Skip to main content

Team-Based Learning (TBL): Theory, Planning, Practice, and Implementation

  • Living reference work entry
  • First Online:
Clinical Education for the Health Professions

Abstract

Team-based learning (TBL) is an effective and resource-wise pedagogical tool with the potential to integrate into a broad range of health educational environments and align student learning outcomes with the knowledge and skills needed by graduates in the workforce. Designed to enhance the quality of student learning, TBL offers a unique approach to small group teaching, providing a resource-efficient strategy to transform small groups into teams. The TBL design provides an effective approach to teach a large number of students in an engaging manner that fosters active small and large group discussion, real-time decision-making, and provision of immediate feedback. Going beyond the simple transfer of knowledge content, TBL focuses on the application of knowledge through conceptual and authentic problem-solving activities. The TBL format offers a feedback-rich learning environment, with opportunities for students to develop critical competencies relevant to healthcare education: teamwork abilities and critical thinking skills.

The purpose of this chapter is to provide readers with an overview of TBL, including the theory and rationale for the use of TBL; the current trends and evidence for TBL in healthcare education; a comparison of TBL with other learning approaches; practical tips for design, implementation, and facilitation of TBL as an instructional strategy within medicine and health education; and emerging trends in the design and application of TBL.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Similar content being viewed by others

Abbreviations

IRAT:

Individual readiness assurance test

SMP:

Sydney Medical Program

TBL:

Team-based learning

TRAT:

Team readiness assurance test

References

  • Abu-Rish E, Kim S, Choe L, Varpio L, Malik E, White AA, et al. Current trends in interprofessional education of health sciences students: a literature review. J Interprof Care. 2012;26(6):444–51.

    Google Scholar 

  • Arnold L, Shue CK, Kalishman S, et al. Can there be a single system for peer assessment of professionalism among medical students? A multi-institutional study. Acad Med. 2007;82: 578–86.

    Google Scholar 

  • Badget RG, Stone J, Collins TC. The importance of free-text responses in team-based learning design. Acad Med. 2014;89:1578.

    Google Scholar 

  • Ballantyne R, Hughes K, Mylonas A. Developing procedures for implementing peer assessment in large classes using an action research process. Assess Eval High Educ. 2002;27:427–41.

    Google Scholar 

  • Barrows HS. Problem-based learning in medicine and beyond: a brief overview. In: Wilkerson L, Gijselaers WH, editors. New directions for teaching and learning. San Francisco: Jossey-Bass; 1996. p. 3–12.

    Google Scholar 

  • Barrows HS, Tamblyn RM. Problem-based learning. An approach to medical education. New York: Springer; 1980. Borges.

    Google Scholar 

  • Branch WT, Paranjape A. Feedback and reflection: teaching methods for clinical settings. Acad Med. 2002;77:1185–8.

    Google Scholar 

  • Buhse M, Della RC. Enhancing interprofessional education with team-based learning. Nurse Educ. 2017;42(5):240–4.

    Google Scholar 

  • Burgess A, Mellis C. Team-based learning in health care education: maintaining key design elements. J Nurs Care. 2015;S1:007.

    Google Scholar 

  • Burgess AW, Mellis CM. In reply to Badgett et al. Acad Med. 2014;89:1578–9.

    Google Scholar 

  • Burgess A, Mellis C. Feedback and assessment during clinical placements: achieving the right balance. Adv Med Educ Pract. 2015a;6:373–81.

    Google Scholar 

  • Burgess A, Mellis C. Receiving feedback from peers: medical students’ perceptions. Clin Teach. 2015b;12:203–7.

    Google Scholar 

  • Burgess A, Roberts C, Black K, Mellis C. Senior medical student perceived ability and experience in giving feedback in formative long case examinations. BMC Med Educ. 2013;13:79.

    Google Scholar 

  • Burgess A, McGregor D, Mellis C. Applying established guidelines to team-based learning programs in medical schools: a systematic review. Acad Med. 2014;89:678–88.

    Google Scholar 

  • Burgess A, Ayton T, Mellis C. Implementation of team-based learning in year 1 of a PBL based medical program: a pilot study. BMC Med Educ. 2016;16(1):1–7.

    Google Scholar 

  • Burgess A, Bleasel J, Haq I, Roberts C, Garsia R, Robertson T, Mellis C. Team-based learning (TBL) in the medical curriculum: better than PBL? BMC Med Educ. 2017;17:243.

    Google Scholar 

  • Burgess A, Ayton T, Mellis C. Implementation of team-based learning within a problem based learning medical curriculum: a focus group study. BMC Med Educ. 2018;18:74.

