Implementing Digital-Supported Team-Based Learning for Large Undergraduate Cohort in a Resource-Limited Setting: A Pilot Study Developed through an International Academic Partnership

Background Rising student numbers and limited teaching resources, particularly in low- and middle-income countries (LMICs) such as Sri Lanka, make it difficult to deliver medical education that is interactive and student-centred. Traditional lectures alone do not sufficiently support the development of clinical reasoning, highlighting the need for active, application-focused teaching methods that align with technology-shaped learning expectations. Team-based learning (TBL) promotes collaboration and accountability, yet its implementation can be resource-intensive and is not well described in large cohorts within LMIC settings. This study focuses on a technology-supported TBL session delivered by a single lecturer and considers student perceptions as well as the influence of an international academic partnership. Method A faculty development programme conducted with the University of Illinois Chicago introduced staff to TBL principles. A pilot TBL intervention was subsequently implemented at the Faculty of Medicine, University of Peradeniya. An existing lecture for third-year medical students was converted into a TBL session. Liaising with established principles, 252 students were assigned to 20 balanced teams. Eight abnormal uterine bleeding case scenarios and preparatory materials were provided two weeks in advance. During the session, the students completed individual and group readiness assessments using Pear Deck, which supported real-time interaction. One lecturer facilitated the discussion of all eight cases within two hours. Student perceptions were collected through a Likert-scale questionnaire and free-text comments. Results Among 252 students, 209 participated (82.9%). Pear Deck supported full team engagement, and all planned case scenarios were completed within the allocated time. A total of 191 students completed the survey (91.38%). The median Likert-scale score was 4 or higher for engagement, teamwork, and use of the digital platform. Preparation-related items were scored lower. Free-text responses described the session as interactive, engaging, and helpful for maintaining attention and encouraging reflection. Discussion A technology-supported TBL session can be implemented successfully for a large student group in a resource-limited context. Students responded positively, despite varying levels of preparation, and the digital platform enabled effective teamwork. Limitations included large team sizes, fixed seating, and the inability to use certain standard TBL tools. Further refinement, faculty development, and curricular integration are considered.