Abstracts – Fundamentals

112 – A Comparison of Active Learning TEAM Approaches: TBL and POGIL
Peggy Mohr, PT, PhD, John B. Shabb, PhD

BACKGROUND: The fundamental components of the Team-based Learning (TBL) approach include the use of permanent teams designed to distribute the resources within the class, assignments designed to promote learning and development of team skills, immediate and frequent feedback from facilitators, and application activities requiring the students to work on a common, significant problem, make a specific choice, and report simultaneously. The TBL approach was developed by Larry Michaelsen in 1979 for use in his business classes (Sweet & Michaelsen, 2012) and has been described with applications to several disciplines in a number of textbooks (Michaelsen et al., 2004; Michaelsen, Parmalee, et al., 2008; Michaelsen, Sweet et al., (2008) and Sibley & Ostafichuk, 2014). This literature has provided a foundation of resource information for the implementation of TBL in both small and large classes.

The Process Oriented Guided Imagery (POGIL) approach also emphasizes active learning and student group activities. It arose from college chemistry instruction in response to the growing concern that traditional teacher-centered instruction, focused on efficient delivery of content, was not adequately developing critical thinking skills, deep understanding of fundamental concepts, development of independent learning habits, or an interest in science (Farrell et al. 1999, Hanson and Wolfskill, 2000). Much research has demonstrated the superiority of such learner-centered constructivist pedagogies over teacher-centered approaches (Eberlein et al., 2008; Weimer 2013; Conway, 2014). POGIL has been successfully implemented in multiple STEM disciplines (https://pogil.org/) including biochemistry (Minderhout and Loertscher, 2007). Materials are designed to guide self-directed small groups through the learning cycle of exploration, concept invention, and application. Instructors encourage students to construct their own understanding of fundamental concepts and to identify and correct misconceptions. The successful use of POGIL in large enrollment classes has been reported (Bailey et al., 2012).

DESCRIPTION: This poster session will compare and contrast the characteristics of two active learning approaches, Team-based Learning (TBL) and Process Oriented Guided Imagery (POGIL), using examples from graduate physical therapy and undergraduate biochemistry courses in which each approach was implemented. Active learning strategies, guided discovery, and student team activities were used with both pedagogical approaches to create environments where students were actively engaged in learning prioritized concepts and essential critical-thinking skills. With both approaches, application exercises were designed to reflect real-world problems. The fundamental components of each approach and how the implementation of similar essential components differed between approaches will be illustrated.

RESULTS: Student summary data from the undergraduate and graduate courses in which these approaches were used will be reviewed as related to recommendations for implementation.


113 – 3 + 2 = 13: How reducing lecture hours can increase the impact of your course
Carmen Jones, MSN, FNP-BC , Janelle Smalls, MSN, RN, CNE

BACKGROUND: Active, team-based learning was introduced into the senior year public health nursing course of the Purdue University School of Nursing in response to gathering evidence at the national and campus levels as well as the insights of our own faculty. At the national level, the Association of American Colleges and Universities outlines High-Impact Educational Practices (AAC&U, 2008) that encourage collaborative assignments and capstone learning experiences. The American Association of Colleges of Nursing provides further guidance in The Essentials for Baccalaureate Education for Professional Nursing Education (AACN, 2008), emphasizing the importance of communication and team work. At the campus level, the Instruction Matters: Purdue Academic Course Transformation or IMPACT initiative empowers faculty with resources to re-envision the classroom. Against this background and armed with our own insights, the TBL project was launched in AY 2014-15.

DESCRIPTION: A Midwest university’s Bachelor of Science in Nursing senior level Public Health course utilizes the TBL approach to educate approximately 50 students in class for 75 minutes, two days a week during a 16 week semester. Students are responsible for assigned textbook readings before class. The course incorporates seven (7) 15 item Individual Readiness Assurance Tests (IRATs), Group Readiness Assurance Tests (GRATs) and a comprehensive 50 item IRAT/GRAT final exam serving as both learning tools and evaluation methods. Thirteen (13) content application activities reinforce foundational nursing concepts learned by guiding teams to solve problems, answer questions, analyze case studies and share in class presentations. Assessment of each student’s contribution and participation in team activities is appraised via a confidential peer evaluation. Summative course evaluation and grades for students are based on individual performance, team member performance and team contribution.

