2019 Abstracts – Fundamentals

101 – Teaching Psychomotor Musculoskeletal Examination Skills and Application of Clinical Pathology with Team-based Learning(TBL) and Peer Review Activities
Peggy Mohr, Thomas Mohr, Meridee Danks, Gary Schlinder, Steve Halcrow, Schawnn Decker, Richard Morgan, and David Relling
University of North Dakota

BACKGROUND:  Musculoskeletal examination skills and clinical pathology courses in Doctor of Physical Therapy programs have traditionally been delivered in a lecture/laboratory format.  This method provides students with content information and laboratory time to practice examination skills but provides minimal time for application of content to clinical practice.  At our institution, these courses are taught during the initial semesters of the program, prior to clinical practicum experiences.  Previous students have reported a lack of understanding of the clinical relevance of the pathology content and how examination techniques are applied in clinical practice. Although someOther professions have reported success with TBL, there is very little literature regarding educational outcomes following TBL with physical therapy students.

DESCRIPTION:  The initial musculoskeletal evaluation and clinical pathology courses were transitioned to TBL with a focus on clinical application.  Application activities, using the 4-S format, included role play demonstrations, team peer-teaching, and team peer review assessment of interrater reliability and skill application.  Simulation activities with “standardized patients” concluded the course sequence and performance assessment.

RESULTS:  Regarding simulation activities, students reported they learned the importance of formulating an examination plan, adjusting for precautions associated with diagnoses, and effectively communicating with patients.  Students also reported an increased understanding of how to integrated clinical procedures within patients’ overall intervention plans.  Student evaluations were positive and indicated:  environment was conducive to learning (4.74/5.0), active participation was promoted (4.85/5.0), interest in content increased (4.6/5.0), and content was intellectually challenging (4.65/5.0).  Faculty reported the TBL and peer review activities resulted in increased identification of student skill deficits, awareness of students’ understanding of course concepts, and opportunities to teach students criteria for optimal performance with reinforcement of safety and precaution implementation.

CONCLUSION:  Student and faculty feedback and high student course grades support the continued use of TBL with peer teaching and peer-review activities.

102 – Effectiveness of Team Based Learning for Students in a Maternal and Newborn Nursing Course
Yukari Igarashi, Miyuki Oka, Yuko Masuzawa, and Kana Shimoda
St.Luke’s International University

Background: In 2012, we implemented TBL in the undergraduate “Maternal-Newborn Nursing” course. However, there have been no in-class course evaluations reflecting students’ voices. Therefore, we decided to conduct an evaluation on the effectiveness of TBL by comparing scores of the: 1) iRAT and  tRAT, and 2) team work.

Description: This research was conducted from April to July in 2018. During the semester students were expected to take the iRAT and tRAT 6 times and were also expected to answer the question “to what extent do you feel you worked as a team?” 2 times using a VAS (0=not at all – 10=completely). The scores of iRAT and tRAT, and the score of team-work were compared.

Results: There were 84 participants divided into 16 teams. Ten teams had higher scores on the tRAT compared to the iRAT. Six teams had lower scores on the tRAT than the highest points of the iRAT. The overall average VAS score of 14 teams on team-work rose from 8.0 in June, to 8.7 in July. The average VAS score of theOther 2 teams had declined. The score of tRAT and VAS were not related to eachOther.

Conclusion: By implementing TBL 10 teams scored higher on the tRAT than the iRAT. The VAS indicated that most students experienced an increasing sense of team-work over the course of their study. It was also found that students’ subjective feedback and the tRAT results were not particularly correlated.

103 – Team-Based Learning with Peer-to-Peer Learning Strategies to Promote Acquisition and Performance of Physical Therapy Musculoskeletal Examination Skills
Steven Halcrow, Peggy Mohr, Thomas Mohr, Schawnn Decker, and Richard Morgan
University of North Dakota

Background: Physical therapy examination skills are commonly taught in laboratory-intensive formats. Laboratory activities are faculty-guided and allow practice of psychomotor skills but do not consistently ensure accountability or provide opportunities for team discussion, peer teaching, and peer reviews. Team-based learning strategies have become prevalent in medical education programs, with results showing improved retention and learning. The benefits of peer review and peer-to-peer activities have also been documented. Our goal was to implement a team-based learning application with peer teaching and peer review activities to promote the acquisition of examination skills and optimize skill performance, while ensuring accountability for preparation. As teaching is a function of physical therapy practice, these activities reflected professional practice in providing “patient” examination and education. Students were required to demonstrate skills, instruct peers, and evaluate peers’ skill application.

Description: An application promoting student preparation that enables teaching of content was provided as a foundational activity. Individuals from each team were selected to be “peer content experts” on specific examination skills and content areas. Faculty mentors reviewed the content and procedures with the peer experts to ensure homogeneity of information and understanding. The peer content experts delivered demonstrations and content instruction to their teams and provided feedback on peers’ application of content and demonstration of examination procedures.

Results: Student survey data indicated the application promoted acquisition of skills (54% extremely, 44% moderately effective) and serving as content expert and teaching was beneficial to personal learning (73% extremely, 25% moderately beneficial). Students also reported that team membership improved skill performances (63% extremely, 35% moderately helpful) and sharing perspectives within teams improved understanding (73% extremely, 27% moderately helpful).

Conclusion: Positive student feedback supported the continued use of the team-based learning application with peer teaching and peer review activities to promote skill acquisition and application of required psychomotor skills.

