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TBLC 2020 Oral Presentations


A New and Diverse Interpretation of 4S: Size, Subject, Support,...and Siblings?
Lauren A. Vicker 
St. John Fisher College


In this oral presentation, the traditional TBL 4Ss (significant, same, specific, and simultaneous) are re-interpreted in a new and diverse way. The presentation, led by two professors uniquely connected but with diverse fields of study and different levels of experience with TBL, will explain how institution size and discipline do not matter when implementing Team-Based Learning, and that support, too, can come from diverse areas.

The presenters include an information systems professor from a large public university and a communications professor from a small liberal arts college. Each will demonstrate how their diverse journeys into Team-Based Learning revealed common approaches, outcomes, and lessons learned.

A key feature of this presentation will be the presentation of avenues of support for those who are looking to implement TBL into their curriculum, whether with professional colleagues or as a single faculty member. The presenters will share their strategies and how they adopted TBL to their fields with an emphasis on how the audience can also adapt these ideas to their own fields of study. Attendees will take away new contacts, resources, and practical lessons based on the experiences of the presenters who have tried, failed at times, and succeeded with Team-Based Learning.

TBL Jeopardy™ using White Boards or Turning Point Team Clickers for Creating Engaging Application Exercises and/or Exam Review Sessions
Jennifer Rene Courtney | John Cusick | Eugene Kreys | Suzanne Clark
California Northstate University College of Pharmacy


Team-based Learning (TBL) and Jeopardy® have traveled parallel paths in recent history.  Both were developed in the 1960s & 1970s and both have proven to be durable, such that when their fundamental components are incorporated appropriately, both can be successfully adapted to a range of settings.  TBL application exercises are most successful when students are actively engaged.  The Jeopardy® platform can be highly engaging and, when correctly delivered, can promote retrieval memory and accountability.  Accordingly, it is not surprising that Jeopardy® has been successfully adapted to TBL.

Aims: This presentation will outline how Jeopardy® has been adapted to TBL classes using several approaches, ranging from team white boards to Turning Point® Team Clickers, the latter using methods from Cusick (MedEdPORTAL, 2016).

White-Board Jeopardy: The economical design and implementation of TBL classes using white boards can employ a free downloadable Jeopardy game and small, erasable white boards for simultaneous reporting of team answers.  Questions are mapped to learning objectives as column headings and engagement can be promoted with iRAT/tRAT points incentives.

Turning Point® Team Clickers: The use of team clickers has been developed for a Jeopardy® review game that incorporates a team leaderboard created with the assistance of our University IT.  This version of Jeopardy® creates fast, but friendly competition and has been useful when teaching large classrooms of up to 120 students, as the team clickers permit engaging discussions in groups of 5-6 students/team.  Individual questions are simultaneously considered by all teams.  Scores are continually tabulated and displayed by the team leaderboard."


A Qualitative Analysis on the Effectiveness of Peer Feedback in Team-Based Learning (TBL)

Sarah Lerchenfeldt | Suzan ElSayed | Stephen Loftus | Gustavo Patino | David Thomas
Oakland University



Peer evaluation is the final practical element of TBL that may be used to promote interpersonal and team skills essential for future success. To our knowledge, there is limited information on medical students’ perceptions of peer feedback, both in terms of its value and how it has affected them as they move forward in their careers. In an effort to improve peer feedback implementation and long-term utility, the goal of this study was to gain a deeper understanding of students’ perceptions about the effectiveness of giving and receiving peer feedback.

This study utilized an exploratory qualitative research design using focus groups. A total of six focus groups were conducted, each comprised of medical students in their first through fourth years, and medical residents who graduated from the same institution. Discussions were transcribed verbatim and thematic analyses were completed by five independent reviewers. Themes were identified by consensus and any differences were resolved by careful re-reading of the transcripts.

Four key themes and several interconnected subthemes were identified. Subthemes for the first key theme, preparation and training, included the importance of peer feedback instruction and the clarification of what constructive feedback involves. With the second key theme, procedure and implementation, noteworthy subthemes included providing oral versus written peer feedback and the use of self-reflection. Faculty role modeling was a notable subtheme identified under the third theme, evaluation of student feedback. Significant subthemes for the fourth key theme, student considerations, included student maturity and evolution through medical school as well as the stresses of grading, and anxiety about faculty perceptions.

