Monday, January 17, 2011

Team-Based Learning at UCSF

Posted by Kevin H. Souza, Assistant Dean for Education and Tracy Fulton, Adjunct Professor, School of Medicine

One of the many innovations available to the UCSF education community through the new Teaching and Learning Center will be classrooms designed for Team-Based Learning. Team learning or team-based learning (TBL) is an instructional strategy designed to transform small groups into powerful, cohesive learning teams, enhance active learning in the classroom, leverage the diversity of experience in a typical class, and provide opportunities to apply course concepts to solve problems. TBL has been shown to improve learning outcomes and help learners improve skills in collaboration and communication (1-6). Furthermore, TBL allows a single instructor to engage multiple small groups simultaneously in the same classroom, and is thus ideal for active learning activities when faculty resources are limited.


The key components of a TBL session focus on both individual accountability and teamwork. Learners are initially exposed to content through pre-assigned readings and are held accountable for preparation using a Readiness Assurance Process (RAP). Following the RAP, learners practice applying content in teams in a series Application exercises. The TBL method has been adapted widely to learners at various levels, and has been used effectively to address many disciplines and competencies.


The new Teaching and Learning Center will be equipped with several classrooms in which TBL can take place in a variety of configurations. 4 large classrooms are each designed to hold 4 teams of up to 6 students, and 7 smaller classrooms each accommodate 2 teams of up to 5, or 1 team of 6-10. Each team can construct and apply knowledge through the TBL process and report back to the instructor and the larger group through projection systems in place for each team. The close proximity and technological advances in these classrooms will allow a small number of facilitators to oversee multiple teams and facilitate inter-team debate and discussion.

Learn more about team-based learning at the TBL Collaborative website.Watch a 12-minute video that shows TBL in action in the lecture hall.

View examples of how the new TLC classrooms can be configured to home teams of 5-7, ideal for TBL.

Find health science learning modules designed for team-based learning on MedEdPortal.
  1. Dunaway GA. Adaption of team learning to an introductory graduate pharmacology course. Teach Learn Med. 2005;17 (1):56–62.
  2. Haidet, P, Morgan RO, O’Malley K, Moran BJ, Richards BF. A controlled trial of active versus passive learning strategies in a large group setting. Adv Health Sci Educ Theory Pract. 2004;9 (1):15-27.
  3. Koles P, Nelson S, Stolfi A, Parmelee D, Destephen D. Active learning in a Year 2 pathology curriculum. Med Educ. 2005;39 (10):1045-55.
  4. Letassy NA, Fugate SE, Medina MS, Stroup JS, Britton ML. Using team-based learning in an endocrine module taught across two campuses. Am J Pharm Educ. 2008;72 (5):103.
  5. Vasan NS, DeFouw D. Team learning in a medical gross anatomy course. Medical Education. 2005;39 (5), 524-.
  6. Zgheib NK, Simaan JA, Sabra R. Using team-based learning to teach pharmacology to second year medical students improves student performance. Med Teach. 2010;32(2):130-5

Monday, September 20, 2010

PRIMEd to Educate Community-Focused Learners


PRIME-US, the Program in Medical Education for the Urban Underserved, provides a programmatic framework for students to develop the knowledge and skills necessary to work effectively with urban underserved communities. The five-year program enrolls 11 first-year medical students in San Francisco and four students at the UC Berkeley-UCSF Joint Medical Program, offering an innovative curriculum focusing on experiential learning, clinical immersion and community engagement, while also providing strong mentorship and support. Dr. Elisabeth Wilson directs the program, Dr. Alma Martinez serves as the executive director, and Dr. Kevin Grumbach chairs the PRIME-US Executive Committee.

