MedEdPORTAL (May 2013)
Adult Fractures
Abstract
Abstract Introduction This team-based learning (TBL) module is designed to introduce students to the assessment and treatment principles of fractures in adults. The module is taught in the second half of the first year of our undergraduate medical program. Students have previously completed courses in normal human structure (anatomy, histology) and have also been introduced to a self-study online module introducing key concepts about fracture healing. Methods This module is administered using TBL principles. Students are sorted into 15 balanced teams of six to seven students at the beginning of the course. Students who self-identify as having previous related knowledge (e.g., background in physiotherapy or kinesiology) are spread out across groups. The module is completed over two classroom sessions. The first session is 1 hour long and involves a readiness assurance test (RAT) completed first by individuals, then subsequently by teams using scratch-off immediate feedback assessment technique. The second session lasts 2 hours and explores a series of cases. The case information is released progressively, with activities alternating between interteam discussion of case material focusing on a defined task, simultaneous reporting of team answers and instructor debrief. The first-session RAT is closed book, whereas during the case session, students are encouraged to consult text and internet references during team deliberations. The RAT is a graded component of the course, while the cases are ungraded. Results This module has been used in various forms in our center over the past 8 years. Students are motivated to arrive prepared by the RAT and almost universally begin the session with a good grasp of basic concepts. The three cases allow contextualized discussion of important principles, including fracture assessment, common injuries (hip fractures in the elderly), and the management protocol for open fractures. Discussion We have found that students appreciate clear instructions related to TBL modules. In particular, it is important to be explicit about the reference(s) from which the RAT is developed. Time management is also important both during the RAT and while conducting the case-based session. During the case-based session, it is important to allot one-third of the time available for each case and to be aware of this during the classroom session. Students appreciate summary slides, and these are provided after the session to allow review prior to the final examination. Skeleton slides or handouts may be provided before or at the beginning of the case-based session at the discretion of the instructor.
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