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scores were subject to Fisher's exact test (N=910
students from 9 years). Groups were defined as
passing or failing IRATs and passing or failing one
or more course exams (70% pass/fail cutoff).
RESULTS
Overall, 30.0% of students failed at least one exam.
Students who failed the initial IRATs had a
significantly higher exam failure rate. As a
diagnostic test, the IRATs had a positive predictive
value of 0.754, a negative predictive value of 0.770,
a likelihood ratio (LR) of 7.16 for failing at least one
exam (i.e., students failing IRATs are 7 times more
likely to fail an exam) and a LR of 6.04 for failing
the course. Scores from only the first one or two
IRATs had a much lower predictive value. Female
students had lower performance on both IRATs and
exams. Their IRAT performance was also less
predictive of exam performance (LR=5.19 for
females v. 11.82 for males). This may be due to a
significant trend of females to perform more poorly
in the first two IRATs than in subsequent IRATs and
exams. The predictive value of IRATs was much
higher than that of entry credentials such as MCAT
scores.
CONCLUSIONS
In addition to its role in TBL per se, IRATs may be
useful in identifying at risk students prior to high
stakes exams. Formal intervention, or at least
informing students of their risk, may help them
remedy early academic problems.
TBL/PBL Abstract ID: 227
BASIC, CLINICAL & SOCIAL SCIENCES
COME ALIVE THROUGH A “LIVING THE
DIABETIC LIFE” MODIFIED TBL
Sally Twining, PhD, Nancy Havas, MD, Kelly
Hagedorn, BA, Erin Preloger, BA, Carina
Jackman, BA, Shannon Baumer, BS, Kimberly
Ginsbach, BA, Medical College of Wisconsin,
Milwaukee, WI, USA
PURPOSE
Chronic disease care requires understanding of
basic science principles and social science principles
along with empathy and compassion. Team-based
Learning (TBL) involves application of scientific
knowledge in a clinical context but traditionally
does not actively target student’s affective learning.
To address this gap, we designed and implemented
a “living the diabetic life” modified TBL.
METHODS
Twenty-eight M1 students completed a basic science
principle pre-test. Consistent with TB, 4 days in
advance, students received preparatory materials:
readings, 1 of 5 “live the diabetic life” scenarios (e.g.
diabetic with low economic status), diabetic glucose
monitoring equipment and required activities. In
class activities began with a pre-meal glucose
measurement and one of three assigned meals.
Students measured glucose levels 4x following
lunch. Teams were formed based on diabetic
scenario. The application exercise was to prepare
and deliver a presentation outlining the diabetic
scenario, patient compliance issues, challenges
associated with “living the life”, implications for
care and impact of diet on glucose levels using
scientific principles. Students completed a post-test
and a qualitative survey.
RESULTS
Students scored an average of 4.1 points out of 17
higher on the post-test relative to the pre-test.
Student presentations demonstrated achieved
science and affective objectives. Overall, students
highly rated the session (Mean =3.5 Scale 1 poor, 4
excellent). Typical comments emphasized the
struggle to comply with a diabetic regimen and
importance of the gained “living” profile of diabetes.
CONCLUSIONS
When a student assumes the role of a chronic
disease patient, the sciences become lived
experiences which translate to patient care and
compassion.
TBL/PBL Abstract ID: 228
ADAPTIVE EXPERTISE IN PBL: CREATING
THE NEXT CHALLENGE
Adam Miller 1 , Lamia Ibrahim MD 2,3 , Katherine
Kelly MD 2 , Dan Wolpaw MD 1,3 1 Case Western
Reserve University, Cleveland, OH; 2 University
Hospitals Case Medical Center, Cleveland, OH;
3 Veterans Affairs Medical Center, Louis Stokes,
Cleveland, OH, USA
PURPOSE
Literature suggests adaptive expertise can be
cultivated through progressive problem solving
challenges. We sought to determine whether we
could identify and cultivate adaptive expertise by
challenging students to apply new pieces of clinical
data to established PBL cases.
METHODS
Our institution uses a small group case-based PBL
preclinical curriculum. At the conclusion of one of
these cases, we introduced new clinical data to
create a novel challenge. We piloted this approach
with two groups of volunteer first year medical
Medical Science Educator © IAMSE 2012 Volume 22(4S) 327