SHINICHI NUNODA    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor (Fixed Term)
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Team-based learning, a learning strategy for clinical reasoning, in students with problem-based learning tutorial experiences.
Journal	Formal name：The Tohoku journal of experimental medicine Abbreviation：Tohoku J Exp Med ISSN code：00408727/13493329
Domestic / Foregin	Domestic
Publisher	Tohoku University Medical Press
Volume, Issue, Page	227(1),pp.23-29
Author and coauthor	OKUBO Yumiko†*, ISHIGURO Naoko, SUGANUMA Taiyo, NISHIKAWA Toshio, TAKUBO Toshio, KOJIMAHARA Noriko, YAGO Rie, NUNODA Shinichi, SUGIHARA Shigetaka, YOSHIOKA Toshimasa
Publication date	2012/05
Summary	Acquiring clinical reasoning skills in lectures may be difficult, but it can be learnt through problem-solving in the context of clinical practice. Problem finding and solving are skills required for clinical reasoning; however, students who underwent problem-based learning (PBL) still have difficulty in acquiring clinical reasoning skills. We hypothesized that team-based learning (TBL), a learning strategy that provides the opportunity to solve problems by repeatedly taking tests, can enhance the clinical reasoning ability in medical students with PBL experiences during the pre-clinical years. TBL courses were designed for 4(th) year students in a 6-year program in 2008, 2009, and 2010. TBL individual scores, consisting of a combination of individual and group tests, were compared with scores of several examinations including computer-based testing (CBT), an original examination assessing clinical reasoning ability (problem-solving ability test; P-SAT), term examinations, and Objective Structured Clinical Examination (OSCE). CBT, OSCE and P-SAT scores were compared with those of students who learned clinical reasoning only through PBL tutorials in 2005, 2006, and 2007 (non-TBL students). Individual TBL scores of students did not correlate with scores of any other examination. Assessments on clinical reasoning ability, such as CBT, OSCE, and P-SAT scores, were significantly higher in TBL students compared with non-TBL students. Students found TBL to be effective, particularly in areas of problem solving by both individuals and teams, and feedback from specialists. In conclusion, TBL for clinical reasoning is useful in improving clinical reasoning ability in students with PBL experiences with limited clinical exposure.
DOI	10.1620/tjem.227.23
PMID	22516766