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Team-Based Learning

Ben and Maytee Fisch College of Pharmacy

Changing the Classroom 

Over the past 20 years or so there has been a shift in how college students are taught. This change has occurred as we gained a better understanding of how people learn and what improves the retention of what they learned. As a result, more faculty members are moving away from traditional lectures and incorporating active learning as part of their teaching. 

This active learning may include intermittent question and answer periods, writing exercises or other activities that engage students in the classroom as they learn the course material. 

One of the active learning techniques that has gained popularity in health care education over the past decade is team-based learning (TBL). This method focuses on students working in teams to solve problems in the classroom rather than sitting through lectures during class time and doing homework exercises at some later point. Read more about TBL in pharmacy education.

A few pharmacy programs have begun to incorporate TBL into their curriculum with only a small number using the method more than just occasionally. Our doctor of pharmacy program will use TBL extensively throughout the curriculum. In fact, our new pharmacy building, W.T. Brookshire Hall, has been designed specifically for TBL in the classroom and collaborative learning outside the classroom.

The Appeal of TBL 

Being a successful pharmacist involves more than knowing a lot about drug therapy. While medication therapy knowledge is essential, equally important is the ability to think critically and solve problems. Since it’s impossible for you to learn every possible nuance of medication therapy management in pharmacy school, the ability to take your core knowledge and apply to new situations is what will differentiate you as an exceptional pharmacist. This is where TBL shines. 

While you are learning the foundational sciences and drug therapy management you are also developing critical thinking and problem solving skills. 

Another attribute of an exceptional pharmacist is being able to communicate clearly. With TBL you will constantly interact with your team members as you work though problems, deliberate possible solutions and agree on answers. As you progress through the program, you will hone your communication skills and learn how to comprehend and explain complex concepts in a clear and concise way using language that both professionals and your patients can understand. 

The ability to work well on a team is vital to being an exceptional pharmacist. No pharmacist works alone. Although a pharmacist may be the only person in a specific location, that pharmacist is a member of a health care team who must work effectively with others to ensure the best care for their patients. 

As the name implies, TBL places students in groups who work together in and out of the classroom as they learn about pharmacy and how to manage drug therapy. This is very different from those “team projects” you worked on where a group of you may have met a couple of times to work on something together, where the result was anything but work from the entire group. 

To function well as a team takes a bit of time and a lot of work, just like any good interpersonal relationship. TBL helps students learn how to develop these professional relationships through improved communication and collaborative learning. 

In our doctor of pharmacy program, we will place you in teams at the beginning of each semester and you will remain in these same teams for each course during that semester. Over the first few weeks your group of individuals will grow into a cohesive team as you begin to communicate and work collaboratively to solve real-world problems. 

By the end of the school semester, our goal is that your group of individuals will have developed into a knowledgeable, high-functioning team who respect and trust one another. This is the hallmark of an effective health care team. 

Each semester we will reorganize your teams. You will get to work with other students from your class just like you did the prior semester. Using this approach, helps you continue to develop and refine your team-building and team-maintenance skills so valued in the workplace today. 

The TBL Difference 

TBL is a significant departure from how many students have been taught in school. Rather than receiving content in class and then going away to solve homework problems, the process is essentially reversed. You use class time to solve problems and time outside the class to digest content. 

How TBL is different from the way some teachers “flip” the classroom is through the readiness assurance process. This is the real key to TBL’s success. Coming to the classroom truly prepared to solve problems is what keeps you on top of the material and helps you apply and retain what you have learned. 

TBL uses modules. You can think of each module as a collection of related topics that are best learned together and that build on your prior knowledge. For each TBL module, a general process is followed that begins with guided preparation, assessment of readiness for class, and the application of knowledge and skills in the classroom to think critically and solve problems. 

Getting Ready for Class 

Pre-class preparation can take many forms including pre-recorded presentations, specific reading assignments and introductory problem sets. It all depends on the faculty member and the content to be learned. In general, an instructor will assign the pre-class material with appropriate learning objectives that guide you as to what needs to be accomplished before class begins. 

