Multi-Campus Team-Based Learning Sheridan, L.*, Barresi, A.#, & Stork, C. Ohio University Heritage College of Osteopathic Medicine Dublin*, Cleveland#, and Athens, Ohio

Introduction Synchronous TBL via Videoconference The Ohio University Heritage College of Osteopathic Medicine (OU- HCOM) recently launched two new extension campuses, in which we Athens conduct live synchronous learning activities to approximately 240 medical students. One of the many challenges faced by faculty Cleveland Dublin teaching both local and distant students simultaneously is how to effectively engage all students in the learning process.

TBL is an active learning strategy that relies on advanced preparation and small group interactions that has found increasing popularity within medical schools since its first use by Seidel and Richards in 2001. More importantly, TBL has also been shown to be effective on many different levels, demonstrated by increased course examination scores (Koles et. al. 2010), increased scores on National Board of Medical Examiners examinations (Levine et. al. 2004), increased student engagement (Haidet et. al. 2004), and the development of effective communication techniques (Hunt et. al. 2003). While there is a plethora of information in the literature on the use of TBL in medical education, very little exists in describing the effectiveness of its use in a multi-campus, synchronous learning environment (Letassy Learner Teams et. al., 2008; Conway et. al., 2010). As medical schools continue to Forty-two student teams of 5-6 students were generated by assigning the alphabetical listing of students on each campus to expand and rely on technology for learning and assessment, it is teams in numerical order: Athens (146 students; 24 teams), Dublin (49 students; 9 teams), and Cleveland (54 students; 9 teams). necessary to ensure that synchronous learning strategies are Team membership is not altered during the academic year. employed in the most effective manner possible.

We present lessons learned in terms of key guidelines and strategies Learning Environment for the planning, execution, and curricular consistency necessary for The classroom settings differ among the three campuses (Athens-lecture hall with 2 large projection screens for viewing instructor successful implementation of synchronous TBL activities via and content; Dublin and Cleveland-6 student “pods” with 2 flat-screen TVs for viewing instructor and content). All students are videoconference. within arms-reach of a table-top microphone for asking questions. TBL Strategy Strategies for Success

Readiness Assurance Process: Planning Execution Consistency • Individual readiness assurance tests (iRATs) contain ten multiple- choice questions (MCQs) and integrate multiple content-based Define roles: Prepare the classrooms: Ensure consistency across themes. Students are notified at the beginning of each course • Lead facilitator/director • Set up course materials courses to maintain learner focus (i.e., minimum of 1 week to maximum of 4 weeks lead time) of • Supporting facilitator(s) • Ready the videoconference on learning and not the learning what content knowledge would be assessed on the iRATs. iRATs • Administrative support technology strategy. are formatted for electronic administration via Blackboard • IT support • Instruct learners to sit in (password protected). teams and prepare for iRAT Suggested Learning Strategy • The team RAT (tRAT) is administered by paper via the immediate feedback assessment technique (IF-AT). It consists of the same Determine the technology Characteristics to Standardize: 10 questions used in the iRAT. Questions and/or objections to requirements: Follow the script during the • Learner expectations RAT questions or answers are clarified or remedied by the • Camera views and angles activity: • Facilitator roles and participating faculty immediately following completion of the tRAT. • Microphone needs • Lead facilitator expectations • Campus location of faculty • Oversees the learning • Grading practices Application Activities: TBL applications are designed to promote participants and electronic activity • TBL procedures problem-solving and/or clinical reasoning skills, and consist of content delivery • Directs supporting • Methods of communication various formats. Student teams work independently to achieve facilitator(s) • Technology consensus answers through discussion and use of reference Create a script that outlines the • Maintains an effective materials (e.g., lecture notes, online resources), at which point play-by-play of the learning pace conducive to learner Clearly and efficiently faculty facilitate inter-team discussion of the correct answer(s) and activity, resources needed, who’s engagement communicate characteristics distractors. responsible, and the technology • Local support is available that diverge from previous requirements at each step and present on campuses experience to all stakeholders. References distant from facilitator(s) 1. Conway SE, Johnson JL, Ripley, TL (2010) Integration of Team-Based Learning Strategies into a Cardiovascular Module. Am J Pharm Educ. 74(2) Devise a back-up-plan in case of • Secondary method of Article 35. 2. Haidet P, Richards B, Morgan RO, Wristers K, Moran BJ (2004) A controlled trial of active versus passive learning strategies in a large group setting. Adv. Health Sci Ed. 9(1):15-27. technology failure communication among 3. Hunt DP, Haidet P, Coverdale JH, Richards BF (2003) The effect of using team learning in an evidence-based medicine course for medical students. Teach Learn Med. 15(2):131-139. 4. Koles PG, Stolfi A, Borges NJ, Nelson S, Parmelee DX (2010) The Impact of Team-Based Learning on Medical Students’ Academic Performance. Acad facilitators and local support Med. 85(11):1739-1745. 5. Letassy NA, Fugate SE, Medina MS, Stroup JS, Britton ML (2008) Using Team-based Learning in an Endocrine Module Taught Across Two Campuses. Practice (e.g., text messaging) Am J Pharm Educ. 75(2) Article 103. 6. Levine RF, O’Boyle M, Haidet P, Lynn D, Stone MM, Wolf DV, Paniagua FA (2004) Transforming a clinical clerkship through team learning. Teach Learn Med. 16(3):270-275. 7. Seidel CL and Richards BF (2001) Application of Team Learning in a Medical Physiology Course. Acad. Med. 76(5):533