RESULTS: The curriculum change from a weekly 3-hour traditional lecture to twice weekly power hours using the TBL approach has allowed time for 13 new application activities while demonstrating improvement in overall student grades.

CONCLUSIONS: The outcomes of this approach will be discussed in terms of expected student results versus observed responses. For those considering adding TBL to their toolkit, “lessons learned” is offered.


114 – How to design and implement peer evaluation in a curriculum wide team-based learning (TBL) undergraduate pharmacy programme in the UK.
Leanne Nation MPharm, MSc, Prof Paul Rutter PhD

Introduction: Peer evaluation (PE) is advocated as one of the seven core elements of TBL, and is essential to ensure that team members contribute time and effort to group work and reinforce individual accountability. There is no fully agreed consensus on what constitutes the “ideal” PE process, which has seen various methodologies devised with reported degrees of successes. When one well, PE appears to promote effective team working but PE remains challenging to health science educators in a variety of settings, not just TBL2.

Design: A curriculum-wide TBL MPharm programme was introduced at Wolverhampton School of Pharmacy, UK in 2014/5. First year students were introduced to peer evaluation in a dedicated teaching session. Students had been using the TBL methodology for three months and were aware that PE was going to form part of their overall TBL grade at the end of the year. A student-led approach to PE was adopted. Students were given information on why PE was essential to TBL and how PE might be implemented with details on how PE scores would be applied to final grades. Three options were given to the students; PE would either form a component of the overall TBL grade and worth 10% or 20%, or PE could be used as a multiplier of the tRAT grade. After the session, students were invited to participate in an online voting poll to decide on which weighting they preferred for PE. The students voted that PE would form 20% of the overall TBL grade at the end of the year.

A criteria setting workshop was then convened and facilitated by two academic staff. Students were given examples of the types of standards they could use but were then allowed to devise their own metrics. Students wrote down their metrics on post it notes, which were then displayed at the front of the class. The academic staff and students collectively categorised these and decided up on seven metrics, to which the class all agreed. The competency levels which the students used to rate the metrics were; never, sometimes, often and always, as used in the Koles PE method. To allow better student understanding and engagement with the process a formative peer evaluation session was conducted at the end of semester one where students had the opportunity to use the criteria. All data generated by students was collated, anonymised and returned to each student. The summative peer evaluation was carried out at the end of semester two using exactly the same criteria and competency levels as in the formative PE. This formed 20% of the student’s final TBL grade for the year. All data generated by students was collated, anonymised and returned to each student.

Conclusion: A student led PE process has been designed and implemented into a curriculum wide TBL MPharm programme.


115 – Writing Application Exercises that Promote Discussion in Calculation-Heavy Classes
Catherine E. Brewer, Monica H. Lamm

BACKGROUND: Chemical engineers, like so many STEM-trained professionals, are expected to work on teams to solve problems once they graduate. The fundamental math and science content-heavy courses commonly encountered in these majors, however, often leaves little time for training and practice in interpersonal skills and teamwork. For this reason, Team Based Learning (TBL) has been implemented in three different core chemical engineering courses over five semesters at two institutions. We have worked together to refine and improve our approaches to address challenges related to course content that requires regular and extensive calculations.

DESCRIPTION: The application of engineering content often involves progressing through more complex and difficult calculations to make design and performance decisions. In our first iterations of TBL application exercises, we attempted to have the teams work these complex problems in class and use the results of their calculations to make decisions. We observed that many teams ended up having one or two people do the calculations, while the remaining team members watched. Much of class time became devoted to number crunching on calculators and comparisons of numerical answers rather than discussions of important concepts. We also found that there was rarely enough time for teams to finish the calculations in class, resulting in individuals trying to complete the problems for their teams after class or us simply providing the solutions. In more recent offerings of the courses, we have reworked our application exercises to focus more on the decisions required in the calculations, rather than the calculations themselves. For example, we may present the problem scenario and provide the teams with a calculated number. From that number, we ask the teams to decide the next step of the process using the implications of the numerical result.