    Google Scholar 

  • Cassidy S. Developing employability skills: peer assessment in higher education. Educ Train. 2006;48(7):508–17.

    Google Scholar 

  • Chan LK, et al. Implementation of an interprofessional team-based learning program involving seven undergraduate health and social care programs from two universities, and students’ evaluation of their readiness for interprofessional learning. BMC Med Educ. 2017;17(1):221.

    Google Scholar 

  • Corbridge SJ, et al. Implementing team-based learning in a nurse practitioner curriculum. Nurse Educ. 2013;38(5):202–5.

    Google Scholar 

  • Coyne L, et al. Exploring virtual reality as a platform for distance team-based learning. Curr Pharm Teach Learn. 2018;10(10):1384–90.

    Google Scholar 

  • Crow J, Smith L. Using co-teaching as a means of facilitating interprofessional collaboration in health and social care. J Interprof Care. 2013;17(1):45–55.

    Google Scholar 

  • Cushing A, Abbott S, Lothian D, Hall A, Westwood OM. Peer feedback as an aid to learning – what do we want? Feedback. When do we want it? Now! Med Teach. 2011;33:e105–12.

    Google Scholar 

  • Davidson LK. A 3-year experience implementing blended TBL: active instructional methods can shift student attitudes to learning. Med Teach. 2011;33(9):750–3.

    Google Scholar 

  • Davis DA, Mazmanian PE, Fordis M, Van Harrison R, Thorpe KE, Perrier L. Accuracy of physician self-assessment compared with observed measures of competence: a systematic review. JAMA. 2016;296:1094–102.

    Google Scholar 

  • Dolmans D, Michaelsen L, Van Merrienboer J, Van der Vleuten C. Should we choose between problem-based learning and team-based learning? No, combine the best of both worlds! Med Teach. 2015;37:354–9.

    Google Scholar 

  • Dunlosky J, Rawson KA, Marsh EJ, Nathan MJ, Willingham DT. Improving students’ learning with effective learning techniques: promising directions from cognitive and educational psychology. Psychol Sci Public Interest. 2013;14(1):4–58.

    Google Scholar 

  • Espey M. Does space matter? Classroom design and team-based learning. Rev Agri Econ. 2008;30:764–75.

    Google Scholar 

  • Fatmi M, Hartling L, Hillier T, Campbell S, Oswald AE. The effectiveness of team-based learning on learning outcomes in health professions education: BEME Guide No. 30. Med Teach. 2013;35(12):e1608–24. https://doi.org/10.3109/0142159X.2013.849802.

    Article  Google Scholar 

  • Gagnon P, Mendoza R, Carlstedt-Duke J. A technology-enabled flipped classroom model. In: The flipped classroom. Singapore: Springer; 2017. p. 211–28.

    Google Scholar 

  • Graffan B. Active learning in medical education: strategies for beginning implementation. Med Teach. 2007;29:86–103.

    Google Scholar 

  • Haidet P, Levine RE, Parmelee DX, Crow S, Kennedy F, Kelly PA, Perkowski L, Michaelsen L, Richards BF. Perspective: guidelines for reporting team based learning activities in the medical and health sciences education literature. Acad Med. 2012;87:292–9.

    Google Scholar 

  • Handley K, Sturdy A, Fincham R, Clark T. Within and beyond communities of practice: making sense of learning through participation, identify and practice. J Manag Stud. 2006;43(3): 641–53.

    Google Scholar 

  • Hattie J, Timperley H. The power of feedback. Rev Educ Res. 2007;77:81–112.

    Google Scholar 

  • Hmelo-Silver CE. Problem-based learning: what and how do students learn? Educ Psychol Rev. 2004;16(3):235–66.

    Google Scholar 

  • Hrynchak P, Batty H. The educational theory basis of team-based learning. Med Teach. 2012;34(10):796–801.

    Google Scholar 

  • Huggett KN, Jeffries WB. An introduction to medical teaching. 2nd ed. Dordrecht: Springer; 2014. p. 69–71.

    Google Scholar 

  • Irby D, Wilkerson L. Educational innovation in academic medicine and environmental trends. J Gen Intern Med. 2003;18:370–6.

    Google Scholar 

  • Koles P, Nelson S, Stolfi A, Parmelee D, Destephen D. Active learning in a year 2 pathology curriculum. Med Educ. 2005;39:1045–55.

    Google Scholar 

  • Lake FR, Vickery AW, Ryan G. Teaching on the run tip 7: effective use of questions. MJA. 2005;182(3):126–7.

    Google Scholar 

  • Larsen DP, Butler AC, Roedigr HL. Repeated testing improves long-term retention relative to repeated study: a randomised controlled trial. Med Educ. 2009;43(12):1174–81. https://doi.org/10.1111/j.1365-2923.2009.03518.x.

