Pharmacy Education

Crew-Based mostly Studying and Lecture Based mostly Studying

Karim Eldin M A Salih,1– 3 El-Fatih Z El-Samani4 , Jalal Ali Bilal,5 Emtinan Okay Hamid,6 Omer Abdelgadir Elfaki,7 Muawia EA Idris,1 Hind A Elsiddig,8 Maha M Salim,8 Hashim Missawi,9 Mohammed Abass,10 Walyeldin Elfakey1

1Division of Pediatrics, School of Medication, College of Bahri, Khartoum, Sudan; 2Division of Pediatrics, School of Medication, College of Bisha, Bisha, Saudi Arabia; 3Division of Medical Training, School of Medication, College of Bisha, Bisha, Saudi Arabia; 4Division of Group Medication, Faculty of Medication, Ahfad College for Girls, Khartoum, Sudan; 5Division of Pediatrics, School of Medication, Shaqra College, Shaqra, Saudi Arabia; 6Division of Group Medication, School of Medication, College of Khartoum, Khartoum, Sudan; 7Division of Inner Medication and Medical Training Unit, Al-Rayan Medical Faculties, Medina Munawara, Saudi Arabia; 8Division of Pathology, School of Medication, College of Bahri, Khartoum, Sudan; 9Division of Pathology, Maternity and Youngsters Hospital, Medina Munawara, Saudi Arabia; 10Division of Pediatrics, School of Medication, Arabian Gulf College, Manama, Bahrain

†El-Fatih Z. El-Samani handed away on 23.12.2020

Correspondence: Walyeldin Elfakey
Division of Pediatrics, School of Medication, College of Bahri, Po Field: 1660, Khartoum, Sudan
Tel +249912364272
Fax +249 155 888 406
Electronic mail [email protected]

Goal: College students’ efficiency in TBL in comparison with LBL must be evaluated. This research aimed to check college students’ efficiency in team-based studying and conventional lectures.
Strategies: A complete of 176 class 4 and 202 class 6 medical college students from College of Bahri, Khartoum, Sudan, participated within the research throughout 2018. Skilled employees have been chosen to conduct the educating and evaluation of the 2 teams, utilizing the usual team-based studying process (iRAT, gRAT and AppT) within the first matter and the lecture-based studying process within the second, throughout the similar time restrict for the 2 strategies.
Outcomes: The 2 lessons total imply rating has a major 5.1 factors distinction (pConclusion: College students’ efficiency utilizing team-based studying was superior to lecture-based studying, irrespective of scholars’ gender, noticeable amongst senior college students.

Key phrases: team-based studying, lecture-based curriculum, medical training, curriculum, evaluation


The recognition of team-based studying (TBL) amongst college students might be as a result of many causes: first, deep studying is established; second, it encourages self-directed studying and avoids simply memorization; and lastly, it prepares college students to unravel issues and fosters teamwork.1,2 Though conventional lecture-based studying (LBL) is required for big teams, team-based studying can be utilized with massive teams, particularly when supplies can be found to college students, which promotes essential pondering and encourages teamwork.3–5 Proof-based research help the usage of self-directed studying, which might be extra helpful than simply giving lectures to offer data.6,7 Many authors think about scholar efficiency in TBL to be the identical as that in conventional lectures8,9; nonetheless, different benefits of TBL may outmatch conventional LBL, as an illustration in prior data earlier than the category, splitting a big group into small teams with out requiring an elevated variety of school, college students taking duty for their very own studying, and enhanced tutor–scholar relationships.10–13 TBL has three steps. Initially, college students should work on their studying project on a subject chosen by their tutor, who gives references or studying supplies primarily based on a timetable. Then on the TBL day, every scholar instantly solutions normally 10 MCQs (ie, particular person readiness assurance take a look at [iRAT]). Instantly after that, the identical MCQs are answered by a predetermined group (ie, staff readiness assurance take a look at (gRAT), then normally 5 new MCQs are answered by all teams. This ultimate take a look at is known as software take a look at (AppT). When all these processes are completed, the scholars and the tutor focus on the solutions to the questions, and eventually, the tutor provides a micro lecture.12,14–18

Rationale: In nations with a setup that’s much like ours, the place the variety of college students is rising and there may be scarcity of school and services, TBL could present an alternate possibility for evaluation in addition to educating technique to enhance studying in medical faculties.

