Implementing a modified team-based learning strategy in the first phase of an outcome-based curriculum--challenges and prospects.

BACKGROUND: Team-based learning (TBL) is an innovative form of collaborative learning. The aim of TBL is to create a motivational context in which students become accountable for their learning. AIM: Student attendance at didactic lecture sessions in our school is usually poor. A modified TBL approach in lieu of lectures was undertaken for the first time in a large class (150 students). This communication reports on the challenges of its implementation in our setting and preliminary data on its effects on student performance. METHOD: Using computer-based evaluation followed by an in-class activity, a modified TBL approach was implemented over two semesters during an introductory basic science course. Data on student performance, student motivation and faculty reflection were collected and analysed. RESULTS: This strategy had significantly enhanced students' class attendance. They performed better on the built-in TBL assessment (IRAT) compared to standard in-course tests. Besides content mastery, TBL approach could also instill useful attitudinal outcomes such as self-directed learning. CONCLUSIONS: The TBL strategy is a viable and refreshing alternative to the usual didactic faculty engagement with the teaching process. Students appear to do better in tests built-in within TBL as compared to stand-alone in-course tests.

"Between a Rock and a Hard Place": The discordant views among medical teachers about anatomy content in the undergraduate medical curriculum.

The last two decades of medical education have been marked by a persistent push towards curricular reform. Anatomy as a discipline, the unshakable foundation of medical teaching for hundreds of years, has been at the centre of this development. Although it is widely agreed that for doctors to be competent, they need an adequate knowledge of anatomy underpinning medicine, there is much less agreement over the quantity required, and who should decide and define it. Many clinicians feel medical students are being under-trained in this basic medical science before reaching the clinical stages. Professional accreditation boards advocate the reduction of factual information in undergraduate medical courses. Anatomists complain of a progressive erosion of the time allocated to the subject. Caught in the midst of this controversy is the student of anatomy who is left bewildered and confused about what is required from him to become a safe and competent health professional. The way forward might, first, be for medical schools to facilitate discussions between students, anatomy professors, and clinicians to bring these divergent perspectives into alignment. Second, the anatomists need to re-invent themselves in two principal frameworks: first, to present the subject in the context within which it will be utilised by the student, and second to employ the overwhelming learning tool of today, i.e. technology, in their teaching and assessment of the subject.

Anatomy practical examinations: how does student performance on computerized evaluation compare with the traditional format?

Practical examinations in anatomy are usually conducted on specimens in the anatomy laboratory (referred to here as the "traditional" method). Recently, we have started to administer similar examinations online using the quiz facility in Moodle™. In this study, we compare student scores between two assessment environments viz. online and traditional environments. We hypothesized that regardless of the examination medium (traditional or online) overall student performance would not be significantly different. For the online medium, radiological images, prosected specimens, and short video clips demonstrating muscle action were first acquired from resources used for teaching during anatomy practical classes. These were optimized for online viewing and then uploaded onto Moodle learning management software. With regards to the traditional format, actual specimens were usually laid out in a circular stream. Identification tags were then attached to specific spots on the specimens and questions asked regarding those identified spots. A cohort of students taking practical examinations in six courses was studied. The courses were divided into three pairs with each pair credit-weight matched. Each pair consisted of a course where the practical examination was conducted online and the other in the traditional format. There was no significant difference in the mean scores within each course pair. In addition, a significant positive correlation between score in traditional and online formats was found. We conclude that mean grades in anatomy practical examination conducted either online or in the traditional format were comparable. These findings should reassure teachers intending to use either format for their practical examinations.

Perceptions and Attitudes of Medical Students towards Two Methods of Assessing Practical Anatomy Knowledge.

OBJECTIVES: Traditionally, summative practical examination in anatomy takes the form of 'spotters' consisting of a stream of prosections, radiological images and dissections with pins indicating specific structures. Recently, we have started to administer similar examinations online using the quiz facility in Moodle™ (a free, open-source web application for producing modular internet-based courses) in addition to the traditional format. This paper reports on an investigation into students' perceptions of each assessment environment. METHODS: Over a 3-year period, practical assessment in anatomy was conducted either in traditional format or online via learning management software called Moodle™. All students exposed to the two examination formats at the College of Medicine & Health Sciences, Sultan Qaboos University, Oman, were divided into two categories: junior (Year 3) and senior (Year 4). An evaluation of their perception of both examination formats was conducted using a self-administered questionnaire consisting of restricted and free response items. RESULTS: More than half of all students expressed a clear preference for the online environment and believed it was more exam-friendly. This preference was higher amongst senior students. Compared to females, male students preferred the online environment. Senior students were less likely to study on cadavers when the examination was conducted online. Specimen quality, ability to manage time, and seating arrangements were major advantages identified by students who preferred the online format. CONCLUSION: Computer-based practical examinations in anatomy appeared to be generally popular with our students. The students adopted a different approach to study when the exam was conducted online as compared to the traditional 'steeplechase' format.

Anatomy "steeplechase" online: necessity sometimes is the catalyst for innovation.

In most medical schools, summative practical examination in Anatomy usually takes the format of a "steeplechase" ("spotters" or "bell ringers") conducted in the gross anatomy laboratory using cadaveric material and prosected specimens. Recently, we have started to administer similar examinations online using the quiz facility in WebCT™ and Moodle™. This article chronicles how we conceived and developed this method within the peculiar nature of our medical school setting. Over a five year period, practical summative examinations were organized as "steeplechase" online. The online examinations were administered using WebCT™ and later Moodle™ learning management software. Assessment "objects" were created from the materials available for anatomy teaching. These were digital images of cadaveric materials, radiological, and prosected specimens. In addition, short video clips of 30 seconds duration demonstrating muscle action were produced. These objects were optimized for online viewing and then uploaded onto the learning management software. A bank of questions (multiple choice or short answer type) was then created and linked to the assessment objects. These were used in place of the steeplechase in the computer laboratory. This method serves a crucial purpose in places like ours where continuous availability of human cadavers is impossible. Although time consuming initially, once questions are setup online, future retrieval, and administration becomes convenient especially where there are large batches of students. In addition, the online environment offers distinct advantages with regards to image quality, psychometric analysis of the examination and reduction of staff preparation time compared to traditional "steeplechase."