Knowledge acquisition in team-based learning

Introduction: Team-based Learning (TBL) has been shown to fulfil learning objectives and improve academic performance in medical education. However, evidence of actual knowledge acquisition through each phase of TBL – TBL-Preparation, Individual Readiness Assessment (IRA), Team Readiness Assessment, Burning Questions (BQ) and Application Exercise (AE) – has not been explored. The use of Concept Recall Test (CRT) as an instrument for tracking and quantifying knowledge has been used in Problem-based learning (PBL) but not in TBL. This study’s aim was to administer CRTs to understand the trend of knowledge acquisition and gain a deeper understanding into the mechanism of how knowledge is developed in TBL. We hypothesised that knowledge is cumulative throughout the stages of TBL. Methods: First-year and second-year students from an undergraduate medical course were recruited. CRTs were administered in between each phase of TBL– giving a total of 6 CRTs per TBL. The CRT scores were determined by two independent markers. These CRT scores reflect the amount of knowledge acquired based on the theory of spreadingactivation in cognitive psychology. Analysis of the mean scores was done using repeated measures ANOVA. Results: In both cohorts, the bulk of knowledge acquisition took place in the self-study phase (p<0.01). Significant declines in CRT scores were seen post-BQ for the first-years; and post-IRA and BQ for the second-years (p<0.01). Discussion: A significant increase in knowledge acquired from baseline to the post-TBL-preparation phase validates the TBL design that develops accountability within teams and therefore motivates students to come well-prepared for TBL lessons. The decline in CRT scores from post-TBL preparation to post-AE is possibly due to knowledge encapsulation of learned concepts. Further studies could be done to validate this phenomenon.Bachelor of Medicine and Bachelor of Surger

Transverse or longitudinal? A survey of volar wrist incision preferences

Introduction: In volar wrist surgery, the traditional longitudinal incision leaves a scar that may be considered cosmetically unpleasant. Recent studies suggest that transverse wrist incisions result in more aesthetically pleasing scars that are well hidden in the wrist crease. The aim of our study was to explore the public’s perceptions of longitudinal versus transverse wrist scars. Methods: A prospective survey was conducted among the general public. Inclusion criteria were patients aged over 18 years with no prior surgery to the wrist. Survey questions assessed included: (a) longitudinal or transverse scar preference; (b) reasons for preference; and (c) demographic information. Results: There were 107 respondents from the general public. More respondents preferred longitudinal scars. Top three reasons for longitudinal scar preference were: (a) perceived damage to wrist structures by a transverse incision; (b) better cosmesis; and (c) scar from the transverse incision appearing like a self-inflicted injury. Top three reasons for transverse scar preference were: (a) easily concealed by accessories; (b) less noticeable; and (c) better cosmesis. Respondents aged 60 years and above were most concerned about possible damage to wrist structures; younger respondents were most concerned that transverse scars appeared like self-inflicted injuries. Conclusion: Respondents from the general public preferred a longitudinal scar to a transverse one. Younger respondents were most concerned about how the transverse scar appeared like a self-inflicted injury while older respondents were most concerned with perceived functional implications of the incisions.Published versio