Differential effects of team-based learning on clinical reasoning

Area of Science:

• Medical Education
• Neurology
• Cognitive Science

Background:

• Clinical reasoning (CR) is crucial for patient care, integrating diverse information and contextual factors.
• Few studies have investigated the impact of team-based learning (TBL) on developing neurological clinical reasoning skills.
• This study addresses this gap by comparing simplified TBL (sTBL) with interactive lectures (IL) for teaching specific neurological concepts.

Purpose of the Study:

• To compare the effectiveness of simplified team-based learning (sTBL) versus interactive lectures (IL) in teaching neuroanatomical localization (NL) and neurological emergencies (NE).
• To assess the impact of these teaching methods on medical students' clinical reasoning skills using a validated Script Concordance Test (SCT).

Main Methods:

• A crossover study design was employed with third- and fifth-year medical undergraduates.
• Participants were randomly assigned to receive instruction in NE via sTBL and NL via IL, or vice versa.
• Outcomes were measured immediately after a 3-hour teaching session using the Script Concordance Test (SCT).

Main Results:

• Students taught neuroanatomical localization (NL) using sTBL demonstrated significantly higher SCT scores compared to those taught with IL (64.8% vs. 61.7%, p=0.013).
• No significant difference in SCT scores was observed for neurological emergencies (NE) between students taught with sTBL and IL (66.6% vs. 67.0%, p=0.75).
• The effect size for NL was 0.38, indicating a moderate improvement with sTBL.

Conclusions:

• Simplified team-based learning (sTBL) is a superior method for teaching neuroanatomical localization compared to interactive lectures (IL).
• Both sTBL and IL were found to be comparable in their effectiveness for teaching neurological emergencies.
• TBL shows potential for enhancing clinical reasoning in complex neurological topics by fostering problem representation and hypothesis generation.