138 – Application of TBL as a review for midterm exams in a histology-focused course
Geoffrey D. Guttmann, Patricia A. Gwirtz

BACKGROUND: At UNTHSC, we run a program, Masters of Medical Science, for students, who want to go a health professional school but do not have grades or test scores to be considered for admission or interview for admission. We offer students a curriculum that includes gross anatomy, histology, physiology, and a number of other biomedical related courses as well as preparation for health professional tests and interviewing for admission. Students often find histology a rather intensive experience as they are asked to integrate microscopic tissue imaging with biological activity. Students initially learn the name of the structure but they have not integrated the biological activity that the structure actually does. We have instituted team-based learning (TBL) activity to bring about not only identification of structures but also the actions of the structure being considered. Our modification to TBL has been to use it as a tool for reviewing the learning materials delivered in class the previous 10 lectures.

DESCRIPTION: We started delivering TBL in the histology course about four years ago and we have seen a different focus among the students. The first is that the two semester Anatomy courses, which use to combine gross anatomy with histology, has changed to separate courses of histology in the fall and gross anatomy in the spring. The second, students study for the TBL as if they are studying for a midterm exam. Thus, students have demonstrated much better preparation for midterm exams and have scored better. We compare grades, which included both gross anatomy and histology, students received before we implemented TBL compared to those since doing TBL in a histology-focused course. We deliver a 10 question IRAT with each question representing one hour of lecture or learning material. The TRAT follows after the IRAT. Students answer each question by recording it on iClicker. Following the TRAT and depending upon time availability, there may be an opportunity to review a clinical case or pathology, which enhances material covered in the quizzes.

RESULT: On an anecdotal note, the students appear better prepared for pre-exam reviews and put in quite a bit of effort in preparation for the TBL session. It has been observed that there has been a lot of discussion going on during the TRAT and students appear animated. Student scores have increased from an average of 88% (pre-TBL) to 92% (with TBL) however these scores do not reflect adjustment for a histology only focused course. For those students, who are admitted to the Texas College of Osteopathic Medicine (TCOM), it appears they are very well prepared for medical school histology and have success with the medical school curriculum.

CONCLUSION: TBL appears to cause a small increase in grade points in the histology course however there is more dynamic learning activity occurring with TBL. We could improve our TBL with more clinical cases for case discussion after the TRAT.