MedEdPORTAL (Jan 2011)
Infective Endocarditis TBL
Abstract
Abstract Introduction This resource includes a monograph integrating microbiology, pharmacology, and immunology of infective endocarditis, six Readiness Assurance Test (RAT) questions and a clinical application exercise. The application is built around an infective endocarditis case due to viridans streptococci. Methods Prior to the session the included advanced preparation readings are distributed to prepare the students for the TBL session. At the beginning of the session, students are asked to complete an Individual RAT (I-RAT). Once the I-RAT is complete, the students are asked to sit in preassigned groups of five to eight students to work on the same RAT questions together in teams. In the application exercise, students are presented with a case and asked to consider the significance of the past history as well as a series of signs and symptoms presented. Questions pertaining to the case are then posed to the class in PowerPoint slide format. Results Overall our students seemed to have a positive reaction to this TBL. Only 8% felt the TBL was of low or marginal value while 54% felt it was acceptable, and 38% thought it was of high value. Where was a strongly positive feeling about the associated reading assignment where 63% found it was of high value and 25% said it was acceptable value, as opposed to only 4% who though it was of marginal value. When asked if they had read the monograph 42% said yes they had read the entire assignment while 33% said they read only part and 20% had only read a little bit of the assignment or none at all. Immediately following the session, the majority (58%) of the students indicated that they felt comfortable practicing their knowledge of infectious endocarditis during the TBL session and the remainder indicated some discomfort with this format. Student generally did well on exam questions derived from the materials and learning objectives. That is, in three of four questions more than 84% of the class chose the correct answers in five-option multiple-choice questions covering either microbiological or pharmacological objectives. Discussion The exercise is organized as an unfolding case history. A key feature is that the slides in the case can be presented in sequence; thus the events unfold over time, mimicking real life. Use of this learning tool encourages collegial interaction, peer-to-peer clarification of knowledge, and dynamic sharing to arrive at consensus choices.
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