Medical students' higher performance on examination questions related to course content learned through TBL suggests that TBL enhances mastery of course content. Students in the lowest academic quartile may benefit more than highest-quartile students from the TBL strategy.

The application of team-based learning (TBL) as a major component of a medical gross anatomy course was evaluated. TBL is a method of small group instruction that addresses some of the shortcomings of other small-group teaching approaches. The core components of TBL were instituted in 12 small group sessions in the course. Each session included objective-oriented assignments, an individual readiness assurance test, a group readiness assurance test and a group application problem. Peer evaluation was carried out on a regular basis. Scores from TBL session activities and course examinations were analyzed and compared to previous years' course performance. Student course evaluation data and faculty feedback were also collected. Student evaluation data and faculty response indicated strong support for the TBL method as it was implemented in the course. Faculty noted improvements in students' day-to-day preparedness and group problem solving skills. Students' mean scores on exams were not significantly different from those of previous years. There was, however, a significantly smaller variance in examination scores that was reflected in a lower course failure rate compared to previous years. Correlation analyses of TBL and examination performance suggested that individual readiness assurance test performance is a good predictor of examination performance. TBL proved to be a superior method for small group learning in our anatomy course. Student performance suggested that TBL may most benefit academically at-risk students who are forced to study more consistently, are provided regular feedback on their preparedness and given the opportunity to develop higher reasoning skills.

Background Although the role of microbes in disease pathogenesis is well established, data describing the variability of the vast microbiome in children diagnosed with ulcerative colitis (UC) are lacking. This study characterizes the gut microbiome in hospitalized children with severe UC and determines the relationship between microbiota and response to steroid therapy. Methods Fecal samples were collected from 26 healthy controls and 27 children hospitalized with severe UC as part of a prospective multi-center study. DNA extraction, PCR amplification of bacterial 16S rRNA, and microarray hybridization were performed. Results were analyzed in Genespring GX 11.0 comparing healthy controls to children with UC, and steroid responsive (n=17) to non-responsive patients (n=10). Results Bacterial signal strength and distribution showed differences between UC and healthy controls (adjusted p<0.05) for Phylum, Class, Order, Family, Genus, and Phylospecies levels with reduction in Clostridia and an increase in Gamma-proteobacteria. The number of microbial phylospecies was reduced in UC (266±69) vs. controls (758±3, p<0.001), as was the Shannon diversity index (6.1±0.23 vs. 6.49±0.04, respectively; p<0.0001). Steroids non-responders harbored less phylospecies than responders (142±49 vs. 338±62, p=0.013). Conclusions Richness, evenness, and biodiversity of the gut microbiome were remarkably reduced in children with UC, compared to healthy controls. Children who did not respond to steroids harbored a microbiome that was even less rich than steroid responders. This study is the first to characterize the gut microbiome in a large cohort of pediatric patients with severe ulcerative colitis and describes changes in the gut microbiome as a potential prognostic feature.