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Inter-professional team-based learning (IPTBL) is an innovative teaching approach initiated by the Li Ka Shing Faculty of Medicine in the University of Hong Kong (HKU). It is a pioneering effort to promote peer-to-peer learning and inter-professional education across healthcare disciplines using team-based learning (TBL), flipped learning and e-learning. First piloted in 2016, the initiative engaged 500+ students across 7 programmes from HKU and the Hong Kong Polytechnic University (PolyU). Based on the feedback collected, the event was further scaled out in 2017, serving more than 1,000 students (and as many as 501 students in one particular session) from 12 programmes from the two universities.

In this large-scale flipped classroom implementation, we have demonstrated the following attributes:

  • Implementation of an entirely new mode of teaching, pushing teachers and students to step out of their comfort zone;
  • Use of technologies to facilitate teacher-student/student-student interactions; and
  • Effective collaboration among teaching units and teaching-support units.

The event served more than 1,000 students (and as many as 501 students in one particular session) from 12 programmes from the two universities.

We are happy to share that the initiative has been recognized locally and internationally. In 2016, the IPTBL team won the Bronze Discipline Award (Life Sciences) in the prestigious QS Stars-Wharton Reimagine Education Awards. Taking one step further in 2017, we had been shortlisted for the HKU Professional Services Awards 2017 (Team category), an annual award programme at the University level to recognise and promote excellence in professional services. We would like to express our gratitude to the University, our colleagues and students for their support, without which our work would not have been possible.

Raising Standards of Classwork Activities

The motivation behind implementing this initiative is to enhance the quality of teaching and learning by pushing both teachers and students out of their comfort zone.

Facilitating teachers to step out of their comfort zone

Traditionally, many teachers tend to focus on their own discipline in teaching or even a particular topic when delivering a lecture. In the case of IPTBL, all members of the teaching team stepped out of their disciplinary silos and collaborated with teachers from different disciplines and institutions.

Facilitating students to step out of their comfort zone

Many health professional graduates in the work field found it difficult to communicate with their colleagues with different backgrounds, as they mainly received training with students from the same discipline in university. In IPTBL, students from multiple disciplines were grouped in ways that reflected the realities of the healthcare sector. This created ample opportunities for them to develop communication and collaboration skills essential for their future career.

Enhancing Teaching and Learning with Technology

Since a large number of students were involved in each session, an online learning platform and a peer evaluation system were developed to facilitate teacher-student and student-student interactions.

Facilitating teacher-student interactions

It is not easy for teachers to engage hundreds of students and monitor their progress simultaneously in face-to-face sessions. To facilitate teachers in managing the class, an online Learning Activity Management System (LAMS) was introduced. In class, students needed to log-in the system and answer questions individually and in teams. The system allowed teachers to track their real-time progress through the different stages of TBL. This system also made it easier for teachers to decide on which groups to interview in the interactive feedback session.

The Learning Activity Management System (LAMS)

Facilitating student-student interactions

A peer evaluation system was developed to enable students to deliver real-time feedback to their teammates for timely self-reflection. The system also came with an online discussion forum to facilitate student interactions after class.

Overcoming Challenges in Implementing Large-Scale Classroom Activities

Careful scheduling

As IPTBL involved teachers and students from multiple departments and universities, careful scheduling of each session was necessary. To accommodate all parties’ schedules, all six sessions were held on Saturday mornings.

Briefing sessions

With a large number of students and teachers from various disciplines involved, it was essential to ensure all necessary operation details were effectively communicated to all parties. To overcome this challenge, the team conducted multiple briefing sessions in both universities, not only with teachers, but also with students. In the briefing sessions, the importance of IPTBL, the session formats and rundown were explained in great details.

Creating an environment suitable for large-scale in-class activities

As it was necessary to accommodate a large number of students in each session, the team chose the Centennial Campus Lecture Hall II as the core learning space as it is a large flat area with mobile chairs and strong WiFi connectivity. Standard large lecture halls such as Grand Hall or Rayson Huang Theatre were not chosen as they might not be suitable for large-scale group discussion, both online and offline. Since the halls are not flat and the chairs are not movable, it will be difficult for students to move around and work in groups. It may also be difficult for teachers and students to communicate online as the WiFi connectivity in these halls are relatively weak.

