Slides for UKCOTS Conference Manchester June 2024. Setting a problem without a right answer: Application exercises for Teams-Based Learning (TBL) in Evidence Based Medicine
Slides from UKCOTS 2024 (UK Conference on Teaching Statistics)
The Medical School at the University of Manchester introduced Teams Based Learning (TBL) for first-year students from October 2023. A week of topic-based course content is brought together at the end of the week with a series of teams-based activities which ends in application exercises. Application exercises are designed to develop higher level thinking skills of application, analysis, evaluation and creativity on top of acquisition of knowledge.
According to Roberson and Frachini (2014), a good application exercise asks students to make a decision after analysing a set of competing priorities and values in an authentic and complex scenario. To encourage student debate and reflective critical thinking, the exercise should ask teams to select the best option out of several plausible ones before simultaneously reporting and then defending their decision to the other teams (Parmelee, 2012). For medical education, application exercises commonly involve a patient case, and students are asked to choose, rank or discount options from a set of diagnoses or treatments (Parmelee and Michaelsen, 2010).
Evidence Based Medicine (EBM) is an element of the medical curriculum where students learn about statistics, study design, critical appraisal and the implementation of research into practice. Recently, the task of incorporating EBM Application Exercises into the curriculum has begun. EBM lends itself well to the application exercise approach. Activities such as designing a research study, appraising the research of others or making a decision based on the results of a study will generally involve multiple competing points of view. The challenge is to design accessible and engaging application exercises that fit into the 10-15 minute TBL format and can be delivered simultaneously though an online learning environment to multiple rooms of medical students, facilitated by non-specialists.
Experiences so far of developing application exercises to integrate EBM into the medical education curriculum will be presented. A short application exercise relating to the choice of control group in a randomised controlled trial will be set for the audience; they will work on it in small groups and defend their answers. The audience will then be asked to workshop their own application exercises on a topic of their choice to be entered in a shared document for post-conference use by others.