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 Table of Contents  
Year : 2018  |  Volume : 5  |  Issue : 4  |  Page : 281-285

The implementation of team-based learning in MBBS pharmacology teaching: A student's perception

Department of Pharmacology, Guru Gobind Singh Medical College, Faridkot, Punjab, India

Date of Web Publication14-Nov-2018

Correspondence Address:
Harminder Singh
Department of Pharmacology, Guru Gobind Singh Medical College, Faridkot, Punjab
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/cjhr.cjhr_66_18

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Background: The objective of this study was to assess the student's perceptions/observation of team-based learning (TBL) in a 2nd year MBBS Pharmacology teaching using the TBL Student Assessment Instrument (TBL-SAI). Methodology: The TBL strategy was administered to 100, 2nd year MBBS Pharmacology students with the help of TBL-SAI surveys. The survey includes 33 items, each rated from one (strongly disagree) to five (strongly agree) and measures three subscales: students' perception/observation of accountability, liking for lecture or TBL, and student satisfaction. Results: Total TBL-SAI score for each component fell above the neutral point score. About 77.9% of the students have felt accountable to participate in the learning. Majority (89.5%) showed a preference for TBL comparable to lecture instruction. In addition, 85.6% of the students were satisfied with the course. Conclusion: The TBL design has been effectively implemented in learning of analgesics and antiulcer drugs in pharmacology with the key objectives of encouraging and perceiving student accountability, satisfaction, TBL versus lecture and student engagement. TBL enhances the student teacher interact and is helpful to students who learn in group activities and is a feasible active-learning academic strategy for large student-faculty ratio. This could be effortlessly tailored for other topics, courses, and programs.

Keywords: MBBS, pharmacology, readiness assurance test, student assessment instrument survey, team-based learning

How to cite this article:
Singh H, Jain A, Bala R, Verma K, Modak S. The implementation of team-based learning in MBBS pharmacology teaching: A student's perception. CHRISMED J Health Res 2018;5:281-5

How to cite this URL:
Singh H, Jain A, Bala R, Verma K, Modak S. The implementation of team-based learning in MBBS pharmacology teaching: A student's perception. CHRISMED J Health Res [serial online] 2018 [cited 2023 Jan 27];5:281-5. Available from: https://www.cjhr.org/text.asp?2018/5/4/281/245448

  Introduction Top

Team-based learning (TBL) is a properly-defined, scholar-centered academic method given by Dr. Larry Michaelsen, that supposedly employs learner in active learning with critical mastering of the given topics/subjects.[1] Learners in TBL come prepared with assigned homework to resolve genuine practical problems in predetermined assigned groups.[1] With frequent assessments, student gets instantaneous feedback of their overall performance as an individual and as a group.[1] TBL enhances student engagement, promotes active gaining of knowledge and it is mostly perceived as enjoyable. That is one of the most important reasons for its use in preclinical and clinical subjects for long time as reported by students.[2],[3],[4]

TBL is being utilized more in medical teaching. The goal of TBL is to move beyond the easy assurance of content and resolve problem with in-depth understanding of the subject gain from TBL inbuilt distinctiveness.[5] Collaborative studying techniques are typically based on the precept that scholars working together as a cohesive team are able to achieve higher stages of studying. The method builds on the strengths of student groups, allowing them to work collectively as a team to reap a common aim.[6]

TBL can be put into practice in three phases. In Phase 1, the learner completes coursework, such as a course book reference readings outside the classroom to make them accountable for the completion of these assignments. In Phase 2, students work together with problems related to assigned topics, in addition to giving readiness assurance tests (RATs), first independently and then in allocated small groups. In the 3rd Phase, the learner seeks advice from faculty to solve complex problems, prompting vigorous participation and learning.[7],[8],[9] TBL is particularly characterized by the key mechanism that the majority of in-class time is dedicated to conclusion-based appliance of coursework done in groups/teams.

TBL-Student Assessment Instrument (TBL-SAI), is an applicable and reliable assessment tool that evaluates student perceptions of accountability, desire for learning, and satisfaction/pleasure in TBL and it was designed by Mennenga for progressive teaching techniques in nursing education.[10]

With the above-said description and hypothesis of TBL, we used TBL as a learning tool for enhanced learning by second professional pharmacology students and assessed their acceptability, satisfaction, TBL versus lecture preference, and engagement during TBL sessions with the help of TBL-SAI.

  Methodology Top

This cross-sectional study used the TBL-SAI tool to examine the perception of MBBS 2nd year students towards implementation of TBL in Pharmacology learning. 100 students participated in this 2-month study. The Institutional Review Board approved this study, and all students consented to the use of their anonymous responses to participate in the current study. No student names were associated with any of the surveys, and all research materials were handled exclusively by the authors of this study. The faculty of the department was sensitized with the TBL methodology and its assessment. We selected two important topics from pharmacology subject, i.e., analgesics and antiulcer drugs and implemented the TBL processes/exercise for given topics.

