Does team-based learning affect test scores of the basic medical sciences students in a modular curriculum?

Objectives: The aim of the study was to determine the effectiveness of team-based learning (TBL) sessions as a learning tool and to assess the satisfaction level of medical students towards TBL in modular curriculum. Methods: Using the quasi-experimental study design, TBL sessions were conducted, involving students of 1st and 2nd year of Bachelor of Medicine and Bachelor of Surgery. The TBL infrastructure comprised of pre-class preparation, in-class individual readiness assurance pre-test and post-test, before and after group discussion, respectively. The responses of the students regarding TBL satisfaction were recorded through a structured questionnaire (5-point Likert-type scale) while Wilcoxon signed rank test was applied to measure the effectiveness of TBL sessions. Results: Out of 192 students, 85% agreed or strongly agreed that TBL helped them think critically, identify their knowledge gaps, boosted their confidence, and motivated them in group participation. Significantly better post-test scores were found in all modules where TBL was used as a teaching tool (Z range = -5.33 to -11.81, P < 0.00). Conclusion: TBL increases the post-test score in majority of the students, indicating improved learning process. It not only keeps students engaged throughout the learning process but incites critical thinking, problem solving skills, and confidence. Further studies are required to see long-term benefit of TBL in students' learning.

Vitamin D levels in children with growing pains.

OBJECTIVE: To estimate the serum levels of vitamin D in children with growing pains and determine the relationship between serum vitamin D levels, parathormone and routine biochemical markers. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Department of Paediatrics, Liaquat National Hospital, Karachi, from October 2008 to September 2009. METHODOLOGY: Hundred children, aged 5-12 years presenting in Paediatric Outpatient Department of Liaquat National Hospital, Karachi, with limb pains, fulfilling the diagnostic criteria of growing pains, were included. Children with any systemic illness, organic cause of pain, rheumatologic disorders and signs of rickets were excluded from the study. Children were investigated for serum total calcium, inorganic phosphorus, alkaline phosphatase, vitamin D3 (25-hydroxecholecalciferol) and parathormone levels. On the basis of serum vitamin D3 level, patients were divided into 3 groups; group 1 with normal level of vitamin D3 (> 75 nmol/L), group 2 with vitamin D insufficiency (level between 50-75 nmol/L), and group 3 with vitamin D deficiency (level < 50 nmol/L). Significance of group proportions was determined using chi-square test with significance at p < 0.05. RESULTS: The mean age of the participants was 8.05 years with the majority (59%) being females. Only 6% had normal vitamin D levels. Over 95% of the children with vitamin D insufficiency had normal alkaline phosphatase and parathormone levels. CONCLUSION: Hypovitaminosis D may have a role in pathogenesis of growing pains. All children with unexplained limb pains without identifiable organic pathology should be tested for vitamin D status, and treated, if necessary. Routine biochemical markers alone are not sufficient to detect all cases of hypovitaminosis D.