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I applaud your thoughtful advanced preparation. You've hit on several of the key challenges implementing TBL.  
One area you didn't bring up is coordinating TBL across courses. Medical education typically has the same students taking the same courses together throughout their program. It is important to ensure that TBL is implemented consistently in concurrent or consecutive courses, so students understand the expectations, and benefit from participation in teams that persist beyond a single course. A curriculum-wide "TBL oversight" group is an effective way to achieve this.
Please see below for replies to your specific questions.
All the best,
Chris BurnsUniversity of Illinois 

Date: Fri, 31 May 2013 18:22:34 +0000
From: [log in to unmask]
Subject: obstacle prevention
To: [log in to unmask]








Hi there,



I have a few questions. First a bit of context. We anticipate implementing TBL within a year or so and want to have a plan for success. We have thought about some potential obstacles that we'd like to prevent.

Having students doing TBL all day would be exhausting. The interaction  for every class would be too much. How is this orchestrated?What happens when a student does not pass the individual assessment and is not prepared? Remedial plan?What successful strategies have been used to deal with a 'lone ranger' style student who feels they don't need other people or feel that they need to control the group process?
Ignore them. It is not possible to get 100% of medical students to agree on anything. Be transparent about why you are using TBL and orient students to this approach, which will be foreign for many/all of them. After that, focus on ensuring that you don't blow it for the majority that "get TBL" with lots of rules and regulations trying force the few "long rangers"  to participate. How much effort do you put into getting all students to attend lecture?
What successful strategies have been used to deal with a 'lone ranger' style instructor who wants to create his/her own version of a TBL hybrid?
The "TBL oversight" group/process that has already been mentioned was a great help at University of Virginia and at University of Illinois. One error both schools made was thinking that having a couple in-house workshops from TBL-experts and sending a few faculty to a TBL-C meeting would be sufficient. It's not. Faculty re-interpreted TBL from their own teaching experience and perspective resulting in pseudo-TBL activities that confused the students and led to dissatisfaction with TBL at student, faculty, and administrative levels. It can be very helpful to incorporate ongoing guidance from someone experienced with TBL. This could be achieved by recruiting an expert to your institution, or by interacting with an outside expert regularly and seeking their input on new modules.



I look forward to some responses.




Sandra Schönwetter


Educational Specialist

Department of Medical Education

S204F, Medical Services Building

University of Manitoba

750 Bannatyne Avenue

email:      [log in to unmask]

phone:    (204) 272-3172

fax:           (204) 480-1372