Feasibility of a Comprehensive Medical Knowledge Curriculum in Internal Medicine Using Team-Based Learning

Team-based learning (TBL) is an active learning strategy with descriptions of its use in resident education limited to pilot studies.

We developed a comprehensive medical knowledge TBL curriculum for an internal medicine residency, and assessed feasibility.

We developed a 135-topic TBL curriculum to replace a noon conference lecture series, and implemented it over a 3-year period (2013-2016). In this article we describe the planning, curricular design, faculty recruitment and development, and lesson structure. We assessed feasibility in terms of faculty participation, resident preparedness, resident and faculty satisfaction, and costs.

Most faculty initially were unfamiliar with TBL. Through faculty resource materials and flexible faculty development, participating faculty increased from 3 to 74. In a 2015 faculty survey (N = 64, 69% response rate), 73% (32 of 44) reported faculty development was adequate, 70% (31 of 44) indicated lesson preparation time reasonable, and 95% (42 of 44) reported preparation materials were helpful. A 2016 resident survey (N = 89, 72% response rate) revealed that most residents completed reading assignments in advance, 78% (50 of 64) found readings manageable, and 77% (49 of 64) felt they learned better from TBL compared to lectures. Costs included compensated time for 1 faculty TBL "champion" and an assistant.

Implementing a comprehensive medical knowledge curriculum using TBL in an internal medicine residency was feasible, and resulted in high faculty acceptance and learner satisfaction. Departmental support of a TBL champion, flexible faculty development, and well-designed resource materials were determinants of success.