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Improving Clinical
Competencies of Medical
Assistant Students through
Team Teaching
Presentation by:
Elengovan Varutharaju
KPP 6043 Pengurusan Pengajaran
Prof. Dr. Othman Lebar
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Introduction
Team teaching is defined as: All arrangements that
include two or more faculty in some level of
collaboration in the planning and delivery of a course
or subject
Davis (1995)
Team teaching induces collaborative learning that reforms
classroom learning by changing students from passive
recipients of information given by an expert teacher to
active agents in the construction of knowledge and skills. It
builds confidence, teacher-student interaction, and
performance improvement .
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Background of Study
In Medical Assistant Education, trainees were expected to
demonstrate clinical competency skills and abilities that
they have mastered not only the composite skills but also
the ability to demonstrate thinking and reasoning skills in
bridging their learning into practice in real-life context.
Medical Assistants are semi professionals envision to
complement and supplement medical practitioners in the
delivery of health care services through the promotion of
health, prevention and managing diseases, and
rehabilitative services; functioning at the primary,
secondary and tertiary level of care.
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Statement of Problem
The current teaching methodology that utilized lecture
demonstration by a single lecturer, could not engage all
students in large groups (a ratio of 1 lecturer to 124
students)

A lack in opportunity for supervised hands-on practice
and not able to engage all students in total can lead to
poor confidence and poor performance.
A preliminary study conducted on the clinical
performance of Year 1 Semester 2 students revealed
poor performance with regards to confidence, thinking
and reasoning skills during the Objective Structured
Clinical Examination (OSCE).

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Statement of Purpose
The purpose of this study was to
examine whether team teaching
improves students performance in
clinical competencies.
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1. Improve students confidence, dexterity,
thinking and reasoning skills in clinical
competencies through team teaching.

2. Enhance students communication and
sosial skills through team teaching and
learning.

3. Encourage greater interaction between
teacher and students through
collaborative approach in teaching
Objective of Study
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Study Methodology
Research Design : Action Research
Participants : 124 student of Year 1 Sem. 2
and 5 teaching staffs.
Method of Data
Collection:
Pre-test and Post Test
Questionnaire to students
Interview with teaching staffs
Method of
Analysis :
Descriptive statistics
Coding and Categorical
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Procedure of Implementation
1. Identification of Problem
Poor performance on clinical competency with
regards to confidence, thinking and reasoning
skills during OSCE
2. Data Collection
2 hours Lecture Demo session on Auscultation
of the Lungs.
2 hours supervised practice in skill lab;followed
by self directed learning x 1 week.
A pre-test using OSCE instrument was conducted.
Assessment focused on composite skills, thinking
and reasoning skills.
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3. Analysis of Data

Skills Mean SD
Composite Skills 8.92 0.95
Thinking and
Reasoning Skills
6.54 2.24
Overall score 7.65 1.30
Table 1. Students performance on pre-test
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Fig.1. Comparision of distribution of grades between composite skills,
reasoning skills and overall score.
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3
31
10
14 14
60
9
29
15
5
3
1 1 1
0
20
40
60
80
100
120
140
A A- B+ B+ B- C+ C+ C- D+ D+ E
Composite skills
Reasonong Skills
Overall Score
115
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Research Question
Do Medical Assistant Students report
improvements in confidence, dexterity,
thinking and reasoning skills, and
social skills through team teaching?
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4. Development of Plan of Action
Team teaching was devised and formulated
with 5 teaching staffs
Aim was to provide:
better teacher-student interaction
adequate opportunity for hands-on
supervised practiced.
improve communicational & social skills


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5. Implementation of Plan of Action
Team teachers briefed about concept of team
teaching and content of Auscultation of the
Lungs one week prior to team teaching session.
All 124 student were divided into 5 smaller group
of 25.
Team teaching conducted by 5 teaching staffs
for two (2) hours.
Students were given 24 hours to practice on
SDL mode.