Our analysis raised awareness about several potential areas of concern and difficulty for students in regards to the TBL peer feedback process. Quality improvement initiatives may include the addition of self-reflection and use of oral instead of written feedback.



"Surviving" TBL team development: an Evidence-Based Practice course with a novel, Survivor-themed, team building scavenger hunt
Diana Langworthy | Tiana Luczak | Sarah Brown
University of Minnesota College of Pharmacy | University of Minnesota Health Sciences Library


Building functional and cohesive teams is an essential component of creating a successful TBL environment and fostering high-level intra-team discussion.  Our aim was to increase students’ autonomy and responsibility for self-learning by setting team and faculty expectations in a collaborative, lively manner prior to the TBL sessions. Our secondary aim was to assess the students’ understanding of biomedical study designs and skill level in literature searching.

We piloted a novel team building activity at the start of an Evidence Based Practice course in the third year doctorate of pharmacy (P3) curriculum at the University of Minnesota College of Pharmacy. This course was structured to utilize TBL in five class sessions. The themed scavenger hunt was inspired by the American television show Survivor™ and focused on TBL teams working competitively to find their evidence-based practice themed team names (e.g., The P-Values) through a virtual scavenger hunt using literature searching techniques in PubMed. After finding their team names within the literature, they designed a team flag that included written expectations for fellow team members and faculty for the semester. The activity concluded with a debriefing on the relationship between expectation setting and team development.

Throughout the activity, students were highly engaged and motivated to work collaboratively with overwhelmingly positive attitudes. Common themes that students identified for expectations of each other included being respectful, an active listener, inclusive, and accountable. Student’s expectations of faculty had similar themes and included being flexible, respectful, understanding, and providing clear communication.

This novel scavenger hunt is an innovative TBL technique that fostered high student engagement and team collaboration. The activity served as a positive and fun method of introducing evidence-based practice concepts and helped students build a solid foundation of unity and understanding through self-determined expectations for a semester of TBL."

An Innovative Approach to Accommodate Different Learning Needs in Medical Histology course
Lu Xu | Andrew Wang | Danielle Krakosky | Angela Sultan
Tulane Medical School

Medical Histology teaching has changed drastically over the last decade from traditional microscopy to virtual microscopy. In this digital age, the way that students learn has changed as well. Many students prefer independent study and preparation over traditional mandatory lectures and laboratory sessions. However, due to the hands-on nature of Histology lab, not all the students were able to learn how to recognize tissues by themselves. We sought to develop an approach that would accommodate students’ different learning needs without compromising the practical elements of Histology.
Tulane Histology course has transitioned to team-based learning (TBL) in the 2018-2019 school year. The preparation materials for TBL were provided online including the Histology lab guide. Students can choose to do the Histology lab independently at home. Option lab sessions associated with TBL preparation materials were offered to the students who preferred learning under faculty supervision. A survey was administered to 191 students from 2018-2019 who experienced the TBL with optional lab approach.

Student satisfaction was significantly higher after implementing TBL with optional lab approach (p< 0.05; 3.79 > 3.34). Most students reported the new method to be helpful for their Histology learning. With the same number of faculty involved in the Histology lab, the approach led to an increase of a faculty to student ratio.  Faculty reported an improved quality of discussion with students and less time spent in the optional lab compared with the traditional laboratory teaching.

Using an innovative approach of combining TBL with an optional lab, we manage to accommodate students with different learning needs, maximize students’ learning efficiency, increase the faculty to student ratio during the contact time, improve the interaction between faculty and students, decrease faculty total time spent in the lab and increase faculty satisfaction.

Challenges to develop TBL modules that integrates 5 basic disciplines in the first year of a Medical School
Fernanda Teresa de Lima | Thomaz Augusto Alves da Rocha e Silva | Welbert Oliveira Pereira
Faculdade Israelita de Ciências da Saúde Albert Einstein


An integrated curriculum presupposes approximation of various disciplines into meaningful associations to focus upon broader areas. Team Based Learning (TBL) seems to be a suitable method for such approach. Our institution delivers almost all instruction in the first four years through active learning, mainly TBL. In two 20-week courses, during the first two semesters, covering Cell Biology, Molecular Biology, Biochemistry, Biophysics and Genetics, 10-16 TBLs were performed, and many challenges were faced when developing modules for the first year of a Medical School.

