Original Publication
Open Access

Hemolytic Anemias vs. Anemias Due to Nutritional Deficiencies: A TBL Module

Published: December 10, 2015 | 10.15766/mep_2374-8265.10304

Included in this publication:

  • Hemolytic Anemias vs. Nutritional Deficiency Anemias TBL Guide.docx
  • Instructor's Guide.docx

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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: This biochemistry team-based learning (TBL) module has been used successfully for 2 years at the Lincoln Memorial University-DeBusk College of Osteopathic Medicine in our Molecular Fundamentals of Medicine (MFM) course to teach first-year medical students the basic biochemistry of anemia and the factors used to distinguish between hemolytic and nutritional deficiency–induced anemias in a clinical setting. There are many anemia TBL modules in the literature that focus on a single cause of anemia. We thought that an important competency of diagnosis is differentiation, as the differentiation of the types of anemia is very important and relies on the knowledge of biochemistry and clinical symptoms. It is this practice of differentiation that sets this TBL apart from other 15 MedEdPORTAL publications on anemias. Methods: Students are given pre-assigned readings 2 weeks prior to the session. On the day of the session students first take an individual readiness assurance test (IRAT), before taking the team readiness assurance test (TRAT), which is the same test taken in small  groups. Students then stay in the groups to work through a series of group application exercises. The entire TBL session takes approximately 95 minutes. Results: The class average has been approximately 74% for the IRAT and 100% for the TRAT. There has never been an appeal of any RAT question. This TBL was well received by the students, and several commented on the importance of the topic. Discussion: We have used this module for 2 years in the MFM course. As stated previously, the TBL module is unique as it compares two classes of anemias. It is also unique because it teaches this important topic specifically to first-year medical students. The terminologies of clinical symptoms and presentations of the cases are suitable for first-year/first-semester medical students.

Educational Objectives

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

  1. Identify erythrocyte membranopathies and the erythrocyte membrane changes that may cause hemolytic anemia.
  2. Describe hemoglobinopathies, and how unstable hemoglobin results in hemolytic anemia.
  3. Identify the problems and/or enzyme deficiencies in erythrocyte metabolism that are associated with hemolytic anemia.
  4. Classify the major types of acquired hemolytic anemia.
  5. Identify the causes of megaloblastic anemia.
  6. Describe the characteristics of iron deficiency anemia.
  7. Distinguish signs and symptoms of hemolytic anemias from those of nutritional deficiency anemias.
  8. Demonstrate proficiency in understanding diagnostic tests for hemolytic and nutritional deficiency anemias.

Author Information

  • Zeynep Gromley, PhD: Lincoln Memorial University-DeBusk College of Osteopathic Medicine
  • Adam Gromley, PhD: Lincoln Memorial University-DeBusk College of Osteopathic Medicine

None to report.

None to report.


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Gromley Z, Gromley A. Hemolytic anemias vs. anemias due to nutritional deficiencies: a TBL module. MedEdPORTAL. 2015;11:10304. https://doi.org/10.15766/mep_2374-8265.10304