program using debates as a teaching tool.     

Impact of Supplemental Material Use on Student Metacognitive Monitoring and Calibration

Objective. To determine whether third year Doctor of Pharmacy students’ self-reported use of optional supplemental material impacted their ability to accurately predict their performance on a low-stakes assessment.Methods. An instructor created optional supplemental material in the form of an online quiz. Students were asked to report whether they used the supplemental material and to predict and postdict their performance on an in-class assessment. The relative accuracy of the predictions and postdictions as well as the assessment grades and overall course grades were compared between students who reported using the supplemental material and those who reported not using the supplemental material.Results. More than half of the students (60%) reported using the supplemental material. Most students underpredicted their performance on the in-class assessment, but there was no difference in the accuracy of predictions based on supplemental material use or non-use (-1.2 vs -1.0) or on the postdictions (-1.3 vs. -1.0). Students who reported using the supplemental material performed better on both the low-stakes assessment (7.7 vs 7.2 out of 10) and overall in the course (87.0% vs 84.9%).Conclusion. Pharmacy students’ self-reported use of optional supplemental material does not appear to impact their ability to accurately predict their performance on a low-stakes assessment.     

An Exploratory Analysis of Personality,Attitudes, and Study Skills on the Learning Curve within a Team-based Learning Environment

Objective. To examine factors that determine the interindividual variability of learning within a team-based learning environment.Methods. Students in a pharmacokinetics course were given 4 interim, low-stakes cumulative assessments throughout the semester and a cumulative final examination. Students’ Myers-Briggs personality type was assessed, as well as their study skills, motivations, and attitudes towards team-learning. A latent curve model (LCM) was applied and various covariates were assessed to improve the regression model.Results. A quadratic LCM was applied for the first 4 assessments to predict final examination performance. None of the covariates examined significantly impacted the regression model fit except metacognitive self-regulation, which explained some of the variability in the rate of learning. There were some correlations between personality type and attitudes towards team learning, with introverts having a lower opinion of team-learning than extroverts.Conclusion. The LCM could readily describe the learning curve. Extroverted and introverted personality types had the same learning performance even though preference for team-learning was lower in introverts. Other personality traits, study skills, or practice did not significantly contribute to the learning variability in this course.     

Best Practices for Implementing Team-Based Learning in Pharmacy Education

Colleges and schools of pharmacy are incorporating more team-based learning (TBL) into their curriculum. Published resources are available to assist instructors with implementing TBL and describing it in the health professions literature. The 7 core elements include: team formation, readiness assurance, immediate feedback, sequencing of in-class problem solving, the 4 “S” structure for developing team application exercises (significant problem, same problem, specific answer choice, simultaneous reporting), incentive structure, and peer evaluation. This paper summarizes best practices related to implementation of TBL in pharmacy education, including courses taught using teaching teams.     

Team-Based Learning to Improve Learning Outcomes in a Therapeutics Course Sequence

Objective. To compare the effectiveness of team-based learning (TBL) to that of traditional lectures on learning outcomes in a therapeutics course sequence.Design. A revised TBL curriculum was implemented in a therapeutic course sequence. Multiple choice and essay questions identical to those used to test third-year students (P3) taught using a traditional lecture format were administered to the second-year pharmacy students (P2) taught using the new TBL format.Assessment. One hundred thirty-one multiple-choice questions were evaluated; 79 tested recall of knowledge and 52 tested higher level, application of knowledge. For the recall questions, students taught through traditional lectures scored significantly higher compared to the TBL students (88%±12% vs 82%±16%, p=0.01). For the questions assessing application of knowledge, no differences were seen between teaching pedagogies (81%±16% vs 77%±20%, p=0.24). Scores on essay questions and the number of students who achieved 100% were also similar between groups.Conclusion. Transition to a TBL format from a traditional lecture-based pedagogy allowed P2 students to perform at a similar level as students with an additional year of pharmacy education on application of knowledge type questions. However, P3 students outperformed P2 students regarding recall type questions and overall. Further assessment of long-term learning outcomes is needed to determine if TBL produces more persistent learning and improved application in clinical settings.     

Comparison of Learning Styles of Pharmacy Students and Faculty Members

Objectives. To compare dominant learning styles of pharmacy students and faculty members and between faculty members in different tracks.Methods. Gregorc Style Delineator (GSD) and Zubin’s Pharmacists’ Inventory of Learning Styles (PILS) were administered to students and faculty members at an urban, Midwestern college of pharmacy.Results. Based on responses from 299 students (classes of 2008, 2009, and 2010) and 59 faculty members, GSD styles were concrete sequential (48%), abstract sequential (18%), abstract random (13%), concrete random (13%), and multimodal (8%). With PILS, dominant styles were assimilator (47%) and converger (30%). There were no significant differences between faculty members and student learning styles nor across pharmacy student class years (p>0.05). Learning styles differed between men and women across both instruments (p<0.01), and between faculty members in tenure and clinical tracks for the GSD styles (p=0.01).Conclusion. Learning styles differed among respondents based on gender and faculty track.     

