Feasibility and sustainability of an interactive team-based learning method for medical education during a severe faculty shortage in Zimbabwe

Abstract

BackgroundIn 2010, in the midst of the human immunodeficiency virus (HIV) epidemic in Zimbabwe, 69% of faculty positions in the Department of Medicine of the University of Zimbabwe College of Health Sciences (UZ-CHS) were vacant. To address the ongoing need to train highly skilled HIV clinicians with only a limited number of faculty, we developed and implemented a course for final-year medical students focused on HIV care using team-based learning (TBL) methods.MethodsA competency-based HIV curriculum was developed and delivered to final-year medical students in 10 TBL sessions as part of a 12 week clinical medicine attachment. A questionnaire was administered to the students after completion of the course to assess their perception of TBL and self-perceived knowledge gained in HIV care. Two cohorts of students completed the survey in separate academic years, 2011 and 2012. Descriptive analysis of survey results was performed.ResultsNinety-six of 120 students (80%) completed surveys. One hundred percent of respondents agreed that TBL was an effective way to learn about HIV and 66% strongly agreed. The majority of respondents agreed that TBL was more stimulating than a lecture course (94%), fostered enthusiasm for the course material (91%), and improved teamwork (96%). Students perceived improvements in knowledge gained across all of the HIV subjects covered, especially in challenging applied clinical topics, such as management of HIV antiretroviral failure (88% with at least a “large improvement”) and HIV-tuberculosis co-infection (80% with at least a “large improvement”).ConclusionsTBL is feasible as part of medical education in an African setting. TBL is a promising way to teach challenging clinical topics in a stimulating and interactive learning environment in a low-income country setting with a high ratio of students to teachers.

Medical Education Partnership Initiative (MEPI) in Zimbabwe: Outcomes and Challenges

“…In a survey that included 120 students, 94% agreed and 71% strongly agreed that team-based learning was a more stimulating approach to learning compared with didactic lectures, and 96% felt that team-based learning enhanced their knowledge of HIV management. 5 …”

“… 3 The University of Zimbabwe College of Health Sciences (UZCHS), the only medical school in Zimbabwe until 2010, faced declines in infrastructure and limited capacity to use technological innovations in education and research. 5 UZCHS was trapped in a vicious cycle, with the emigration of existing faculty and an inability to attract candidates for specialist training, leading to low faculty-to-student ratios, and in turn, low enrollment and graduation of students.…”

Chronic kidney disease in rural areas of Sri Lanka: an evolving catastrophe needing an urgent response

“…These should be competency-based and team-based, and include core clinical skills, accessing social support, ethical issues of allocating resource and palliative care. Such models have been successfully used to tackle HIV/AIDS in resource poor settings [16]. This will give practical training to wide range of staff categories with a focus on the management of CKD, and renal replacement therapy.…”

Applying team-based learning of diagnostics for undergraduate students: assessing teaching effectiveness by a randomized controlled trial study

“…The operating characteristics of TBL are that students are main actors who engage in group discussions under the guidance of teachers to promote the students’ self-motivated learning and teamwork 2–4. Compared with the traditional teaching method that is dominated by a teacher’s lectures, TBL more underscores the students’ main actor role in the learning process while teachers act as guides and advisers; TBL attaches more importance to students’ participating and taking the initiative in the teaching process 5,6. Currently, although its teaching effectiveness and applicability remain controversial, the TBL teaching method has been recognized and adopted by medical schools in most countries 7–12.…”