In healthcare system Implementing Team-Based Learning for Before and During Class are rules and manners of collaborative and vast information. It is interactive and dynamic process as compare to traditional method of teaching only giving knowledge.
Before and During Class to Implementing Team-Based Learning
How to Implementing TBL
Effectively using TBL typically requires redesigning a course from beginning to end, and the redesign process should begin well before the start of the school term. The redesign process involves making decisions about and/or designing activities at four different points in time.
These are
(a) before class begins
(b) the first day of class
(c) each major unit of instruction
(d) near the end of the course
Before Class Begins
As traditional health professions education starts with a lengthy knowledge-acquisition/knowledge-application phase that spans several academic terms or even years. During that time, students take a series of lecture-based courses in which they are asked to absorb a great deal of knowledge that they will then later (sometimes much later) be asked to put to use. TBL, however, uses a fundamentally different knowledge-acquisition/knowledge application model.
With TBL, students repeat the knowledge-acquisition/knowledge-application cycle several times within each individual course. With TBL, students individually study the course content, discuss it with their peers and the instructor (see the RAP below) and immediately apply it in solving problems much like those they will face in professional practice.
Thus, students in TBL courses develop a much better sense of the relevance of the material because they seldom have to make inferences about when and how the content might become useful in the real world. Rather than being filled with libraries of ‘‘inert knowledge’’ (White head, 1929) from which they then later must extract needed information with great effort, students walk away from TBL courses having already begun the practical, problem-solving process of learning to use their knowledge in context.
This benefit, however, does not occur by accident. Designing a successful TBL course involves making decisions related to:
(a) identifying the instructional goals and objectives
(b) partitioning the course content into macro units and identifying the key concepts for each unit
(c) designing a grading system for the course
Backward Design
Designing a TBL course requires instructors to think backward to deal effectively with care design decisions. What do we mean by think backward? In most forms of higher education, teachers traditionally design their courses by asking themselves what they feel students need to know, then telling the students that information, and finally testing the students on how well they absorbed what they were told.
In TBL, courses are not organized initially around what you want the students to know, but instead what you want them to be able to do. Wiggins and McTighe (1998) coined the term ‘‘backwards design’’ to describe the process of building courses this way, and its benefits are intuitively obvious: as any experienced doctor will tell you, being able to recite all the subtle differences between one form of a disease and another is a very different kind of knowledge than being able to quickly diagnose the correct form of that disease suffered by a real, living patient.
What are students who really ‘‘get it’’ doing ? Imagine you are working shoulder to shoulder with students from not so long ago, and in a wonderful moment you see them do something that makes you think, ‘‘Hooray! They really got from my class what I wanted them to get—there’s the evidence!’’
When designing a course backward, the question you ask yourself is: What, specifically, is that evidence? What could students be doing in that wonderful moment to make it obvious they really internalized what you were trying to teach them and are putting it to use in the world? For every course there are several answers to this question, and these different answers will correspond to the macro units of the redesigned version of the course.
A given real-world moment will likely demand knowledge from one part of a course but not another. So for any given course, you should brainstorm about a half dozen of these proud moments in which a former student is making it obvious that he or she really learned what you wanted the student to learn. For now, don’t think about the classroom, just imagine the student is doing something in a real clinical or laboratory context.
Also, don’t be afraid to get too detailed as you visualize these moments—in fact come up with as many details as you can about how this former student is doing what he or she is doing, what decisions the student is making, in what sequence, under what conditions, and so on. These detailed scenarios become useful in three ways.
First, the actions taking place in the scenarios will help you organize your course into macro units. Second, the scenarios will enable you to use your class time to build students’ applied knowledge instead of inert knowledge. Third, the details of the scenario will help you design the criteria for the assessments upon which you can base your students’ grades.
Once you have brainstormed your ‘‘Aha! They got it!’’ scenarios and the details that accompany them, let’s step into the classroom. Those half dozen or so scenarios are what you want your students to be able to do when they have completed your class: they are your instructional objectives. Now you are ready to ask three more questions:
- What will students need to know in order to be able to do those things? Answers to this question will guide your selection of a textbook, the contents of your course packet, laboratory exercises, and will likely prompt you to provide supplementary materials of your own creation or, simply, reading guides to help students focus on what you consider most important in the readings or lab findings. In addition, it will be key in developing questions for the RATs (see below).
- While solving problems, what knowledge will students need to make decisions? Answers to this question will help you import the use of course knowledge from your brainstormed real-world scenarios into the classroom. You may not be able to bring the actual clinical or laboratory settings in which your scenarios occurred into the classroom (although digital video, simulation mannequins, computer animations, and so on are coming much closer to approaching ‘‘real’’), but you can provide enough relevant information about those settings to design activities that require your students to face the same kinds of problems and to make the same kinds of decisions they will make in the clinical and laboratory settings.
- What criteria separate a well-made decision from a poorly made decision using this knowledge? Answers to this question will help you begin building the measures you will use to determine how well the students have learned the material and how well they can put it to use under specific conditions.
In summary, TBL leverages the power of action-based instructional objectives to not only expose students to course content but also give them practice using it. When determining an instructional objective, it is crucial to know how you are going to assess the extent to which students have mastered that objective.
Some teachers feel that designing assessments first removes something from the value of instruction— that it simply becomes ‘‘teaching to the test.’’ Our view is that yes, you absolutely should teach to the test, as long as the test represents (as closely as possible) the real use students will ultimately apply the course material to: what they are going to do with it, not just what they should know about it.
