Take a look at the list of teamwork competencies from Medical Teamwork and Patient Safety from the Agency for Healthcare Research and Quality (AHRQ). How might students in an undergraduate classroom begin to learn these competencies?

Building a Collaborative Classroom Environment

One of the most frequent issues raised by instructors who are trying to move from a teacher-centred to a team-centred classroom is “How do I get students to collaborate effectively?” The answer is not a simple one because most North American students arrive in the medical classroom from a learning environment that encouraged competition and frequently viewed collaboration between students as a doorway to cheating. Many of the most successful students in this environment viewed collaborative activities as a plot to improve the grades of poor students at their expense.

So you need to help students learn to collaborate and I suggest you begin that process by familiarizing yourself with Dr. J. Salmons’ Five Levels of Collaboration, which progress from least trust required to unconscious trust.

1. Dialogue
2. Peer Review
3. Parallel Collaboration
4. Sequential Collaboration
5. Synergistic Collaboration

Dialogue

Begin your course with daily opportunities for students to practice speaking and listening to each other in order to build trust. Avoid the traditional instructor asks a question and a single student answers and use a variety of the following:

• Write, pair, share
• Clicker polls
• Clicker quizzes
• Group discussions
• Structured Controversy
• Integrated Case Learning
  

Peer Review

The week before the first paper or assignment is due begin the process of orienting them to critiquing each others work. Explain the concept of rubrics to the class and ask them what criteria they would use to evaluate the assignment/paper. If they have an adequate understanding of the concept, get them to create the rubric; otherwise share your rubric with them. Be open with the students that this is a stage in learning to work as a team. Choose one of the following depending on the size of the group and their readiness for the task:

• Partner – give each other feedback on the format/spelling/sentence structure but not on the content before the work is handed in
• Comment – post the assignment online in a Wiki or Blog and expect at least two thoughtful comments from each student on someone else’s work as part of their marks
• Critique someone else’s work using the established rubric and compare it to the instructor’s critique for marks.

Parallel Collaboration

At this stage, participants divide up the group’s assignment and each individual completes a section independently. The final presentation of the assignment may be vetted by one individual who is ideally the best writer/presenter but who may be just the strongest personality. In some cases, students each present their section and no teamwork is involved. To help students move through this individual stage, you might ask them to do some of the following:

• Encourage them to participate in some sort of group editing/review which can be facilitated by using either Google Docs or a Wiki
• Assign group roles such as gatekeeper, task completer, food bringer etc. or help them identify their role
• Ask group to mark each other on participation in the group role while you mark individual contributions

Sequential Collaboration

The students are developing the skills of team and task management and begin to appreciate the importance of both functions, so they need an assignment that can be accomplished in a series of stages, such as research - group writing - presentation of paper. At each stage, a product will be presented to you by a set date and the students are expected to plan, create and critique this product as a group. Marks for this stage are based on expected group performance not individual.

Synergistic Collaboration

The unconsciously competent team collaboration point may not be achievable in a single course.

Resources

Medical Students’ Attitudes about Team-Based Learning in a Pre-Clinical Curriculum
This study demonstrates that students’ attitudes about working within teams, their sense of professional development, and comfort and satisfaction with peer evaluation change in a curriculum using Team-Based Learning.

Read the BMJ module Team working: a user's guide

Read this article about quality control for some ideas about improving teamwork?

TEACHING AND ASSESSING COLLABORATION SKILLS

Web 2.0 Collaboration Rubric

Small Group Facilitation Skills variety of resources from the Florida State University's Medical School.

Resources for Small Group Facilitators from the University of Ohio.

Doc.com consists of 41 completed media-rich modules covering all aspects of "healthcare communication skills". NEW additions are that the learning management system now allows the institution administrators to bulk sign-up users and to bulk assign them into learning groups. And administrators of learning groups now can easily assign tasks to their students and assess their performance on Multiple Choice and Short Answer Questions.

Team Based Learning Modules(UBC)

• Team Formation
• Introducing TBL to your Students
• Setting Grade Weights
• Pre-Class Preparation
• Readiness Assurance Process
• Application Exercises
• Peer Evaluation

The TBLC is dedicated to providing resources and support for faculty using TBL™ in their classroom. The TBLC maintains a secure (membership required) Case Bank, organizes the annual TBL conference, and presents a series of online seminars in current topics in TBL. Membership in the TBLC is $50 and gets you access to the case bank, the online seminar series, and entitles you to a discount on TBL conference registrations.



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or The Case Curriculum Model
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