Skip to main content

Advertisement

SpringerLink
Log in

Utilization of Team Process Framework to Improve Small-Group Learning in Medical Education

  • Monograph
  • Published:
Medical Science Educator Aims and scope Submit manuscript

Abstract

The setting for medical practitioners typically involves collaborative and interdisciplinary teams. Medical schools have embraced many teaching methods that use a group of learners to facilitate learning. However, the actual learning benefits of these methods require additional inquiry in the areas of team cognition and team processes. There is limited research that evaluates the value of the team process behaviors in medical education to improve collaborative learning outcomes. This conceptual article provides a framework for team learning processes based on the theoretical foundation of social learning and the development of group shared mental models during team interactions that impact a student’s performance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ortega A, Sánchez-Manzanares M, Gil F, Rico R. Enhancing team learning in nursing teams through beliefs about interpersonal context. J Adv Nurs. 2013;69(1):102–11.

    Article  Google Scholar 

  2. Renshaw I, Davids K, Savelsbergh GJ. Motor learning in practice: a constraints-led approach. New York, NY: Routledge; 2010.

    Google Scholar 

  3. Argote L, Gruenfeld D, Naquin C. Group learning in organizations. In: Turner ME, editor. Groups at work: theory and research. Mahwah, NJ: Lawrence Erlbaum Associates; 2001. p. 369–411.

    Google Scholar 

  4. Lau K, Chan DW. Reading strategy use and motivation among chinese good and poor readers in Hong Kong. J Res Read. 2003;26(2):177–90.

    Article  Google Scholar 

  5. Van Der Vegt GS, Bunderson JS. Learning and performance in multidisciplinary teams: the importance of collective team identification. Acad Manag J. 2005;48(3):532–47.

    Article  Google Scholar 

  6. Currey J, Eustace P, Oldland E, Glanville D, Story I. Developing professional attributes in critical care nurses using team-based learning. Nurse Educ Pract. 2015;15(3):232–8.

    Article  Google Scholar 

  7. LCME Standards, Publications, and White Papers. Functions and structure of a medical school standards for accreditation of medical education programs leading to the M.D. degree. http://www.lcme.org/publications.htm. Updated 2015.

  8. Commission On Osteopathic College Accreditation. COM accreditation standards and procedures. http://www.osteopathic.org/inside-aoa/accreditation/COM-accreditation/Documents/com-accreditation-standards-8-29-2016.pdf. Updated August 29, 2016. Accessed 09/30, 2016.

  9. Reeves S, Perrier L, Goldman J, Freeth D, Zwarenstein M. Interprofessional education: effects on professional practice and healthcare outcomes (update). Cochrane Database Syst Rev. 2013; 3(3). doi:10.1002/14651858.CD002213.pub3.

  10. AAMC. Core entrustable professional activities for entering residency. https://members.aamc.org/eweb/DynamicPage.aspx?Action=Add&ObjectKeyFrom=1A83491A-9853-4C87-86A4-F7D95601C2E2&WebCode=ProdDetailAdd&DoNotSave=yes&ParentObject=CentralizedOrderEntry&ParentDataObject=Invoice%20Detail&ivd_formkey=69202792-63d7-4ba2-bf4e-a0da41270555&ivd_prc_prd_key=E3229B10-BFE7-4B35-89E7-512BBB01AE3B. Updated May 28 2014. Accessed September 30, 2016.

  11. Hickman SE, Wocial LD. Team-based learning and ethics education in nursing. J Nurs Educ. 2013;52(12):696–700.

  12. Albanese MA, Mitchell S. Problem-based learning: a review of literature on its outcomes and implementation issues. Acad Med. 1993;68(1):52–81.

    Article  Google Scholar 

  13. Alexander BJ, Lindow LE, Schock MD. Measuring the impact of cooperative learning exercises on student perceptions of peer-to-peer learning: a case study. J Physician Assist Educ. 2008;19(3):18–25.

    Article  Google Scholar 

  14. Haidet P, O'Malley KJ, Richards B. An initial experience with “team learning” in medical education. Acad Med. 2002;77(1):40–4.

    Article  Google Scholar 

  15. Searle NS, Haidet P, Kelly PA, Schneider VF, Seidel CL, Richards BF. Team learning in medical education: initial experiences at ten institutions. Acad Med. 2003;78(10):S55–8.

    Article  Google Scholar 

  16. Vasan NS, DeFouw DO, Holland BK. Modified use of team-based learning for effective delivery of medical gross anatomy and embryology. Anat Sci Educ. 2008;1(1):3–9.