    Article  Google Scholar 

  • Levine R, Hudes P. How-to guide for team-based learning. International Association of Medical Science Educators; 2014.

    Google Scholar 

  • Liebel G, Burden H, Heldal R, Viktoria, RISE – Research Institutes of Sweden, & IKT. For free: continuity and change by team teaching. Teach High Educ. 2017;22(1):62–77.

    Google Scholar 

  • Lochner L, et al. Applying interprofessional team-based learning in patient safety: a pilot evaluation study. BMC Med Educ. 2018;18(1):48.

    Google Scholar 

  • Lohman MC, Finkelstein M. Designing groups in problem-based learning to promote problem-solving skill and self-directedness. Instr Sci. 2000;28(4):291–307.

    Google Scholar 

  • Luetmer MT, et al. Simulating the multi-disciplinary care team approach: enhancing student understanding of anatomy through an ultrasound-anchored interprofessional session. Anat Sci Educ. 2018;11(1):94–9.

    Google Scholar 

  • Maeno T, et al. Interprofessional education in medical schools in Japan. PLoS One. 2019;14(1):e0210912.

    Google Scholar 

  • McGrath JE. Small group. Research. 1991;22(2):147–74.

    Google Scholar 

  • Meers-Scott D, Taylor L, Pelley J. Teaching critical thinking and team based concept mapping. [Educational]. In: Torres PL, Marriot RV, editors. Handbook of research on collaborative learning using concept mapping. Hershey: IGI Global; 2010. p. 171–86.

    Google Scholar 

  • Mezirow J. Transformative dimensions of adult learning. 1st ed. San Francisco: Jossey-Bass; 1991.

    Google Scholar 

  • Michaelsen L, Richards B. Drawing conclusions from the team-learning literature in health- sciences education: a commentary. Teach Learn Med. 2005;17:85–8.

    Google Scholar 

  • Michaelsen LK, Sweet M. The essential elements of team-based learning. New Dir Teach Learn. 2008a;116:7–27.

    Google Scholar 

  • Michaelsen LK, Sweet M. Excerpt from Chapter 2 of Michaelsen LK, Parmelee D, Levine R, McMahon K. Team-based learning for health professions education: a guide to using small groups for improving learning. Stylus Publishing, LLC: Sterling; 2008b.

    Google Scholar 

  • Michaelsen L, Parmelee D, McMahon KK, Levine RE, editors. Team-based learning for health professions education. Sterling: Stylus; 2007.

    Google Scholar 

  • Michaelsen LK, Davidson N, Major CH. Team-based learning practices and principles in comparison with cooperative learning and problem-based learning. J Excell Coll Teach. 2014;25(3–4):57–84.

    Google Scholar 

  • Muzyk AJ, et al. Implementation of a flipped classroom model to teach psychopharmacotherapy to third-year Doctor of Pharmacy (PharmD) students. Pharm Educ. 2015;15:44.

    Google Scholar 

  • Nieder GL, Parmelee DX, Stolfi A, Hudes PD. Team-based learning in a medical gross anatomy and embryology course. Clin Anat. 2005;18:56–63.

    Google Scholar 

  • Nordquist J, Sundberg K, Laing A. Aligning physical learning spaces with the curriculum: AMEE guide no. 107. Med Teach. 2016;38:755–68.

    Google Scholar 

  • O’Daniel M, Rosenstein A. Capter 33: professional communication and team collaboration. In: Highes RG, editor. Patient safety and quality: an evidence based handbook for nurses. Rockville: Agency for Healthcare Research and Quality; 2008.

    Google Scholar 

  • Oblinger D, Lippincott J. Learning spaces (c2006. 1 v). Boulder: Educause; 2006.

    Google Scholar 

  • Ofstad W, Pharm D, Brunner LJ. Team-based learning in pharmacy education. Am J Pharm Educ. 2013;77(4):70.

    Google Scholar 

  • Parmelee D, Michaelsen LK, Cook S, Hudes PD. Team-based learning: a practical guide: AMEE guide no. 65. Med Teach. 2012;34:e275–87.

    Google Scholar 

  • Persky AM. Qualitative analysis of animation versus reading for pre-class preparation in a “flipped” classroom. J Excel College Teach. 2015;26(1):5–28.

    Google Scholar 

  • Rajalingam P, Rotgans JI, Zary N, Ferenczi FA, Gagnon P, Low-Beer N. Implementation of team-based learning on a large scale: three factors to keep in mind∗. Med Teach. 2018;40(6):582–8. https://doi.org/10.1080/0142159X.2018.1451630.

