Harvard Macy Community Blog

Fostering the ongoing connectedness of health professions educators committed to transforming health care delivery and education.

#MedEdPearls May 2018 - Flipping with TBL

Flipping the classroom with team-based learning (TBL) is becoming common practice in medical education.  Key to its success as a learner-centered teaching strategy is its scalability to large classrooms through the employment of high-performing learner teams, requiring less faculty time/numbers compared to other learner-centered strategies such as problem-based or case-based learning.  Individual learners are motivated to come to class prepared by both a readiness assurance process (i.e., quiz) and team accountability.  Class time is then focused on application of knowledge through problem solving and clinical reasoning. 

Compared to traditional teaching strategies such as lecture, TBL not only significantly increases knowledge scores1, but also offers opportunities for developing and measuring competencies of contemporary healthcare such as professionalism, communication, team work, and even team reflexivity2. As a pedagogical framework, TBL further facilitates integration of additional teaching strategies3 to optimize learning, retention, and teaching satisfaction.  As an opportunity for scholarship, there is a dearth of flipped classroom literature reporting measurement of outcomes other than knowledge gains.  So why not flip for TBL?

Check out the TBL Collaborative, MedEdPortal, or the following resources to get started!

  1. Fatmi M, Hartling L, Hillier T, Campbell S, Oswald AE. The effectiveness of team-based learning on learning outcomes in health professions education: BEME Guide No. 30. Med Teach. 2013. Nov;35:1608-1624. Doi: 10.3109/0142159X.2013.849802. https://www.ncbi.nlm.nih.gov/pubmed/24245519
  2. Schmutz JB, Kolbe M, Eppich WJ. Twelve tips for integrating team reflexivity into your simulation-based team training. Med Teach. 2018. Apr:1-7. doi: 10.1080/0142159X.2018.1464135.https://www.ncbi.nlm.nih.gov/pubmed/29703126
  3. Domans D, Michaelsen L, van Merrienboer J, van der Vleuten C. Should we choose between problem-based learning and team-based learning? No, combine the best of both worlds! Med Teach. 2015. Apr;39(4):354-359. doi: 10.3109/0142159X.2014.948828. https://www.ncbi.nlm.nih.gov/pubmed/25154342 

Leah Sheridan, PhD, is a medical educator in physiology. Leah currently holds a position as Associate Lecturer at Ohio University Heritage College of Osteopathic Medicine. Leah’s areas of professional interest include teaching effectiveness, assessment for learning, and pedagogy. Leah can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it..

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Bedside teaching – in person, and on screen; a tale of two techniques

The adage coined by Sir William Osler that “medicine is learned by the bedside and not in the classroom” remains a founding principle of medical schools internationally. In recent decades, changes in the healthcare environment have seen an erosion in time spent by the student at the bedside: rapid patient turnover; shorter-than-ever hospital stays; and increased community care have all limited the exposure to stark physical findings of disease which were so commonplace in centuries gone by. In addition, an explosion of technological aids and simulated learning environments are transforming teaching opportunities and the term “bedside” is not as unilateral as it perhaps once was. 

For students to leave medical school with excellent diagnostic and clinical examination skills remains as essential today as it was in Osler’s time. How we can ensure this is cultivated in a challenging new era is an important focus for medical education. How can technology be used to our advantage to enhance medical education? What areas can it be applied effectively to? How can we ensure traditional bedside teaching does not suffer in an era where time by the bedside can be challenged?

 

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Gregg Wells

deliberate, realistic, & safe ...

"The aim is not to replace in-person teaching, or in the case of NeuroCog, teaching of physical signs by the bedside, but rather t... Read More
Wednesday, 09 May 2018 12:12 AM
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The Thermodynamics of Motivation: Moving beyond Drive Theory

Let’s start with a mental exercise. Rank your motivation for the following activities:

(A) Brushing your teeth

(B) Filing your taxes (knowing you’re not getting that refund)

(C) Eating your favorite candy

Got your ranking? Hold on to it, and we’ll revisit that in a moment.

Most of us are familiar with Newton’s first law of thermodynamics: an object in motion will stay in motion, and an object at rest will stay at rest until acted upon by an outside force. What if we thought about motivation in the same way rather than our more common framework of having or not having motivation? If we thought of motivation as an object experiencing accelerating and decelerating forces, would we change the way we think about our actions or inactions? In what ways would we think about our students’ motivations? Our colleagues? Would it give us a more effective framework to identify and impact those positive and negative forces?

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#HMIChat April 2018 - Learning Analytics, Promises and Perils

The April HMI chat focused on learning analytics, with a rich discussion on the exciting potential for these tools as well as some caveats regarding their use. This is an exciting new area in technology enhanced education. Many interesting questions and multiple engaging discussions happened during synchronous and asynchronous chats.

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What is the Silent Scream that Disrupts a Culture of Safety?

Like a tree that falls in the woods, yet no one hears it; a silent scream is the muting of voices and rejection of alternative perspectives to maintain a single monolithic reality.                                 K. Beard

Several years ago, I visited a family member who had undergone a partial nephrectomy. As I entered Randy’s (fictitious name) room, I immediately saw what I interpreted to be signs of distress. Randy’s mouth was open, yet he uttered no words. His eyes had a fixed downward gaze, and his facial expressions portrayed a hint of fear that coalesced with discomfort. The image, coupled with the rapid yet shallow rise and fall of his chest, pushed me out of my comfort zone. Was I interpreting these cues correctly? I whispered, “Are you ok?” Randy’s response solidified my suspicions.

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