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Implementation of Team-Based Learning in an Asynchronous Distance Education Graduate Nursing Course

Paula Timoney

Project Team
  • Terri Cavaliere, Stony Brook University

Stony Brook University


Tier Two

Project Abstract:

It is suggested that the implementation of team-based learning principles in the curriculum of an asynchronous distance education nurse practitioner program will improve student engagement, increase student and faculty satisfaction and promote quality learning experiences.

Project Objectives:
• Support faculty development
• Improve student engagement
• Increase student satisfaction
• Increase faculty satisfaction
• Promote student learning
• Ensure student success
• Disseminate outcomes

Team-based learning (TBL) is an instructional strategy which consists of small group activities designed to provide students with both conceptual and procedural knowledge. The four essential principles of TBL are: properly formed and self-managed groups, student accountability, meaningful assignments, and frequent and timely feedback.

Background: The idea of TBL originated in the 1970's by Michaelsen (2008) as a pedagogical method in a large class room setting in the school of business at University of Oklahoma. While the use of TBL has predominantly been seen in education and business schools, a few health care educators have embraced the strategy.

Traditionally, educators have focused on teaching the essential course content. Many times the content is memorized and regurgitated without the ability to synthesize or apply the knowledge. In contrast, in TBL the instructor focuses on learning; students learn and apply factual knowledge to complex situations as the team develops. The instructor and students become partners in the educational process.

Multiple authors report that the use of TBL increases student engagement, increases student retention, improves student satisfaction and enhances student performance. However, in a systematic research review of 17 original studies by Sisk (2011), evidence of TBL's effectiveness is unclear. In addition, there is a paucity of literature describing implementation of the TBL strategy in distance education. This project will be the first known implementation of TBL in a distance education graduate nursing course. It will address the gap in the literature by evaluating the overall effectiveness of TBL in an asynchronous distance education course.

Health care professionals must work as a team to improve care delivery and promote patient safety. Michaelsen (2008) suggests that TBL will help to prepare students to be more effective health care providers. Nurse practitioners (NP) are prepared to be leaders in health care. Implementation of TBL in the NP program will introduce the concepts and skills necessary to build effective teams while promoting student learning.

In 2013 Stony Brook University School of Nursing ranked eighth in distance nursing education by US News and World Reports. The neonatal nurse practitioner (NNP) program has a long and successful history in distance education. The content is delivered asynchronously through recorded lectures, reading assignments, worksheets and clinical applications. The NNP Program faculty continually seeks to develop innovative strategies to enhance student learning and success.

Plan: To elevate the quality of the program, Neonatal Clinical Pharmacology, a required course in the neonatal nurse practitioner program, will be revised to include principles of TBL: learning activities consisting of individual and group assignments, discussion boards, peer evaluations, and objective exams. The Faculty Center (TFC) will work with course faculty on instructional re-design of the curriculum.

At the beginning of the semester, the students will be randomized to groups of five to seven members. The team membership will remain consistent throughout the course. Each team member will have an opportunity to lead the team, as the team leaders are rotated with each assignment.

The team-based learning instructional activity sequence consists of three parts:
• Preparation
• Individual study
• Readiness assurance
• Individual readiness assurance test (IRAT)
• Group readiness assurance test (GRAT)
• Written appeals from teams
• Instructor feedback
• Application of course concepts

Learning activities consist of individual reading assignments, completion of individual readiness assurance tool, followed by a team assignment, and completion of a group readiness assurance tool. Peer evaluations will also be completed. Team assignments will then be posted simultaneously on a discussion board and reviewed by all students in the course. Team discussions will be facilitated by the course faculty.

Validated tools will be adapted to an on-line format to measure student engagement, and student and faculty satisfaction. Examination scores will be compared with the scores of students in the course as it is currently delivered. Results will be disseminated through publications and presentations at local and national conferences.

Conclusion: Team-Based Learning complements the use of evidence based practice and encourages lifelong learning. Successful implementation of TBL in this course will lead to expansion of TBL principles to other distance education courses in the school of nursing and other health care disciplines. This project supports the objectives of the Open SUNY initiative designed to ensure student success, and promote faculty development in providing innovative strategies to maximize student learning.


Michaelsen, LK & Sweet, M (2008, Winter). The essential elements of team-based learning. New Directions for Teaching and Learning (16) 7-27. doi: 10.1002/tl.330

Sisk, RJ (2011). Team-based learning: Systematic research review. Journal of Nursing Education, 50(12) 665-669.

Project Outcome:

Implementation of Team-Based Learning (TBL) in the NNP program introduced the concepts and skills necessary to build effective teams while promoting student learning. Team-based learning complements the use of evidence based practice. Effectiveness of TBL as a teaching pedagogy in this course will lead to expansion of TBL in other distance education courses.

Project Outcome Report