To assess the accomplishment of using TBL, the TBL-SAI was administered at the end of each topic.[10]

Study instrument

The TBL-SAI tool is specifically designed to assess student perceptions of TBL.[10] The existing TBL-SAI is a 33-item tool/instrument that scores on a 5-point Likert scale. All items are keeping a tally on a scale from 1 to 5 (1 - strongly disagree, 2 - stands for disagreeing, 3 - neither disagree nor agree (Neutral), 4 - agree, and 5 - strongly agree). The TBL-SAI includes three subscales: (1) accountability composed of eight items, (2) preference for lecture or TBL, containing 16 items, and (3) student satisfaction, comprising of nine items where scores range from 9 to 45. The total scores of the TBL-SAI range from 33 to 165.[10]

In Phase 1, at the beginning of the week main topic of discussion was announced. In Phase 2, RAT (from assigned topics) was taken, for each student who completed 20 questions of the multiple choice individual RAT. Following the individual RAT, students were divided into 10 teams/subgroups of 10 students each. Again teams completed a group RAT. In Phase 3, (application of the concepts), students were engaged in peer-teaching and case consultation centered on the specific topics within the region of the body being learned. This component took place in the classroom to facilitate inter- and intra-team discussions. Application exercises followed “the 4 S's” as suggested by Michaelsen: (1) each team worked on the same problem, (2) the problem was clinically significant, (3) each team made specific choices; and (4) the team answered each question related to the application exercise simultaneously.[1] At the end of the whole exercise, students were asked to fill the TBL-SAI questionnaire. An additional Likert scale was used (range 1–5) to assess the student engagement.

TBL intervention was done as shown in [Flow Chart 1].

Statistical analysis

Baseline distinctiveness (demographic) was summarized by descriptive statistics. Frequency, mean, percentages and standard deviation were calculated wherever appropriate. A Comparison was done with the unpaired t-test. P ≤ 0.05 was considered statistically significant.

  Results Top

A total of 100 MBBS 2nd professional students participated in the current study. The mean age in male group was 20.11 years and in female group 19.6 years. Gender wise no significant difference was observed.

The results of the TBL-SAI are shown in [Table 1]. The table includes the TBL-SAI subsets' possible ranges and the neutral point of each subset. The range, average, and standard deviation are given for each subset, as well as the percentage of the student's whose score was above the neutral point. The results indicate that 77.9% of the students have felt accountable to not only themselves but also to their team to participate in the learning. The majority of students (89.5%) showed a preference for TBL comparable to lecture instruction. In addition, 85.6% of the students were satisfied with the course. Together, these results indicate a successful implementation of TBL in the medical students.
Table 1: Scores from the team-based learning student assessment instrument

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TBL versus lecture preference accounts for average score of 50.51 for males and 51.8 for females for TBL. The mean student satisfaction score was 31.57 in the males and 30.8 score in the females. Student engagement was almost the same in both the groups with an average score of 3.9 in the male group and 3.8 in the female group. The average score above the neutral point described in percentage as shown in [Table 1], [Table 2], [Table 3]. The peculiar finding was on the score of TBL versus lecture that indicates 89.5% above the neutral point.
Table 2: Scores from the team-based learning student assessment instrument score according to male student perception

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Table 3: Scores from the team-based learning student assessment instrument score according to female student perception

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The gender-wise male and female groups perceive the TBL and given feedback in an identical manner except for TBL versus lecture score, which was significantly higher in male group as shown in [Table 2], [Table 3] and [Figure 1].
Figure 1: Comparison of the average score of all the parameters in male and female students TBL-SAI: Team-based learning-student assessment Instrument

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  Discussion Top

In the search for a teaching method that can optimally impart to students the subject of Pharmacology, which is already perceived to be complex, TBL appeared at first glance to be the ideal solution.

This pilot study was intended to get information, data on the feasibility, acceptance, accountability, and engagement of the method. We used TBL as an augmenting strategy of learning to develop critical thinking and problem-solving abilities.

The accountability subscale assesses a student's preparation for class and their readiness to contribute to their team.[10] Based on a neutral score of 24, the scores ranged from 8 to 36, a high level of accountability (77.9% higher than the neutral score) with TBL was noticed in our study. These results suggest that accountability may be a valued component of the TBL pedagogy for pharmacology students studying in 2nd year MBBS course.

Student satisfaction refers to positive feelings and attitudes toward a course format (TBL or traditional lectures).[10] With a neutral score of 27 for the level of satisfaction, high levels of satisfaction scores were noticed ranging from 14 to 51 (85.6% above the neutral score); thus, our students felt satisfied with the implementation of a TBL strategy in conventional pharmacology teaching. When we tested for the students' preference for lectures or TBL, we considered the students' ability to recall the material and pay attention in lectures versus TBL. Both male and female students scored well above the neutral score of 45 (89.5% above neutral point). However, there is a significant difference between the two groups in relation to preference for TBL with males preferring TBL more as compared to females.