RESULTS: Developing application exercises that can be completed within the allotted time and that provide meaning experience with complex engineering problems is still difficult. However, we have found that placing emphasis on decision-making rather than calculated results has led to more involvement during class for all team members. We have also had more opportunities to explore cases where there is no clear answer and when trade-offs must be made, as well as to demonstrate the consequences of specific decisions on the problem solving process.

CONCLUSION: Shifting the focus of application exercises in TBL chemical engineering core courses from calculations to decisions in the problem-solving process have improved student involvement and allowed for more productive discussions.


116 – Using TBL Methods to Make the Transition to Professional Presentations with Quality Sources
Suzanne Clark, Ph.D.

Background: Effective professional education programs help students make the transition from oral presentations delivered in college classrooms to post-graduate presentations delivered in professional settings. Whereas in undergraduate oral skills classes, instructors typically grade oral presentations based on the development of effective oral delivery skills. However, at the post-graduate professional level, oral skills alone cannot sustain a professional presentation, for the audience of professional peers is also highly focused on the quality of the information presented, including the currency and authority of sources used.

Optimal sources require structured, systematic searches of high-quality databases “and then careful utilization of that material in the presentation. However, for the typical undergraduate, structured, systematic searching of the peer-reviewed literature is a skill not often appreciated” let alone enjoyed – by the current generation of students who, although highly internet-savvy, may not question the quality of the results delivered to them by the search engine. Thus, preparing for professional presentations can be a surprisingly difficult transition for students to make, for such transitions require them to break years-old habits of random keyword searches that yield sources of a wide range of quality and currency. Instead, they must become skilled at structured, systematic searches of peer-reviewed literature that yield current, authoritative sources and that require substantial effort to understand, utilize and cite.

Description: Team-based learning approaches can help students make the transition to professional presentations through a step-wise approach, starting with systematic searches and source identification, through source analysis and utilization, and closing with careful citation. First year pharmacy student teams develop clinical case presentations using the same subjective-objective-analysis-plan (SOAP)-based approach, with team members charged with evaluating the quality, utilization, and citation of each other’s sources.

Results: Student teams build systematic searches in PubMed using Medical Subject Heading (MeSH) terms and advanced limits, and then employ the selected sources in carefully cited presentations. Team grades, including a peer-graded component, include a component of source quality, utilization, and citation.

Conclusion: This approach provides a team-based framework with which students can begin to approach and utilize the peer-reviewed medical literature.


117 – Pharmacology and Therapeutics of Hypertension: Developing Evidence Based Practice Skills in a Team Based Learning Classroom
Debra Barnette, PharmD, Amanda Zeek, PharmD, Mindy Lam, PharmD

Background: For 4 years our Pharmacology and Therapeutics (P&T) course has utilized Team Based Learning (TBL) for our disease-state workshops. Two 60-student workshops are structured with an individual and team Readiness Assurance Process (RAP), followed by application mini-cases. Over the past two years our cardiovascular section has extensively revised several primary care topics to reflect updated and relevant guidelines and recent clinical trials. We sought to develop student evidence based practice (EBP) skills in our P &T classrooms.

Description: Our P&T courses are divided into four semesters across the second and third years of the doctor of pharmacy curriculum. Approximately, fourteen three-hour workshops are provided each semester. Hypertension is the initial disease state workshop conducted. Required readings prior to class included The Joint National Committee (JNC 8) on Hypertension and the available information on the SPRINT trial (podcast and press release). Specific learning objectives were written to guide updating the RAP and applications exercises.

Results: Two ambulatory care residents successfully completed the Hypertension module updates. The application cases were directly linked back to specific learning objectives. The integration of current trial information synthesized and applied by the students enhanced their critical thinking and EBP skills. The Podcast also provided a viable alternative format to deliver pre-classroom work. The overall workload on the students deemed reasonable.

Conclusion: The use of updated materials and alternative media sources allowed for the successful integration of EBP skills into our TBL classroom. A similar process will be utilized to develop future primary care focused TBLs.


118 – Group Tests and the Tragedy of the Commons
Foy D. Mills, Jr., Ph.D., Shyam S. Nair, Ph.D., Art Wolfskill, Ph.D.

