Team-based testing gives students a chance to earn additional points on individual unit tests by immediately re-taking the test as a team competing against other teams. This instructional approach has enjoyed widening implementation and impressive anecdotal support, but there remains a dearth of empirical studies evaluating its prescribed processes and promoted outcomes. Although the posited effectiveness and appeal of team-based testing seem consistent with the benefits of test-enhanced learning and collaborative learning in general, several limitations are readily apparent. Namely, the current format of the individual and team readiness assurance tests is expressly multiple-choice. Though there are some advantages of this type of question (e.g., ease of administering and grading), the long-term cognitive disadvantage relative to short-answer questions is well documented. Furthermore, it is not clear whether the proposed gain in learning through this format is attributable to the group effect -- be it social or cognitive, or simply to repeated exposure to the test items. Therefore, this study measured the effects of initial test question Format (short-answer vs. multiple-choice), Mode (individual vs. group), and Exposure (once vs. twice) on four delayed measures of learning: Old multiple-choice items (ones students had initially been tested over), Old short-answer items, New multiple-choice items, and New short-answer items. Two weeks after watching a video-recorded lecture, 208 college students took a thirty-item test comprising both the old and new items in multiple-choice and short-answer formats. Results revealed that 1) taking an initial test twice is better than once when the delayed test has old short-answer items or new multiple-choice items, 2) taking an initial short-answer test is better than multiple choice when the delayed test has either old multiple-choice, old short-answer, or new multiple-choice items, and 3) taking an initial team test is no different than taking an individual test when it comes to long-term learning. Particularly noteworthy from these results is how a) the effects of short-answer tests and taking tests twice are not present within Team conditions, and b) taking a multiple-choice test twice is as effective as taking a short-answer test once. Implications are discussed in light of learning theory and instructional practice. / text

The objectives of this thesis were to examine (1) associations between primary care type (team-based versus non-team based) and access problems (difficulty in access and self-reported unmet need), and (2) if socioeconomic variations in access problems were less graded for team-based than non-team-based primary care. Data came from a nationally representative cross-sectional survey, the 2008 Canadian Survey of Experiences with Primary Health Care. Using logistic regression, we examined the associations between primary care type and access problems, adjusting for demographic, health status, socioeconomic, and health care supply factors. We then stratified by primary care type to compare steepness of socioeconomic associations with access problems. Primary care type had no statistically significant, independent associations with access problems. No statistically significant socioeconomic gradients in access problems were observed regardless of primary care type, except that difficulty in access was statistically significantly and positively graded by education for non-team-based primary care.

This text is a complete team-based and project-based learning course focused on the application of the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) to unique groups of program clients and patients. It is designed to engage undergraduate students in exploration of the different facets of the ICF, in how the ICF differs from medical and social models because of these facets, and how each applies to, and ensures, an awareness of all of the ways in which health affects and is affected by peoples’ characteristics and environments. The text includes readings, digital links, readiness assurance elements, and guidelines for individual and team deliverables, but can also be used as a stand-alone text to provide a rich constructivist approach to understanding the structure of the ICF and how to use it for problem solving and decision-making with a patient/client population. It is the author’s intention that the text be used as suits the instructor, and modified to fit the pre-professional or paraprofessional healthcare students being taught, so while case study examples for rehabilitation are include, the text will lend itself to any patient or client group. / https://dc.etsu.edu/etsu-oer/1008/thumbnail.jpg

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Team-based primary care is an innovative care delivery model that has the potential to improve access to comprehensive, coordinated, and high-quality patient care. It is understood that in order for primary care teams to work effectively, health care providers must work across disciplinary boundaries and develop strong relationships that enable them to coordinate their roles and expertise. This research investigated how health care providers make use of different team structures (i.e., tools) to manage their interdependent work, enabling them to deliver team-based primary care. This research also examined how team structures influence the intra-team relationships important for coordinating care. By exploring the different ways primary care teams enact team structures, this research identifies ways primary care teams use team structures differently to address the needs of patients and coordinate team-based care. In-person interviews were conducted at 7 primary care clinics participating in a population health management program in a southeastern city in the United States. Research participants from various health care disciplines (e.g., medicine, nursing, social work) were asked to describe their experiences delivering team-based primary care. Interviews were recorded, transcribed, and analyzed. Data were analyzed using a constant comparative approach in order to investigate how different team structures were used to address the needs of patients and the challenges of delivering team-based primary care. The data suggested that primary care teams enact structures in different ways. In some teams, huddles were used to anticipate the specific needs of patients and coordinating care, referrals occurred via warm handoffs with co-located providers, and protocols were used to facilitate collaborative problem-solving. In other clinics, huddles were focused on clinic operations, referrals were performed using traditional methods (e.g., phone calls), and protocols were used to guide task delegation. Participants in some clinics described how team huddles were used to leverage high-quality relationships by fostering respectful interactions between team members. More research is needed to determine whether the use of patient-focused huddles, warm handoffs, and protocols that initiate problem-solving is associated with better patient outcomes, particularly for patient populations with complex medical and non-medical needs.