Designing a Grading System
The third step in redesigning the course is to ensure that the grading system is designed to reward the right things. An effective grading system for TBL must:
(a) provide incentives for individual contributions and effective work by the teams, as well as
(b) address the equity concerns that naturally arise when group work is part of an individual’s grade. The primary concern here is typically borne from past group work situations in which students were saddled with free-riding team members and have resented it ever since. Students worry that they will be forced to choose between getting a low grade or carrying their less-motivated peers. Instructors worry that they will have to choose between grading rigorously and grading fairly. Fortunately, all of the above concerns are alleviated by a grading system in which a significant proportion of the grade is based on (a) individual performance.
(b) team performance
(c) each member’s contributions to the success of their teams. As long as that standard is met, the primary remaining concern is that the relative weight of the factors is acceptable to both the instructor and the students.
The First Hours of Class: Getting Started on the Right Foot
Activities that occur during the first few hours of class are critical to the success of TBL. During that time, the teacher must see that four objectives are accomplished. The first objective is ensure that students understand why you (the instructor and/or course director) has decided to use TBL and what that means about the way the class will be conducted. The second objective is to actually form the groups. The third and fourth objectives include alleviating students’ concerns about the grading system and setting up mechanisms to encourage the development of positive group norms.
Introducing Students to TBL
Because TBL is so fundamentally different from traditional instructional practice, it is absolutely critical that students understand both the rationale for using TBL and what that means about the way the class will be conducted. Educating the students about TBL requires (at a minimum) providing students with an overview of the basic features of TBL, how TBL affects the role of the instructor and their role as students and why they are likely to benefit from their experience in the course.
This information should be printed in the course syllabus, presented orally by the instructor, and demonstrated by one or more activities. In order to foster students’ understanding of TBL, we typically use two activities. The first involves explaining the basic features of TBL using overhead transparencies (or a PowerPoint presentation) including a discussion of the way in which learning objectives for this course will be accomplished through the use of TBL, as compared to a course that is taught with a more traditional approach. ( et al., 2002, 2004).
The second activity, which, with class periods of less than an hour, might occur on day two, involves using part of the first class as a demonstration of a RAT (see below) using either the course syllabus or a short reading on TBL and/or about giving helpful feedback (see Michaelsen & Schultheiss, 1988) as the content material to be covered.
Forming the Groups
As discussed above, two factors must be taken into consideration when forming the groups: (a) the course-relevant characteristics of the students, and (b) the potential for the emergence of subgroups. As a result, the starting point in the group formation process is to gather information about specific student characteristics that will make it easier or more difficult for a student to succeed in this class.
For a particular course, characteristics that could make it easier for a student to succeed might include such things as previous relevant course work or practical experience, access to perspectives from other cultures, and so on. Most commonly, student characteristics making it more difficult for them to succeed are the absence of those that would make it easier, but might include such things as a lack of language fluency.
The second factor that can affect student performance in a group is the presence of built-in subgroups, for example, boy/girl friends, sorority/fraternity members, ethnic groups, and so forth. Regardless of the process used to form the groups, both of these categories of individual member characteristics need to be evenly distributed across the groups (Michaelsen et al., 2002, pp).
We recommend actually forming the groups in class in the presence of the students as a means of avoiding student concerns about ulterior motives the instructor may have had in forming groups. We begin the group formation process by simply asking questions about the factors that are important to group success. For a class in pharmacology, typical questions could include, ‘‘How many of you have worked as a pharmacist?’’ ‘‘How many have completed more than one class in biochemistry?’’ ‘‘How many of you attended high school outside of the United States?’’ and so forth.
Students respond to each of the questions either orally or with a show of hands. Then, we create a stratified sampling frame by having students possessing a series of specific assets form a single line around the perimeter of the classroom with the rarest and/or most important category at the front of the line. After students are lined up, we have them count off down the line by the total number of groups (five to seven members) in the class. All ‘‘ones’’ become Group 1, all ‘‘twos’’ become Group 2, and so on. Following this procedure rapidly creates heterogeneous (and approximately equivalent-ability) teams.
Alleviating Student Concerns About Grades
The next step in getting started on the right foot with TBL is to address student concerns about the grading system. Fortunately, student anxiety based on previous experience largely evaporates as students come to understand two of the essential features of TBL. One is that two elements of the grading system create a high level of individual accountability for pre-class preparation and class attendance—counting individual scores on the RATs and basing part of the grade on a peer evaluation.
The other reassuring feature is that team assignments will be done in class and will be based on thinking, discussing, and deciding, so it is highly unlikely that one or two less-motivated team mates members can put the group at risk. Years of experience have taught us that the most effective way to alleviate student concerns about grades is to directly involve students in customizing the grading system to this class. Students become involved by participating in an exercise called Setting Grade Weights (Michaelsen, Cragin, & Watson, 1981; Appendix B in Michaelsen et al., 2002, 2004).
Within limits set by the instructor, representatives of the newly formed teams negotiate with one another to reach consensus (i.e., all of the representatives must agree) on a mutually acceptable set of weights for each of the grade components: individual performance, team performance, and members’ contributions to the success of their teams. After an agreement has been reached regarding the grade weight for each component, the standard applies for all groups for the remainder of the course.
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