Background: Students exposed to team-based learning (TBL) for the first time are often skeptical, particularly high-performing students. Many high-performing students dislike group work due to previous experiences with “divide and conquer” or feeling that they assume the task of assignment completion regardless of group members’ contributions. Subsequently, the high-performing student feels cheated as the grade earned for all group members was due “solely” to their effort, whether real or perceived. TBL properly applied is designed to mitigate this situation as students are expected to evaluate and assign a score to each peer’s contribution to team effort. Additionally, helping students learn to function as teams is a consistent message from surveys of employers and is often a stated learning outcome of undergraduate education at many universities.

Description: An email sent anonymously from a student in Dr. Mills’ Principles of Agricultural Economics course, a lower-division course, was received between completion of the first hourly exam and the formative peer evaluation process. The person, apparently a high-performing student, expressed his/her concerns about the “free-rider” referencing “The Tragedy of the Commons.” Though the student used Wikipedia for his/her sources, the thoughtfulness expressed in the student’s discourse prompted a response from Dr. Mills. Mills chose to address the student’s concerns using the language of the class which is economics, a decision-making science.

Evaluation: Using the comments feature in Word, a response to each student’s point was made by Dr. Mills. Before the email response could be sent, the formative peer evaluation was administered and no additional concerns were raised via email by this student. However, Dr. Mills used this process to explore the topic with the class in general.

Conclusions: An evidently high-performing student expressed concern that the team’s grade would be set by their individual effort and that other students, possibly “free-riders,” would benefit with minimal to no investment in the team process. We suggest that this concern may be more prevalent among high-performing students than expressed by this single incident. Consequently, it prompted our thinking, can an instructor using TBL use the language of their discipline to assuage fears expressed by high-performing students? The anonymous email will be displayed with faculty comments to illustrate this process.


119 – Implementing Team-Based Learning: Strategies for Reducing Student Resistance
Cynthia Campbell

BACKGROUND: Successfully implementation of team-based learning (TBL) requires adherence to elements of the TBL model and may require the use of strategies to address student resistance. Students often resist the idea of working in teams due to negative group experiences and a lack of awareness of the benefits of TBL. Additionally, students are often reluctant to engage with new strategies in the classroom until they feel more comfortable with the expectations. Thus the strategies instructors uses to introduce and implement TBL can influence how students perceive it and their degree of resistance or acceptance.

DESCRIPTION: Lessons from my own attempt at integrating TBL in an upper-division psychology course suggests some strategies that can smooth the transition and create greater student acceptance. In order to increase student acceptance of TBL it is important to be transparent with regard to group creation, how points and grades are calculated, and the reasons for implementing TBL. Providing students with the opportunity to make choices about how group work impacts their grade can also help alleviate student concerns. Explicit instruction on the rationale of the readiness assessment process (RAP) can help students acquire an appreciation for how the process supports deeper learning. Most importantly, the challenges students encounter and areas for improvement can be identified through employing a mid-semester student feedback assessment.

RESULTS: Using these strategies, I observed greater engagement and increasing endorsement of TBL across the semester. While students demonstrated initial resistance to the idea of working in teams, they appeared intrigued by the rationale and research-support for TBL. In introducing TBL to students, I described my choice to use TBL as a desire to help them take responsibility for their learning and achieving a deeper understanding and appreciation for the course material. Students seemed responsive to my sincere interest in their learning and achievement. Students responded enthusiastically to the option of choosing how RAP points were weighted. Transparency in the creation of groups in class led to student cooperation in the process. When students struggled to write quality appeals and demonstrated frustration with the appeals process, a deeper explanation of the process and the rationale behind it led to greater acceptance and groups that were resistance and struggling to work together demonstrated more willingness to engage. Obtaining mid-semester feedback from students provided the opportunity to make minor adjustments which allowed me to reaffirm my concern for students and their learning. The mid-semester assessment also allowed me to use students’ own responses to demonstrate the benefits of TBL, thereby increasing student acceptance and engagement. Additional insights are expected to be follow from student feedback to be acquired at the end of the semester.

CONCLUSION: Implementing TBL takes conscious effort, clear bidirectional communication with students and may require some remedial actions to address concerns that arise. However, using some of these aforementioned strategies can assist instructors in moving students through the adjustment process and reduce student resistance, thereby improving the chances of successful implementation of TBL and its benefits.