Faculty, administration/curriculum, students and characteristics of specific courses influence ongoing utilisation of TBL. Those who desire to implement TBL would do well to take these factors into account as they plan implementation efforts at their schools.

We reduced the amount of time spent in teacher-driven content delivery by 50 percent and covered the same amount of content with no detrimental effects on knowledge acquisition or attitude enhancement. Teaching strategies that foster learner-to-learner interactions will lead to more active engagement among learners, however, these learners may value the session less. Further research is needed to explore learner perceptions of the teaching process and other outcomes of active learning in medical education.

Educators' contributions to their institutions must be visible to be valued. The establishment of documentation standards for education activities provides the foundation for academic recognition of educators.

Background: We implemented team learning, an instructional method that fosters small-group learning, in an evidence-based medicine (EBM) course. Our goal was to align instructional methods with EBM practices. Description: Team learning provides an alternative to lectures in large-group settings. It involves out-of-class preparation followed by in-class 131The contents of this article were developed under a grant for the Fund for the Improvement of Postsecondary Education (FIPSE), U.S. Department of Education. However, those contents do not necessarily represent the policy of the Department of Education, and you should not Courses in evidence-based medicine (EBM) are being introduced into medical school curricula as recognition of the value of EBM in clinical practice continues to increase. EBM refers to the regular use of the best available evidence to inform management decisions in the care of patients. The literature suggests that courses in EBM may, and often do, increase students' knowledge and use of EBM principles and concepts. 1-3 Consequently, in 1997, faculty implemented an EBM course at our institution for 2nd-year medical students not unlike EBM courses at other institutions. Nevertheless, soon after implementation, faculty and administration recognized an inconsistency between the learning strategies commonly promoted in these EBM courses and the underlying problem-solving strategies inherently espoused by EBM practices.Most instruction directed to large groups of learners, including instruction in many EBM courses, tends to place heavy emphasis on the transmission of facts. Consequently, instruction tends to relegate learners to a passive role in the learning process. Grading schemata, which often emphasize individual accountability over learning in community, tend to rely on multiple-choice examinations that reinforce students' tendency to focus their learning on "acquiring the facts needed for the test" rather than on real-life application of medical knowledge. Unlike these teaching and evaluation settings, EBM is often practiced in team settings where individuals share in problem solving and contribute to group success, in which problems are not well defined and decision makers have imperfect knowledge and in which no single best answer is readily available. 4 Over time our EBM course was redesigned with an overarching goal to "practice what was preached" by using instructional strategies shown in the literature to foster student learning behaviors closely related to the types of behaviors expected of effective practitioners of EBM. 2,4 This redesigned course specifically sought to promote individual responsibility and accountability for independent, out-of-class learning of core concepts and to promote group responsibility for collaborative, in-class learning through solving of real-world problems.Recent trends in medical education suggest that this goal for an EBM course is philosophically sound but pragmatically difficult. 5 During the past 15 to 20 years, significant changes have been made at...

Medical and health sciences educators are increasingly employing team-based learning (TBL) in their teaching activities. TBL is a comprehensive strategy for developing and using self-managed learning teams that has created a fertile area for medical education scholarship. However, because this method can be implemented in a variety of ways, published reports about TBL may be difficult to understand, critique, replicate, or compare unless authors fully describe their interventions.The authors of this article offer a conceptual model and propose a set of guidelines for standardizing the way that the results of TBL implementations are reported and critiqued. They identify and articulate the seven core design elements that underlie the TBL method and relate them to educational principles that maximize student engagement and learning within teams. The guidelines underscore important principles relevant to many forms of small-group learning. The authors suggest that following these guidelines when writing articles about TBL implementations should help standardize descriptive information in the medical and health sciences education literature about the essential aspects of TBL activities and allow authors and reviewers to successfully replicate TBL implementations and draw meaningful conclusions about observed outcomes.