Incentive structure in team-based learning: graded versus ungraded Group Application exercises.

PURPOSE: Previous studies on team-based learning (TBL) in medical education demonstrated improved learner engagement, learner satisfaction, and academic performance; however, a paucity of information exists on modifications of the incentive structure of "traditional" TBL practices. The current study investigates the impact of modification to conventional Group Application exercises by examining student preference and student perceptions of TBL outcomes when Group Application exercises are excluded from TBL grades. METHODS: During the 2009-2010 and 2010-2011 academic years, 175 students (95.6% response rate) completed a 22-item multiple choice survey followed by 3 open response questions at the end of their second year of medical school. These students had participated in a TBL supplemented preclinical curriculum with graded Group Application exercises during year one and ungraded Group Application exercises during year two of medical school. RESULTS: Chi-square analyses showed significant differences between grading categories for general assessment of TBL, participation and communication, intra-team discussion, inter-team discussion, student perceptions of their own effort and development of teamwork skills. Furthermore, 83.8% of students polled prefer ungraded Group Application exercises with only 7.2% preferring graded and 9.0% indicating no preference. CONCLUSION: The use of ungraded Group Application exercises appears to be a successful modification of TBL, making it more "student-friendly" while maintaining the goals of active learning and development of teamwork skills.

Development of emotional intelligence in a team-based learning internal medicine clerkship.

BACKGROUND: Although increasing number of articles have been published on team-based learning (TBL), none has explored team emotional intelligence. AIM: We extend the literature by examining changes in team emotional intelligence during a third year clerkship where TBL is a primary instructional strategy. We hypothesized that team emotional intelligence will change in a positive direction (i.e., increase) during the clerkship. METHOD: With IRB approval, during the 2009-2010 academic year third-year students in their internal medicine clerkship (N = 105, 100% response rate) completed the Workgroup Emotional Intelligence Profile - Short Version (WEIP-S) at the beginning and at the end of their 12-week clerkship. TBL is an instructional strategy utilized during the internal medicine clerkship. RESULTS: Paired t-tests showed that team emotional intelligence increased significantly pre to post clerkship for three of the four areas: awareness of own emotions (p = 0.018), recognizing emotions in others (p = 0.031), and ability to manage other's emotions (p = 0.013). There was no change for ability to control own emotions (p = 0.570). CONCLUSION: In an internal medicine clerkship, where TBL is utilized as an instructional strategy, team emotional intelligence increases. This supports TBL as an adjunctive tool to traditional medical education pedagogy.

Treatment of pediatric suppurative mastoiditis: is peripherally inserted central catheter (PICC) antibiotic therapy necessary?

OBJECTIVE: A review of the treatment of pediatric acute mastoiditis requiring surgical intervention managed with and without PICC therapy postoperatively. STUDY DESIGN AND SETTING: Retrospective study of 42 cases from 1989 to 2004 treated at a regional children's hospital. RESULTS: Sixteen patients received postoperative PICC therapy and 26 received a course of oral antibiotics. The PICC group received on average 12.12 days of intravenous antibiotics compared to only 3.53 days for the non-PICC group (P < 0.001). No differences were observed between the two groups in treatment outcomes. One patient from each group required rehospitalization. One minor complication was experienced in a patient in the PICC group. There were no surgical complications. The total cost for outpatient PICC therapy increased treatment costs by approximately $1500 to $2500. CONCLUSIONS: Oral antibiotic therapy is sufficient after surgical intervention for acute pediatric suppurative mastoiditis without intracranial complications and does not result in adverse treatment outcome. SIGNIFICANCE: Use of PICC therapy after surgical intervention for mastoiditis should be limited. EBM RATING: B-3b.