PS2 - 07: THE SIGNIFICANT IMPACT OF A DEDICATED TEAM-BASED LEARNING CURRICULUM ON A SURGERY CLERKSHIP AND STANDARDIZED NATIONAL EXAMINATIONS
Leander Grimm, MD, FACS, FASCRS, Patrick Steadman, BS, Crawford Cox, BS, Bin Wang, PhD; University of South Alabama

Background: Student performance on standardized national exams plays an ever-increasingly important role in application for residency and often determines how competitive students are to match in residency.  Team-Based Learning (TBL) is an increasingly utilized educational model designed to enrich student experience, seeking to flip the classroom from passive lecture to active learning, which allows medical students earlier opportunities to apply their studies in a clinical scenario.  In 2012, our College of Medicine (COM) adopted a new curriculum centered on TBL for the first two years of medical school.  Coinciding with the entry of this initial class of students into their third year, the Department of Surgery designed and implemented a TBL curriculum for the third-year surgery clerkship.  In this study, we aimed to evaluate the hypothesis that the new TBL curriculum across the COM was associated with improved performance on standardized national exams. 

Methods: We analyzed performance on USMLE Step 1 and 2 CK and the Surgery National Board of Medical Examiners (Surgery-NBME) over the last 10 years at our institution between our 2 study groups (pre and post-TBL implementation), using the z-test by the Central Limit Theorem.  The pre-TBL group was comprised of the graduating classes of 2008-15, while the post-TBL group consisted of the graduating classes of 2016-18. MCAT scores were compared using ANOVA for baseline differences in intelligence between the two groups. 

Results: There was no difference in MCAT scores between the groups (pre-TBL 29.97, post-TBL 29.84, p=0.797).  The post-TBL group showed a statistically significant 55% improvement in the surgery NBME (62%ile nationally, p<0.0001, effect size=8.43) compared to the pre-TBL group (40%ile), as well as 4.45% improvement in Step 1 scores (p<0.009, effect size=2.37) and 6.11% improvement in Step 2 CK scores (p<0.0001, effect size=4.75). 

Conclusion: Implementation of a Team-Based Learning Curriculum across the first 3 years at our COM was strongly associated with a significant improvement on student performance on USMLE Step 1 and 2 CK and the Surgery NBME.  The TBL curriculum appears to be especially effective for the exams with the heaviest proportion of clinical questions (Surgery NBME and Step 2 CK).