Year 1 have embraced it fine as they know nothing else. Year 2 &3 having been used to small group work in a different way. All three years are used to 'lectures'. Its safe to say they didn't like the fact that even though they had been assigned protected time to do the pre-reading (which they often didn't do and show up 'cold' for these sessions but also for everything else) - this has been a shock to their system - but I will enforce this, their adult learners and shouldn't expect to be spoon fed - is this the norm?

We've quickly realised that the students really like clinical cases to use to work with their reading and these are obviously really ideal for the applied activities. The challenge is they want to take away the cases and answers (once the logic is teased out) but l obviously want to use these again for future years rather than write new ones every year. The medical students have a senior / junior system, so the risk is that they will pass the answers on to years below them in time ( which educationally is obviously of no use!) but I wondered if anyone had encountered this issue or ways around it? Their counter argument being how can they reflect and read after the class if they aren't allowed to take away or make copies of the Q&A's.

Questions and answers are currently being done via slides on power point and Turning Point handset technology. They grumble because they have to wait for all the teams to press the answer buttons and it can take some time; Turning Point have just updated this to self paced activities (http://www.turningtechnologies.com/self-paced-training) so this may help - and this means we could use 'sponge activities' - but any other thoughts here would be gratefully accepted!

Facilitation skills seem key. Some of our TBL tutors find it challenge to deal with (in particular) the 'older' students (ie in the UK most med students go in at the 17/18 yrs age whilst a few pew year will be post-grad on their second degree) - who can lead an entire group of 40/50 into dissent when they don't agree with answer - despite a clear and concise appeals process.

We are planning to use iPeer to try out peer feedback at the end of the second semester and I wondered if anyone has found this helpful?

Thanks for any thoughts or advice. To end with a big positive, many of the students love it - they can understand how it works and I have noticed some fantastic changes and  improvement in the years 2 &3 in other parts of the teaching that I feel has happened because of the TBL process. So it isn't all bad!