Team-based learning pedagogy enhances the quality of Chinese pharmacy education: a systematic review and meta-analysis

Abstract

Background: Recent years have witnessed the wide application of team-based learning(TBL) pedagogy in Chinese pharmacy education. However, the relevant systematic review evaluating the effects of such new pedagogical approach has not been established. The present study was designed to examine systematically the effect of using TBL approach in pharmacy education in China.

Methods: Six databases were searched from the inception to January 2019. The studies reporting the performance of pharmacy students in Chinese university or college receiving TBL pedagogy compared to those receiving traditional lecture-based learning (LBL) were enrolled to be analyzed. Scores of the objective theoretical test were considered as the primary outcome, and the results from questionnaires about the number of students who approved the effects of TBL pedagogy on improving their learning enthusiasm, self-study ability, thinking ability, and communication skills were considered as the secondary outcome. A meta-analysis was conducted following the guidelines of the Cochrane Reviewer's Handbook and the Preferred Reporting Items for Systematic Reviews and Meta Analyses statement.

Results: A total of 1271 students in 12 studies published from 2013 to 2018 were enrolled in present analysis. Compared with traditional LBL pedagogy, TBL pedagogy exhibited more effectiveness in developing the objective tests scores of pharmacy students from both universities (SMD = 1.69, 95% CI [1.10, 2.28], p < 0.00001) and colleges (SMD = 4.37, 95% CI [1.33, 7.40], p < 0.00001), and such pedagogy applied well in experiments-oriented courses (SMD = 2.14, 95% CI [0.86, 3.43], p < 0.00001) and theory-oriented courses (SMD = 2.77, 95% CI [1.41, 4.14], p < 0.00001). In addition, it developed students' learning enthusiasm, students' self-study ability, thinking ability, and enhanced students' communication skills.

Conclusions: TBL pedagogy has developed rapidly and applied widely in Chinese pharmacy education during the last decade. The results indicated that such novel pedagogy is compatible with the present situation of Chinese pharmacy education. And it could be considered as an effective method to enhance both the theoretical test scores and various abilities of Chinese pharmacy students.

Keywords: Chinese pharmacy education; Lecture-based learning; Meta-analysis; Team-based learning.

Fig. 1

Flow chart of literature screening and the selection process

Fig. 2

Risk of bias assessment of included studies. Notes: Green + dot, low risk of bias; yellow? dot, unclear risk of bias; red - dot, high risk of bias

Fig. 3

Forest plot of theoretical scores for TBL compared with LBL. (a) Subgroup analysis of scores of students from colleges versus students from universities; (b) Subgroup analysis of scores of students experienced experiments-oriented courses versus theory-oriented courses. Squares symbolize SMD point estimate, and horizontal lines represent 95% CI. The diamond represents the overall summary estimate. (CI: confidence interval; SMD: standardized mean difference)

Fig. 4

Begg’s Funnel plots of theoretical scores with pseudo 95% confidence limits (Theoretical scores for TBL compared with LBL. Egger’s test, p = 0.049; Begg’s Test, p = 0.373)

Fig. 5

Forest plot of the students’ various qualities and abilities for TBL compared with LBL. (a) Effects on developing students’ learning enthusiasm; (b) Effects on developing students’ self-study ability; (c) Effects on developing students’ thinking ability; (d) Effects on enhancing students’ communication skills. The explanation for forest plot is stated in Fig. 3