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6. Collecting Data to Measure Improvement
Post-test using the same OSCE instrument was
carried out 24 hours later on 124 students.
Questionnaires were released to the students
and collected back on the same day. The
questionnaire focused on (i) Confidence building,
(ii) Dexterity, (iii) Thinking and Reasoning skills,
(iv) Student-teacher interaction, and (v) Learning
climate and culture. All 124 questionnaires were
returned.
A semi structured interview was done on 5
lecturers expectations, opinion and limitations of
team teaching.
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7. Analysis of Data
Skills
N=124
Pre-Test
N=124
Post-Test
t
Mean SD Mean SD
Composite Skills 8.92 0.95 9.65 0.80 6.51
Thinking and Reasoning
Skills
6.54 2.24 8.74 1.56 9.16
Overall score 7.65 1.30 9.20 0.95 10.68
Table 3. Students performance of pre-test and post-test
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Scores Composite skills Thinking and reasoning
skils
Total score
Pre Test Post test Pre Test Post test Pre Test Post test
A 92.74%
(115)
94.35%
(117)
41.94%
(52)
77.42%
(96)
48.39%
(60)
88.71%
(110)
A- 0.81% (1) 0.81% (1) - 7.26% (9) 6.45% (8)
B+ 1.61% (2) 4.84% (6) 2.42% (3) 1.61% (2) 23.39% (29) 4.03% (5)
B 1.61% (2) - 12.10% (15) 0.81% (1)
B- 2.42% (3) 25.0% (31) 19.35% (24) 4.03% (5)
C+ 0.81% (1) - 2.42% (3)
C 10.06% (10) 1.61% (2) 0.81% (1)
C- - 0.81% (1)
D+ 11.29% (14) 0.81%
D
E 11.29% (14)
Table 2: A comparison on distribution of score between pre test and post test
OSCE on Auscultation of the Lungs
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Items (About Team Teaching)
Strong
Agree
Agree Disagree
Strongly
Disagree
Improve skills of clinical competency 69.35% 29.03% 1.62%
Superior to lecture-demo 59.68% 37.10%
Improves confidence 54.84% 45.16%
Enhances student- teacher interaction and
relationship
51.61% 48.39%
Provide opportunities for supervised
hands-on practice.
74.19% 25.81%
Enhances deep understanding in small
group teaching
69.35% 25.81% 3.22% 1.62%
Encourges thinking and reasoning skills
through discussion
43.55% 48.39% 8.06%
Create a condusive teaching and learning
climate
56.45% 43.55%
Provides effective sharing of informations 58.06% 38.71% 1.62%
Provide free flow of feedback and opinin 58.06% 38.71% 3.22% 1.62%
Fosters team work and spirit of
togetherness
53.23% 41.93% 4.84%
Creates a collaborative learning culture 54.84% 41.93% 3.22%
Fosters practice and respect among
teachers and students
58.06% 38.71% 3.22%
Builds motivation and student support
system
54.84% 45.16%
Table 4. Percentages of students response concerning team teaching
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8. Evaluation of Data
Performance of students in Pre-test and post-test
The mean scores of students performance after
team teaching where higher than of lecture
demo in both the composite skills (t=6.51,
p<0.01) and reasoning skills (t=9.16,p<0.01)
hence having a positive impact on overall
students performance ( t=10.68, p<0.01)
Perception of students towards team teaching
Students provided a positive response
concerning team teaching approach that had
improved their confidence, enhance dexterity,
improving thinking and reasoning skills, building
on student-teacher interaction and the creation of a
conducive and collaborative learning culture.
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Teaching staffs opinion of team teaching.
All five lecturers provided a positive feedback regarding
team teaching. On the opinion about team teaching, one
lecturer quoted:
Basically I feel that team teaching is much more ... the impact is
much more greater than normal teaching. Since we are teaching
in small group, the students concentration is there,the quality is
there and we really teach, students interaction with the teacher
is much more appealing compared to a large group.

In exploring elements of deep understanding, reasoning
skills and collaboration in team teaching, the lecturer
explained:
Yes, they do ask a lot of questions as the ratio of students to
teachers is relatively small as compared to lecture demo .... the
impact is there. If a large group it is difficult, because there are
some students who quite shy to ask but in small group it is much
more easier in team teaching there is active participation and the
impact is much more great.
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Teaching staffs opinion of limitations in team
teaching.
The lecturer felt that team teaching involves
disruption of normal ways of teaching, putting
aside own teaching schedule, sharing of power
and personal space. In terms of infringement of
personal space and power sharing, the lecture
responded:
Definitely! Individual teachers teaching and a group of
teachers in team teaching method is definitely different
because as you have said a single teacher who does a lecture
demo, he controls the whole thing and what ever he is going
to imply is all based on his knowledge. Whereas compared to
the ones in team teaching, we share the knowledge and the
knowledge is given and we share and tranfer it to the
students.
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Conclusion
Team teaching as a pedagogical approach in
paramedical education have provided evidence
of enhancing clinical competencies of students.
Team teaching also provides an insight into
practice of teaching and provide our students
with better opportunity to learn and grow.
Team teaching also possess its limitation in
terms of educators expectation of power and
space sharing as well as requirement of skills
that will facilitate working collaboratively.
The success of Team teaching depends on
lecturers choice and scheduling accommodation
and its advantage far overweighs the limitations
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Limitations of Study
Focusing on a single procedure limits
direct generalizability to larger population
The improved performance of students in
the post-test may be partially
contributed by the repeated reinforcement
of theoretical and practical content during
team teaching.
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Significance of Study
Lies in the potential to inform instructional
designers, curriculum leaders and teachers the
potential of team teaching in improving students
performance in clinical competency
Further investigations into the value of team
teaching, will provide a major source of influence
to adapt and adopt team teaching as an option
for pedagogical approach as future teaching and
learning practice
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References
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