    Article  Google Scholar 

  • Reimschisel T, Herring AL, Huang J, Minor TJ. A systematic review of the published literature on team-based learning in health professions education. Med Teach. 2017;39(12):1227–37. https://doi.org/10.1080/0142159X.2017.1340636.

    Article  Google Scholar 

  • River J, et al. A systematic review examining the effectiveness of blending technology with team-based learning. Nurse Educ Today. 2016;45:185–92.

    Google Scholar 

  • Roediger H, Putman AL, Sumeracki MA. Ten benefits of testing and their applications to educational practice. In: Psychology of learning and motivation, vol. 55. Oxford; 2011. p. 1–36.

    Google Scholar 

  • Searle NS, Haidet P, Kelly PA, Schneider VF, Seidel CL, Richards BF. Team learning in medical education: initial experiences at ten institutions. Acad Med. 2003;78(10 Suppl):S55–8.

    Google Scholar 

  • Seel NM. Assimilation theory of learning. In: Encyclopedia of the sciences of learning. New York: Springer; 2012. p. 324–6.

    Google Scholar 

  • Shepard LA. The role of assessment in a learning culture. Educ Res. 2000;29:4–14.

    Google Scholar 

  • Silbert B, Lake FR. Peer-assisted learning in teaching clinical examination to junior medical students. Med Teach. 2012;34:392–7.

    Google Scholar 

  • Singer IJ. What team teaching really is. Indianapolis: Indiana University Press; 1964. p. 13–22.

    Google Scholar 

  • Sweet M, Michaelsen LK. Team-based learning in the social sciences and humanities: group work that works to generate critical thinking and engagement. Sterling: Stylus; 2012.

    Google Scholar 

  • Taylor D, Miflin B. Problem-based learning: where are we now? Med Teach. 2008;30(8):742–63.

    Google Scholar 

  • Thistlethwaite JE, Davies D, Ekeocha S, Kidd JM, MacDougall C, Matthews P, Purkis J, Clay D. The effectiveness of case-based learning in health professional education. A BEME systematic review: BEME guide no. 23. Med Teach. 2012;34(6):e421–44. https://doi.org/10.3109/0142159X.2012.680939.

    Article  Google Scholar 

  • Thomas PA, Bowen CW. A controlled trial of team-based learning in an ambulatory medicine clerkship for medical students. Teach Learn Med. 2011;23:31–6.

    Google Scholar 

  • Thompson BM, Schneider VF, Haidet P, Levine RE, McMahon KK, Perkowski LC, Richards BF. Team-based learning at ten medical schools: two years later. Med Educ. 2007;41(3):250–7.

    Google Scholar 

  • Tuckman BW. Developmental sequence in small groups. Psychol Bull. 1965;63:384–99.

    Google Scholar 

  • Van Blankenstein FM, Dolmans DHJM, van der CPM V, Schmidt HG. Which cognitive processes support learning during small-group discussion? The role of providing explanations and listening to others. Instr Sci. 2011;39:189–204.

    Google Scholar 

  • Wiener H, Plass H, Marz R. Team-based learning in intensive course format for first-year medical students. Croat Med J. 2009;50:69–76.

    Google Scholar 

  • Wiggins G, McTighe JH. Understanding by design. Columbus: Merrill Prentice; 1998.

    Google Scholar 

  • Willett LR, Rosevear GC, Kim S. A trial of team-based versus small-group learning for second-year medical students: does the size of the small group make a difference? Teach Learn Med. 2011;23(1):28–30.

    Google Scholar 

  • World Health Organization. Framework for action on interprofessional education and collaborative practice. Geneva: Health Professional Network Nursing and Midwifery Office, Department of Human Resources for Health; 2010.

    Google Scholar 

  • Wright KJ, Frame TR, Hartzler ML. Student perceptions of a self-care course taught exclusively by team-based learning and utilizing twitter. Curr Pharm Teach Learn. 2014;6(6):842–8.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Annette Burgess .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Singapore Pte Ltd.

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Burgess, A., Matar, E. (2020). Team-Based Learning (TBL): Theory, Planning, Practice, and Implementation. In: Nestel, D., Reedy, G., McKenna, L., Gough, S. (eds) Clinical Education for the Health Professions. Springer, Singapore. https://doi.org/10.1007/978-981-13-6106-7_128-1

Download citation

  • DOI: https://doi.org/10.1007/978-981-13-6106-7_128-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-6106-7

  • Online ISBN: 978-981-13-6106-7

  • eBook Packages: Springer Reference EducationReference Module Humanities and Social SciencesReference Module Education

Publish with us

Policies and ethics