Tuesday, November 16, 2010

Anatomy TBL - Sometimes Less than Awesome

Get ready for a long one with no pictures....

It's that lovely time of year right now - that time between taking an exam and actually getting your grade back. There are those I've spoken to that are absolutely positive they completely bombed our first anatomy exam, there are those (whom I haven't actually talked to, but I'm sure they exist somewhere) that are secretly happy about how they felt it went, and then there are those like me who vacillate constantly between best and worst case scenarios depending on the moment (my "worst"-case scenario: law school next year). And then of course there are the smart people who choose not to obsess about the exam after it's too late to do anything about it anyway, and do fun things instead.

Let me explain how anatomy works here, and why this test seemed so particularly difficult to everyone. And then, I promise, I will talk about something other than class for the next few blog posts.

So first off, there are no lectures at all for anatomy or histology (there are a few for embryology). Everything we learn is through TBL, or Team-Based Learning, which is the newest cool thing in medical education. Let's say tomorrow's subject is the upper arm. In our syllabus, there will be a list of pages in our book to read (for example, the chapter on the upper arm), followed by 3-4 pages of questions to answer or structures to identify based on that reading. When we go into class the next day, everyone takes an individual short quiz based on the reading, then we go over alllll the reading questions with our TBL group (a 6-person team assigned at the beginning of the course), and then at the end you take that same quiz again as a group. Finally, you go to the lab and dissect, or look at histology slides. The tests are supposedly based only on questions and structures from the TBLs (also, apparently, on practice questions from specific review books which we should be required to buy if they are needed to adequately prepare for the exam, just saying...)

During all this time, the professors are walking around answering any questions that people may have. The professors really are so helpful and amazing at explaining things ... when you ask them questions. If you go through the TBL and your group knows all the answers (or worse: thinks they know all the answers), then you don't fully utilize the professors. But they tend to give lots of hints to the groups they talk to about what to focus on and what can sort of be ignored for the test, so the groups that don't ask as many questions seem to be at a disadvantage to the groups that are constantly badgering the professors (in my head: professor-hogs). But no matter what, each group talks to different professors and for different amounts of time, so by the time the test comes around, there are lots of different rumors floating around like "I heard this nerve is super important, but don't really bother with the lower leg" or "someone told me that it came straight from the professor that there are only two important arteries we have to know." Everyone ends up knowing, or thinking they know, a different amount of information for the test. Which is frustrating when you actually get to the test and (shocking!) some rumors are true, and some are so very not true.

The reason TBL is big right now is because it's all about active learning vs. lectures, which are passive learning. For a lecture, you as the student don't need to do any preparation, and you can totally sleep or zone out through the whole thing. With TBL, you come into class prepared every day having basically learned the information already, and in class you reinforce that information by going over it with your teammates and getting to actually see the things you read about in the body or on models. In general, I really like TBL. It forces you to stay on top of your stuff, which is important. But I really think we need a fewwwww lectures interspersed throughout (a) to tie some things together so we can see the big picture, which is hard to do when you're answering very specific questions from a text book, (b) to learn how to correctly pronounce things!!!, and (c) so that everyone is getting the same reliable information when it comes to what to focus on for the test. As a friend of mine put it, "I'm so happy to be spending close to $30,000 a year to get the opportunity to teach myself anatomy." Of course that's not really the case, but sometimes it does feel that way.

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