Educational Innovation in an Undergraduate Medical Course: Implementation of a Blended e-Learning, Team-Based Learning Model
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Medical education has been the subject of ongoing reform since the second part of the 18th century (Papa & Harasym, 1999). Most recently, medical education has been redefined to include a broad set of competencies over and above traditional expertise. In an attempt to facilitate this approach, different instructional models have been proposed. Most of these seek to foster learner engagement and active participation and promote life-long learning. Nevertheless, there is no consensus amongst medical educators about the optimal way to teach future physicians. Despite the efforts of both researchers and local champions, instructional innovations frequently fail. Fullan (2001) ascribes this to faulty assumptions on the part of planners as well as to the inherent complexity of the organizations involved, further stating that effective change requires some degree of reculturing. This study examines the process of educational change in an undergraduate medical course over a three-year period. Formerly taught exclusively by large class lectures, the course was redesigned to include a blend of e-learning and Team-Based Learning (TBL). The process of change is described and viewed in parallel from the perspectives of both student and teacher while uncovering contextual and process elements that contributed to the outcome. Shifting student attitudes to teaching and learning were identified over time, suggesting that these evolve in parallel to faculty experience implementing a new teaching strategy. Van Melle (2005) has suggested that acceptance of educational innovation is dependent on the environment and organizational context. The results of this study highlight the importance of these factors in the successful introduction of a new instructional paradigm as well as the value of longitudinal evaluation of instructional changes in order to better understand their transformational potential.