    Article  Google Scholar 

  17. Hendelman WJ, Boss M. Reciprocal peer teaching by medical students in the gross anatomy laboratory. Acad Med. 1986;61(8):674–80.

    Article  Google Scholar 

  18. Krych AJ, March CN, Bryan RE, Peake BJ, Pawlina W, Carmichael SW. Reciprocal peer teaching: students teaching students in the gross anatomy laboratory. Clin Anat. 2005;18(4):296–301.

    Article  Google Scholar 

  19. Nnodim J. A controlled trial of peer-teaching in practical gross anatomy. Clin Anat. 1997;10(2):112–7.

    Article  Google Scholar 

  20. Sandra A, Ferguson KJ. Analysis of gross anatomy laboratory performance using a student dissection/presentation teaching method. Teach Learn Med. 1998;10(3):158–61.

    Article  Google Scholar 

  21. Sultan S, Hussain I. Comparison between individual and collaborative learning: determining a strategy for promoting social skills and self-esteem among undergraduate students. J Educ Res. 2012;15(2):35.

    Google Scholar 

  22. Mennenga HA, Smyer T. A model for easily incorporating team-based learning into nursing education. Int J Nurs Educ Scholarsh. 2010;7(1) doi:10.2202/1548-923X.1924.

  23. Elbaum B, Vaughn S, Hughes M, Moody SW. Grouping practices and reading outcomes for students with disabilities. Except Child. 1999;65(3):399.

    Google Scholar 

  24. Levine RE, O'Boyle M, Haidet P, et al. Transforming a clinical clerkship with team learning. Teach Learn Med. 2004;16(3):270–5.

    Article  Google Scholar 

  25. Razzouk R, Johnson TE. Case studies’ effect on undergraduates’ achievement, attitudes, and team shared mental models in educational psychology. Educ Technol Res Dev. 2013;61(5):751–66.

    Article  Google Scholar 

  26. Michaelsen LK, Knight AB, Fink LD. Team-based learning: a transformative use of small groups in college teaching. Sterling, VA: Stylus Publishing, LLC; 2004.

    Google Scholar 

  27. Druckman D, Bjork RA. Learning, remembering, believing: enhancing human performance. Washignton, DC: National Academies Press; 1994.

    Google Scholar 

  28. Dunaway GA. Developments: adaption of team learning to an introductory graduate pharmacology course. Teach Learn Med. 2005;17(1):56–62.

    Article  Google Scholar 

  29. Cooke NJ, Salas E, Cannon-Bowers JA, Stout RJ. Measuring team knowledge. Hum Factors. 2000;42(1):151–73.

    Article  Google Scholar 

  30. Rentsch JR, Hall RJ. Members of great teams think alike: a model of team effectiveness and schema similarity among team members. In: M. M. Beyerlein D. A. Johnson, ed. US: Elsevier Science/JAI Press; 1994, pp. 223–261.

  31. Cannon-Bowers JA, Salas EE. Making decisions under stress: implications for individual and team training. Washington, DC: American Psychological Association; 1998.

    Book  Google Scholar 

  32. Guzzo RA, Salas E. Team effectiveness and decision making in organizations. Vol 22. Pfeiffer; 1995.

  33. Levine JM, Moreland RL. Progress in small group research. Annu Rev Psychol. 1990;41(1):585–634.

    Article  Google Scholar 

  34. Hackman JR. Groups that work (and those that donʼt): creating conditions for effective teamwork. San Francisco: Jossey-Bass; 1990.

    Google Scholar 

  35. Johnson TE, Khalil MK, Spector JM. The role of acquired shared mental models in improving the process of team-based learning. Educ Technol. 2008;48(4):18–26.

    Google Scholar 

  36. Bruner JS. The culture of education. Cambridge, MA: Harvard University Press; 1996.

    Google Scholar 

  37. Bruner JS. Acts of meaning. Vol 3. Harvard University Press; 1990.

  38. Vygotskij LS. Thought and language. Cambridge: MIT Press; 1986.

    Google Scholar 

  39. Vygotsky LS. Mind in society: the development of higher psychological processes. Cambridge, MA: Harvard University Press; 1980.

    Google Scholar 

  40. Piaget J. The child’s conception of the world. London. New York: Routledge; 1997.

    Google Scholar 

  41. Johnson RT, Johnson DW. Cooperative learning in the science classroom. Sci Child. 1986;24:31–2.

    Google Scholar 

  42. Alvermann DE, Hinchman KA, Moore DW, Phelps SF, Waff DR. Reconceptualizing the literacies in adolescents’ lives. Routledge; 2007

  43. Vacca R, Vacca J, Mraz M. Learning area reading: literacy and learning across the curriculum. Boston: Allyn & Bacon; 2011.

