Team-Based Learning

In this module you will learn about team-based learning (TBL) and how to implement it in your teaching. TBL is not another name for small groups, and it’s not the same as problem-based learning (PBL). Students can work in teams in any of these, but TBL is different.

So what is it?

Video: Listen as Dr. Borowitz describes TBL in more detail.

We’ve talked about the structure of TBL and some of the basic features that distinguish TBL from other types of active learning. But according to Larry Michaelsen, the chief architect of TBL, there are a few essential elements necessary for a successful TBL session.

Video: Listen as Dr. Borowitz describes these essentials features.

To summarize, Michaelsen’s essential elements of TBL include:

• Properly formed and managed teams
• Student accountability for their individual and group work
• Frequent and timely feedback
• Assignment design to promote learning and team development

Permanent groups are a key feature of TBL. It takes time for a group of assembled individuals to develop the characteristics of teams.

Students should not be allowed to self-select during team formation. Such teams often are social groups where existing relationships make cohesion difficult. There is also evidence that student-selected teams underperform compared to other methods.

Groups should be balanced by features you feel are important for your course. For example you might want to ensure that students with a science background are not all concentrated in a subset of the teams. The drawing illustrates a way of distributing students.

In order for students to get the maximum amount out of a TBL session it is necessary for them to do preparatory work before class. Before getting to the exercises where they apply the knowledge they have gathered, it is necessary for them to show that they’ve done the preparatory work. This is done with not one, but two examinations, that they take first as individuals, and second, in their teams. We call this process readiness assurance.

Video: Watch a demonstration of an individual readiness assurance test.

Note that Dr. Borowitz wears a baseball cap in these sessions to denote when the TBL exercise is taking place; he removes the hat when he returns to a lecture discussing general features of TBL.

Video: Watch a demonstration of a group readiness assurance test.

You can review the answer keys from the classroom sessions in the videos above.

After the GRAT some time should be allotted for students to dispute an answer. This should be encouraged, and other teams who got the intended answer engaged to explain why they disagree. If there is confusion about an answer, a mini-lecture to clarify is appropriate.

Video: Listen and read below Dr. Borowitz’s explanation of commonly made mistakes and how group dynamics emerged from the IRAT/GRAT session.

Overwhelming students with too much advance reading

• Students will tend to devote a fixed amount of time to reading, skimming if there is too much, so use their attention wisely.

Testing in tremendous detail, or making questions too hard or easy

• The goal of the RAT is readiness, not mastery of the material. Target averages for the IRAT should be around 60%; for the GRAT target averages should be around around 80-90% so they can see the value of the team activity.

Letting people use computer resources during the GRAT

• The GRAT is the first opportunity for them to explore how they will work in teams. If they are drawn instead to computers, you’ve lost an opportunity to set the tone.

The application exercises are the heart of TBL. In this video, Dr. Borowitz is conducting a TBL that is designed to teach participants how to write National Board-type multiple choice questions.

Video: Listen to how Dr. Borowitz sets up the exercise.

See the actual exercises, from the classroom video above, on multiple choice questions.

In designing and conducting the exercises, Michaelsen emphasizes 4 essential features, that he calls the 4 S’s of TBL. These are:

1. Significant problem
2. Same problem
3. Specific choice
4. Simultaneous reporting

Let’s look at these in a little more detail.

Specific Choice: Reducing complex data to a simple response requires high level thinking; it is also best way to ensure concise reporting and to allow comparison across teams.

Simultaneous Reporting: This refers to having all teams report their answers at the same time. Sequential reporting, though often used, produces answer drift; there are subtle pressures for students to agree with those who answered before them, and by the end of the reporting there can appear to be consensus that didn’t exist before, missing a chance for discussion.

Video: Watch the following session clip to see one low-tech way of doing simultaneous reporting using “voting cards.”

Video: Watch this next clip to see what happened in this session. If this happens once it might be a fluke, but if it happens repeatedly it means you need to rework your application exercise.

More on Simultaneous Reporting: Sometimes people object to TBL because it is hard to write multiple choice questions to capture the complexity of an exercise. There are, however, other methods. In some cases small whiteboards can be used in the same way as cards for students to write a short answer to a question and hold them up simultaneously.

When a particular exercise lends itself to an even more complex answer, a common technique is to use a Gallery Walk, where teams post their answers and other teams circle around and critique them, sometimes by commenting directly on the posted answer. This can lead to robust discussion.

Video: In this session clip. Dr. Borowitz has asked each team to come up with a multiple choice question for a clinical vignette.

There is no set rule for how you rate the components of a TBL. However, the grade should include some combination of individual and team work and each component should count at least 10%.

Peer evaluation (based on team contribution) is considered essential to TBL and is more important the more TBL sessions there are as part of a course. This, more than anything else, holds students accountable to their teams. However, this can also create tensions within teams or between the class and the instructor. If a class is only going to have one or two TBL sessions peer evaluation may not be worth the problems.

The following is one example of weighting used in TBL grading:

IRAT 20%
GRAT 30%
Applications 40%
Peer 10%

Application Exercise Grading: Grading multiple choice questions with a single best answer is straightforward. If a more complex reporting mechanism is used for the application exercises, it will be necessary to develop a grading rubric.

Forum: Discuss if you have developed a rubric for evaluating an application exercise.

If you’re interested this document shows more details about peer grading.

Note that Michaelsen favors a process by which the class decides upon relative weights, with each team coming up with a proposal and representatives from the teams meeting and returning to their teams to achieve consensus.

Forum: Consider your own experiences with peer grading. Did you have any challenges? How did you structure peer grading?

Some of the main advantages are summarized here:

• Active learning; keeps students engaged
• Provides a small group experience to a large group of students
• Models cooperative learning important to physician practice
• It works!

At the same time, however, there are some disadvantages to be aware of:

• Higher performing students may “carry” lower performing students
• Instructors may have trouble identifying students in need of help
• It requires extensive upfront preparation on the part of the instructor
• It’s better for depth than breadth
• It’s hard to cover content at the pace typical in medical schools
• Some students may not like it