Describe our experience in developing integrated TBL modules and how we approached these challenges.

Teaching plans, syllabus, pre-class and in-class materials from seven semesters (February 2016 to July 2019) were reviewed, and faculty was interviewed to provide understanding of challenges and how they overcame them.

There were 5-7 TBL modules during first semester and 5-9, on the second. At each semester, at least one new TBL module was developed, totalizing 37 different modules. Development of objectives, content and appropriate application exercises integrating the different subjects, followed by lack of pre-class material in appropriate volume and difficult level were the main challenges. Literature search from the standpoint of disciplines in isolation to later find common ground, exploration of student’s early clinical experiences, clinical-research partnership and multidisciplinary discussion rounds provided clarification of objectives and ideas for exercises. Feedback from faculty from clinical years also ensured vertical integration between basic and clinical sciences. Creative pre-class videos and materials, using clippings and excerpts of different texts were developed. Reading guidelines are carefully prepared, often in the form of questions, to ensure that the student understands what goals to achieve when reading the material.

Developing TBL modules integrating 5 basic disciplines and clinical sciences in the first year of a medical school brought many challenges. Careful and creative preparation and team work were essential to overcome them.

Combining the Elements of Team-Based and Project-Based Learning in an Undergraduate Rehabilitation Sciences Course to Increase Student Engagement and Improve Outcomes
Laurie A. Schroder
East Tennessee State University

Abstract Unavailable


Implementing a Team-of-the-Month Award to Recognize and Incentivize Effective Teamwork
Suzanne Clark | Tarnjit Kaur
California Northstate University College of Pharmacy

TBL teamwork can be facilitated by helping teams progress smoothly through the stages of forming, storming, norming and performing.  Although students may not come to a TBL class with effective teamwork skills, these can be learned and practiced, with appropriate guidance.  This can include providing education on characteristics of effective teams, reinforcement of effective teamwork strategies, opportunities for self-reflection, and regular feedback.  Similarly, good teamwork can be incentivized through acknowledgment and recognition.

To promote and recognize effective teamwork, we have developed a Team-of-the-Month award open to teams from all classes across our curriculum.

A set of criteria listing effective teamwork skills are provided to all students in the College of Pharmacy PharmD program.  Criteria include smooth team transitions (forming through performing), team accountability to members (and members to teams), responsible collaborations, mentorship, professionalism, and patience.  Teams are required to reflect on qualities that make/made their team excellent and to discuss how their team exemplifies up to three criteria from a list.  They can also propose their own criteria, to allow for creative reflection by teams.  At our program, advanced students have been on up to 6 different TBL teams by the time they complete their three didactic years.  Students have expressed an interest being allowed to nominate a previous team, instead of being limited to current teams.  Accordingly, students can nominate any team on which they have been a member.  This is important, for as students progress through the program they have more experience with effective teamwork and may better recognize effective teamwork, in retrospect.

Nominations are scored using a set of criteria including standard assessments (word count, deadline, number of criteria addressed directly) and compelling narrative.  Winning teams are acknowledged at a College-wide meeting, where they read their narrative and are photographed for website acknowledgment.

Implementation of Spark, an open source solution for the team-quiz
Reid Proctor | Renee Hayslett
Mercer University College of Pharmacy | Mercer University College of Pharmacy



Conventional TBL uses IF-AT cards to deliver the team-quiz component of the Readiness Assurance Process (RAP). We observed the use of IF-AT cards in various settings and identified that their use could be challenging in a large classroom setting. We sought to implement an electronic platform that would facilitate efficient delivery of the team-quiz.

Within the last year and a half we began integrating TBL within our pharmacy program. To reduce logistical challenges in the large classroom, which includes distributing and collecting IF-AT cards, time to grade them, and additional personnel needed to facilitate this paper based process, we implemented the Spark system.

Spark is a web based platform and is based on the Moodle system, an open source software program. Spark is used in conjunction with the Respondus Lockdown Browser®, making it a secure process for the RAP. Spark, like the IF-AT cards, supports an answer until correct function along with additional capabilities such as fill-in-the-blank and select all that apply, thus allowing greater flexibility with question types. In addition to supporting the RAP, Spark has been used to effectively deliver a variety of application activities. We conducted 49 TBL sessions within the last year, all using the Spark system to deliver the team quiz as well as some application activities. 

