Team-based learning improves knowledge and retention in an emergency medicine clerkship

Abstract

Background: Team-based learning (TBL) as an instructional pedagogy is increasingly recognized to improve student engagement, value of teamwork, and performance on standardized assessments when compared to traditional lecture-based instruction. The aim of this study is to compare two educational modalities (TBL and didactic/case discussion) on knowledge-based outcome and student perceptions. Methods: Two emergency medicine clerkship academic years were studied. In the first year, all topics were delivered via didactic presentations along with case discussions. In the second year, eight topics were delivered using TBL while three topics were delivered via didactic/case discussions. Final exam marks were compared. Student satisfaction survey was also conducted and analyzed. Results: After adjusting for student past performance and exam difficulty, student marks improved in the second year for both TBL and didactic/case discussion topics. The average mark for topics taught via TBL in the second year was significantly higher than the average mark on the same topics taught didactically in the first year by 7.5% (T test, p < 0.001). The marks for topics taught via TBL showed better improvement comparing to topics taught via didactic/case discussion by 2.3% (ANOVA-RM, p = 0.042). Student marks related to TBL topics were significantly higher on the medical exit exam (paired t test, p = 0.007). Student response to TBL survey was positive. Conclusions: TBL as part of a blended learning environment facilitated improved knowledge-based performance in an emergency medicine clerkship following end clerkship and medical school exit assessments, suggesting TBL stimulates long-term retention. The high acceptance of TBL among our students suggests a preference of this learning modality to didactic teaching.