    Google Scholar 

  44. Koles PG, Stolfi A, Borges NJ, Nelson S, Parmelee DX. The impact of team-based learning on medical studentsʼ academic performance. Acad Med. 2010;85(11):1739–45.

    Article  Google Scholar 

  45. Su F, Beaumont C. Evaluating the use of a wiki for collaborative learning. Innovations in Education and Teaching International. 2010;47(4):417–31.

    Article  Google Scholar 

  46. Ofstad W, Brunner LJ. Team-based learning in pharmacy education. Am J Pharm Educ. 2013;77(4). doi:10.5688/ajpe77470

  47. Lave JW, Wenger E. Situated learning. Legitimate peripheral participation. Cambridge: Cambridge University Press; 1991.

    Book  Google Scholar 

  48. Tennant M. Psychology and adult learning. London: Routledge; 1997.

    Book  Google Scholar 

  49. Wenger E, McDermott RA, Snyder W. Cultivating communities of practice: A guide to managing knowledge. Harvard Business Press; 2010.

  50. Wenger E. Communities of practice: learning as a social system. Systems thinker. 1991;9(5):2–3.

    Google Scholar 

  51. Johnson DW, Johnson RT, Smith KA. Active learning: Cooperation in the college classroom. ERIC; 1998.

  52. Deutsch M. A theory of cooperation and competition. Human Relations. 1949;2:129–52.

    Article  Google Scholar 

  53. Deutsch M. Cooperation and trust: some theoretical notes. In: Jones MR, editor. Nebraska symposium on motivation. Lincoln, NE: Univer. Nebraska Press; 1962. p. 275–319.

    Google Scholar 

  54. Johnson DW. The social psychology of education. 1970.

  55. Johnson DW, Johnson RT. An educational psychology success story: social interdependence theory and cooperative learning. Educ Res. 2009;38(5):365–79.

    Article  Google Scholar 

  56. Mpofu DJS, Das M, Stewart T, Dunn E, Schmidt H. Perceptions of group dynamics in problem-based learning sessions: a time to reflect on group issues. Med Teach. 1998;20(5):421–7.

  57. Cannon-Bowers J, Salas E, Converse S. Shared mental models in expert team decision making. In: N. John Castellan J, ed. Individual and group decision making: current issues. Hillsdale, NJ: Erlbaum Associates; 1993, pp. 221–245.

  58. Klimoski R, Mohammed S. Team mental model: construct or metaphor? J Manag. 1994;20(2):403–37.

    Google Scholar 

  59. Cannon-Bowers JA, Tannenbaum SI, Salas E, Volpe CE. Defining competencies and establishing team training requirements. Team effectiveness and decision making in organizations. 1995;333:380.

    Google Scholar 

  60. Kirschner F, Paas F, Kirschner PA. Individual versus group learning as a function of task complexity: an exploration into the measurement of group cognitive load. In: Zumbach J, Schwartz N, Seufert T, & Kester L, editors. Beyond knowledge: the legacy of competence. Dordrecht: Springer; 2008. pp. 21–28.

  61. Kirschner F, Paas F, Kirschner PA. Individual and group-based learning from complex cognitive tasks: effects on retention and transfer efficiency. Comput Hum Behav. 2009;25(2):306–14.

    Article  Google Scholar 

  62. Cannon-Bowers J, Salas E. Reflections on shared cognition. J Organ Behav. 2001;22(2):195–202.

    Article  Google Scholar 

  63. Johnson TE, Lee Y, Lee M, O'Connor DL, Khalil MK, Huang X. Measuring sharedness of team-related knowledge: design and validation of a shared mental model instrument. Hum Resour Dev Int. 2007;10(4):437–54.

    Article  Google Scholar 

  64. Rouse WB, Cannon-Bowers JA, Salas E. The role of mental models in team performance in complex systems. Systems, Man and Cybernetics, IEEE Transactions on. 1992;22(6):1296–308.

    Article  Google Scholar 

  65. DeChurch LA, Mesmer-Magnus JR. Measuring shared team mental models: a meta-analysis. Group Dynamics: Theory, Research, and Practice. 2010; 14(1):1.

  66. Kleinman DL, Serfaty D. Team performance assessment in distributed decision making. Proceedings of the symposium on interactive networked simulation for training. Orlando, FL: University of Central Florida; 1989. p. 22–7.