A Multiyear Analysis of Team-Based Learning in a Pharmacotherapeutics Course

Objectives. To evaluate the impact of team-based learning (TBL) in a pharmacotherapeutics course on pharmacy students’ ratings of faculty instructors and the course, and to assess students’ performance after implementation of team-taught TBL.Design. Teaching methodology in a pharmacotherapeutics course was changed from a lecture with recitation approach in 2 semesters of a 6 credit-hour course to a TBL framework in a 3-semester 3+4+5 credit hour course. The distribution of faculty of instruction was changed from 4 faculty members per week to 1 faculty per 1-credit-hour module. TBL consisted of preclass study preparation, readiness assurance (Individual Readiness Assessment Test and Group Readiness Assessment Test), and in-class application exercises requiring simultaneous team responses.Assessment. Retrospective analysis of student ratings of faculty and instructional methods was conducted for the 2 years pre-TBL and 4 years during TBL. Final course grades were evaluated during the same time period. Student ratings showed progressive improvements over 4 years after the introduction of team-based learning. When aggregated, ratings in the “excellent teacher” category were unchanged with TBL compared to pre-TBL. Improvements in faculty instructor approaches to teaching were noted during TBL. Group grades were consistently higher than individual grades, and aggregate course grades were similar to those prior to TBL implementation.Conclusion. Implementation of TBL in a pharmacotherapeutics course series demonstrated the value of team performance over individual performance, indicated positive student perceptions of teaching approaches by course faculty, and resulted in comparable student performance in final course grades compared to the previous teaching method.     

Use of Virtual Patients in an Advanced Therapeutics Pharmacy Course to Promote Active,Patient-Centered Learning

Objective. To assess student satisfaction and learning of course objectives following the integration of virtual patient cases designed to promote active, patient-centered learning in an advanced therapeutics pharmacy course.Design. A dynamic virtual patient platform that incorporated a branched-narrative, decision-making teaching model was used in an advanced therapeutics course to supplement lecture content.Assessment. Presimulation and postsimulation tests were used to assess student learning. The use of virtual patients significantly enhanced student learning for both higher- and lower-level test questions (p<0.001 and p=0.01, respectively). Students agreed or strongly agreed that the virtual patient cases provided an effective way to learn (72%), were enjoyable (69%), and were appropriate in content (80%), and that more should be incorporated (59%).Conclusion. The use of virtual patients in an advanced therapeutics practicum effectively promoted active, patient-centered learning; engaged students in an interactive and dynamic educational technology; encouraged teamwork; enhanced higher-level student learning; and improved student satisfaction in the course.     

A Randomized Crossover Comparison of Team-based Learning and Lecture Format on Learning Outcomes

Objective. To compare learning outcomes and student confidence between team-based learning (TBL) and lecture.Methods. A crossover study was conducted with 30 students divided into two sections. Each section was taught six therapeutic topics (three TBL and three lecture). There were two assessments of 24 questions each. A survey (Likert scale) assessing student confidence and attitudes was administered at the end.Results. A significantly higher overall examination score was observed for TBL as compared to lecture. Students were more confident in providing therapeutic recommendations following TBL. Higher survey scores favoring TBL were also seen related to critical-thinking skills and therapeutic knowledge.Conclusion. Learning outcomes and student confidence in performing higher-order tasks were significantly higher with TBL. The findings of this novel crossover type design showed that TBL is an effective pedagogy.     

改革药剂科管理模式,促进医院药学工作发展

本文介绍了该院药剂科管理模式改革的具体做法和所取得的成效。即将原科主任负责制的管理体制改革为部主任负责制,实行部、系统两级分工把关制,有力地促进了临床药学、制剂室管理、科学研究、人才培养等工作,取得了较好的社会效益和经济效益。     

A Concept Mapping Activity to Enhance Pharmacy Students’ Metacognition and Comprehension of Fundamental Disease State Knowledge

Objective. To examine the impact of pre-class concept mapping activities on pharmacy students'' ability to self-assess their degree of foundational disease state knowledge and predict their pre-class quiz performance.Methods. Second year pharmacy students in a problem-based learning course were responsible for self-directed learning of foundational knowledge for 14 disease states. After completing their independent pre-class reading, students worked in groups to create concept maps for which feedback was provided for four laboratory sessions, worked in groups to create concept maps but received no formal feedback for three laboratory sessions, and did not engage in any formal group activity for seven laboratory sessions. The day following each session, prior to the formal in-class discussion, students were asked to predict the number of questions they could answer correctly on a quiz covering foundational knowledge and then completed the quiz. Quiz performance was compared based on the three conditions, and bias and absolute bias were calculated to evaluate students’ metacognitive skills.Results. There was no difference in pharmacy students’ metacognition based on the conditions, as reflected by inaccuracy between predicted and actual quiz scores. However, when students had engaged in concept mapping the previous day, their quiz performance was significantly higher than when they had not.Conclusion. Concept mapping did not improve pharmacy students’ metacognitive skills but did have a small effect on their quiz performance. More research is needed to tease apart the roles of concept mapping, group activity, and feedback in altering pharmacy students’ quiz performance and metacognitive skills.     

Impact of a Service-Learning Course on First-Year Pharmacy Students’ Learning Outcomes

Objectives. To assess the differences in learning outcomes of first-year (P1) pharmacy students enrolled in a course based on service learning with those of a comparable group of students not enrolled in a course involving service learning.Design. Students on 2 campuses of a school of pharmacy completed a required P1 course involving service learning. A control group of students at a different school completed typical P1 courses, none of which involved service learning.Assessment. A questionnaire was administered to P1 students in the study group at the conclusion of the service-learning course, and a similar questionnaire was administered to P1 students in the control group in the spring of their P1 year. Survey questions inquired about what the students had learned generally and in the areas identified as common to the 2 groups of respondents. Differences in the learning outcomes of the students were identified, most notably in the areas of professional communication, cultural competence, the elderly, and awareness of service-providing agencies in the community.Conclusion. This study demonstrated that service-learning positively impacts pharmacy students’ learning outcomes.