Aims of this research: to check scholar efficiency in team-based studying and that in conventional lecture-based studying, the place TBL is feasible in each preclinical and medical phases.

Our analysis query is whether or not there are any variations in scholar efficiency between team-based studying and conventional lecture-based studying, ie, is peer efficiency is best than particular person efficiency.


Examine Design, Setting, and Individuals

Individuals on this intervention research have been fourth-year and sixth-year medical college students at College of Bahri in Khartoum, Sudan, throughout the tutorial 12 months 2018–2019. The college implements a curriculum that makes use of completely different educating methods, however primarily lectures and a hybrid problem-based studying (PBL). The fourth-year college students (n=225) have handed the preliminary primary sciences of anatomy, physiology, and biochemistry; and the research was carried out within the pathology course. The sixth-year college students (n=220), alternatively, have accomplished all the fundamental sciences, and enrolled in main medical programs. The consultants primarily based the choice for sixth- and fourth-year college students for the research on the next assumption. The fourth 12 months within the halfway after intermediate and may fairly judges what studying methodology will match them relatively than second- or third-, whereas sixth-year college students will be in a greater place to inform which is one of the best after they completed their presumed program. The research was carried out on their pediatrics course. All the scholars had no earlier expertise with TBL, however they have been accustomed to lectures.


The scholars from each lessons have been oriented prematurely about TBL and conventional lectures as instructional interventions. The research aims have been defined to them, and it was made clear that their participation was elective. Two specialised school members carried out the orientation about TBL in each lessons. The scholars who opted to take part within the research have been 176 from class 4 and 202 from class 6 with a response price of 78.2% and 91.8%, respectively.

TBL Intervention

The aims and contents for the subject of nephrotic syndrome have been defined to all of the sixth-year college students taking part within the research utilizing PowerPoint slides and pamphlets. The pathology of pores and skin tumors was defined in the identical method to the fourth-year college students. TBL was used for over 2 hours in each lessons. The scholars did their studying 1 week earlier than the TBL workshop, after which at a specified day, every scholar answered the person readiness assurance take a look at (iRAT). The tutor then randomly divided class 4 college students into 10 teams and sophistication 6 college students into 8. Then, the scholars answered the identical take a look at in consensus as a bunch (gRAT). After accumulating the reply sheets from each checks, the tutor administered the appliance take a look at, the place the teams got playing cards that contained reply selections and the right reply card could be raised by every group after the dialogue after which the tutor would file the outcomes and assign scores to every group. This was labeled as Software Take a look at (AppT).

LBL Intervention

Within the lecture-based intervention, completely different subjects have been chosen: sickle cell anemia for sophistication 6 college students and mind tumors for sophistication 4 college students. The identical TBL tutor delivered the lecture for the 2 lessons and spent the identical time period as for TBL. The lectures have been carried out as standard ones utilizing visible aids within the type of a PowerPoint presentation, emphasizing the aims and inspiring the scholars to ask questions. Then, the scholars have been requested to individually reply the take a look at (TrT).

Measuring Consequence

The iRAT, gRAT, and AppT scores have been used to measure the end result of the scholars’ studying when the TBL intervention was used, whereas the TrT rating was used to measure the educational consequence when the standard lecture intervention was used. The overall rating for iRAT was 50, that for gRAT was 30, and that for AppT was 20, collectively making a complete rating of 100 (whole TBL). The end result for the standard lecture-based studying was measured utilizing a take a look at with a complete rating of 100. The checks consisted of questions with a scenario-based, single greatest right reply. All the scholars weren’t conscious that the questions for iRAT, gRAT, and AppT have been the identical however organized in numerous orders.

Statistical Evaluation

Knowledge have been coded, entered, summarized and analyzed utilizing SPSS software program model 21. Categorical and nominal variables have been expressed as frequencies and percentages. The Shapiro–Wilk take a look at was used to check the traditional distribution of the take a look at scores. Paired pattern t-test and linear regression have been used to check quantitative knowledge. A p-value of <0.05 was thought-about important.


A reliability evaluation was carried out on the 4 take a look at scores for TBL, iRAT, gRAT and Appt, and the entire summation of all of them (whole TBL). Cronbach’s α confirmed that the completely different modalities of TBL take a look at scores had acceptable reliability, α = 0.69. A decrease, nonetheless acceptable, worth of reliability (Cronbach’s α=0.58) was obtained when the evaluation was carried out on the ten take a look at scores altogether together with scores for LBL. Most checks appeared price of retention as a result of alpha worth was decreased when any of the checks have been deleted from the gadgets’ whole statistics.