    Google Scholar 

  67. Rouse WB, Cannon-Bowers J, Salas E. The role of mental models in team performance in complex systems. Systems, Man and Cybernetics, IEEE Transactions on. 1992;22(6):1296–308.

    Article  Google Scholar 

  68. Smith-Jentsch K, Johnston JH, Payne SC. Measuring team-related expertise in complex environments. In: Cannon-Bowers JA, Salas E, editors. Making decisions under stress: implications for individual and team training. Washington, DC, US: American Psychological Association; 1998. p. 61–87.

    Chapter  Google Scholar 

  69. Mathieu JE, Heffner TS, Goodwin GF, Salas E, Cannon-Bowers JA. The influence of shared mental models on team process and performance. J Appl Psychol. 2000;85(2):273.

    Article  Google Scholar 

  70. Salas E, Diaz Granados D, Weaver SJ, King H. Does team training work? Principles for health care. Acad Emerg Med. 2008;15(11):1002–9.

    Article  Google Scholar 

  71. Albon R, Jewels T. Mutual performance monitoring: elaborating the development of a team learning theory. Group Decis Negotiation. 2014;23(1):149–64.

    Article  Google Scholar 

  72. Dickinson TL, McIntyre RM. A conceptual framework for teamwork measurement. Team performance assessment and measurement. 1997:19–43.

  73. Eccles DW, Tenenbaum G. Why an expert team is more than a team of experts: a social-cognitive conceptualization of team coordination and communication in sport. J Sport Exercise Psychol. 2004;26(4):542–60.

    Article  Google Scholar 

  74. Fiore SM, Salas E, Cuevas HM, Bowers CA. Distributed coordination space: toward a theory of distributed team process and performance. Theoretical Issues in Ergonomics Science. 2003;4(3–4):340–64.

    Article  Google Scholar 

  75. Mohammed S, Dumville BC. Team mental models in a team knowledge framework: expanding theory and measurement across disciplinary boundaries. J Organ Behav. 2001;22(2):89–106.

    Article  Google Scholar 

  76. Kaufman D, Sutow E, Dunn K. Three approaches to cooperative learning in higher education. Can J High Educ. 1997;27(2/3):37–66.

    Google Scholar 

  77. Smith-Jentsch KA, Campbell GE, Milanovich DM, Reynolds AM. Measuring teamwork mental models to support training needs assessment, development, and evaluation: two empirical studies. J Organ Behav. 2001;22(2):179–94.

    Article  Google Scholar 

  78. Marks MA, Mathieu JE, Zaccaro SJ. A temporally based framework and taxonomy of team processes. Acad Manag Rev. 2001;26(3):356–76.

    Google Scholar 

  79. Nonose K, Kanno T, Furuta K. Effects of metacognition in cooperation on team behaviors. Cogn Tech Work. 2014;16(3):349–58.

    Article  Google Scholar 

  80. Tipping J, Freeman RF, Rachlis AR. Using faculty and student perceptions of group dynamics to develop recommendations for PBL training. Acad Med. 1995;70(11):1050–2.

    Article  Google Scholar 

  81. De Grave WS, Dolmans DH, Der Vleuten V, Cees PM. Student perspectives on critical incidents in the tutorial group. Adv Health Sci Educ. 2002;7(3):201–9.

    Article  Google Scholar 

  82. Elgort I, Smith AG, Toland J. Is wiki an effective platform for group course work? Australasian Journal of Educational Technology. 2008; 24(2).

  83. Van Berkel HJM, Dolmans DHJM. The influence of tutoring competencies on problems, group functioning and student achievement in problem-based learning. Med Educ. 2006;40(8):730–6.

    Article  Google Scholar 

  84. Kaba A, Wishart I, Fraser K, Coderre S, McLaughlin K. Are we at risk of groupthink in our approach to teamwork interventions in health care? Med Educ. 2016;50(4):400–8.

    Article  Google Scholar 

  85. Sikorski EG. Team knowledge sharing intervention effects on team shared mental models and team performance in an undergraduate meteorology course. Florida State University; 2009.

  86. Johnson TE, Sikorski EG, Mendenhall A, Khalil M, Lee Y. "Selection of team interventions based on mental model sharedness levels measured by the team assessment and diagnostic instrument (TADI)". In: Computer-based diagnostics and systematic analysis of knowledge. Springer; 2010, pp. 335–354.

  87. Michaelsen LK, Parmelee DX, McMahon KK. Team-based learning for health professions education: a guide to using small groups for improving learning. Stylus Publishing, LLC.; 2008.

  88. Egolf D, Chester S. Forming storming norming performing: successful communication in groups and teams. IUniverse; 2013.

