Our goal was to redesign the clerkship curricula using Team Based Learning (TBL) to teach clinical reasoning, critical thinking, localization, and team collaboration while maintaining student satisfaction and NBME scores.

TBL is a student-centered approach using a flipped classroom model. Students review material before class and work through difficult concepts together with a preceptor. Class time is prioritized with application exercises and complex clinical cases rather than passive learning through a didactic series. TBL seems to be more effective than traditional classroom lectures but more difficult to design.

The clerkship leadership designed an original TBL series with eight clinical cases to replace traditional lectures. Medical students on their neurology clerkship rotation are divided into groups of four to five to work through the cases and later debate answer choices between teams. Anonymous, voluntary, self-reported surveys were collected at the end of each TBL session.

We collected 210 surveys for the first six months of the TBL pilot. Students said their groups worked well together (96.2% agreed) and the debated class discussions improved their understanding (98.1% agreed). Students were very satisfied with the facilitator’s ability to enhance their learning (98.6% agreed). Students felt that the TBL sessions overall were “very good” (mode of 4 out of 5). Mean NBME scores trended towards improvement with TBL curriculum (83.3) when compared to two years of historical controls pre-TBL (81.6, p=0.07).

Student satisfaction was very positive for a novel TBL curriculum on the neurology clerkship. TBL sessions generated more exploration of the topic when the questions were complex, directed towards concepts instead of facts, and reflected “real-life” situations.  The NBME exam scores during this initial phase trended towards improvement. We provide examples of survey and case design to help those interested in pursuing a TBL curriculum.