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Discussion of How the Problem was Identified and Explored. Board review has long been a tradition of many internal medicine training programs. Large in part, programs understand the importance of sessions focused on the ABIM exam. However, the classic format for these types of sessions often pertains to a standard review of multiple choice questions. We sought to redesign the format of our board review sessions based on premises of adult learning. Team Based Learning is known for drawing out misconceptions and using peer-based discussion to enhance interactive learning and retention. Thus, a TBL-based format was used to redesign the multiple choice question (MCQ) sessions. Description of the Innovation. Our board review sessions originally included MCQ answer and review with a subspecialist in the specified field representative of each subject (e.g. GI fellow facilitating GI board review). On average, 12 PGY3 residents attend each board review session which occurs during academic half day. In the new format, residents are separated into 4 teams with 6 high difficulty MCQs representing the Individual Readiness Assurance Test (IRAT) and subsequently the same MCQs in a Group Readiness Assurance Test (GRAT) format. Teams are then responsible for revealing their answers and a discussion is facilitated by a general internist with knowledge in testing and medical education. Results to Date. Testing of the 4 resident teams from a randomly selected sample revealed improvement in scores from an average IRAT to GRAT for the following teams: team one 2.5/6 to 4/6, team two 2.3/6 to 4/6, team three 4.5/6 to 6/6, team four 3.3/6 to 5/6. Analysis of individual residents also indicated substantial rises in correct answers for the IRAT as compared to the GRAT (e.g. 1/6 to 5/6). Anonymous survey data indicates an overwhelmingly positive response to the TBL session, with an average 11.4/12 of the residents indicating both their enjoyment of the session (5/5 on a 5 point Likert scale) and increased perception of improved medical and testing knowledge 4.6/5). Discussion/Reflection/Lessons Learned. Incorporation of a TBL-based format for internal medicine board review enhances individual and group learning for resident physicians. Interestingly, resident physicians enjoyed these sessions facilitated by general internal medicine faculty with an expertise in medical education in lieu of a content expert.


Presented at Association of Program Directors in Internal Medicine (APDIM) Spring Conference, 04/27/2015, Houston, TX.