The general efficiency outcomes confirmed a imply rating of 70.5 for TBL and 65.4 for LBL within the mixed class 4 and sophistication 6. The imply distinction in scores (5.0 marks) was important (p<0.001, 95% CI: 3.5, 6.0). The histogram (with average skewing to the left) confirmed that many extra college students failed to attain above 60% in LBL in comparison with TBL (Determine 1).

Determine 1 Comparability of scholars’ scores within the checks following TBL and LBL.

We carried out analyses for all of the females (312) and all of the males (66) individually and noticed a consistency of the prevalence of TBL to LBL in both gender. The imply rating was 71.0 for TBL and 66.0 for LBL within the feminine lessons with a imply distinction of 5.1 (p-value <0.001, 95% CI: 3.3, 6.8). Male lessons, alternatively, confirmed a barely decrease imply rating in each TBL (68.1) and LBL (62.8). However, the imply distinction of 5.3 factors, was important (p<0.001, 95% CI: 2.1, 8.5), Desk 1.

Desk 1 Paired t-Take a look at Evaluating Scores of TBL and LBL Amongst Male (n=66) and Feminine (n=312) College students

A outstanding distinction within the outcomes was noticed once we in contrast the 2 strategies in school 6 individually from class 4. The category 6 imply rating was excessive for each TBL and LBL (77.2 and 70.2, respectively) with a major imply distinction of seven.0 factors (p<0.001, 95% CI 5.1, 8.9). At school 4, the rating was decrease for each strategies (imply 62.8 for TBL and 59.9 for LBL). The imply distinction was 2.95 (p<0.05; 95% CI: 0.46, 5.43), as proven in Desk 2.

Desk 2 Paired t-Take a look at Evaluating Scores of TBL and LBL Amongst College students of Class 6 (n=202) and Class 4 (n=176)

We carried out a stratified evaluation to check the variations within the imply scores of the 2 strategies by gender and sophistication. The imply scores and distinction continued to be extremely important for each the females and the males in school 6. Females scored 77.4 and 70.5 in TBL and LBL, respectively, with imply distinction 6.7 (p< 0.001, 95% CI: 4.8, 9.0), whereas males scored 76.0 and 68.7 in TBL and LBL respectively with imply distinction 7.3 (p<0.01, 95% CI: 2.8, 11.8). The imply scores and the distinction within the imply scores in school 4 was not important for the females (imply distinction 2.7; p=0.07, 95% CI: –0.22, 5.64), nor was it important for the males (imply distinction 3.82; p=0.10, 95% CI: –0.79, 8.42).

To regulate any confounding impact of gender and sophistication on scholar efficiency, we used a multivariate linear regression mannequin to estimate the imply anticipated efficiency of TBL and LBL. The estimated imply rating for LBL was 59.1 (95% CI: 57.5, 60.8) for a feminine in fourth Class. Males scored a median of 1.5 factors lower than females however weren’t important. On common, college students scored 12.2 factors extra in the event that they have been in school 6 in comparison with class 4 (95% CI: 10.4, 14.0, p < 0.001). Whereas controlling the impact of gender and sophistication, college students scored a median of 5.1 factors greater when taught by way of TBL, in comparison with LBL (95% CI: 3.3, 6.9, p < 0.001), Desk 3.

