Team-based learning on a third-year pediatric clerkship improves NBME subject exam blood disorder scores

Purpose: At our institution, speculation amongst medical students and faculty exists as to whether team-based learning (TBL) can improve scores on high-stakes examinations over traditional didactic lectures. Faculty with experience using TBL developed and piloted a required TBL blood disorders (BD) module for third-year medical students on their pediatric clerkship. The purpose of this study is to analyze the BD scores from the NBME subject exams before and after the introduction of the module.

Methods: We analyzed institutional and national item difficulties for BD items from the NBME pediatrics content area item analysis reports from 2011 to 2014 before (pre) and after (post) the pilot (October 2012). Total scores of 590 NBME subject examination students from examinee performance profiles were analyzed pre/post. t-Tests and Cohen's d effect sizes were used to analyze item difficulties for institutional versus national scores and pre/post comparisons of item difficulties and total scores.

Results: BD scores for our institution were 0.65 (± 0.19) compared to 0.62 (± 0.15) nationally (P = 0.346; Cohen's d = 0.15). The average of post-consecutive BD scores for our students was 0.70 (± 0.21) compared to examinees nationally [0.64 (± 0.15)] with a significant mean difference (P = 0.031; Cohen's d = 0.43). The difference in our institutions pre [0.65 (± 0.19)] and post [0.70 (± 0.21)] BD scores trended higher (P = 0.391; Cohen's d = 0.27). Institutional BD scores were higher than national BD scores for both pre and post, with an effect size that tripled from pre to post scores. Institutional BD scores increased after the use of the TBL module, while overall exam scores remained steadily above national norms.

Conclusions: Institutional BD scores were higher than national BD scores for both pre and post, with an effect size that tripled from pre to post scores. Institutional BD scores increased after the use of the TBL module, while overall exam scores remained steadily above national norms.