Using Spark to support TBL has resulted in a number of benefits.
Eliminated the need to distribute or collect any type of paper quiz.
Immediate collection of the team-quiz results
Implementation of additional question types within the RAP beyond single-selection multiple choice.
Supported a greater range of application exercises beyond multiple choice questions within the large classroom.
Provided a cost friendly solution. 

We have found Spark to be a valuable and efficient system and will continue to develop how we use it in TBL."


Involving Patients/Standardized Patients in TBL
Wendy Madigosky | Michelle Colarelli | Lisha Bustos | Elshimaa Basha
University of Colorado Anschutz Medical Campus



Healthcare professional students apply their learning with patients and standardized patients (actors trained to portray patients in a standardized fashion).  Does it work to involve patients and standardized patient in TBL?   At the University of Colorado Anschutz Medical Campus, patients and standardized patients are involved in two different ways within a TBL-based interprofessional education course for dental, medical, nursing, pharmacy, physical therapy, and physician assistant students.

Patients/Family Advocates help to teach in a session about ‘Patient Engagement’ in health care at the individual, system and societal level.  Advocates have 3 roles: 1) represent the patient/family voice and role in health care and health professions education, 2) be a resource to student teams as they determine the best strategy to engage a patient/family at the individual level during their application exercises, 3) provide feedback and encouragement to student teams during report outs and inter-team discussion.   In effect, they join the facilitator as being a visiting ‘guide on the side’ with authentic expertise in this content area.  Standardized Patients portray challenging patients/providers as part of the application exercises during our ‘Advocacy and Assertion’ session.   In this session, teams are required to speak up in scenarios that otherwise might result in patient harm.  Standardized Patients enable teams to demonstrate their skills and communication approaches during the application exercise report out, and also provide feedback during the inter-team discussion.

In this presentation, we will describe how to recruit, train and involve Patients/Family Advocates as well as Standardized Patients in traditional TBL sessions.  We will also share feedback from students, faculty, patients and standardized patients based on engaging them in TBL sessions, and future directions.

Threshold Concepts-Based TBL
Suzan Kamel-ElSayed | James Grogan | Stephen Loftus
OUWB School of Medicine


The purpose of this presentation is to introduce participants to threshold concepts and how they can be used to improve educational programs. Many students struggle because of information overload. Threshold concepts help us to address the problems of curriculum overload and cognitive load. Threshold concepts have characteristics of being troublesome, transformative, integrative, bounded and irreversible. Identification of threshold concepts in different disciplines can be used as a foundation for designing an effective and powerful TBL session. This is because threshold concepts are those ideas that learners often find difficult but must understand in order to progress in understanding. TBL is an ideal environment for learners to articulate their understanding or misunderstanding of these key ideas and help each other work toward mastery of threshold concepts. This is because threshold theory recognizes the importance of liminality which is the need for many students to spend time working through difficult concepts before fully understanding them. On another level, threshold concepts can enhance teachers ability to integrate across disciplines, especially those from humanities, social and biomedical sciences. TBL session and application exercises, in particular, provide an ideal opportunity for students to engage with threshold concepts critically to solve complex problems. One limitation is that preparatory work of faculty is needed to collaboratively identify threshold concepts in their courses.



The RAPsody of Virtual Reality Team-Based Learning
Jody K. Takemoto | Rachel A. Bratteli | Brittany L. Parmentier | Thayer Merritt | Leanne Coyne
California Heath Sciences University | The University of Texas at Tyler, Ben and Maytee Fisch College of Pharmacy | The University of Texas at Tyler, Ben and Maytee Fisch College of Pharmacy | The University of Texas at Tyler, Ben and Maytee Fisch College of Pharmacy | California Health Sciences University


Purpose: The purpose of this study was to develop and implement the readiness assurance process (RAP) in a virtual reality (VR) environment and to evaluate the effectiveness of the RAP in a VR team-based learning™ (TBL) scenario.

Methods: Participants were recruited through postings on the University campus and through student organization listservs. Students were provided with a short reading and escorted to individual VR stations to complete the RAP (e.g. iRAT, tRAT, appeals, and clarifying points). A survey collected participant demographic information and specific questions about their VR TBL experience using a 5-point Likert scale and open-ended questions.

