title: Incentive structure in team-based learning: graded versus ungraded Group Application exercises.
abstract: OBJECTIVE
  Previous studies on team-based learning (TBL) in medical education demonstrated improved learner engagement, learner satisfaction, and academic performance; however, a paucity of information exists on modifications of the incentive structure of "traditional" TBL practices. The current study investigates the impact of modification to conventional Group Application exercises by examining student preference and student perceptions of TBL outcomes when Group Application exercises are excluded from TBL grades.
  
  
  METHODS
  During the 2009-2010 and 2010-2011 academic years, 175 students (95.6% response rate) completed a 22-item multiple choice survey followed by 3 open response questions at the end of their second year of medical school. These students had participated in a TBL supplemented preclinical curriculum with graded Group Application exercises during year one and ungraded Group Application exercises during year two of medical school.
  
  
  RESULTS
  Chi-square analyses showed significant differences between grading categories for general assessment of TBL, participation and communication, intra-team discussion, inter-team discussion, student perceptions of their own effort and development of teamwork skills. Furthermore, 83.8% of students polled prefer ungraded Group Application exercises with only 7.2% preferring graded and 9.0% indicating no preference.
  
  
  CONCLUSIONS
  The use of ungraded Group Application exercises appears to be a successful modification of TBL, making it more "student-friendly" while maintaining the goals of active learning and development of teamwork skills.
authors.affiliation: Academic Affairs, Wright State University Boonshoft School of Medicine, Dayton, OH, USA.
authors.forename: Adam S
authors.initials: AS
authors.lastname: Deardorff
authors.forename: Jeremy A
authors.initials: JA
authors.lastname: Moore
authors.forename: Colleen
authors.initials: C
authors.lastname: McCormick
authors.forename: Paul G
authors.initials: PG
authors.lastname: Koles
authors.forename: Nicole J
authors.initials: NJ
authors.lastname: Borges
references.citation: Am J Pharm Educ. 2010 Nov 10;74(9):160
references.pmid: 21301594
references.citation: Anat Sci Educ. 2009 Jul-Aug;2(4):150-5
references.pmid: 19572279
references.citation: Acad Med. 2010 Nov;85(11):1739-45
references.pmid: 20881827
references.citation: Med Teach. 2009 Nov;31(11):1013-7
references.pmid: 19909042
references.citation: Med Educ. 2005 Jun;39(6):594-604
references.pmid: 15910436
references.citation: Med Teach. 2012;34(10):802-6
references.pmid: 23009257
references.citation: Med Teach. 2011;33(9):750-3
references.pmid: 21592018
references.citation: Acad Med. 2006 Apr;81(4):354-73
references.pmid: 16565188
references.citation: Med Educ. 2007 Mar;41(3):250-7
references.pmid: 17316209
references.citation: Acad Med. 2012 Mar;87(3):292-9
references.pmid: 22373620