Bringing Team Charters to PBL: Can Charters Impact Team Experience?

Objective/Purpose: To assess the impact of team charters on medical students’ team dynamics and experiences. Need for Innovation: Many medical schools have added curricula to address the need for robust teamwork skills among healthcare professionals. Research on business students suggests that team charters—written documents that teams create to establish mutual expectations—can have a positive impact on team performance and member satisfaction. However, we are not aware of research examining the use of team charters for medical students. We sought to determine how the use of team charters impacted medical students’ team performance and overall satisfaction with problem-based learning (PBL) in the pre-clerkship environment. Methods: We performed a randomized controlled trial including PBL groups from the first year curriculum. Twelve PBL groups received the team charter intervention while the other 12 groups served as controls. In the intervention group, PBL facilitators viewed a learning module introducing them to the team charter concept. In the first PBL group meeting, PBL facilitators and students completed a team charter using a standardized template. The team charter contained 7 sections for teams to review together: team purpose, mutual expectations, potential problems, roles and role distribution, attendance, peer feedback, and reflection on team goals. The control group PBL facilitators did not learn about charters nor did these groups complete a team charter. Educational Outcomes: At the conclusion of the six-week, seven-session PBL module, students in the intervention and control groups completed paper surveys to assess attitudes and behaviors about their team experience. Both groups completed 18 core questions pertaining to group behaviors; the intervention groups’ survey included 6 additional questions that were specific to their experience with the team charter. Survey completion was optional and written consent was obtained from students to analyze their responses. Of the 82 students in the intervention group, students agreed or strongly agreed that the charter was beneficial to the team dynamic (n=54; 68%), that discussing potential problems up front made it easier to avoid them (n=63; 81%), and that agreeing ahead of time on a feedback mechanism made it easier to provide feedback (n=51; 64%). Future analyses will determine if teamwork behaviors or satisfaction differed between the intervention and control groups. Conclusion: This is a feasible and well-accepted innovation. It requires minimal additional curricular time while providing students an opportunity to enhance experiential learning of teamwork behaviors. It is unclear if a one-time use of a team charter will meaningfully impact student teamwork behaviors, so we hope to continue to include the charters in future PBL groups and reassess the response to the exercise.