Different student perceptions of the effectiveness of Team Based Learning exercises between undergraduate health sciences and medical students

In the fall of 2013 we substituted a didactic lecture for a Team Based Learning exercise (TBL) in an undergraduate Anatomy and Physiology course with an enrollment of 285. We also substituted a didactic lecture for an on‐line video, and ran a TBL exercise during the previously scheduled lecture slot for the neuroanatomy block of an MD class with an enrollment of 160. The exercise consisted of 1) an individual readiness assessment (five MCQs) test (iRAT), 2) review of the iRAT questions, 3) separation of the students into teams to discuss a case study, and 4) a team effort in answering a multiple choice question based on the case study (gRAT). The iRAT and gRAT scores were recorded using an iClicker (undergraduate) or Scantron card (MD). The results were similar for the undergraduate class over two years. 80% of undergraduate students felt that the iRAT helped keep them on task, 54% felt that the iRAT prepared them for the MCQ Midterm exam, and 42% felt that the TBL allowed them to discuss concepts that they would not otherwise have considered. However, more than 53% of students ranked the TBL as the least liked activity in either this course or any other course they have taken. The paradoxical response was attributed by undergraduate students to the stress and the time required to prepare for the exercise (54%). In contrast, the MD students ranked the TBL exercise (67%) higher than the iRAT (63%) and just as valuable as dissection (67.3%) for their learning. We conclude that factors determining how students rank the TBL learning activity include the size and makeup of the TBL groups, whether the activity is part of a summative evaluation, and the experience of the student learner.