From Resistance to Engagement: Factors That Influence Student Outcomes in Team-Based Learning

Background : Traditional didactic methods in health sciences education are increasingly being replaced with active learning strategies such as Team-Based Learning (TBL), which fosters engagement through collaboration, knowledge application, and peer interaction. This study provides practical insights for educators aiming to integrate TBL into biomedical basic science courses, focusing on student feedback and perceptions about TBL format in one graduate-level histology course. Methods : Study participants included students from two separate offerings of the same graduate histology course (Cohort A: n = 28; Cohort B: n = 27). All students enrolled were invited to participate in the study by completing a questionnaire and/or participating in a focus group. Eleven students completed the questionnaire (5 from Cohort A; 6 from Cohort B), and 18 participated in the focus groups (7 from Cohort A; 11 from Cohort B). Qualitative data were analyzed using an abductive approach, incorporating frame and taxonomic analyses. Results: Four key themes emerged as conditions influencing students’ engagement with TBL: (1) preparation and self-regulated learning, (2) understanding and valuing teamwork, (3) student motivation, and (4) attitudes toward active learning. Conclusion: Grounded in constructivist learning theory, TBL can offer a transformative educational experience by promoting self-regulation, collaboration, and deeper engagement. However, its success depends on factors such as student readiness, team cohesion, and prior exposure to active learning, which underscores the need for deliberate instructional design, explicit student orientation, and consistent faculty facilitation to ensure effective implementation.