The PRIME-US program is at the core of the California Proposition 1D funded Teaching and Learning Center, which includes using TLC technology and facilities to train physicians who work with underserved populations. The TLC will offer a range of new facilities to support PRIME including: technology-enhanced classrooms equipped with telemedicine, videoconference and other technology to enable remote participation and interaction; a modern clinical skills center to enable "hands-on" training for medical procedures both in-person and via telemedicine; upgraded physician desktop technology to enable a greater number of consultations with clinicians and their underserved patients in locations such as public health clinics; and the facilities and technology infrastructure to enable greater interaction with faculty, clinicians, students and others at other sites such as UC medical schools, prisons and distant health care facilities.



Training in the use of telehealth methods to remotely deliver and manage health care will be a focus of the new center and important to the PRIME-US curriculum. PRIME students complete a longitudinal clinical experience in one of the San Francisco public health or safety net clinics and many of these clinics will be equipped with telemedicine equipment as part of the Prop-1D funding. PRIME students who are trained to use this equipment will be able to facilitate patient consultations between the clinic and a specialist located at San Francisco General Hospital or the UCSF Medical Center. Other telehealth activities can include patient education and monitoring. A curriculum in how to use telehealth methods in the practice of a health profession is being developed for the TLC.

PRIME-US graduated its first students this spring, with graduates choosing to pursue training in primary care internal medicine, family medicine, emergency medicine and public health. As of fall 2010, the program has grown to 63 students. More than 70% of the students accepted into the program are underrepresented in medicine or students from socioeconomically disadvantaged backgrounds.

PRIME-US students participate in an orientation to provide them with an opportunity to explore the Bay Area’s underserved communities and to get to know each other. The PRIME-US curriculum consists of afternoon seminars that give students a solid foundation in the principles, practices and populations of urban underserved care. These interactive sessions with faculty and community members are complemented by site visits to community-based organizations and leadership workshops. Students are also placed in community clinics for their preceptorship and participate in service learning and community engagement activities. Critical reflections captured in the UCSF Portfolio enable students to document and share their activities and track development of their competencies.

PRIME-US connects students to career and project mentors, creates opportunities for peer and near-peer mentoring, and provides facilitated discussion groups to enhance personal and professional growth. A collaborative fourth-year elective with the Health and Society pathway provides all PRIME-US students with an opportunity to participate in a capstone experience. Additional electives, evening seminars and weekend workshops are open to all interested students to ensure that everyone benefits from PRIME-US.

For more on the UC PRIME-US program visit http://www.universityofcalifornia.edu/news/article/24075.

Thursday, July 1, 2010

Using Standardized Patients to Promote Interprofessional Learning

The importance of interprofessional education (IPE) has been recognized on both the national and international level. In a report published in 2003, the Institute of Medicine called for significant changes in healthcare professional education in order to meet the changing healthcare environment. They made the following recommendation: “All health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches and informatics,” (Greinder and Knebel. “Health Professions Education: A Bridge to Quality,” 2003). In addition, an interprofessional team-based approach to chronic illness is one of the essential elements in the Chronic Care Model, a well-described model for designing healthcare systems to deliver high-quality chronic illness care. IPE activities can serve as a platform for other innovative cases to be developed that can be used collectively by the schools, and with potential for expansion for use by the health care professionals at the Medical Center.

A centerpiece of the new Teaching and Learning Center is the Kanbar Center for Simulation, Clinical Skills and Telemedicine Education. Clinical skills are often taught by using highly trained actors to play patients – standardized patients. These standardized patients are seen in mock examination rooms by students who are able to practice their history taking, physical exam and communication skills in a safe environment.

The new Teaching and Learning Center has a strong focus on Interprofessional Health Education (IPHE) and over the past year Maria Wamsley, Associate Clinical Professor of Medicine, and colleagues from the schools of dentistry, nursing, pharmacy and physical therapy have collaborated on a very successful pilot curriculum that brings interprofessional teams of students together to evaluate a patient and collaboratively formulate a treatment plan. The project was funded in part by the Instructional Grants Program administered by the UCSF Library, which focused its awards on IPHE starting in 2009. Goals of the project are to enhance knowledge of other healthcare professionals, foster collaboration in patient management and to improve communication skills.

