Poeppelman Rachel Stork, Liebert Cara A, Vegas Daniel Brandt, Germann Carl A, Volerman Anna
J Grad Med Educ. 2016 Oct;8(4):510-517. doi: 10.4300/JGME-D-15-00516.1.
Team-based learning (TBL) promotes problem solving and teamwork, and has been applied as an instructional method in undergraduate medical education with purported benefits. Although TBL curricula have been implemented for residents, no published systematic reviews or guidelines exist for the development and use of TBL in graduate medical education (GME).
To review TBL curricula in GME, identify gaps in the literature, and synthesize a framework to guide the development of TBL curricula at the GME level.
We searched PubMed, MEDLINE, and ERIC databases from 1990 to 2014 for relevant articles. References were reviewed to identify additional studies. The inclusion criteria were peer-reviewed publications in English that described TBL curriculum implementation in GME. Data were systematically abstracted and reviewed for consensus. Based on included publications, a 4-element framework-system, residents, significance, and scaffolding-was developed to serve as a step-wise guide to planning a TBL curriculum in GME.
Nine publications describing 7 unique TBL curricula in residency met inclusion criteria. Outcomes included feasibility, satisfaction, clinical behavior, teamwork, and knowledge application.
TBL appears feasible in the GME environment, with learner reactions ranging from positive to neutral. Gaps in the literature occur within each of the 4 elements of the suggested framework, including: , faculty preparation time and minimum length of effective TBL sessions; , impact of team heterogeneity and inconsistent attendance; , comparison to other instructional methods and outcomes measuring knowledge retention, knowledge application, and skill development; and , factors that influence the completion of preparatory work.
基于团队的学习（TBL）促进问题解决和团队合作，并已作为一种教学方法应用于本科医学教育，据称有诸多益处。尽管已为住院医师实施了TBL课程，但在研究生医学教育（GME）中，尚无关于TBL开发和使用的已发表的系统评价或指南。
回顾GME中的TBL课程，找出文献中的差距，并综合出一个框架，以指导GME层面TBL课程的开发。
我们检索了1990年至2014年的PubMed、MEDLINE和ERIC数据库，以查找相关文章。对参考文献进行审查以识别其他研究。纳入标准为以英文发表的、经同行评审的描述GME中TBL课程实施情况的出版物。对数据进行系统提取并审查以达成共识。基于纳入的出版物，开发了一个包含4个要素的框架——系统、住院医师、意义和支架——作为在GME中规划TBL课程的逐步指南。
9篇描述住院医师培训中7种独特TBL课程的出版物符合纳入标准。结果包括可行性、满意度、临床行为、团队合作和知识应用。
TBL在GME环境中似乎是可行的，学习者的反应从积极到中性不等。建议框架的4个要素中的每一个要素在文献中都存在差距，包括： ，教员准备时间和有效TBL课程的最短时长； ，团队异质性和出勤不一致的影响； ，与其他教学方法的比较以及衡量知识保留、知识应用和技能发展的结果；以及 ，影响准备工作完成的因素。