Results: Participants from diverse backgrounds and educational experiences participated in a RAP TBL experience. Participants tended to be White (30%), Female (51%), and/or between the ages of 18-24 years (89%). The majority of participants responded positively to the experience indicating that they would take a VR TBL course (83.33%) and would actually choose this environment over current online methods for team activities (88.89%). A small percentage experienced vertigo (29.63%) while participating.

Conclusion:  This pilot study is the first successful demonstration of TBL conducted in VR. Opportunities for improvement includes minimizing vertigo while in the learning environment and improving use of this technology for team activities and assessments. Additional studies are warranted to implement a complete TBL module in VR from RAP through application exercises.

Acknowledgements: The authors would like to thank the Team-Based Learning Learning™ for their financial support.

Faculty Approaches and Attitudes towards TBL Pre-Class Learning Materials
Allen Keshishian Namagerdi
California Health Sciences University, College of Pharmacy


Background: Literature review suggests various preparatory materials include instructor-prepared handouts, literature articles, textbook sections, PowerPoint slide set with audio, prerecorded lecture, and video for students pre-class preparation in a TBL setting. Although there are multiple kinds of pre-class preparatory materials, and there is great variance in how well students learn content out of the class, which is crucial to designing and preparing pre-class materials, there are no empirical and controlled research studies on the best strategies to provide the necessary pre-class content instruction.
Aim: Review and analyze the faculty approaches and attitudes towards pre-class learning materials for disciplines taught in a TBL setting.

Methods: Survey questions using Likert scale followed by open-ended questions were designed for this quantitative and descriptive study. Study population included faculty and instructors who had been teaching in TBL settings in disciplines including but not limited to pharmaceutical, clinical and socioeconomical sciences as well as business, law, mathematics and English. All data was derived from online survey results.

Results: Anonymous survey containing 17 questions was sent to 210 faculty and instructors of k-12/high school or equivalent, undergrad and post grad institutions with TBL. Based on the survey results, 'Guided handout' was ranked by faculty as the most effective pre-class material for facilitating students learning. About 80% of faculty said that they had almost always (more than 75% of times) assigned guided handout as a pre-class material to their students. Also, results of survey showed that 'Level of student engagement' and 'Development of critical thinking' were ranked by faculty as two most important factors in preparation of pre-class materials.

Conclusion: Results of this study can be implemented in designing pre-class learning materials at TBL institutions to improve students pre-class readiness more effectively."


The Effects of Team-Based Learning (TBL) on Leadership Development: Initial Perspectives from Pharmacy Preceptors and Student Pharmacists
Marta Brooks| Robert Haight
Regis University


As the role of the pharmacist evolves, the need of pharmacists to be efficient leaders increases. The Regis University School of Pharmacy employs TBL as its primary means of educating students. Students work in teams throughout their first three years of pharmacy school, which allow students to gain skills related to interpersonal relations, group dynamics, and communication. The objective is to explore whether TBL influences leadership development in a Doctor of Pharmacy program.

This study examines the perceptions that student pharmacists and preceptors have with TBL and improved leadership skills. Qualitative analysis was conducted using grounded theory to analyze preceptor interviews and will be similarly analyzed for student focus groups. Utilizing an a priori codebook, the researchers coded themes in the transcripts. The researchers will then compare themes from student and preceptor responses to determine similarities.

To date, nine preceptors (majority 26-35 years of age) were interviewed. All participants precepted students for more than six years and at least P4 students. All interviewees stated that leadership skills are an important aspect of being a pharmacist and were not taught while they were in school. Interviewees stated that communication is a dimension of being a leader and a pharmacist. Interviewees also noted a link between TBL and being a leader, with statements such as “Communication is fostered by TBL” and “ability to fit with any multidisciplinary team is evident.” The interviewees also stated that TBL gave students skills necessary to be successful in their careers as healthcare team-members.

Leadership and the ability to communicate and work in a team are important aspects of being a pharmacist. Preceptor interviews reveal that Student Pharmacists who learn through TBL gain general leadership and communication skills that set them apart from their counterparts. The next phase will be to explore student perceptions of leadership development.

We have not received any funding nor is this a student abstract submission.




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