  89. Johnson DW, Johnson RT, Stanne MB, Garibaldi A. Impact of group processing on achievement in cooperative groups. J Soc Psychol. 1990;130(4):507–16.

    Article  Google Scholar 

  90. Johnson DW, Johnson RT, Holubec EJ. Cooperation in the classroom. 8th ed. Edina, MN: Interaction Book Co; 2008.

    Google Scholar 

  91. Bogard T, Liu M, Chiang YV. Thresholds of knowledge development in complex problem solving: a multiple-case study of advanced learners’ cognitive processes. Educ Technol Res Dev. 2013;61(3):465–503.

    Article  Google Scholar 

  92. Putri P, Dewi A. The effect of communication strategy and planning intervention on the processes and performance of course material development teams. Florida State University; 2012.

  93. Biggs JB. Teaching for quality learning at university: what the student does. 3rd ed. McGraw-Hill Education: UK; 2009.

    Google Scholar 

  94. Quarstein VA, Peterson PA. Assessment of cooperative learning: a goal-criterion approach. Innov High Educ. 2001;26(1):59–77.

    Article  Google Scholar 

  95. Thompson BM, Levine RE, Kennedy F, et al. Evaluating the quality of learning-team processes in medical education: development and validation of a new measure. Acad Med. 2009;84(10 Suppl):S124–7.

    Article  Google Scholar 

  96. Willis SC, Jones A, Bundy C, Burdett K, Whitehouse CR, O'Neill PA. Small-group work and assessment in a PBL curriculum: a qualitative and quantitative evaluation of student perceptions of the process of working in small groups and its assessment. Med Teach. 2002;24(5):495–501.

    Article  Google Scholar 

  97. Aguado D, Rico R, Sánchez-Manzanares M, Salas E. Teamwork competency test (TWCT): a step forward on measuring teamwork competencies. Group Dynamics: Theory, Research, and Practice. 2014;18(2):101.

    Article  Google Scholar 

  98. Brock D, Abu-Rish E, Chiu CR, et al. Interprofessional education in team communication: working together to improve patient safety. BMJ Qual Saf. 2013;22(5):414–23.

    Article  Google Scholar 

  99. Stevens MJ, Campion MA. Staffing work teams: development and validation of a selection test for teamwork settings. J Manag. 1999;25(2):207–28.

    Google Scholar 

  100. Sonesh SC, Gregory ME, Hughes AM, et al. Team training in obstetrics: a multi-level evaluation. Families, Systems, & Health. 2015;33(3):250.

    Article  Google Scholar 

  101. Funke GJ, Knott BA, Salas E, Pavlas D, Strang AJ. Conceptualization and measurement of team workload: a critical need. Hum Factors. 2012;54(1):36–51.

    Article  Google Scholar 

  102. Sigalet E, Donnon T, Cheng A, et al. Development of a team performance scale to assess undergraduate health professionals. Acad Med. 2013;88(7):989–96.

    Article  Google Scholar 

  103. O'Malley KJ, Moran BJ, Haidet P, et al. Validation of an observation instrument for measuring student engagement in health professions settings. Eval Health Prof. 2003;26(1):86–103.

    Article  Google Scholar 

  104. Johnson TE, Lee Y. The relationship between shared mental models and task performance in an online team-based learning environment. Perform Improv Q. 2008;21(3):97–112.

    Article  Google Scholar 

  105. Lee M, Johnson TE. Understanding the effects of team cognition associated with complex engineering tasks: dynamics of shared mental models, task-SMM, and team-SMM. Perform Improv Q. 2008;21(3):73–95.

    Article  Google Scholar 

  106. Spector L. "Towards practical autoconstructive evolution: self-evolution of problem-solving genetic programming systems". In: Genetic programming theory and practice VIII. Springer; 2011, pp. 17–33.

Download references

Author information

Authors and Affiliations

  1. University of South Carolina School of Medicine, 607 Grove Road, Greenville, SC, 29605, USA

    Mohammed K. Khalil, Ihsan A. Elkhider & Melinda Ingiaimo

  2. Northeastern University, Boston, MA, USA

    Tristan E. Johnson

Authors
  1. Mohammed K. Khalil
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ihsan A. Elkhider
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Melinda Ingiaimo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tristan E. Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mohammed K. Khalil.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Khalil, M.K., Elkhider, I.A., Ingiaimo, M. et al. Utilization of Team Process Framework to Improve Small-Group Learning in Medical Education. Med.Sci.Educ. 27, 123–134 (2017). https://doi.org/10.1007/s40670-016-0359-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40670-016-0359-z

Keywords

Search

Navigation