Evaluation of the effectiveness of student learning and teacher instruction on team-based learning during quality control of diagnostic imaging

Figures & data

Table 1. Schedule and topics of four TBL modules

Week	Topic
7	The quality control of film/screen receptors and processors
10	The quality control of radiography
12	The quality control of mammography
14	The quality control of computed tomography

Table 2. Time duration of TBL procedures for each module

In-class activities	Time duration (min)
IRAT-pre	15
GRAT	20
Appeal	10
Mini-lecture	10
Application	20
Feedback and peer evaluation	10
IRAT-post	15
Total	100

Table 3. Item and percentage of TBL grading

item	percentage
IRAT-pre	35%
GRAT	15% (peer-review weighted)
Application	15% (peer-review weighted)
IRAT-post	35%

Table 4. Description of open-ended questions and teacher interview questions for reflection

Question	Description
1	How much time did you spend on pre-class preparation?
2	Do you consider the amount of pre-class preparation materials suitable for you? Why?
3	Do you consider the difficulty level of pre-class preparation content suitable for you? Why?
4	In the TBL class, most in-class activities were conducted through group discussion. Did this method influence your learning? How did it influence your learning and why?
5	Do you hope the course instructor continues to use TBL in future courses? Why?
6	Do you have any suggestions for the TBL classes this semester?
	Description for teacher interview
1	First of all, I would like to ask what the topic of the TBL class was last time.
2	How did you design the TBL class last time? Why?
3	Did the instructional procedures you designed go well as expected in the class? Why?
4	Was students’ learning in TBL class as expected? Why?
5	After teaching the TBL class, would you modify the way to assign pre-class preparation and test design materials, or the methods of running appeals, mini-lectures, or applications? Why?

Table 5. Comparison of TBL scores on IRAT-pre, GRAT, and IRAT-post scores

Module	IRAT-pre-Score	GRAT Score	IRAT-post Score	P value^a	P value^b	P value^c
1	51 $\pm$ 21	87 $\pm$ 10	94 $\pm$ 12	P < 0.001	P < 0.001	P < 0.01
2	51 $\pm$ 19	85 $\pm$ 10	78 $\pm$ 15	P < 0.001	P < 0.001	P < 0.01
3	61 $\pm$ 20	91 $\pm$ 10	64 $\pm$ 14	P = 0.250	P < 0.001	P < 0.001
4	52 $\pm$ 16	80 $\pm$ 11	97 $\pm$ 6	P < 0.001	P < 0.001	P < 0.001
All	54 $\pm$ 19	86 $\pm$ 11	83 $\pm$ 18	P < 0.001	P < 0.001	P = 0.192

^aindicates IRAT-pre vs. IRAT-post.

^bindicates IRAT-pre vs. GRAT.

^cindicates GRAT vs. IRAT-post.

Table 6. Frequency of hours students spent on pre-class preparation

Hours spent	Frequency
0–3 hours	20 students
3–6 hours	12 students
>6 hours	5 students
No response	3 students
Total	40

Table 7. Coding of frequency of students’ responses to four open-ended questions

	Frequency of response coded
Questions	Yes	No	Ambiguous	No response
2. Do you consider the amount of pre-class preparation materials suitable for you?	26	6	5	3
3. Do you consider the difficulty level of pre-class preparation content suitable for you?	18	13	5	4
4. In the TBL class, most activities are run in group discussions. Does group discussion influence your learning?	35	2	0	3
5. Do you hope that the course instructor continues to use TBL in the course in the future?	35	2	0	3

Table 8. Themes coded from the responses to three open-ended questions and excerpts provided

First Level	Second Level	Excerpt	Q4	Q5	Q6
TBL Instructional Elements	Multiple types of test items	S12: My understanding is strengthened. I can also understand other’s opinions. The test items show diversification and it is wonderful to not limit the content within PPT. (Q4)	✓	✓	✓
	Pre-class preparation	S8: I sometime don’t understand the content of PPT in pre-class preparation materials. (Q6)	✓	✓	✓
	Peer evaluation	S15: To do peer evaluation is to contribute to each other’s learning. (Q4)	✓
	Semester design	S12: 1. I hope the whole TBL lesson can change to 1hr TBL+1hr lecture on PPT.; 2. The materials for pre-class preparation could be less so I could be better fully prepared.; 3. The teacher could have more time on lecturing with PPT.; 4. I feel it would be better if we could have 1hr TBL and 1hr lecture every week and cover less content. (Q6)			✓
	Time management	S8: Time management of class time should better improve. (Q6)			✓
	Mini-lecture	S28: I had better impressions when I read before class and then I had better understandings when the teacher lectured on the content in the class (Q5)		✓	✓
	Teaching strategy	S33: I hope we could use IRS to give the answers so we wouldn’t always fail giving the answers with not raising the cards in time. (Q6)			✓
Team	Team effectiveness	S1: TBL can strengthen my impressions, and it is more interesting to learn in groups than doing pre-class preparation by myself. (Q5)	✓	✓
	Team formation	S19: We can have different group members in every class. In some groups, there are members actually only listening to others’ opinions. (Q6)			✓
Learning	Content understanding	S12: My understanding is strengthened. I can also understand other’s opinions. The test items show diversification and it is wonderful to not limit the content within PPT. (Q4)	✓	✓	✓
	Learning strategy (brainstorming, imagination)	S16: In the process of group discussions, I could know the differences of learning strategies used between my peers and I. (Q4)	✓	✓
Motivation	Fun	S15: TBL is fun and interesting. (Q5)	✓	✓
	Concentration	S26: TBL is interesting. I can enhance students’ concentration and familiarity of test items. (Q5)	✓	✓
	Learning interest	S37: Because I didn’t learn with this kind of learning experience before, I felt very innovative and easily got interests in learning. (Q4)	✓	✓
	Participation	S19: At first I didn’t get used to this method and got bad feelings, but afterwards I felt this method actually could enhance my willingness and participation in learning. (Q5)		✓

We checked the themes appearing in students’ responses. Q4 is about students’ reasons why group discussions influence their learning. Q5 is about students’ perceptions of the teacher continuing to use TBL. Q6 is about suggestions for TBL classes.

Table 9. Themes coded from the instructor’s three interviews and excerpts provided

Theme	Excerpt	1^st interview	2^nd interview	3^rd interview
Topic of course content	I feel I may modify the topics after my first TBL lesson. At the beginning, I chose the latter three topics related to three different instruments. After first TBL lesson, I would chose the latter three topics based on the instruments with simpler principles. (1^st interview)	✓	✓	✓
Difficulty level of pre-reading	I would let students focus on learning principles in pre-reading and discussion. Because testing needs real instruments, … it is hard to image what instruments look like when students read by themselves. So I modified the content of pre-reading. (2^nd interview)	✓	✓	✓
Time management of TBL teaching	There is one area to work on-that is time management of discussion activities. I was over time in the last TBL lesson. I paid more attention to time management of discussions this time. (3^rd interview)	✓	✓	✓
Test design	I had 5 more test items on GRAT and five application items. So maybe I don’t need the 5 more test items on GRAT as I need to consider time since I need to do post individual test (1^st interview)	✓	✓	✓
Use of multiple teaching strategies	We could have different actions each time when choosing groups to answer the questions. For example, I could see which group stands up the fastest, they could first answered the question. (3^rd interview)		✓	✓