As the number of students varied in each session, floor plans were drawn for each session to ensure that all students enjoyed the best learning environment. In the actual implementation, balloons with group numbers were attached to each group so that teachers and students could quickly locate individual teams.

Balloons with group numbers were attached to each group so that teachers and students could quickly locate individual teams.

Collaborations with teaching-support units

Logistics of setting up a suitable environment for large-scale group discussions can be complicated. Reconfiguring the Centennial Campus Lecture Hall II for the IPTBL initiative is particularly challenging, as the hall is usually partitioned into four standard classrooms. Transforming this learning space requires partitions to be lifted up and chairs to be reorganized – a process that would take several hours to complete. As the sessions were held on Saturday mornings, when most HKU offices were closed, the team had to liaise with parties such as Examinations Office and Estates Office to arrange for earlier set up of the venue on the night before.

Each session required materials such as reception tables, refreshments and backup paper tests (in case the online learning system failed to function properly). As most HKU offices were closed on Saturday, transportation of materials was a major challenge to overcome. Extra efforts were made to ensure logistics concerns were addressed – All the materials needed were transported from HKU Medical Campus to Main Campus on the night before. With the assistance from units such as Information Technology Services (ITS) and Learning Environment Services (LES), storage areas were made available.

Multiple rehearsals

To ensure the smooth running of the event, multiple rehearsals had been conducted. With limited time available for each IPTBL session (only 4 hours each) and a tight schedule, time management was crucial to ensure students went through the complete TBL process. Intensive rehearsals and prior testing of the online learning system were necessary to minimize technical problems and possible delays in the actual implementation.

Looking Forward

The IPTBL programme had grown continuously from 2016 to 2017. In the future, the course team aims to continuously improve the online learning platform to provide more informative feedback to both the facilitators and students.

If you are interested in using technology in class or experimenting with new ways of teaching, contact us.

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Inter-professional team-based learning (IPTBL) is an innovative teaching approach which aims at promoting peer-to-peer learning and collaborations across disciplines. In 2016, the Li Ka Shing Faculty of Medicine piloted IPTBL with nearly 600 medical, health and social care students from HKU and the Hong Kong Polytechnic University. This year, the organizing team scaled it up to serve more than 1,000 students from the following programmes: Chinese medicine, medicine, nursing, pharmacy, and social work from HKU; and medical laboratory science, nursing, occupational therapy, physiotherapy, radiography, and social work from PolyU.

The details of implementation are as follows:

Topic of Instructional Unit Date No. of participants
Anticoagulation Therapy January 21, 2017 247
Depression February 11, 2017 310
Fracture February 18, 2017 437
Multiple drugs February 25, 2017 347
Developmental delay March 18, 2017 192
Cancer March 25, 2017 501

What’s new this year?

(1) Venue: To facilitate group discussion and communication between teachers and students, IPTBL was conducted this year in Lecture Hall II at the Centennial Campus, a flat area with mobile chairs and strong WiFi connectivity.

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Before: IPTBL was conducted in a lecture theatre setting in the 2016 pilot round. Students in groups tended to face the stage most of the time.

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After: Groups were arranged in circles this year. This picture features 71 small groups of five to seven students seated in the spacious Lecture Hall II. The IPTBL team would like to thank colleagues from the Examinations Office, Estates Office and Learning Environment Services of ITS who made all the six sessions possible.

(2) Team progress chart: How to pace the 4-hour face-to-face IPTBL session is a big challenge. While the moderators and content experts had to be very conscious of the time, students also played an important role in moving the session forward. The newly added team progress chart displayed on one of the four screens in front of the hall, indicating whether a particular group had finished the assigned task – just like what a leaderboard does in online games. This provided motivation to students to complete their work in a timely manner, and also gave teachers some idea on which groups to interview in the interactive feedback session.

(3) Peer evaluation: Team-based learning creates many opportunities for students to learn with, from and about each other through intensive interaction and collaboration. During each session, they got to know each other’s expertise and communication style. Peer evaluation is a mechanism for them to provide honest feedback to their peer teammates in terms of four competencies: values/ ethics, roles/ responsibilities, communication, and teamwork. At the end of each session of this year’s IPTBL, students would fill in their peer evaluation scores in an online form. They would then be directed to another page which showed them, in real-time, the average scores that he/she received from other teammates.

