The Case for Inteprofessional Education Teaching in Online Team-based Learning

• In Event: EDHP- The Case for Inteprofessional Education Teaching in Online Team-based Learning

Short Description

Background
The medical education system has gone through a rapid transition to emergency remote teaching as a consequence of the COVID 19 pandemic. Such a significant disruptive change that occurred in the learning environment has brought challenges to the instructors. For example, instructors are constrained with time and resources to prepare for the online course delivery, acquire a certain level of digital literacy to deliver a quality online course, and training to facilitate effective online discussion and interaction. In addition to the general difficulties faced by all institutions, our medical program encountered its unique challenge. Team-based learning (TBL) and interprofessional education (IPE) teaching methods are the primary instructional strategies applied in our program. Specifically, a team of professors scaffolds students' problem-solving process during the TBL. When transitioning to online teaching, the most challenging aspects for our instructors are to manage multiple TBL activities at a distance and virtually facilitate the activities with a team of instructors from different disciplines.
Our medical program is designed to fully integrate medicine and engineering principles in a 4-year curriculum. The students enrolled in this program are expected to use both medicine and engineering strengths to develop novel and innovative therapies and devices, speed translation into clinical practice, and eventually improve patient care. Accordingly, the ultimate teaching goals are to build students' capacity to learn content, enhance problem-solving skills, and help them develop from critical to creative thinking. Therefore, the TBL and IPE teaching methods have been adopted to teach all the pre-clerkship courses to help students achieve the designated teaching goals.
An infusion of TBL and IPE is a creative instructional strategy. The TBL is a learner-centered instructional strategy that emphasizes developing a high level of team collaboration to address significant problems (Michaelsen and Knight, 2004, Murzi, 2014). Students work in teams to solve the problems based on real cases, while a team of professors scaffolds their problem-solving process from multiple perspectives (i.e., engineering, medical research, and clinical and basic sciences). The IPE teaching enables the instructors to model the knowledge generation process through interactions and collaborations (Carpenter et al., 2007; Crow & Smith, 2003); moreover, more than two instructors co-teaching enable students to receive multi-perspective feedback during the TBL process (Anderson & Speck, 1998; Colarulli & McDaniel, 1990; Schaefer Fu & Chase, 1991; Winn & Messenbeimer-Young, 1995).

Online TBL Facilitation
Two learning tools were identified to empower an effective online transition. One was InteDashboard which is web-based software designed to facilitate TBL activities. This tool allowed professors to immediately identify and address complex concepts using real-time data displayed on the dashboard, thereby streamlining the discussion process. The other tool was Zoom which accommodates virtual meetings with high-quality screen sharing, the formation of student groups in breakout rooms, and the flexibility for the instructors to switch between breakout rooms to facilitate students' problem-solving process.
At the beginning of the online TBL session, the course coordinator announced the TBL procedure and rules of online classroom conduct. The students all had their cameras on throughout the TBL session for observation purposes. Once IRAT started, the students stayed in the main room in Zoom to take the 15 minutes IRAT, and then they were automatically assigned to the corresponding breakout rooms for the TRAT. Meanwhile, the professors observed the students' responses provided by the InteDashboard and identified the challenging questions that needed clarifications. After TRAT clarification, students were sent back to their breakout rooms for the application activities. During the team discussion activities, professors visited breakout rooms periodically to interact and facilitate student discussions. Once the application session was over, students were brought back to the main room for the class discussion. One professor led the class discussion, one operated the software to display students' responses, and one monitored the chats where students could post their questions.

Results and Discussion
At the end of the course, all students of the 2020 cohort (n=25) were sent a Qualtrics survey to provide their perspectives on the overall online TBL experience. The learner satisfaction survey used to collect data (Roh et al., 2014) is a 5-point Likert scale composed of 26 questions probing seven categories, including learning process, pre-assignment, team activity, orientation, course content, peer evaluation, and physical environment.
A total of 19 students completed the survey, which was 76% of the response rate. The 73.16 % (n=14) and 77.63 % (n=15) of the students respectively were satisfied (Likert scale of 4 or greater) with the TBL learning process (e.g., class discussion, professor facilitation, and feedback), and the team activities (e.g., learned from the team, summarizing information, team feedback). However, the satisfaction for pre-assignment (e.g., time, level of difficulty, outcomes clearly articulated) was ranked lowest 59.22% (n=11). The category of orientation (e.g., clear learning outcomes, goals, processes, appropriate number of RAT questions) was scored 61.41% (n=12), and the course content (e.g., pre-assignment was helpful, RAT difficulty was appropriate) was 61.84% (n=12).
Despite the unprecedented challenges due to the pandemic, our faculty has delivered the TBLs online using digital technologies. While we still have things to improve, we would like to share our best practices that can be helpful for those who want to run the TBL online. Firstly, preparation is essential for a successful online TBL delivery. It is critical to review the in-class facilitation process, identify the potential problems in transitioning to online delivery and discover the solutions that address the possible challenges. Secondly, a practice run is helpful in evaluating timing, technology operation, the quality of multidisciplinary cooperative teaching, and adjustment of the delivery plan. Thirdly, a constant reflection on the facilitation practices is part of the continual improvement process. Reflections on teaching allow the evaluation of the facilitation process and make modifications as needed. Lastly, set up rules for online class conduct. Online classroom management is important to ensure that the online TBL sessions go smoothly (social presence).

Reference
Anderson, R. S., & Speck, B. W. (1998). "Oh what a difference a team makes": Why team teaching makes a difference. Teaching and teacher education, 14(7), 671-686. https://doi.org/10.1016/S0742-051X(98)00021-3
Carpenter, D. M., Crawford, L., & Walden, R. (2007). Testing the efficacy of team teaching. Learning Environments Research, 10(1), 53-65.
https://doi.org/10.1007/s10984-007-9019-y
Colarulli, G., & McDaniel, E. (1990). Interdisciplinary general education: Five ways it promotes good freshman teaching and learning. Journal of The First-Year Experience & Students in Transition, 2(1), 107-118. Google Scholar
Crow, J., & Smith, L. (2003). Using co-teaching as a means of facilitating interprofessional collaboration in health and social care. Journal of Interprofessional Care, 17(1), 45-55. https://doi.org/10.1080/1356182021000044139
Michaelsen, L. K., Knight, A. B., & Fink, L. D. (2004). Team-based learning: A transformative use of small groups in college teaching.
Murzi, H., & Carrero, O. P. (2014, October). Impact of team-based learning on promoting creative thinking in undergraduate engineering students. In 2014 IEEE Frontiers in Education Conference (FIE) Proceedings (pp. 1-4). IEEE. https://doi.org/10.1109/FIE.2014.7044370
Roh, Y. S., Lee, S. J., & Mennenga, H. (2014). Factors influencing learner satisfaction with team‐based learning among nursing students. Nursing & health sciences, 16(4), 490-497. https://doi.org/10.1111/nhs.12118
Schaefer Fu, G., & Chase, M. (1991). Team-Teaching as a Form of Staff Development: Or When Are Two Teachers Better than One?. Guidelines, 13(2), 81-87.
Winn, J. A., & Messenbeimer-Young, T. (1995). Team teaching at the university level: What we have learned. Teacher Education and Special Education, 18(4), 223-229. https://doi.org/10.1177%2F088840649501800402

Authors

• Presenter: Yun Li, Texas A&M University

• Contributor: Ian Murray, Texas A&M University