Implementation of team-based learning in a new postgraduate medical curriculum

Medical educators have long wrestled with a deceptively simple question: how do you teach the dense foundational science that underpins clinical medicine without burning out students and faculty alike? A new pilot study from Griffith University and the University of the Sunshine Coast in Australia suggests that a structured, team-based approach may be part of the answer. Published in BMC Medical Education, the research describes the implementation of team-based learning, or TBL, in a postgraduate medical program during a period of curriculum transition, offering one of the clearest practical accounts yet of what happens when a program built around problem-based learning pivots to a different pedagogical engine.

Team-based learning is not simply students sitting in groups. It is a highly structured instructional strategy in which learners first prepare individually, then test their knowledge alone, and finally repeat the same test within a small team, followed by instructor-led application exercises that push teams to debate, defend, and refine their reasoning. The method rests on a constructivist view of education, in which the focus of instruction shifts from the teacher to the student, and knowledge is actively built rather than passively received. Its appeal in medical education lies in a combination of efficiency and engagement: a single instructor can manage large numbers of students organized into small teams, while the repeated testing and immediate feedback loops are thought to strengthen retention and clinical reasoning.

The Australian program in question had traditionally delivered its pre-clinical foundational knowledge through problem-based learning, a method in which small groups of students work through open-ended clinical cases with a facilitator. PBL has a long pedigree and strong theoretical support, but it is resource-hungry. Each group requires a trained facilitator, session preparation is labor-intensive, and the open-ended format can leave students uncertain about whether they have covered the right material. When the program moved to a new postgraduate curriculum, the teaching team saw an opportunity: pilot TBL in place of PBL for one block of the program, reduce the time and resource demands, and capture evidence on whether students perceived any difference in their learning.

The study, led by Rebecca Donkin and Nicole Flemming, took a mixed methods approach. Forty-eight first-year pre-clinical medical students and two instructors participated. To generate a comparative quantitative measure, the researchers drew on a reference group of 25 students who completed only problem-based learning, and compared them with 23 students who experienced both PBL and team-based learning during the renal system block of the program. This design meant that the two cohorts could be compared on knowledge performance, while the students who actually experienced TBL could also be questioned in depth about their perceptions of the new format.

The quantitative headline is reassuring for curriculum designers: knowledge performance between the groups was comparable. Students taught through the new team-based format did not fall behind their peers on the old pathway, a finding that matters enormously when a program stakes its reputation on a teaching change. Comparable grade outcomes remove the most serious objection to a pedagogical switch, namely that students might pay for the experiment with their exam results. The researchers report that this equivalence gave the teaching team confidence to change the teaching framework from PBL to TBL for the pre-clinical curriculum across the Australian medical program.

But the more interesting story lies in the qualitative data. Student perceptions of TBL compared with PBL were mixed, containing both positive and negative views, and the researchers organized the feedback around themes of time for learning tasks, class dynamics, feedback on learning, and learning design. Students perceived that team-based learning provided opportunities to develop team skills such as communication, reasoning, and building rapport within a small group format united by a common goal. These are precisely the capabilities that clinical practice demands, where doctors must function within teams, articulate and defend clinical reasoning, and establish trust with colleagues and patients under time pressure. A classroom format that rehearses those behaviors while teaching renal physiology offers a double return on instructional time.

The instructor perspective added a practical dimension that is often missing from education research. Feedback on small group learning and the implementation of TBL was collected from the two instructors, whose general experience of the format informed the study’s conclusions. Instructors in team-based learning act less as content deliverers and more as facilitators of application exercises, and the pilot suggests that this role can be sustained with fewer resource demands than the facilitator-intensive PBL model. For programs facing faculty shortages or expanding cohorts, that efficiency is not a trivial side benefit; it can be the deciding factor in whether a curriculum reform is feasible at all.

The study is candid about its limits. With 48 students and two instructors, this is a pilot, not a definitive trial, and the comparison groups were not randomly assigned. The reference group completed only PBL, so the quantitative comparison captures cohort-level equivalence rather than a controlled measure of TBL’s effect on individual learning gains. Perceptions were collected during a curriculum transition, a period when any change can generate enthusiasm from novelty or resistance from disruption. The authors themselves frame the work as describing implementation and observed perceptions, providing confidence for a teaching framework change rather than proving TBL superior in every respect.

Even so, the findings land at a moment when medical schools worldwide are rethinking how to deliver foundational science to postgraduate students, many of whom arrive from diverse backgrounds and must absorb a vast body of pre-clinical knowledge in compressed timeframes. The constructivist logic behind both PBL and TBL is shared, but the delivery mechanics differ sharply. TBL’s individual readiness tests ensure that students arrive prepared, its team tests harness peer pressure and peer explanation to consolidate understanding, and its application exercises force teams to commit to answers and defend them, generating immediate, structured feedback. The pilot’s evidence that this machinery produces comparable knowledge outcomes while cultivating communication and rapport suggests that the format can carry the academic load of a pre-clinical curriculum.

What makes the study resonate beyond its immediate program is the demonstration that a curriculum transition can be piloted, measured, and adjusted with modest numbers and mixed methods, rather than imposed wholesale on the strength of theory alone. The Griffith and Sunshine Coast team showed that students perceived genuine team-skill benefits, that grades held steady, and that instructors could sustain the format, and on that basis the program committed to the change. For medical educators watching from other institutions, the message is that the switch from problem-based to team-based learning is not a leap of faith but a calculated, evidence-generating maneuver, one that this Australian pilot has now walked through end to end.

Subject of Research: Team-based learning proves its worth in new postgraduate medical curriculum

Article Title: Implementation of team-based learning in a new postgraduate medical curriculum

Article References: Donkin, R., & Flemming, N. (2026). Implementation of team-based learning in a new postgraduate medical curriculum. BMC Medical Education. https://doi.org/10.1186/s12909-026-10391-8

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10391-8

Keywords: Implementation, team-based, learning, postgraduate, medical, curriculum, scientific research