104 – What is facilitation? Reflections from a TBL Facilitator
Emmanuel Tan
Lee Kong Chian School of Medicine, Nanyang Technological University

This presentation aims to address one of the fundamental questions on starting a TBL program and facilitating a TBL session – what does it means to facilitate a TBL session. Facilitation, as a concept, is usually understood as the opposite of a didactic teaching approach. Facilitating is thus usually associated with the use of questions, to probe for understanding and achieve learning. But, is facilitation just that – merely asking questions? Herein lies the raison d’etre of this presentation – what does it really mean to facilitate a TBL session?

Using Gibbs’ reflective cycle (1988) as a framework, this presenter of this paper critically reflect on his earlier experiences on TBL facilitation, and attempt to construct some meaningful sense on the concept of facilitation. The presenter has facilitated TBL sessions for Year 1 and 2 medical students in an undergraduate MBBS program.

Through this reflective exercise, the presenter gains a better appreciation of the different dimensions of facilitation. It is not just about asking questions, though the questions itself and the manner it is asked can have influence on the class discussion. Facilitation is also about managing the flow and momentum of the teaching session, even on small and fine details such as when to take a short break during a TBL session.  Finally, facilitation is also about fostering a positive and conducive environment, which enhances the learning experience.

In conclusion, TBL facilitation may mean different things to different facilitators. Nonetheless, the reflection of this TBL facilitator is hopefully useful, especially in the context of beginning TBL facilitator, to have a better appreciation of the practice of facilitation.

105 – TBL in Year 11-12 Mathematics Classroom: From Passive to Active Learning
Puay San Chan
Yishun Innova Junior College

BACKGROUND: Traditionally, the teaching of A-level Mathematics at junior colleges in Singapore is conducted using a lecture-tutorial system. Many of my students expressed difficulties in understanding concepts taught in lectures and experienced frustration in completing home-assignments. The learning culture in my classes was generally passive and there was little opportunity for collaborative and experiential learning. A revolution in pedagogy was deemed imperative in changing the learning culture to promote self-directed and independent learning while equipping the students with 21st century skills such as collaboration and critical thinking skills.

DESCRIPTION: TBL was first introduced to three year-12 classes in 2015 for one semester as a pilot study. The positive feedback received spurred me on to implement TBL fully for the two-year curriculum in 2016 & 2017. The change in pedagogy involved immense planning and preparation of teaching resources, which included getting students’ buy-in, re-writing learning objectives and revamping lecture notes of all topics into student-friendly version to ease students’ self-learning, crafting of MCQs for Readiness Assurance Tests (RAT) and designing Application Activities. Students even initiated a pre-RAT chat-time at the start of each lesson for clarification of doubts in pre-lesson learning.

RESULTS: Survey on students’ acceptance of TBL showed 88% preference for TBL. Positive comments included “TBL made me learn so much more compared to lecture-tutorial setting … I often find myself prioritising Math overOther subjects” and “…Not only did we clarify our doubts, we also reinforced our own understanding by helping one another. WhenOthers raised doubts that I had not thought of, it instigated my curiosity which made me more attentive in the session … it is a very engaging method of learning.”  

CONCLUSION: The positive impact on students’ learning culture has strengthened my determination to continue adopting TBL in my mathematics classroom.

106 – A Grading System for Team-Based Learning Class Activities in Undergraduate Courses
Staci N Johnson
Southern Wesleyan University

Team-Based Learning (TBL) is an active learning pedagogy that focuses on real-world application of course learning outcomes and building effective team-work skills.  In-class application activities are designed with two main goals in mind: 1) Use and apply course content to solve a real-world problem, in order to achieve greater understanding and mastery of course learning outcomes; and 2) Require team members to work together to improve the team performance skills of communication, cohesion, mutual respect, and leadership.  Various discussions within the TBL community have attempted to address the need for and process of assigning grades for in-class activities.  Utilizing research-based findings, the “Team Activity Performance Grading” system was developed, which includes a rubric for grading and a remediation procedure.  The rubric, using the main criterion for TBL success presented in Michaelsen and Sweet (2008), was developed to allow for clear communication of expectations for students and simple assessment of these activities by the instructor.  The remediation procedure is also outlined, implementing steps for supporting and developing learner self-regulation, which allows teams to repair an unsatisfactory grade.   The rubric and remediation procedure are currently being utilized in undergraduate science courses, but could have broader application to Other disciplines or education levels.

Best Poster Award Nominee
108 – Utilizing TBL Online in a Research Methods Course: A Pilot Study
Jennifer Styron and David Bilberry
Eastern Virginia Medical School

Designing activities that actively engage students in the learning process continues to be a challenge when constructing online courses. Challenges to active engagement include the utilization of tools to increase social presence and sense of community, and ensuring that students have the technology competencies needed to engage successfully within the course. Quality Matters (QM), an international organization that provides quality assurance for online education (MarylandOnline, Inc., 2018), has developed eight general standards to guide the design of online and blended courses aimed at learner engagement through active learning.

Along with interaction and engagement challenges relative to active learning, there are obstacles impacting student persistence in science, technology, engineering and mathematics (STEM) courses. The primary obstacle is course delivery based on lecture style methods. This style, based on passive learning methods, has been identified as one of the major barriers regarding student persistence and subsequent graduation rates. A viable option to address these areas of concern is to incorporate the increased use of active learning strategies, such as team-based learning, in instructional delivery. This pedagogical method has been proven to improve content acquisition, knowledge transfer, and critical thinking. Additionally, team-based learning has led to increased communication, collaboration and student engagement.

This authors of this proposal introduced team-based learning in an online educational research methods course as a tool to transition it from static, independent, asynchronous activities to application based asynchronous and synchronous team activities. The purpose of the pilot was to investigate the use of Team-Based Learning to determine if this method had a positive impact on student efficacy and engagement. Results of course evaluations and student surveys post course completion will be reported and discussed along with recommendations for implementing team-based learning in an online learning environment.