Peer-Assisted and Team-Based Learning: A new hybrid strategy for Medical Education

ABSTRACT Medical education has been significantly changing in the last years, mainly due to new conceptions of the teaching-learning processes that advocate the employment of active methods of learning, such as Team-Based Learning (TBL). Peer-Assisted Learning (PAL) is a long-established strategy that has been used in several undergraduate courses. This study describes a pilot test of a new model of PAL developed with an adapted TBL strategy, that was called “PAL-TBL method”. The test occurred during Human Physiology classes with first-year Medical undergraduate students from Universidade de Pernambuco - Garanhuns Campus, Brazil. The PAL-TBL was designed as a teaching-learning methodology to improve academic education. Here, the organizational dynamics and the design of the activities carried out from 2016 to 2017 are reported. The resulting PAL-TBL methodology is characterized as the following: (i) timing I or material preparation (context/scenario) and study/analysis of the material by the participants; (ii) timing II or verification of prior knowledge (individual and team test), questioning and feedback and (iii) timing III or applying the concepts learned. It is worth mentioning that the end of timing II consisted of a moment for evaluating the team’s work and the materials used. Material production happened through the interaction between student-tutors and the (supervising) professor, aiming to share experiences as well as to elucidate the importance of using active methods during the academic development of useful competencies for medical practice. The methodology developed allowed students to reflect extensively on the problems presented in the class discussions, allowing for a richer learning experience. Further applications of PAL-TBL in advanced years of the course will be done to confirm the benefits of this hybrid strategy for medical education.

摘要：近年来，医学教育发生了显著变革，这主要源于倡导采用主动学习方法的教学新理念，例如基于团队学习（Team-Based Learning，TBL）。同伴互助学习（Peer-Assisted Learning，PAL）是一项历史悠久的教学策略，已在多门本科课程中得到广泛应用。本研究针对采用改进型基于团队学习（TBL）策略开发的新型同伴互助学习（PAL）模式开展试点测试，该模式被命名为"PAL-TBL教学法"。本次测试在巴西伯南布哥大学加兰胡斯校区（Universidade de Pernambuco - Garanhuns Campus）的人体生理学课堂开展，受试对象为该校一年级医学本科学生。本PAL-TBL教学法旨在优化医学教育教学体系，本文报告了2016至2017年间开展的相关活动的组织流程与设计方案。最终形成的PAL-TBL教学法具有如下流程特征：(1) 第一阶段：材料准备（情境/案例设定）与学员自主研读、分析材料；(2) 第二阶段：前置知识验证（个人测试与团队测试）、答疑与反馈；(3) 第三阶段：运用所学概念解决问题。值得注意的是，第二阶段结束时会设置团队作业与所用教学材料的评估环节。教学材料的制作通过学生助教与指导教授的协作互动完成，旨在分享教学经验，并阐明在医学人才学术培养阶段采用主动学习方法对提升临床实用能力的重要意义。本教学法可引导学员针对课堂讨论中提出的问题进行深度反思，从而获得更为丰富的学习体验。后续将在本课程更高年级中推广应用PAL-TBL教学法，以验证该混合式教学策略在医学教育中的应用价值。