Uncover it, students would learn leadership from Team-Based Learning (TBL): The effect of guided reflection and feedback

Abstract

Context: Little is known about best practices for teaching and learning leadership through Team-Based learning™ (TBL™) with medical students. We hypothesized that guided reflection and feedback would improve shared leadership and shared leadership capacity, and enhance team decision quality in TBL teams. We used the Kolb experiential learning theory as the theoretical framework.

Method: The study was conducted at Tehran University of Medical Sciences. Three TBL sessions with 206 students (39 teams) participated in the study. Using a quasi-experimental design, one batch received guided reflection and feedback on their team leadership processes (n = 20 teams) and the other received only TBL (n = 19 teams). Observers measured shared leadership using a checklist. Shared leadership capacity was measured using a questionnaire. Scores on a team application exercise were used to assess quality of team decisions.

Results: Evidence did not support our first hypothesis that reflection and feedback enhance shared leadership in TBL teams. Percentages of teams displaying shared leadership did not differ between intervention and control groups in sessions 1 (p = 0.6), 2 (p = 1) or 3 (p = 1). The results did not support the second hypothesis. We found no difference in quality of decision making between the intervention and control groups for sessions 1 (p = 0.77), 2 (p = 0.23), or 3 (p = 0.07). The third hypothesis that the reflection and feedback would have an effect on shared leadership capacity was supported (T = −8.55, p > 0.001 adjusted on baseline; T = −8.55, p > 0.001 adjusted on gender).

Discussion and conclusion: We found that reflection and feedback improved shared leadership capacity but not shared leadership behaviors or team decision quality. We propose medical educators who apply TBL, should provide guided exercise in reflection and feedback so that students may better understand the benefits of working in teams as preparation for their future roles as leaders and members of health care teams.

Acknowledgements

Authors thank all students who participated in this study and Education Development Office employees of TUMS School of Medicine for their support in implementation.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes on contributors

Maryam Alizadeh, M.Sc., Ph.D. student of medical education, Department of Medical Education, School of Medicine, Tehran University of Medical Sciences. She is the coordinator of TBL at TUMS School of Medicine. This article is extracted from her dissertation.

Azim Mirzazadeh, MD, Dip. HPE, Iran Health Professions Education Research Center, Department of Medical Education (second affiliate), School of Medicine, Tehran University of Medical Sciences (TUMS). He was involved in curriculum reform of the University Undergraduate Medical Program. Now, He is the Director of Education Development Center of TUMS.

Dr. Parmelee is Associate Dean for Medical Education at Wright State University Boonshoft School of Medicine, Dayton Ohio and 2016 recipient of the Robert Glaser Award for Medical Education of the AAMC and AOA Honorary Society.

Elizabeth J. Peyton, Ph.D. she is currently Postdoctoral Research Fellow, Veterans Health Administration, National Center for Organization Development.

Leila Janani, Ph.D. she is an Assistant Professor of Biostatistics at Iran University of Medical Sciences (IUMS). Presently; she is also working at Clinical Trial Center (CTC; http://ctc.tums.ac.ir) as a Lecturer and a Director of Biostatistics unit.

Gholamreza Hassanzadeh or Hassanzadeh G. Ph.D. is Professor at Department of Anatomy, School of Medicine, Tehran University of Medical Sciences. He was involved in the planning and execution of TBL at TUMS, School of Medicine for the basic science curriculum. He has conducted TBL workshops at numerous schools in Iran.

Saharnaz Nedjat, MD, Ph.D. is a Professor in Epidemiology and Biostatistics Department, School of Public Health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran (IR). She is one of the BICC members in TUMS.