Retention in Enhanced Team Based Learning Course: retain or refrain?

Students’ ability to retain content in medical school has always been a concern. At Duke-NUS Medical School, we modified our Team-Based Learning (TBL) classes known as TeamLEAD, a learning strategy for first year basic science content, to include an open/closed-book option in the readiness assurance phase to engage teams in deeper discussion. We hypothesize that the open-book option allows students to engage in deeper learning in their teams, which leads to an improvement in retention ability for each individual student at the end of their first year basic science curriculum. Methods: A total of 115 MCQs used throughout first year basic science courses from 2011 to 2013 were repeated during a two-week end-of-year review. We analysed the extent of students’ retention by examining the influence of team’s choice for open/closed-book on initial and repeated individual performance score. Results: Student’s individual scores increased from 56.2% correct the first time encountering the questions to 68.7% for the second time (p<0.01). For teams that chose open-book option for group readiness assurance (GRA) test, individual students’ second encounter score increased by 11.8% (p<0.01) compared to 10.3% (p<0.01) for teams that chose closed-book option. Students’ retention was higher for those questions from second half of the year compared to questions from first half (p<0.01). Conclusion: Implementation of open-book component enables students to drive challenging discussion in teams. This helps individual students to consolidate, recall and retain more information over time, which results in an improved individual performance at the end-of-year review.