title: A Randomized Controlled Trial of Team-Based Learning Versus Lectures with Break-Out Groups on Knowledge Retention.
abstract: OBJECTIVE
  This goal of this study was to evaluate the efficacy of team-based learning (TBL) on knowledge retention compared to traditional lectures with small break-out group discussion (teaching as usual (TAU)) using a randomized controlled trial.
  
  
  METHODS
  This randomized controlled trial was conducted during a daylong conference for psychiatric educators on attention-deficit hyperactivity disorder and the research literacy topic of efficacy versus effectiveness trials. Learners (n = 115) were randomized with concealed allocation to either TBL or TAU. Knowledge was measured prior to the intervention, immediately afterward, and 2 months later via multiple-choice tests. Participants were necessarily unblinded. Data enterers, data analysts, and investigators were blinded to group assignment in data analysis. Per-protocol analyses of test scores were performed using change in knowledge from baseline. The primary endpoint was test scores at 2 months.
  
  
  RESULTS
  At baseline, there were no statistically significant differences between groups in pre-test knowledge. At immediate post-test, both TBL and TAU groups showed improved knowledge scores compared with their baseline scores. The TBL group performed better statistically on the immediate post-test than the TAU group (Cohen's d = 0.73; p < 0.001), although the differences in knowledge scores were not educationally meaningful, averaging just one additional test question correct (out of 15). On the 2-month remote post-test, there were no group differences in knowledge retention among the 42 % of participants who returned the 2-month test.
  
  
  CONCLUSIONS
  Both TBL and TAU learners acquired new knowledge at the end of the intervention and retained knowledge over 2 months. At the end of the intervention day and after 2 months, knowledge test scores were not meaningfully different between TBL and TAU completers. In conclusion, this study failed to demonstrate the superiority of TBL over TAU on the primary outcome of knowledge retention at 2 months post-intervention.
authors.affiliation: Central Regional Hospital, Butner, NC, USA. grace.thrall@duke.edu.
authors.forename: Grace C
authors.identifier: http://orcid.org/0000-0001-8135-692X
authors.initials: GC
authors.lastname: Thrall
authors.affiliation: Baylor College of Medicine, Houston, TX, USA.
authors.forename: John H
authors.initials: JH
authors.lastname: Coverdale
authors.affiliation: McMaster University, Hamilton, ON, Canada.
authors.forename: Sophiya
authors.initials: S
authors.lastname: Benjamin
authors.affiliation: Keck School of Medicine of University of Southern California, Los Angeles, CA, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Wiggins
authors.affiliation: Keck School of Medicine of University of Southern California, Los Angeles, CA, USA.
authors.forename: Christianne Joy
authors.initials: CJ
authors.lastname: Lane
authors.affiliation: Keck School of Medicine of University of Southern California, Los Angeles, CA, USA.|SUNY Downstate, Brooklyn, NY, USA.
authors.forename: Michele T
authors.initials: MT
authors.lastname: Pato
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000628:therapy*; D004501:Education, Medical / Q000379:methods*; D019317:Evidence-Based Medicine / Q000193:education*; D005180:Faculty, Medical / Q000193:education*; D006801:Humans; D007858:Learning; D008568:Memory; D011570:Psychiatry / Q000193:education*; D013663:Teaching
keywords: Evidence-based medicine; Lecture-based learning; Medical education; Residency training; Team-based learning