Embedding team-based learning in graduate anatomy: The impact on student performance

Team-based learning (TBL) is widely used in health professions education; however, its role within integrated curriculum redesigns serving increasingly heterogeneous student populations remains less well understood. Grounded in a conceptual framework emphasizing preparation, individual accountability, collaborative knowledge construction, immediate feedback, and application, this study evaluated TBL within a redesigned graduate-level gross anatomy course. Four cohorts (2022-2025) were analyzed: Two completed the original lecture-based curriculum and two completed a redesigned curriculum incorporating TBL, required human donor dissection laboratories, formative assessments, and team-based examinations. A standardized Individual Performance Score (IPS) enabled comparison across cohorts. Grade distributions, item-level psychometric indices, early assessment predictive value, and student perceptions were also evaluated. Overall IPS differences were not significant (H = 6.50, p = 0.089); however, the redesigned curriculum was associated with a higher proportion of A grades (+11.7%, p = 0.012) and differences in performance distribution (U = 16,143.5, p = 0.043). TBL-aligned items demonstrated stronger discrimination and point-biserial correlations, while early practical performance strongly predicted overall outcomes. Student perceptions were favorable, with 90.8% endorsing TBL activities and 94.1% reporting that team-based examinations supported understanding. Embedding TBL within an integrated graduate anatomy curriculum may support high achievement, assessment quality, and collaborative learning. However, the historical cohort design, concurrent admissions changes, and multifaceted curricular redesign limit causal attribution to TBL alone. These findings support positioning TBL as one component of a broader curricular framework rather than an isolated intervention.