Do Team Size and Team Cohesiveness Matter in Interprofessional Team-Based Learning? A Peer Assessment Study Involving Health and Social Care Students in Hong Kong

Abstract

Background and Aims Team-based learning (TBL) has been used as the pedagogy for implementing interprofessional education. Students from different professional disciplines were mixed into small interprofessional teams of five to seven students, which then go through the TBL process: individual readiness assurance test, team readiness assurance test, appeal, feedback, and application exercise. At the end, students in each team assess one another in each of the four interprofessional collaboration practice competencies (ICPC: values/ethics, roles/responsibilities, communication, team and team work). This study aims to (1) find out which disciplines, if there are any, are evaluated more favourably than others, and if the favourable assessment is consistent across the four ICPC; (2) to delineate the effects of team size and cohesiveness on team achievement, as indicated by the team scores in team readiness assurance test and application exercise. Specifically, we want to find out if cohesive teams will perform significantly better than the non-cohesive teams. Methods The study involved 276 Chinese students from five disciplines: Chinese medicine (n=15), medicine (n=94), nursing (n=104), pharmacy (n=31), and social work (n=32). In the peer assessment, each student distributed 10 points among the team members according to their performance, for each of the four ICPC. We used variance of peer assessment scores as an indicator of team cohesiveness. Analysis of variance and hierarchical regression were used. Results Nursing and pharmacy students obtained higher peer assessment scores than Chinese medicine, medicine, and social work students across the four ICPC. Higher team scores were associated team cohesiveness and larger team size (6-7 members). Hierarchical regression results suggest that team size significantly explained 3.1% to 7.2% of the variance of team readiness assurance test scores and application exercise scores. Team cohesiveness explained a unique additional variance in the two team performance measures, ranging from 1.8% to 12.1%. Conclusion Larger team size and team cohesion predict TBL team achievement in IPE. These imply the need for educational institutions implementing interprofessional team-based learning to aim for a bigger team size (preferably 6 or 7) and to nurture team cohesion, as they translate into team achievement. It is therefore important to find ways to trigger team cohesiveness and to reduce social loafing so that all the disciplines will be perceived to be key players in IPTBL.