Different theories exist that attempt to explain the slight preference for TBL versus traditional lectures. First, the introduction of a new learning strategy deviates from the traditional teacher-centered lecture format that students typically experience.[11] Second, the highest preference for TBL may be due to the inbuilt characteristic of a new generation of students who such as collaborative, learner-centered, experiences with clear directions, and real-life applications.[12],[13],[14]

The direct association among student engagement, positive learning outcomes, and student satisfaction has long been recognized.[15] Further students are engaged in the learning process and this leads to higher pace of course material preservation and degree completion.[16] A central precept of TBL as an instructional strategy in higher education curricula holds that students should learn more about the benefits of teamwork.[17] Without a doubt, the significance of people who know how to work successfully in teams on academic tasks is increasingly recognized, and we found that more than half of our students were habitually used to learn alone and hence they discovered the TBL as high-performance learning tool.

In this present study, students gave a feedback for more TBL sessions to be organized for them. This is similar to other studies in which students preferred TBL instruction.[18] In an organized review concern to TBL published during 2003–2011 found that students were satisfied with TBL and their engagement was higher in TBL classes and students with regular TBL classes scored higher on assessment as well.[19]

  Conclusion Top

The TBL may promote closer interactions with faculty and other students and gives the opportunity to engage members who would benefit from group work but, lacking the chance of group learning. In conclusion, the TBL design has been effectively initiated with a component of analgesics and anti-ulcer drugs in pharmacology with the key objectives of perception of students in relation to student accountability, satisfaction, TBL versus lecture, and student engagement. It is a feasible active-learning academic strategy that can be used even in the classroom with large student–faculty ratio and could be modified as per the requirement.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Michaelsen LK, Sweet M. The essential elements of team-based learning. New Dir Teach Learn 2008;2008:7-27.  Back to cited text no. 1
Michaelsen LK. Getting Started with Team-Based Learning. Sterling, VA: Stylus Publishing; 2004.  Back to cited text no. 2
Haidet P, Fecile ML. Team-based learning: A promising strategy to foster active learning in cancer education. J Cancer Educ 2006;21:125-8.  Back to cited text no. 3
Vasan NS, DeFouw D. The use of reading assignments and learning issues as an alternative to anatomy lectures in team-based learning curriculum. In: Michaelsen LK, Parmelee DX, McMahon KK, Levine RE, editors. Team-Based Learning for Health Professions Education. Virginia: Stylus Publishing; 2007.  Back to cited text no. 4
Michaelsen L, Richards B. Drawing conclusions from the team-learning literature in health-sciences education: A commentary. Teach Learn Med 2005;17:85-8.  Back to cited text no. 5
Beatty SJ, Kelley KA, Metzger AH, Bellebaum KL, McAuley JW. Team-based learning in therapeutics workshop sessions. Am J Pharm Educ 2009;73:100.  Back to cited text no. 6
Abdelkhalek N, Hussein A, Gibbs T, Hamdy H. Using team-based learning to prepare medical students for future problem-based learning. Med Teach 2010;32:123-9.  Back to cited text no. 7
Cestone CM, Levine RE, Lane DR. Peer assessment and evaluation in team-based learning. New Directions for Teaching and Learning 2008:69-78. DOI: 10.1002/tl.334.  Back to cited text no. 8
Thompson BM, Schneider VF, Haidet P, Perkowski LC, Richards BF. Factors influencing implementation of team-based learning in health sciences education. Acad Med 2007;82:S53-6.  Back to cited text no. 9
Mennenga HA. Development and psychometric testing of the team-based learning student assessment instrument. Nurse Educ 2012;37:168-72.  Back to cited text no. 10
Latman NS, Lanier R. Gross anatomy course content and teaching methodology in allied health: Clinicians' experiences and recommendations. Clin Anat 2001;14:152-7.  Back to cited text no. 11
Mangold K. Educating a new generation: Teaching baby boomer faculty about millennial students. Nurse Educ 2007;32:21-3.  Back to cited text no. 12
Wilson M, Gerber L. How generational theory can improve teaching: Strategies for working with the millennials. Curr Teach Learn 2008;1:29-44.  Back to cited text no. 13
Billings D. Teaching learners from varied generations. J Contin Educ Nurs 2004;35:104-5.  Back to cited text no. 14
Kuh G. What we're learning about student engagement from NSSE: Benchmarks for effective educational practices. Change 2003;35:24-32.  Back to cited text no. 15
Kraska M. Retention of graduate students through learning communities. J Ind Teach Educ 2008;45:54-70.  Back to cited text no. 16
Fink LD. Beyond small groups: Harnessing the extraordinary power of learning teams. In: Michaelsen LK, Baumann Knight A, Fink LD, editors. Team-Based Learning: A Transformative Use of Small Groups. Westport (CT): Praeger; 2002. p. 3-25.  Back to cited text no. 17
Ravindranath D, Gay TL, Riba MB. Trainees as teachers in team-based learning. Acad Psychiatry 2010;34:294-7.  Back to cited text no. 18
Sisk RJ. Team-based learning: Systematic research review. J Nurs Educ 2011;50:665-9.  Back to cited text no. 19


  [Figure 1]

  [Table 1], [Table 2], [Table 3]


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