BACKGROUND AND OBJECTIVES: Interprofessional education (IPE) is recommended by many as a means by which to prepare clinicians for collaborative practice and a mechanism by which to improve the overall quality of health care. The objective of this study was to determine the impact of an interprofessional medicine-pharmacy student home visit experience on students’ self-assessments of skills and abilities related to team-based care and identification of medication-related problems. METHODS: Third-year medical and fourth-year pharmacy students completed an interprofessional home visit centered on identification of medication-related problems. Students were surveyed before and after the IPE assignment to assess changes in self-assessed skills and abilities. Survey items consisted of Likert-type statements on a 5-point scale (1=strongly disagree, 5=strongly agree) and free-text responses. Students also completed reflection papers regarding their experiences. RESULTS: Twenty-two medical and 20 pharmacy students conducted medication-focused interviews of 22 patients at home as interprofessional teams. Medical and pharmacy student self-assessments of skills and abilities related to team-based care and identification of medication-related problems improved after completion of the assignment. Both groups of students perceived an improvement in confidence regarding communication skills, both with patients and with other health professions students. Changes were reported on 12 survey items. Student feedback on the IPE experience was positive. CONCLUSIONS: Students’ self-perception of skills and abilities related to interprofessional team-based care and identification of medication-related problems are improved after IPE medication-focused home visit assignment. Student feedback supports the value of interprofessional patient care clinical experiences.

Scant research exists to illuminates the nature of organizational efforts, or support systems, designed to provide work teams with what is needed to be successful. The sample (N = 20) consists of experienced researchers and practitioners discussing work team implementations and the ongoing support needed for sustainability. The following seventeen team-based support systems were examined: (a) rewards and recognition, (b) team goal setting, (c) performance measurement, (d) performance appraisal, (e) team placement and structure, (f) communication and information systems, (g) culture, (h) training, (i) knowledge management, (j) business strategy, (k) leadership, (l) between teams integration, (m) resource distribution, (n) physical workspace, (o) program evaluation and renewal, (p) personnel selection system, and (q) work process design. This study uses a grounded theory approach to build a support system model and provide hypotheses for future research.

The purpose of this study was to test the effectiveness of the readiness assurance process of team-based learning (TBL) in virtually isolated settings. Many Internet sites offer courses for adults to use on their own without access to mentors or other learners. However, educational theory suggests that people learn better with others than by themselves. The focus of this investigation was whether the inclusion of the readiness assurance process would increase participants’ levels of learning based on Bloom’s revised taxonomy within the limits of virtual isolation. In this study an experimental pretest-posttest design was employed. Using a 2- day mini-course about listening in marriage, 117 participants were randomly assigned to three groups. In the TBL group, married couples worked together following the principles of the readiness assurance process. In the independent group, one spouse from a marriage worked alone, also following the principles of the readiness assurance process. In the baseline group, one spouse from a marriage took the pretest and posttest only. The first posttest, called posttest-L, measured lower levels of learning (remembering and understanding). The second posttest, called posttest-D, measured deeper learning (applying and evaluating). Using ANCOVA with the pretests as the covariates, results showed a statistically significant difference in learning gains between the TBL group and the independent group for lower levels of learning (ES = .39). However, statistical significance was not achieved for deeper learning. Moreover, TBL scores and independent scores were no different from the baseline scores for measures of deeper learning. Along with explanations for these results, limitations of the study are described and suggestions for future research are offered.

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Background/Rationale - East Tennessee State University developed four interprofessional (IP) team-based education and practice clinics from within an already established network of nine nurse-managed clinics. The purpose of these IP clinic teams is to build capacity for interprofessional practice (IPP) and deliver effective health management to patients with multiple chronic conditions (MCC) through evidence-based practice to improve health outcomes in underserved populations. Description of Innovative Approach - This project took the innovative approach of acknowledging the specialized knowledge, skills, and contributions of nursing, pharmacy, and nutrition specialties, empowering each discipline to be an active decision-maker in the healthcare team. The IP team embedded themselves in existing nurse managed clinics, conducting “student led” clinics at the various sites. A Clinical Fellows Model was utilized to enhance the students learning experience and to promote IPP upon graduation. Challenges and Strategies of IP Team Development - During the first year of the project, the IP team overcame barriers with purposeful strategy which has created unique opportunities for the remaining grant period. Challenges and barriers were overcome with attention to building team collaboration through education and familiarity with working in the interprofessional setting. Discussion – The Clinical Fellows Model was derived from four IP competencies: roles and responsibilities, values and ethics, teamwork, and communication. The student led IP clinics have grown in the number of sites and disciplines supporting East Tennessee State University’s vision of true interprofessional education and practice for managing patients with MCC.