Promoting the Active Learning of Pharmacology and Clinical Therapeutics Utilizing Team‐Based Learning (TBL) Methods in Second Year Systems Modules

Curricular reforms in pharmacology teaching have stressed a movement toward more active learning methods that support both higher order critical thinking and collaborative learning to develop teamwork skills essential to resolving complex problems. Secondly, evidence suggests that teaching pharmacology using clinically relevant scenarios encourages retention, motivation, and may facilitate transfer from foundational knowledge to clinical application as medical learners progress from their second year (M2) into clerkship. However, limited curricular and faculty resources can make the transition to more active learning methods challenging. To stimulate higher order clinical reasoning about complex pharmacotherapeutics in our curriculum, pharmacology concepts were incorporated into large classroom team‐based active learning sessions (TBLs) addressing the diagnosis and treatment of diseases in cardiopulmonary and neurological systems second year modules. Six TBLs incorporating cardiopulmonary pharmacology were implemented at the beginning of the M2 year while 7 sessions incorporating neuropharmacology were implemented at the end of M2 year. High yield categories incorporated into TBL learning included: antihypertensives, antiarrhythmics, heart failure therapeutics, bronchodilators, antidepressants, antipsychotics, anxiolytics, anticonvulsants, opioid analgesics, and mood stabilizers. Preparatory materials included pharmacology interactive didactics, electronic self‐learning module narrated tutorials (SLMs) with interactive games and quizzes, and/or text book readings. Individual preparation was assessed by individual readiness assurance exams (IRAT) and the learners worked in TBL‐assigned diverse groups of 6–7 to answer questions covering the diagnosis and treatment of diseases. TBLs designed to integrate multi‐therapeutics covered topics such as chronic pain, medication‐induced delirium, and heart failure. Ambiguous questions addressing treatment choices encouraged more debate, small group engagement, and large classroom discussion between teams. Outcomes data support effectiveness of learning using this method, as mean performance on assessment items covered in TBL has been above the pharmacology mean of 86% and learners have evaluated the neuropharmacology TBLs positively for promoting clinical relevance and integration of psychiatry with pharmacology. Additionally, learners value TBLs on topics like chronic pain because multi‐therapeutic drugs are reviewed and disorders covered in previous systems, like diabetic neuropathy, are integrated to provide an end of year review preceding USMLE Step 1 exams. Further, TBL's can be implemented using few faculty and limited resources. In summary, incorporation of pharmacology into TBLs supports active learning, critical thinking, and clinical integration of foundational knowledge using large classroom collaborative learning processes.