Desk 3 A number of Linear Regression for Anticipated Efficiency Rating


To one of the best of our data, that is the one obtainable research in Sudan that outlines the standard of scholar efficiency in TBL versus conventional lecturing. TBL was persistently superior in scholar efficiency to LBL, regardless of the gender of the scholars, as there was no important distinction in efficiency by gender, in both class. Extra college students in TBL scored greater marks. Nevertheless, this greater TBL efficiency was evident in school 6. Evidently TBL is extra steady and helpful to senior medical college students. Maybe, it required college students who’re extra skilled and unbiased learners, in addition to staff employees with a better sense of duty towards their tutorial work. These findings might be defined by the nice preparation earlier than the take a look at, which impacts efficiency in iRAT, and the collaboration among the many staff members throughout gRAT. In truth, a number of research have documented that college students carried out higher in TBL than in LBL,19,20 the outcomes of the research of Reagans, Argote, and Brooks (2005), who used genuine TBL within the office.21 Additionally, this research is in concord with that of Edmondson, Winslow, Bohmer, and Pisano (2003), who reported that TBL enhances data amongst staff members.22 It’s according to research executed amongst medical college students (women and men) on the Boonshoft Faculty of Medication (2004–2005), which adopted a curriculum much like that of the College of Bahri’s School of Medication.23 The findings listed below are comparable with the research executed amongst medical college students at Wright State College when their efficiency by TBL was in comparison with that of scholars who took the standard technique of educating.24 There was correspondence with research on dental college students on the College of Florida which confirmed that college students who acquired data by way of TBL did nicely of their examination and retained data for a very long time, which allowed them to do nicely within the office in comparison with studying by way of conventional LBL.25 Our research is analogous with these of Yan et al, on the Medical Faculty of Chifeng within the Folks’s Republic of China, which reported greater TBL examination scores in contrast with conventional lecture examination scores (81.70±8.53 vs 74.41±8.27, p<0.01) and better marks reported in TBL in contrast with these in LBL and traditional tutorial (CT) teams as  proven in Hashilkar.25,26 There’s some resemblance with the outcomes of an Indian research carried out on college students from a school of pharmacology.27 Lastly, it’s apparent that TBL helps collaborative studying by way of groups, which is mirrored by completely different research.28

Whereas in our setup senior college students carried out higher than junior ones, nonetheless, our junior college students carried out nicely in TBL, which is akin to the findings of different research.29 TBL, with the upper efficiency, in contrast with conventional lectures, will set a excessive commonplace, an element that would guarantee social accountability and good high quality of docs.30–33 Our research confirmed that females and males carried out equally, in TBL and LBL. The marginally greater scores of females in each strategies weren’t statistically important. Nevertheless, at Maulana Azad Medical School in India, TBL was noticed to be an efficient studying instrument for females and excessive achievers.18,29,34 The findings that TBL was superior to conventional lectures are supported by many research; nonetheless, this is determined by college students’ optimistic notion of TBL,35 interplay between college students, altering experiences amongst college students and the collaborative nature of TBL,28 enhanced communication, professionalism, self-directed studying, essential pondering, and data software.30 Lastly, latest research by many authors help this research, identified the precious benefits of it and really helpful it for implantation in studying.36–39


This comparability of scholar efficiency by way of exposures to TBL and LBL was primarily based on the evaluation of every group utilizing iRAT, gRAT, Appt for TBL and classical evaluation for LBL (MCQs, and so on). A real distinction in efficiency can solely be evaluated if graduates who’re merchandise of the 2 strategies have been assessed utilizing an ordinary evaluation for each instructional strategies. Later in service, analysis may mirror how a lot data and abilities have been retained from being skilled utilizing these two completely different instructional strategies. Furthermore, this comparability was solely made on chosen subjects in solely two disciplines relatively than on full programs, moreover massive variety of the small teams. On this paper, we didn’t research the scholar views and we suggest additional research to contemplate this level.


Medical college students’ efficiency utilizing team-based studying was persistently superior to conventional lecture-based studying, irrespective of scholars’ gender. Senior medical college students scored higher than junior college students following team-based studying. The research highlighted an answer to an academic course of in nations with low sources.

Moral Approval and Consent

The moral approval of the research was obtained from the College of Bahri Analysis and Moral Committee (UB-REC). All members have offered written knowledgeable consent. This research complies with the Declaration of Helsinki.


The authors want to share condolences with all colleagues and reader for the unhappy dying of our senior coauthor Professor Elfatih Elsamani, who move away throughout the preparation and submission of this manuscript, as a result of COVID-19 and particular condolences to his household and college students, with out his meticulous fingers on and steerage this work may not be materialized. At this juncture, the authors want to convey their appreciation to the scholars who agreed to take part on this research, Mr Ayman Elshayeb for modifying our references and Madam Fadia for her nice work in knowledge entry.

Writer Contributions

All authors made a major contribution to the work reported, whether or not that’s within the conception, research design, execution, acquisition of knowledge, evaluation and interpretation, or in all these areas; took half in drafting, revising or critically reviewing the article; gave ultimate approval of the model to be printed; have agreed on the journal to which the article has been submitted; and conform to be accountable for all elements of the work.


The authors report no conflicts of curiosity on this work.


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