Lost in Translation? A Scoping Review on the Reporting of Team-Based Learning Adaptations
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Jennifer Anne Cleland1,2, Anita Pienkowska1, Rachel Ellaway3
1Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Introduction:
Team-based learning (TBL) is a popular instructional method within medical education. Much research has compared the efficacy of TBL to other learning approaches. However, little is known about how and why TBL is contextualised and enacted in practice. To address this gap, we asked: How often, in what ways, and for what reasons has TBL been adapted in medical education?
Methods:
A scoping review was conducted following the PRISMA-ScR framework. Searches of seven databases were conducted in 2024 and 2026. Articles were included if they were English-language empirical studies examining the application of TBL within medical education. Data was extracted regarding whether TBL had followed Michaelsen's original sequence of (broadly) Pre-class Preparation, Readiness Assessment (individual and team) and Application Exercises, or had been adapted. If adapted, we examined which elements of TBL had been contextualized along with the rationale for these changes.
Results:
Across the 354 articles reviewed, more than half (n = 183) reported contextualized TBL. The number of articles reporting adaptations increased over time, across all contexts. Which elements of TBL had been adapted and in what ways varied widely but the most frequently changed or omitted component was the Application Exercise (49%), followed by Pre-class Preparation (34%, 62/183). Explicit rationales for adaptations were relatively rare (70/183 studies) but aligned with three broad categories: moving TBL online during the COVID-19 pandemic, saving time/workload, and educational efficacy.
Discussion:
TBL contextualization was commonplace. While this itself is not problematic, there was little explicit articulation of how and why medical educators have adapted TBL for their own contexts. More explicit and better reporting of the rationale for TBL contextualization should allow scholars to identify and explore context-specific factors such as institutional pressures, cultural influences, educator preferences etc. that shape how TBL is enacted and how this may alter its efficacy and utility.