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Dr. LK Chan explained to students how to fill out the online peer evaluation form. By the way, did you notice the balloons in the picture? They indicate the group numbers so that teachers/ facilitators could quickly locate where the teams are.

Exemplary facilitation skills
Team-based learning incorporates many elements of constructivist learning (Hrynchak & Batty, 2012). The teachers (content experts) spent much time to come up with carefully-crafted application exercises which can reveal common misconceptions and debatable topics from which students build new understandings. During the interactive feedback session, many teachers showed excellent skills in facilitating the discussion of a large group of students, such as:

  • not picking the team leader to present the team’s views;
  • asking open-ended questions with a focus on understanding the students’ rationale in picking a particular answer;
  • encouraging students to articulate their thoughts;
  • addressing uncertainties or disagreements;
  • providing a closure after each discussion; and
  • paying attention to teams or students who are not taking part (e.g., by inviting a range of teams to give their opinions).

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IPTBL is the Bronze Winner for Discipline Award (Life Sciences) in the prestigious QS Stars-Wharton Reimagine Education Awards 2016. The team celebrated the success after a briefing session in January 2017.

Way forward
The IPTBL team is now reviewing the feedback from students and teachers. They are thinking about improving the implementation in the following ways:

  • shortening the readiness tests in order to leave more time for discussion on the clinical scenario;
  • re-voicing students’ opinions when they contribute something that appears to be complex or not too well understood to students from other disciplines.
  • Adding new functions to the online platform for running IPTBL to provide more informative feedback to both the facilitators and students.

For those of you would like to learn more about IPTBL or contribute to it, please contact Dr. Fraide A. Ganotice, Jr., Program Coordinator at Li Ka Shing Faculty of Medicine, via ganotc75@hku.hk. If you want to get to know the technical aspects of running large classes, you may reach out to the Technology-Enriched Learning Initiative (TELI) via enquiry@teli.hku.hk.

Look forward to IPTBL 2018!

Reference
Hrynchak, P. & Batty, H. (2012) The educational theory basis of team-based learning. Medical Teacher 34, 796-801.

Further reading

  1. Breaking through the Silos with Technology and Team-Based Learning
  2. Big Success at International Award to Reimagine Education
  3. Learning to Work in Teams: Interprofessional Learning for Health Students

Reimagine Education-01

Two HKU collaborative projects are being recognized at the prestigious QS Stars-Wharton Reimagine Education Awards. The inter-institutional team, “Interprofessional Team-based Learning (IPTBL) for Health Professional Students”, led by Dr. Lap Ki Chan (Li Ka Shing Faculty of Medicine) is the Bronze Winner for Discipline Award (Life Sciences). The international team, “Problem-based learning and Educational Technologies in Clinical Education – An Interactional Ethnography”, led by Dr. Susan Bridges (Faculty of Education/ Centre for the Enhancement of Teaching and Learning) won the Bronze Regional Award (Asia).

Reimagine Education-01
From Left to Right:
Dr Fraide A. Ganotice, Jr., Mr. Nunzio Quacquarelli (CEO and founder of Quacquarelli Symonds Ltd.), Dr. Susan Bridges, Prof. Judith Green

Shortlisted candidates from around the world gathered in Philadelphia on Dec 5-6, 2016 to showcase their projects in this “Oscars” gathering for innovative higher education pedagogies. From over 500 projects, the panel of judges selected all submissions from HKU to be among the 120 that are shortlisted for the final contest.

Reimagine Education-01
Prof. Ricky Kwok and Dr Fraide A. Ganotice presenting at the Reimagine Education Awards

Reimagine Education-01
Dr. Susan Bridges presenting at the Reimagine Education Awards

Both projects have the vision in realizing how technology should be infused in teaching across multiple scales, including: student numbers, time (e.g., learning cycles) and disciplines. The improvements in outcomes are supported by quantitative and qualitative research data. TELI is proud to have been particularly involved in the IPTBL project on various fronts, including the development of the Learning Activity Management System (LAMS) electronic platform, the implementation and connectivity that are all crucial in the development of the IPTBL.

Further reading:

  1. (大公報 Tai Kung Pao) 港大兩個項目獲國際創意教育獎項
  2. (文匯報 Wen Wei Po) 港大奪全球教學創新兩銅


IPTBL is a pioneering effort in conducting interprofessional education (IPE) using team-based learning (TBL).

jimsil-2“In running this type of events, technology is tremendously important,” said Dr. Chan in the seminar.

