Long-term Outcomes of team-based learning

Team-based learning (TBL) is associated with improved end-of-course exam performance, but the impact on long-term retention is unknown. We compared the impact of three teaching methods: traditional case-based small group discussion (TSG), TBL or no small group reinforcement on short-term understanding and long-term retention after a haematology course.

Knowledge assessments were conducted prior to, immediately after and 14 months after course completion. Several topics covered by TSG were switched to TBL and could be directly compared.

We recruited 24% of eligible students (n = 70). Of these, 48 completed the final assessment (69% retention). Pre-course, participants scored 31% correctly, which increased to 78% post-course with significant differences: TBL 87%; TSG 78%; no small group 76% (p < 0.01 for both comparisons). At long-term follow-up, the effect of the teaching method was no longer significant: TBL 75%; TSG 67% (p = 0.14); no small group 70% (p = 0.36). When restricted to topics converted from TSG to TBL, the long-term benefit was not shown: TSG 59%; TBL 54% (p = 0.47).

We confirm increased understanding gained by using TBL, but this did not lead to better long-term retention. Improved scores on short-term testing has value for student well-being and competitiveness for residency application. TBL may still be of long-term benefit through modelling team decision making and self-directed learning that are core features of how clinical medicine is practiced. However, our findings argue against justifying the adoption of TBL on the basis of superior long-term retention.