Sixty-nine students and 17 faculty facilitators participated in the pilot during 2009-2010 and the response from participants has been overwhelmingly positive. Overall faculty and student satisfaction with activity is high. The exercises improves student attitudes towards working in teams in the areas of “Team Value” and “Team Efficiency” and students report learning about the roles of other professionals and increased comfort in working collaboratively.

Once the new Kanbar Center opens Dr. Wamsley and colleagues plan to expand the pilot to accommodate 200 students and improve integration of activity into existing curricula for each professional school.

Friday, April 16, 2010

Behind the Scenes Construction Update

by Gail Persily, UCSF Library

The construction contract was officially awarded to McCarthy Building Companies on February 18. And by March 1, access to the Parnassus Library's 2nd floor was completely closed off.

As shown in this photo taken by project architect Malvin Whang of HED, the space has been stripped down to the studs, aside from some sections of wood paneled walls and pillars that are being preserved. Heavy demolition work took place mid-March in the late night, early morning hours when the Library was closed. The demolition has been a lengthy process, requiring both brute force and precision and some odds and ends are still being hauled out as I write this.

The crews are back to working normal day shifts. Those of us who work and study in the Library are still experiencing quite a bit of noise - occasionally loud bangs, sawing, dragging, you name it. Fortunately, there are plenty of ear plugs available at the service desks to distribute to anyone who needs them. We definitely observe more students using their iPods to tune out the construction noise.

Project Manager, Patti Mitchell, and the construction firm consistently express confidence that the TLC will open January 2011 as planned. McCarthy projects that construction will be completed in November, leaving December for furniture installation and move in. The Kanbar Center is counting on these dates as they will need to vacate their temporary space in December and be fully operational on January 17st, “This date is critical,” say Michael Quirk, Kanbar Operations Director. "Several events are already scheduled beginning January 18, including a campus wide open house and and airway management training course. ”
In May, we will be testing out sample furniture from multiple vendors. We hope to get as many people as possible to try out the various task chairs, bar stools, computer desks, and lounge chairs and help us pick the best combination of furniture for this multi-functional space.

Plans are also underway for a campus wide open house event for January 18-21, with activities that will showcase the Kanbar Center's new interactive technology that will be used in the simulation rooms and clinical exam rooms. Opportunities to explore the features of the classrooms and Technology Commons are also planned.

We are continuing to post photos on the TLC website documenting progress, but you can also find them on flickr. As we deal with the dust and the noise and the occasional snafu, these images really help us stay enthusiastic about the project.

Monday, January 11, 2010

TLC Project and Sustainability


Submitted by Malvin Whang, RA LEED AP
Associate, Harley Ellis Devereaux


The new Teaching and Learning Center (TLC) has been designed to provide the latest in health science and interdisciplinary teaching. The project also incorporates many features that enhance the space and provide responsible stewardship of the environment. The project will utilize LEED (Leadership in Energy and Environmental Design) to prioritize, design, measure and certify the project is in line with UCSF’s goal of reducing the environmental footprint of the University.

LEED is a widely used project certification system developed by the USGBC (United States Green Building Council). LEED projects can be certified at varying levels from certified, silver, gold and platinum with platinum certification representing the highest level of certification. LEED certification utilizes a credit system that measures specific aspects of the projects within the whole-building approach to sustainability. The number of total credits garnered determines the level of certification for the project. The TLC will meet the minimum points for LEED certified level.

LEED categories include Sustainable Sites (SS) where the TLC earns a credit for sustainable site features such as proximity to public transportation. The TLC earns credits in Water Efficiency (WE) by using low flow water fixtures and waterless urinals to reduce water usage by more than 30% over comparable facilities. The TLC earns credits in Energy & Atmosphere (EA) by reducing energy use with efficient lighting, lighting controls and by optimizing existing heating and ventilating equipment serving the 2nd floor of the Library.

