Claire Burns, Lecturer in Nursing at The University of Manchester, summarises her experience of introducing Team-Based Learning (TBL) to improve engagement with biosciences in undergraduate nursing.
Nursing students’ struggles with bioscience have been well-documented in the nursing literature in recent years (Barton et al., 2021). As universities move towards a more blended learning environment with fewer hours on-campus, educators face the challenge of ensuring that the time students do spend on campus is worthwhile, meaningful and engaging as well as equitable and inclusive.
The University of Manchester Bachelor of Science in Nursing (BNurs) includes a unit of learning in ‘Applied Bioscience in Nursing Practice’ in Year 2 of the programme. This follows on from a ‘Fundamentals of Anatomy and Physiology’ learning unit in Year 1. Since the inception of the new nursing curriculum in 2019, bioscience teaching has been delivered online with asynchronous pre-learning activities in the virtual learning environment, followed by weekly synchronous online clarification sessions, designed to reinforce key learning objectives and clear up any student confusion about the week’s topic. However, we realised that most students did not actively participate in the online sessions and student feedback indicated a strong preference for in-person sessions. In response to this, the unit teaching team discussed how best to deliver the unit. Prior to the new curriculum, the unit had been delivered as weekly lectures and 60-minute seminars. The team were reluctant to return to this didactic and passive method of teaching. After exploring innovative teaching methods, it was decided this would be an exciting opportunity to introduce Team-Based Learning (TBL) to the nursing bioscience curriculum.
TBL, first introduced by Michealson in the 1970s (Sterpu et al., 2024) involves several steps, including:
- Team formation – students are placed into teams for the duration of the learning unit. These teams collaborate to complete seminar tasks.
- Pre-learning – learners must complete pre-learning before attending the TBL session to prepare for in class tasks.
- Individual Readiness Assurance Test (iRAT) – This is typically a set of multiple-choice questions (MCQs) that students complete in class, individually and under exam conditions. These MCQs are the foundation for later in-class tasks
- Team Readiness Assurance Test (tRAT) – this involves learners working together in teams to answer the same MCQs as in the iRAT. This encourages collaboration, debate and peer learning. This important step allows learners to refine their understanding, through discussion before committing to an answer. Feedback on team responses is provided immediately, and facilitators can identify which topics learners are having difficulty with and deliver focused teaching based on this.
- Application exercises – these are structured activities designed to give students the opportunity to apply their knowledge to real-world problems, reflective of clinical practice.
Prior to the start of teaching activities in Year 2, learners attended an introduction to TBL session. To help ensure this session addressed learner concerns and potential barriers, it was co-created and delivered with one of our Year 3 undergraduate students who had previous experience of TBL. During this session, students were allocated to their TBL groups and participated in a TBL session about the pedagogy of TBL and how to be an effective team member. Learners were also given access to the Learning Activity Management System (LAMS). LAMS is a digital platform for designing, managing and delivering collaborative learning activities and allows session facilitators to track student progress both individually and in teams. This first session was important to lay out the ground rules and expectations for TBL as well as troubleshooting technical issues and familiarising learners with the TBL process and LAMS system. Reactions of students at the start of this session point were varied; some students were engaged and motivate for a new way of learning, whilst other were more apprehensive and unsure of expectations. Most learners adapted to TBL quickly and it was exciting to hear the buzz of group conversations and observe interactions.
TBL was then introduced to the Bioscience unit. Quantitative teaching evaluations have subsequently demonstrated that students are more satisfied with their bioscience learning than previous cohorts and rate their lecturers’ teaching quality more highly. Qualitative feedback from students has been mixed. Some students report difficulty with this new method of active learning and state they prefer didactic lectures, finding it hard to manage their time and motivate themselves to complete the pre-learning. However, most students report they are satisfied with TBL with one neurodiverse student stating that the design of the pre-learning and TBL sessions helps them to stay focused. Other students appreciate the collaborative learning offered by TBL and appreciate the opportunity to learn with and from their peers, recognising this reflects real world practice. Feedback from all facilitators on the unit has been positive, with one previously highly sceptical member of staff reporting that they had been ‘completely won over’ by this innovative and energetic approach to bioscience delivery.
Overall, the introduction of TBL has been positive. Although some learners struggle with this active form of learning, it is recognised that TBL is more effective than traditional pedagogical approaches (Nawabi et al., 2021). Negative qualitative feedback indicates that students often do not feel prepared for active learning and perceive that they are ‘teaching themselves’. To help change this perception, TBL is being extended into the Year 1 bioscience unit, providing earlier exposure for learners to equip them with the skills they need to thrive in collaborative learning right from the start of their nursing journey.
The Bioscience team at The University of Manchester would love to compare experiences and ideas with other colleagues who are also using TBL, or similar techniques. If you would like to be part of these discussions, please contact: Claire.Burns@Manchester.ac.uk
References:
Barton, M. J., Bentley, S., Craft, J., Dupen, O., Gordon, C., Cayanan, E. A., … & Johnston, A. N. (2021). Nursing students’ perceptions of clinical relevance and engagement with bioscience education: A cross-sectional study of undergraduate and postgraduate nursing students. Nurse education today, 99, 104767. https://pubmed.ncbi.nlm.nih.gov/33571929/
Nawabi, S., Bilal, R., & Javed, M. Q. (2021). Team-based learning versus Traditional lecture-based learning: An investigation of students’ perceptions and academic achievements. Pakistan journal of medical sciences, 37(4), 1080–1085. https://doi.org/10.12669/pjms.37.4.4000
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