This Phase is called the Base Test in the Medicine programme at KI. You will find that it can also be called "Readiness Assurance Test" elsewhere. It normally only consists of the Test activities as described below. Note that in the Medicine programme KI the Base Test is not an exam nor part of an exam, but a powerful and central learning activity, making use of the pedagogic principles of the testing effect, hypercorrrection, calibration and peer learning. Typically, iRAT and tRAT are obligatory activities, that must be completed within the scheduled time. Conceptually the Base Test is related to mentometer sessions and quizzes that are used as learning tools in courses, and to discussion questions made for seminars or group discussions, and self-study questions that students work on on their own in the flipped-class room format.

For Phase 2 - Base Test, a set of Single Best Answer (SBA) questions is developed. SBA:s are popular in medical education where there is a major focus on developing clinical and scientific reasoning skills - finding by reasoning the Best alternative from several alternatives that are all somewhat plausible but one is Best. Also, a key factor in this kind of learning is also understanding Why something is best. Compare this to the traditional Multiple Choice Questions where often one alternative is Correct and the others Not Correct. In the process of working with this kind of questions it is imperative also to discuss why certain alternatives are Not the Best Alternative.

The questions also function as a kind of study guide; they should cover the TBL Module outcomes proportionally and point the students towards the most central, most important concepts in the Module. The questions can be designed to help students overcome common misconceptions too. A typical set is 20-30questions for a TBL Module, scheduling about 90 seconds per SBA item. The bulk of the questions should be the same level of the exam, but some of the sufficiently challenging so that they would be difficult for an individual student but suitable and solvable as a challenge for Team discussions. Make sure that the students or the Teams cannot find the Best answer with a simple web search.

At KI, we use a system called InteDashboard linked with the Canvas pages as a platform for this part, including the follow-ups.

The Base Test has three Parts in the Medicine Programme at KI:

iRAT / Base Test individually: the student tries to answer the Base Test questions individually, in a scheduled time slot on the course. The student answers the questions in the InteDashboard system. No result-% or Facit is given. It is not important that the students get all the questions right at this point. This can be done digitally, or in a room such as a lecture hall.
tRAT / Base Test in Teams: Immediately after the individual Base Test, the students tackle exactly the same Base Test questions together in a team and try to reason and agree which is the best alternative for each question. The Team then checks their answers one by one using a physical Scratch Card that has the facit (you saw them in the short movie from University of Texas) or at KI, using the InteDashboard system, but now in the team mode. The concept is Immediate Response - the team gets immediate response on their reasoning.
iRAT / tRAT Follow-up: This is done after the Base test in Teams. At KI, we can use the rich student data from InteDashboard, to show which of the iRAT items were difficult. It is important to spend time on items and alternatives that the students had most difficulties on. Students may also give feedback (challenges) on improving the questions or answer alternatives. Using InteDashboard, the teacher actually gets facit to see which questions the students most struggled with, and which questions were obviously too easy. Note that the teacher should not share the results of any individual students. This should be done strictly anonymously. The follow-ups are typically the most difficult parts but also the most critical parts of the TBL module. It is important to focus on important, central questions that adequatly challenges the students. Do not bore the students in follow-ups.

Example of an actual SBA question used in the medicine programme (try to reason!). You don't have to submit the answers.

What is typical of recessive genetic traits?

a) Recessive traits are gradually becoming more rare as dominant alleles become more common

b) If two recessive alleles are combined (as in a homozygote), neither one will be visible in the phenotype

c) Recessive alleles are slowly being eliminated through evolution

d) Recessive alleles are typically unusual genetic diseases

e) Recessive alleles are not visible in the phenotype when in combination with corresponding dominant alleles

Note if you want to see how this this works in practice, contact teachers in charge of TBL modules (duarte.ferreira@ki.se or matti.nikkola@ki.se) and ask if you can observe this learning activity on actual course. We highly recommend that you do this before trying to run a TBL module on your own.