Credits in Materials & Resources (MR) have an impact on the TLC project as the project is an interior remodel project that falls within LEED CI (Commercial Interior) category of projects. Many credits are earned within MR for reusing much of the material within the existing space, diverting construction waste from landfills, specifying products with high recycled content, using regional products that are manufactured within 500 miles and using only woods from certified suppliers practicing sustainable forestry.

Indoor Environmental Quality (IEQ) is another important category for the TLC project as it deals with a range of topics including prohibition of cigarette smoking near entrances of the project to improve air quality to monitoring the quantity of fresh air into the space. The TLC project earns credits for providing and executing Indoor Air Quality (AIQ) management plans for construction and occupancy, using low VOC (volatile organic compounds) materials in adhesives, paints, carpets and furniture. In fact, to eliminate VOC’s from even the lowest VOC content carpet adhesives, the carpet tiles specified utilize a new adhesive-less installation method that further reduce VOC from the project.

LEED certification provides a facility with a baseline for sustainability in the design and construction of the project. As noted by the Chancellors Advisory Committee on Sustainability (CACS), “UCSF is in an excellent position to improve our relationship with the environment and health of the planet”. For the project to be truly sustainable, learners, faculty and staff at UCSF must continue to reduce, reuse and recycle.

Monday, December 14, 2009

Interim Technology Commons Combines Library Computing Services


The Library's Interactive Learning Center (ILC) and Center for Instructional Technology (CIT) labs are moving to new temporary quarters on the 5th floor in the East Asian Room (CL 506). This interim Technology Commons will combine ILC and CIT worsktations in one location and create an environment similar to the new Tech Commons planned for the 2nd floor.

The labs have shut down operations during the move and will reopen January 4th, 2010 in the new location. Not all computing services will come online immediately, but the staff will get everything up and running as quickly as possible. Proxy access via UCSF ID will be required evenings and weekends. The interim Tech Commons will provide the same wide range of computer services with a few changes:
  • The smaller - although beautiful - space means fewer computers will be available.
  • The space will also serve as a classroom during non-peak study hours. Although the classroom space won’t be available for use until after January 4th, reservations can still be made.
  • CIT access will no longer require a special code. Specialized multi-media workstations will be available for curricular-related work on a first-come, first-serve basis in the Tech Commons.
  • CIT workstations will require users to log in with their Active Directory accounts. When a user logs into a workstation for the first time, a personal folder will be created where the user can store working files. Users should consider using their own external hard drives to save their working files (or borrowing a hard drive from the Tech Commons). CIT workstations are not backed up.
  • The AV Production Room will be relocated to the 4th floor. AV Production Room users will use their campus ID to gain access via a Proxy lock. Room reservations will be possible via an Exchange calendar.
  • CIT equipment loans will continue to be available. Borrowers will now come to the Tech Commons to borrow and return equipment.
  • Tech Commons staff will provide first-level support for the CIT workstations. For more in-depth support, users can make appointments with CIT staff, who will not be located in the Tech Commons.
During this transition phase, the Library is committed to maintaining the same high-level of service it has always provided to students and CIT Lab users. The future looks bright as we plan for the new Teaching and Learning Center, which will include a new Technology Commons and is scheduled to open in January 2011.

Please send any questions or comments to the Tech Commons staff or email the CIT staff.

Thursday, November 5, 2009

ALERT: Work Starting on Library's 2nd Floor!


Visitors to the Library will notice visible signs of the TLC project getting underway on the 2nd floor. This week a visqueen wall was installed in preparation for removing all of the shelving from the floor.

Shelving removal will begin November 9 and continue through November 20. Work will be suspended November 21-December 14 so that the floor is available as study space during final exams.

Of note, the shelves are being removed by a company who will recycle them for reuse in other libraries.