Simple maths of ‘task-based learning (TBL)’ in Acute Medicine TBL = effective learning + timely completion of tasks + productivity

Dear Sir

Despite major structural and organisational advancements in Acute Medicine, it remains a very busy medical specialty. Clinical activity in Acute Medicine is on the rise in the United Kingdom. In addition to timely and effective clinical management of the acutely unwell patients, ensuring patient safety and meeting high professional standards, we also have an important responsibility to train students both at post-graduate as well as at undergraduate level. People often end up thinking whether they have to make a choice between service commitments or training. That is where TBL can be very useful; it ensures good quality training and timely completion of tasks without causing delays in service provision.

During undergraduate as well as postgraduate training, healthcare professional spend a significant amount of time working in clinical environment carrying out various tasks. These tasks can be used as the central focus and further learning arranged around it (O’Halloran 2001). Such learning strategy is termed a task-based learning (TBL). Relevant learning objectives derived from the task may include generic skills like communications skills as well task specific outcomes like understanding of basic medical sciences, disease prevention, health promotion, physical examination skills and clinical management of a disease.

We have employed TBL locally in our very busy Acute Medicine department with undergraduate as well postgraduate students and have received excellent feedback from students and trainees, who get the feeling of being involved in patient care and decision-making and have reported increased level of confidence in managing various conditions. This has no adverse effect on our unit's waiting times.

TBL offers many advantages as following (Harden et al. 2006).

1. TBL is an opportunity for on-the-job learning and suits well to clinical environment.

2. It follows the principles of adult and independent learning.

3. TBL offers an excellent opportunity to allow horizontal and vertical integration.

4. It gives students an opportunity to see the learning in its real life perspective

5. It prepares the students for what is expected of them after graduation.

6. Service provision can be continued while learning takes place alongside it.

7. It is relevant and time efficient.

TBL's limitations include

1. It is a relatively new concept (and terminology) and long-term drawbacks are not known.

2. Teachers (clinicians) would need some training to facilitate TBL in their clinical settings.

3. Too many new strategies can cause confusion amongst senior medical staff who are already struggling to come to terms with PBL.