Monday, March 5, 2012

TBL Website, Video, and personal explanation

For people who are still unsure what the TBL format is like, there is a helpful website with a lot of information that should answer all of your questions. Team-based Learning Collaborative.

A video from the Duke-NUS campus is here:

Update: After talking to my husband I realized that other people still really don't understand what the TBL format is like so here is an example:

During a TBL session the students are in groups of 4-6 students. We are given a sheet with a patient's pertinent medical history (age, chronic conditions) and the symptoms for the current illness. The groups talk and list out their top possible diagnoses, which are turned in to the proctors who hand out part two. In the second part the groups are asked what tests they would perform and why. In part three they suggest their top five treatment steps. In part four they might get blood work results, an EKG or be told newly developed symptoms and have to explain what that indicates. In part five they might have to alter their diagnosis based on changing symptoms/test results/response to treatment.

Then the entire class goes over the various groups' answers and groups might be asked why they choose a certain test given the symptoms, etc. Sometimes we find out what the actual diagnosis is, but other times the case is based on a recent patient and tests are still pending.


  1. That was really helpful. Even after an interview TBL was really vague. Thanks!

    1. Sorry about not giving a more transparent explanation earlier, but glad it makes more sense now. :)

  2. Great background information on TBL. The video and website really helped a lot in trying to make sense of this collaborative-type of learning.

    However, I am not a fan of this learning method at all, and frankly, I'm glad that Duke University declared my P.A. application to be "incomplete". I would have never been able to tolerate learning in this fashion, as I would have adopted a more independent, individualized approach. In the long run, I don't believe that TBL is an effective method of learning. Clearly, it's an example of social cognitive learning theory, but the focus is mostly centered among fellow students rather than utilizing the student-teacher dynamic....and that is where it fails.

    You see, this is not supposed to be some sort of philosophical dialogue among students who don't know anything. This is great for pondering the meaning of life, but not when it comes to patient health. Putting together a group of people (who don't know anything) to ask questions in order to come up with some sort of answer(s) is a huge time-waster. I was never a fan of group projects in college because some people would do all the work while others did nothing. A similar debacle could develop in TBL as well, and I would never want to take any chances of that happening. When I apply to medical school in the future, one of the first things I'll research (besides how to finance my medical education) will be how the curriculum is taught. That is SUCH an important element in any student's education, and I'll be sure to stay away from any college that adopts an exclusively TBL-based learning style.

    For a great thread on the weaknesses of TBL, I advise you all to check out this link, "Team-based Learning and its Discontents":

    1. "I would have never been able to tolerate learning in this fashion, as I would have adopted a more independent, individualized approach."

      I'm going to have to disagree with a basic premiss of your comment. TBLs are application exercises, not, as it seems that you're implying, where you would expect to be taught material for the first time. The actual learning is highly individualized since it is self motivated, self paced and there are at least four different ways students can access the material (streaming lectures, annotated powerpoint slides, notes written in a narritive style, or reading the textbook itself).

      As far as it being social cognitive theory, I would have to disagree with that as well. The application exercises don't involve modeling behaviors or, I would even argue, vicarious learning. Rather the benefit of group dynamic is that the individuals voicing answers must be able to justify/defend/explain them to their group mates, so it motivates the individuals in the group to have the necessary background information. Additionally for someone whose foundation in a subject is not at the same level as others, it gives them the opportunity to ask questions in a setting less intimidating than a standard classroom environment and to receive answers or explanations from peers who are more likely to couch the information in accessible terms.

      This is not high school, this is not middle school, and this is not undergrad. No one signed up for Duke medical school or graduate school with the idea that they were going to coast through it, they came to work and to get the most out of their time here. Not to say on a given topic a certain person might be more familiar or comfortable with the material than another, but it isn't consistent where one person is coasting while another one is doing all the work. We're all adults.

      I'm glad that it has worked out for you that you're not going to have to deal with a curriculum that you're so obviously opposed to. Good luck with avoiding it in the future as well.

      The thread does address that how the TBLs are structured makes a huge difference in their usefulness and some of the posters also seem to be under the impression that TBLs are somehow supposed to be a student's primary source of learning. And I hope that in my description it was more clear that, at least in our case, TBLs are where the students are practicing their differential diagnosis skills as well as putting information together (in terms to treatment/interpreting test results) from the various courses we've had.

      I'm not saying that I completely love TBLs and that I think everyone should learn everything that way, but it isn't impossible to learn that way either.

    2. Right. It's certainly not impossible to learn this way, but it's definitely not everyone's favorite method of learning. In fact, this TBL is a rather new method of learning that has recently been introduced into medical curricula. So technically, you can consider it to be in a "clinical trial" phase of sorts. As a student, I refuse to be a part of any experiment involving how I learn until it's been proven effective for the vast majority of students.

      I will learn however I choose to learn and whatever works best for me as a student, and that's that. That is the bottom line right there. The tried and true methods always work.

      I'm sorry that you didn't understand exactly what social cognitive learning theory entails. A Wikipedia lookup of what constitutes this theory doesn't justify your disagreement about it (the "vicarious learning" comment was the tip-off), because in fact, TBL IS an example of this theory at work. From what I understand (and feel free to correct me), the instructor poses a certain case in the beginning of the session and writes stuff on the board. THAT right there is an example of modeling...then the students feed off each other by asking questions, etc etc. They then report back to the instructor who facilitates additional instruction, etc. Social cognitive theory at work..plain as day. (I'm so glad I took an Educational Psychology course) :)

    3. It is a test weekend, so I don't actually care enough to study up on social cognitive theory beyond a cursory glance at the wikipedia page. And no, our TBLs are not structured how you've written but that may be the case in other programs. In our situation we work through the differential diagnosis and treatment in our groups and submit the work either online or directly to the facilitators. The results are not discussed with the class as a whole until after all of the work has been turned in from each group.

      Was the Educational Psychology course relevant for your under graduate degree? It seems like an odd choice for someone that wasn't going for teaching...

  3. Ahh, the test was today, wasn't it? How did it go?! And more importantly, how are you coping with your test anxiety? Has it been improving?

    The Educational Psych course was not relevant at all to my undergraduate degree....and that's because it was a graduate course I took. Two different things...

    It's really not an odd choice because I do have an interest in teaching, and I decided to do one grad semester in a teaching program (which got me 8 credits...will definitely come in handy down the road).

    1. The test was fine. The anxiety is much better since the Christmas break, thanks.

      Ah, that makes sense. I guess an academic medical center position would be right up your alley then?

  4. Sure, I'd love like 15 years haha :-)