Dear Sandra,

I’m writing to comment on two issues that you’ve raised: 1) training up your faculty to implement TBL and, 2) dealing with faculty who insist on doing their own version of TBL.

 

On the first, I completely agree with Chris about the importance of getting help with a major TBL implementation effort.  I’m not sure what you’ve already done but, if at all possible, I'd strongly recommend inviting one or more TBL veterans to come to your campus to work with your faculty at two different stages in the process. Although there would be some costs involved, I think it is really risky to do a large-scale TBL implementation without getting help from someone with real TBL expertise.  Based on the experience of a number of schools that have relied on a single staff member and/or self-education from the literature and the web site, the cost of NOT investing in the training can be much higher. That's because it is so imperative to be successful in your first TBL offerings.  If you struggle in your initial attempts, it will be extremely hard to regain a positive momentum. Even if the problem is due to a faulty implementation of TBL, the doubters on your faculty will conclude that TBL doesn't really work (or doesn't work with your students or with your subject matter or something else). Further, their negative voice will be very persuasive and get louder with each challenge you encounter.

 

Overall, I'd recommend two different types of external help. The first would be to bring in someone well before you schedule a large-scale TBL introduction to do a series of workshops. That would allow your faculty to actually experience the key activities involved in TBL under the direction of someone who really knows how to do it. For most faculty, such an experience does three important things. One is that the workshops end up being a recruiting tool. Understanding what TBL really is and how it works, greatly reduces the anxiety that, for many, is a barrier to giving it a try and decreases the extent to which faculty members might want to deviate from TBL practice and do their own thing. Second, having actual experience with TBL typically creates the high level of motivation and commitment that you will need to sustain the effort required to get the design work done. Finally, the faculty who step forward and join the effort will have a common and well-grounded understanding of TBL that will build their confidence to move ahead.

 

The second time that I would bring in a TBL veteran would be after you have some modules that you think are pretty much ready to go. At that point, someone who really knows what they are doing would be able to spot any serious flaws in your planned implementation. In addition, they would also be able to suggest modifications that would make your initial offerings more exciting for both you and your students.

 

With respect to the second issue—faculty who want to implement their own version of TBL—that is a very real problem for two quite different reasons. One is the impact on the perceptions of those who don’t follow TBL practice. The other is the potential negative impact on the overall TBL implementation effort that might result from STUDENTS’ negative reaction to what they’ve been told is TBL but really isn’t.

I think the key to minimizing potential problems with the “deviator’s” perceptions is openly talking about implementing TBL as a “treatment fidelity” issue. In fact, you need to have them ask themselves the question of, “How much can I change what I do and still legitimately call it TBL?” They can choose what kinds of assignments they give, how they manage their classes and how the grades are determined, etc. but, THEY CAN’T CHOOSE THE OUTCOME—WHETHER THEY LIKE IT OR NOT, THE OUTCOME WILL SIMPLY BE THE NATURAL CONSEQUENCE OF THEIR CHOICES.

 

If they follow ALL of the basic TBL prescriptions (see the attached TBL standards, the course scorecard at www.teambasedlearning.org and the attached Academic Medicine article by Haidet, et al), their groups will develop into teams pretty quickly and are very likely to be motivated to achieve the learning outcomes that are set for them.  If they decide against following all of the components of TBL (depending on which ones they decide to ignore) the process will be longer and, some groups will never become teams.  Further, which of the elements of TBL they can end up with two very different but, nonetheless invalid conclusions. One possibility is that their choices may either fail to produce positive outcomes and/or create negative side effects that lead them to conclude that TBL simply won’t work in their subject area (or with their/your students, etc.) when they really haven’t tried TBL at all.  However, they may be so convinced of their conclusion that their negative voice might become a significant barrier for the doubters among faculty or students. The other potential problem with partially implementing TBL is almost the opposite. Depending on which parts are left out, even a partial implementation of TBL CAN produce such positive results—particularly when compared to the outcomes from traditional lecture courses—that they won’t be motivated to make any further changes. (see the attached Preface to the latest TBL book—Sweet & Michaelsen, 2012 for some specific examples of this one).

 

I think the best way to deal with the “do your own thing” faculty is to emphasize the issue of treatment fidelity but, from the PATIENTS’ standpoint. It would be unethical to give a patient one treatment and call it something else. That is because, if it fails, it would likely create negative consequences for both the mis-informed patient and the larger medical community who might begin to question the validity of the treatment simply because it had been falsely labeled. Similarly, it would be unethical to both their students (who are patients in an educational treatment context) and their faculty peers for a faculty member to call a educational treatment TBL when it is something else. Thus, in my opinion, a faculty member who insists in doing their own thing has a professional obligation to tell students (and faculty peers): 1) what they intend to do,  2) why they’ve decided to do it and, 3) give their approach a name other than TBL. That way if the approach succeeds, everyone wins—the faculty member legitimately gets credit for having invented something good, student outcomes are good and the rest of the educational community has learned something as well. However, if the approach fails, everyone learns and TBL does not unfairly get the blame.

 

If you have questions, let me know.

 

Larry



On Fri, May 31, 2013 at 9:47 PM, Chris Burns <[log in to unmask]> wrote:
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 Burns
University 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.
  1. Having students doing TBL all day would be exhausting. The interaction  for every class would be too much. How is this orchestrated?
  2. What happens when a student does not pass the individual assessment and is not prepared? Remedial plan?
  3. 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?

  1. 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

 




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Larry K. Michaelsen, Professor of Management
Dockery 400G, University of Central Missouri
Warrensburg, MO 64093
660/543-4315 voice, 660/543-8465 fax
For info on:
Team-Based Learning (TBL) <www.teambasedlearning.org
Integrative Business Experience (IBE) <http://ucmo.edu/IBEl>
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