Pathology – Research and Practice 208 (2012) 300–305 Contents lists available at SciVerse ScienceDirect Pathology – Research and Practice journa l h omepage: www.elsevier.d e/prp Original article Revitalizing pathology laboratories in a gastrointestinal pathophysiology course using multimedia and team-based learning techniques Alexander R. Carbo a,b , Paola G. Blanco a,b , Fiona Graeme-Cooke c,b , Joseph Misdraji c,b , Steven Kappler a,b , Kitt Shaffer e , Jeffrey D. Goldsmith d,b , Tyler Berzin a,b , Daniel Leffler a,b , Robert Najarian d,b , Paul Sepe a,b , Jennifer Kaplan d,b , Martha Pitman c,b , Harvey Goldman d,b,1 , Stephen Pelletier b , Jane N. Hayward a , Helen M. Shields a,b,* a Department of Medicine, Beth Israel Deaconess Medical Center, United States b Harvard Medical School, United States c Department of Pathology, Massachusetts General Hospital, United States d Department of Pathology, Beth Israel Deaconess Medical Center, United States e Department of Radiology, Boston University School of Medicine, United States a r t i c l e i n f o Article history: Received 30 August 2011 Received in revised form 20 January 2012 Accepted 24 February 2012 Keywords: Modified team-based learning Multimedia presentations Interdisciplinary curriculum a b s t r a c t In 2008, we changed the gastrointestinal pathology laboratories in a gastrointestinal pathophysiology course to a more interactive format using modified team-based learning techniques and multimedia presentations. The results were remarkably positive and can be used as a model for pathology laboratory improvement in any organ system. Over a two-year period, engaging and interactive pathology laboratories were designed. The initial restructuring of the laboratories included new case material, Digital Atlas of Video Education Project videos, animations and overlays. Subsequent changes included USMLE board-style quizzes at the begin- ning of each laboratory, with individual readiness assessment testing and group readiness assessment testing, incorporation of a clinician as a co-teacher and role playing for the student groups. Student responses for pathology laboratory contribution to learning improved significantly compared to baseline. Increased voluntary attendance at pathology laboratories was observed. Spontaneous student comments noted the positive impact of the laboratories on their learning. Pathology laboratory innovations, including modified team-based learning techniques with individ- ual and group self-assessment quizzes, multimedia presentations, and paired teaching by a pathologist and clinical gastroenterologist led to improvement in student perceptions of pathology laboratory con- tributions to their learning and better pathology faculty evaluations. These changes can be universally applied to other pathology laboratories to improve student satisfaction. © 2012 Elsevier GmbH. All rights reserved. Introduction Pathology is viewed as a core subject that is the major link between basic science and clinical medicine [1,4]. The methods for teaching pathology in medical school have been the source of recent discussion in the literature [1,3,4,7,8]. Many schools have inte- grated pathology into the organ systems courses so that pathology Abbreviations: DAVE, Digital Atlas of Video Education Project; IRAT, individ- ual readiness assessment testing; GRAT, group readiness assessment testing; ERCP, endoscopic retrograde cholangiopancreatography. * Corresponding author at: Beth Israel Deaconess Medical Center, Division of Gas- troenterology, 330 Brookline Avenue, Boston, MA 02215, United States. Tel.: +1 617 667 2109; fax: +1 617 667 5826. E-mail address: hshields@bidmc.harvard.edu (H.M. Shields). 1 Deceased. is no longer a free-standing course [1,4,8]. Ways to teach pathol- ogy in an integrated course range from lectures to labs and small group discussions [1,4,8]. Digitized slides have replaced using the microscope [8]. In integrated pathology courses, the great majority of courses appear to have pathologists in total control of the course structure and curriculum [8]. In 2008, we changed the gastrointestinal pathology laboratories in a gastrointestinal pathophysiology course to a more interactive format using modified team-based learning techniques and multi- media presentations. This was in response to a widening gap that had been noted between the pathology laboratory evaluation score for the statement “Please rate the labs in terms of their contribution to your learning” and the evaluation score for the same question for the tutorial sessions [6]. The students’ perception of less value for the learning experienced in the pathology laboratories compared with the tutorials translated into an overall impression that the 0344-0338/$ – see front matter © 2012 Elsevier GmbH. All rights reserved. doi:10.1016/j.prp.2012.02.010