Though Infectious Diseases education has traditionally relied upon didactic sessions, the use of active learning methods like Team-Based Learning (TBL) has risen dramatically in undergraduate medical education (UME). TBL has been implemented with favorable outcomes in UME, and used in a modified form in graduate medical education (GME). However, the feasibility and acceptability of un-modified or complete TBL in graduate medical education (GME) is unknown making direct comparisons to UME outcomes speculative.
We conducted a prospective mixed methods study of 101 Internal Medicine (IM) residents and 8 ID faculty members at a mid-sized university with a 3+1 rotation system. We designed and implemented 9 discrete ID sessions over 5 weeks led by a TBL “coach” and a TBL naïve facilitator. Each session included the 7 key TBL elements. Faculty completed a baseline survey, residents completed post session surveys, and both participated in focus groups. Feasibility was met if the 7 elements were utilized by participants. A priori acceptability was met if average TBL attendance equaled standard practice (≥25 residents) and 50% or more participants rated the sessions overall as facilitating their learning “very well” (4) or “extremely well” (5) on a 5 point Likert scale. Quantitative data were analyzed using chi square for categorical variables and t-tests.
Seventy-two residents participated out of 93 available over the 5 weeks. Of the eight unavailable residents rotating off site, 3 returned to attend a TBL session. The average attendance rate was 25 residents per session and 23 attended ≥4 sessions. All TBL elements were successfully implemented and utilized. Of the 72 participants, 89% completed post-session surveys. Of those surveyed, 86% rated the TBL sessions a “4” or “5” overall (p<0.001) with a sensitivity analysis that also exceeded the a priori goal of 50% for each session. The TBL naïve facilitator was rated “very” or “extremely” effective in 96% of surveys.
Our study demonstrates that un-modified TBL is a feasible and acceptable pedagogical method in GME ID curricula. This not only serves a model for future use of TBL in GME but also provides the groundwork for comparative outcome based studies and significant ID curricular innovations.
E. Haney, None