[Interview] Dr. Robert Kamei on TBL in medical education

[Interview] Dr. Robert Kamei on TBL in medical education

Dr. Robert Kamei, Professor, Associate Provost (Education) and Director at Duke-NUS Medical School – a collaboration between Duke University and the National University of Singapore – has developed and evaluated the educational impact of innovative programs for learners at the undergraduate and graduate medical school level. Cognalearn learns from the founder of TeamLEAD a teaching methodology rooted in Team-Based Learning (TBL) about his experience with TBL, his involvement with InteLearn” and the future of TBL in medical education.

When did you first learn of, and begin to engage with the concept of Team-Based Learning?

I first began to engage with the concept of TBL when I was appointed to be Vice Dean at Duke-NUS Medical School, and I was given 15 months to develop and implement a new educational curriculum for the school. At that time, Duke-NUS Medical School had just been established. So myself, Sandy Cook who really worked to implement this and get the faculty aligned and Doyle Graham, the former Dean of Education at Duke University worked to develop TeamLEAD for Duke-NUS.

As we did it, I would say that the Duke educational faculty leadership was very supportive. We visited schools such as Wright State University that had already implemented team-based learning into their medical educational curricula and took this opportunity to do something different. This was before the term flipped classroom was developed. We worked with Duke Medical School’s faculty and educational materials such as problems and videos to develop Duke-NUS’ curriculum.

Would you say that the Team-Based Learning pedagogy is the future of teaching in medical education?

I think that there is no single pedagogical approach that covers all of what students need. An educationalist’s job is to select the right tools for the right educational goals. For example, when we began to develop TeamLEAD at Duke-NUS Medical School, I had to be an evangelist for the approach. Even though the claim that a lecture in medical school is like “educational malpractice” was brought up during this time period, I didn’t completely believe in it. A lecture can really inspire a people, however, the majority of medical education is about supplying a large amount of content, for which it isn’t a good pedagogical approach. TBL plays a huge role in supplying content, because it can really educate students about team building and communication skills.

How does the Team-Based Learning pedagogy improve the attainment outcomes of medical students at Duke-NUS as compared to traditional teaching methods?

It’s hard to obtain evidence for attainment rates of various medical schools due to the “ceiling effect”, in that if everyone does well it’s hard to differentiate between them. Duke-NUS is unique because it covers the same curriculum with the same attainment rates, but in half the time, as compared to medical schools with more traditional teaching methods. A student would say that their communication skills wouldn’t improve if they were sitting in a lecture theater all day as opposed to in a team-based learning class as team interaction is critical.

We also looked at this from an administrator’s standpoint taking the learning material and asking students to learn and apply it is more compatible to learning sciences than a single lecture. Deans also don’t have to worry about students who don’t participate because they’re physically and/or mentally ill, because intervention can be done at an earlier stage than in a lecture environment. Students can identify other students that are perhaps struggling, and you can do something about it. From a faculty standpoint, TBL is more efficient as they are able to come in and provide their clinical expertise directly to students without any other additional processes and/or educational training involved.

How did you become involved with the development of InteLearn?

I met Brian O’Dwyer the Commercial Founder of CognaLearn through the Duke Alumni Association in Singapore. I suggested that he explore the education stage, and eventually, he became the first Entrepreneur-in-Residence at Duke-NUS Medical School. After learning more about TeamLEAD, work began on how to incorporate this methodology into technology. I really helped him connect the dots.

Do you think that medical schools are progressing rapidly towards the adoption of Team-Based Learning pedagogy in their curricula?

With any sort of innovation, there are early adopters, and for Team-Based Learning in medical education, we were very happy to be early adopters. We were early adopters at the time of the internet, the advent of online video, instructional tools, the timing was right for us to pull together. We capitalized on the timing of all of this electronic technology and packaged it into a program that we could call our own, and the timing was right. We’ve had hundreds of visitors now at Duke-NUS Medical School to learn more about TeamLEAD, and so it slowly caught, and with the advent of the flipped classroom, people are now adopting the flipped classroom model.

What other realms of medicine do you think would benefit from the Team-Based Learning pedagogy besides clinical education?

In clinical education, there are students that work in a team that hovers patients, and so essentially taking care of patients is an element of Case-Based Learning. You see the patient, you think that this is a patient with pneumonia or a lung infection and then you research information, read it, and make your best case. Then you have a case discussion with your team. I think that from a clinical standpoint, as you get more advanced, there’s less need to use Team-Based Learning, but it can be quite useful in continuing medical education programs. Students of continuing educational programs are people you want to deliver a particular curriculum to, people you want to obtain particular facts from.[/vc_column_text]

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