The expectation is that you will understand important foundational concepts prior to coming to class so that deeper learning can occur during class time. It is not the goal to have you master material before class, but rather have a solid fundamental understanding of the important concepts so that those concepts can be applied during class. Of course, you can always work with your team or seek help from the instructor before class on those really tough topics. 

An Active Classroom 

At the start of class, you take an individual quiz that assesses your readiness to actively participate in the class. This graded quiz is called a readiness assessment test (RAT) and helps you self-assess your preparation for class. It also serves as a powerful incentive for you to keep up with the course material since RATs are graded. 

Following the individual RAT, your team takes the same graded RAT together. The team discusses, negotiates and selects the best answer for each of the questions. Since students don’t all study the same or come to class with same level of understanding of the pre-class material, discussions that occur during the team RAT are great for refining conceptual understanding and preparing your team to solve problems in the classroom. 

After the individual and team RATs, the instructor will review the questions and have an interactive discussion with the entire class to ensure the students have an appropriate understanding of the pre-class material. At this time, instructors will generally review more challenging concepts and perhaps introduce more advanced topics in preparation for the problems to be solved during class. This facilitated discussion, often called a mini lecture, is important for both the instructor and students to help identify areas that may still be perplexing and provides topics the instructors can address with individual teams later during the class period. 

When the individual and team RATs are done and the facilitated discussion is finished, the readiness assurance process is complete. This process helps prepare you and your teammates to solve significant and challenging problems in the classroom. 

The problems you will solve in the classroom, called application exercises, are at the core of learning using TBL. These problems are designed to have your team delve into real situations that face practicing pharmacists. Just like in the real world, these problems often don’t have a single right answer, but have several correct answers where one may be better than the others. This approach helps your team appreciate that in practice, pharmacists need the ability to seek alternative solutions when multiple potential solutions are available. 

Following completion of an application exercise, teams are often asked to present and defend their answers. At times, teams even debate each other over the merits of their choices. Instructors use these events to enrich the learning experience as a team may present an approach to solving a problem not intended by the instructor. Instructors will also use this time to explore new avenues of critical thinking that help students enhance their problem solving skills. 

Midterms and Finals are Different 

At designated intervals during the semester, most courses will have major examinations, like midterm exams. At the end of the semester, a final exam will be given to assess the knowledge gained during the course. These exams are different than with traditional courses in that the way students study for them is greatly influenced by the use of TBL. 

Students keep up with the material as they get prepared for class and take the individual and team RATs. The students then apply that knowledge during class. As a result, there is less of a pre-exam scramble to study that lessens the stress for many students. In other words, the exams are just as detailed and tough as with traditional courses, but you are better prepared as you continue to study for midterms and finals and you end up not needing to cram for the exams. 

Why Not Lecture? 

That’s a valid question with an easy answer. We don’t lecture because lectures really don’t work well. As odd as that may sound, it’s true. Well if that’s the case, then why are school lectures so common? The reasons are fairly simple. First, lectures are efficient at delivering content. If you have ever sat through an hour-long, 150 slide presentation, then you understand about the efficiency of delivering content. Although lectures are efficient at providing information, lectures are not necessarily effective for learning. 

Another reason is lectures are efficient for giving information to a large number of people -- just like that Psychology 101 class you took with 800 other students. It takes the same energy to prepare and deliver a slide presentation for hundreds of students as it does for dozens of students. More people may have heard the information, but individuals didn’t necessarily learn more as a result. 

Probably the most likely reason is that many teachers were taught using lectures and thus learned to teach using lectures. We model what we know. Although bright and talented teachers may be exceptional at delivering a lecture, it’s clear that when students are actively engaged in the classroom and responsible for their learning, they have better comprehension and greater retention. And that’s what learning is all about. 

A Better Way to Learn

We believe that using TBL is a better way to teach and a better way for you to learn. Not only will you prepare better for class, but the time in class will be spent applying what you are learning in a way that improves communication and critical thinking. This will lead to a deeper understanding of the complex world of pharmacy and a stronger set of skills when you enter into the profession. Instructors will challenge you in and out of the classroom to be the best possible pharmacist for your patients. You will develop lasting professional relationships with your classmates as you learn and teach each others throughout the curriculum. You will graduate with the best education in pharmacy.

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