Team-Based Learning for medical statistics

Dr. Sandra Stinnett teaches a medical statistics course to third year medical students at the Duke School of Medicine. Students learn statistical techniques they will use to analyze their own data for their thesis research. Dr. Stinnett was dissatisfied with traditional teaching methods, as students were not learning to apply their statistical knowledge. In 2010, she revised her course to use the team-based learning (TBL) approach.

How did she teach using TBL?

Preparation prior to class: students are required to read  a text and journals, watch JMP software demonstrations, her PowerPoint presentations, and watch recorded lectures from  previous years. All the course materials were available via BlueDocs, the medical school’s Learning Management System.

During class: students take Individual Readiness Assurance Tests, based on the material studied, followed by a the same test taken as a team, the Group Readiness Assurance Test.  Students discuss and debate the answers, which helps all students master the material.  Then, the teams work on Application Exercises, which require thought, discussion and computation.

What were the results?

Student feedback and evaluations were positive. Students demonstrated that they learned, and were engaged and active. She found the course was more enjoyable to teach.

Watch a video to listen to what she and her students said –

What does she like most about TBL?

“What I like most about using TBL is not lecturing! Students are bored with lectures and I am tired of delivering them. In TBL, students are engaged in learning and I am more engaged with them. The class is active and exciting for all of us.”

What, if any, challenges does she face?

“The biggest challenge for me is creating multiple choice questions that facilitate learning. This is an art that I am acquiring as I go along. The National Board of Medical Examiners has a publication that is very instructive. I am using its guidelines and templates for formatting questions. And there are many articles that are available on the internet. Still, it is difficult to formulate plausible options for the answers in a way that tests students’ ability to apply their knowledge rather to demonstrate just rote memorization.”

What does she say to those who are new TBL?

I would encourage anyone using TBL to join the Team-Based Learning Collaborative. This is an organization of people who have many insights to share. Their annual meeting is a gold mine of hands-on instruction and the web site ( has videos, books and case banks that are extremely helpful. I would also advise people to have a mentor to get feedback on their materials. I am finding that it is good to “test-drive” the modules before using them in a class. You can then see which questions work well and which ones need tweaking. Otherwise, your first class will demonstrate that for you!

How can she help faculty who are new to TBL?

I am willing to talk to anyone at Duke who is new to TBL. I am participating in a certification program through the Team-Based Learning Collaborative. As part of that program, I am required to mentor someone else. I am passionate about using this method and eager to engage with others at Duke so that I can also learn from their experiences also.

If you would like to consult with her or ask her to be a mentor, email or call Dr. Sandra Stinnett at, or 919-818-8870.