Original Publication
Open Access

Biochemistry and Pathology of Bleeding: An Integrative Approach to Team-Based Learning

Published: May 14, 2015 | 10.15766/mep_2374-8265.10099

Included in this publication:

  • Instructor's Guide.docx
  • TBL Module.docx
  • TBL Facilitation Scheme.pptx

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Introduction: Team-based learning (TBL) is designed to be a highly interactive, small-group exercise that promotes the application of knowledge, higher-order thinking, peer-to-peer teaching, problem solving, communication, and professionalism. This TBL module provides students the opportunity to integrate and apply both biochemistry and pathology concepts of hemostasis and thrombosis. Through the course of this TBL module, students will develop an understanding of the coagulation cascade, clinical laboratory tests used to diagnose hemostasis and thrombosis, and the respective pathological conditions associated with hemostasis and thrombosis. Methods: The coagulation cascade and primary and secondary hemostatic mechanisms are difficult concepts and are often times not well understood by medical students. The goal of this TBL is to provide a framework for medical school students to understand a variety of different areas in bleeding and hypercoagulation (thrombosis) and to be able to discuss clinical presentations and laboratory diagnosis of these conditions. Results: This TBL module has been piloted for 2 years in the first-year medical school curriculum at the West Virginia School of Osteopathic Medicine. At this time, we have data on more than 400 students. The mean individual readiness assurance test (IRAT) score for the class of 2017 was 75% and the mean team readiness assurance test (TRAT) score was 96%, a difference of more than 20%. The mean IRAT score for the class of 2018 was 74.7% and the mean TRAT was 97.2%, a difference of 22%. In addition, the summative examination scores for this material were higher than other biochemistry and pathology subject areas. Discussion: We conclude that this TBL was a highly effective teaching tool for this subject area and this TBL did a really good job of integrating both basic and clinical science content.

Educational Objectives

By the end of this module, the learner will be able to:

  1. Diagram the primary and secondary hemostatic pathways.
  2. Explain the origin of platelets, including their anatomy and membrane receptor functions.
  3. Assess the etiology, pathogenesis, clinical manifestations, and laboratory testing results of quantitative and qualitative platelet disorders.
  4. Compare and contrast idiopathic thrombocytopenic purpura from thrombotic thrombocytopenic purpura in terms of clinical presentation and pathologic findings.
  5. Categorize the different types of von Willebrand disease in terms of etiology, pathogenesis, clinical manifestations, and laboratory testing.
  6. Identify common bleeding disorders including the pathophysiology, the genetic inheritance patterns, the clinical presentations, and laboratory testing.
  7. Identify and classify inherited and acquired clotting disorders in terms of mechanism of action, clinical manifestations, and testing.
  8. Describe Antiphospholipid Syndrome in terms of etiology, pathogenesis, clinical presentation and clinical manifestations.

Author Information

  • Brian Griffith, PhD: West Virginia School of Osteopathic Medicine
  • Patricia Canfield, MD: West Virginia School of Osteopathic Medicine

None to report.

None to report.


Griffith B, Canfield P. Biochemistry and pathology of bleeding: an integrative approach to team-based learning. MedEdPORTAL. 2015;11:10099. https://doi.org/10.15766/mep_2374-8265.10099