We all need to learn to collaborate, and through collaboration, we learn more. With technology, it is now easier to create new collaborative grounds for students. Having a firm belief that “collaborative work will lead to better patient outcome,” Dr. Lap Ki Chan (Li Ka Shing Faculty of Medicine) initiated Interprofessional Team-Based Learning (IPTBL), a technology-facilitated project, with a team of pioneers, including Dr. Charlene C. Ho, School of Biomedical Sciences; Dr. Fraide A. Ganotice, Jr., Bau Institute of Medical and Health Sciences Education; Dr. Veronica Lam, School of Nursing; Dr. Ming Fai Law, Department of Social Work and Social Administration; and Dr. Gordon Wong, Department of Anaesthesiology. The team shared their experience in a seminar on 6 June 2016.

IPTBL – How does it work?

jimsil-2“The future is bright I think. TBL is the way to go in healthcare,” said Dr. Gordon Wong in the seminar.

Collaborative learning is nothing new in education. But what makes IPTBL special is that it is a pioneering effort to promote interprofessional education (IPE) across healthcare disciplines using team-based learning (TBL) and ed-tech. Students from multidisciplinary silos teamed up to tackle clinical cases, debate on questions and appeal to facilitators regarding the answers. So far, the project has successfully broken down the silos of 7 different programmes and engaged 600 students from HKU and PolyU.

The use of ed-tech
It would be impossible to engage such a large number of learners simultaneously without the help of technology. To enable effective class management, an e-platform called the Learning Activity Management System (LAMS) was utilized. It allowed teachers to track the progress of all students through the different stages of TBL.

Technology makes collaboration easier in the classroom. Contact us if you want to create new collaborative opportunities for your students.

More photos of the seminar can be found on our Facebook and Twitter.

Further reading:
Larry Michaelson, L. (2009). The Essential Elements of Team-Based Learning. Adapted from Chapter 1 of Michaelsen, L., Sweet, M. & Parmalee, D. (2009). Team-Based Learning: Small Group Learning’s Next Big Step. New Directions in Teaching and Learning, 7-27.
Download here

Event video

Effective communication and collaboration is one of HKU’s educational aims. In our healthcare-related curricula, we strive to offer students a range of opportunities to work together and build a professional network on campus. One recent attempt was a UGC-funded programme entitled “Interprofessional Team-based Learning (IPTBL) for Health Professional Students,” launched in January 2016.

The main purpose of IPTBL is to facilitate deeper learning experiences and interactions of health professional students in their roles and responsibilities; and to enable them to actively learn in small groups. During the session, teams of students from Medicine, Pharmacy, Nursing, Chinese Medicine and Biomedical Sciences from HKU and PolyU completed tests based on suggested readings, first individually and then as a cross-disciplinary team. Team members then worked together on case-based application exercises. The way teams were arranged reflected the realities of the healthcare sector, where professionals from a variety of disciplines work together to improve the well-being of patients.

“It’s a great way for healthcare professionals to meet when they are studying, and then build relationships, friendships, so that when they go to the HA [Hospital Authority] or the community, they are familiar with each other, and they know how each other works [and] thinks,” said Dr. Alan Worsley, who served on the teacher panel as a Pharmacy content expert.  

In fact, teachers also mirrored the process their learners went through in the face-to-face sessions when they collaboratively examined clinical cases and addressed questions from students.

Collaborative learning in the IPTBL programme is further enhanced by the use of the Learning Activity Management System (LAMS), which provided instant statistics that help facilitators check the progress of individuals and teams. The system also came with an online discussion forum designated for interactions after the face-to-face sessions. According to the Principal Investigator of this project, Dr Lap Ki Chan (Li Ka Shing Faculty of Medicine), “in each of the sessions of this team-based programme we’re talking about 500 to 600 students. Without the use of technology it is difficult to manage such a large number of students.” TELI collaborated with the IPTBL team to ensure that the LAMS functioned smoothly and that the face-to-face sessions were conducted effectively.

More than 500 students across 7 programmes from 2 universities participated in the first two IPTBL days on January 16 and February 20, 2016. The programme is growing continuously and is expected to serve over 1000 students in total from 12 programmes by 2017. This would be the first large-scale interprofessional education programme in Hong Kong.

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