Team-based learning (TBL) in the medical school admissions process:
A pilot and feasibility study.
2007 Team-Based Learning Conference
31 May – 1 June 2007
Sandy Cook, PhD; Associate Dean for Curricular Development
Robert K. Kamei, MD; Vice Dean for Education
Duke-NUS Graduate Medical School (GMS)
Background/Purpose. The purpose session is to report our exploration of the value and feasibility of
using TBL in the admissions process and obtain the groups feedback on next steps. We introduced TBL
during the applicant interview day at the Duke-NUS Graduate Medical School, Singapore, for several
reasons. First, when we proposed that the major learning strategy would be TBL, we were told that TBL
would not work with Asian students. They would not be comfortable and would not engage discussions.
Thus, we felt it was critical to test that hypothesis and find a way to inform the applicants of the primary
teaching methodology being used in case it affected their decision to attend. Second, Asian students are
reportedly excellent test takers and we anticipated having many applicants with equally high test scores.
We needed to be able to find some other way to help with the selection process. Thus, we wanted to be
able to observe applicants engaged in discussions, debates, and critical thinking, in hopes of gaining
more insights to their character, personality, and potential intellectual contribution to the medical school.
Methods. 63 applicants participated in a 2-hour TBL sessions. Usually, two TBL sessions were
conducted with two group of 3 or 4 applicants. Prior to coming to campus, applicants were sent an
article to read about impact of pharmaceutical gifts1. Using the basic TBL framework, each applicant
completed a 7-item Individual Assessment Test (IRAT), then completed the Group Assessment Test
(GRAT). The RATs were followed by a series of application questions. The IRAT and GRAT data
were collected, but results were anonymous. Although data were collected, no names were on the forms
Following the group discussion of the application questions, there was a debrief session about the
process and its value. In addition, applicants completed an confidential exit questionnaire that included
two open-ended questions on the TBL session; What did you like best and How could we improve the
Results. IRAT mean score correct was 55% (n=63 individuals, range 100%-14%). GRAT mean was
73% (n=16 groups, range 100-57%), without any appeals. In the exit survey, participants reported it was
both a fun & interesting way to learn (n=22), a great opportunity to interact with other applicants (n=9)
and enjoyed being able to learn from others and hear differing opinions (n=42). Enjoyed the debates
(n=4). In addition, they felt it gave a winning picture of what the learning environment will be like at
the school (n=9). On the question of what we could improve, most said they could not think of ways to
improve or left it blank (n=41). The constructive comments were to have more controversial topics
(n=1), More time for more in-depth discussion (n=5), and more opportunity for debate (n=1).
Conclusions. We found it feasible to add a TBL session in the applicant interview day. As a recruitment
tool, the session appears very successful in giving applicants a taste of the learning environment and
making the applicant day unique and fun. For the facilitators, it demonstrated that Asian students were
very receptive to TBL. In addition it was an exceptional opportunity to see all candidates in a less
formal setting and see them being engaged in critical thinking and the learning process. What additional
data might be possible to collect and what research questions might we explore from this experience?
Wazania A. (2000). Physicians and the pharmaceutical industry: Is a gift ever just a gift? JAMA, Jan
19, 2000, 283(3) 373-380.