A controlled trial of team-based learning in an ambulatory medicine clerkship for medical students

Background: Team-based learning (TBL) has been studied in several preclinical settings, but there is less evidence for its effectiveness in clinical curricula. Purpose: We compared the impact of TBL versus usual small group lecture (SGL) on knowledge objectives in a clinical clerkship. Methods: We used an unblinded crossover design with 112 students rotating through the Ambulatory Medicine clerkship. In each rotation of the clerkship, 3 clinical topics were taught as SGL and 3 as TBL. We compared performance on the knowledge examination for those items taught with TBL and those with SGL. Results: Performance by students taught by TBL was higher than those taught by SGL in each topic, except Hypertension. The average effect size of the six measures was 0.51. Conclusions: TBL appears to be a more effective method than the usual small group lecture in achievement of knowledge objectives for clinical clerkship students.