Background Foundational knowledge of anesthesia techniques is essential for medical students. Team-based learning (TBL) improves engagement. Web-based virtual environments (WBVEs) allow many learners to join the same session in real time while being guided by an instructor. Objective This study aimed to compare a WBVE with face-to-face (F2F) delivery of the same TBL curriculum in terms of postclass knowledge and learner satisfaction. Methods We conducted a randomized, controlled, assessor-blinded trial at a Thai medical school from August 2024 to January 2025. Eligible participants were fifth-year medical students from the Faculty of Medicine, Khon Kaen University, who attended the anesthesiology course at the department of anesthesiology. Students who had previously completed the anesthesiology course or were unable to comply with the study protocol were excluded. They were allocated to one of the groups using a computer-generated sequence, with concealment of allocation to WBVE (on the Spatial platform) or F2F sessions. Both groups received identical 10-section content in a standardized TBL sequence lasting 130 minutes. Only the delivery mode differed (Spatial WBVE vs classroom F2F). The primary outcome was the postclass multiple-choice questionnaire score. The secondary outcome was learner satisfaction. Individual knowledge was assessed before and after the session using a 15-item questionnaire containing multiple-choice questions via Google Forms. Satisfaction was measured immediately after class on a 5-point Likert scale. Outcome scoring and data analysis were blinded to group assignment. Participants and instructors were not blinded. Results In total, 79 students were randomized in this study (F2F: n=38, 48%; WBVE: n=41, 52%). We excluded 2% (1/41) of the students in the WBVE group due to incomplete data. There were complete data for the analysis for 78 participants (F2F: n=38, 49%; WBVE: n=40, 51%). Preclass scores were similar between groups (F2F: mean 6.03, SD 2.05; WBVE: mean 6.20, SD 2.04). Postclass knowledge did not differ significantly (F2F: mean 11.24, SD 1.93; WBVE: mean 10.40, SD 2.62; mean difference 0.88, 95% CI –0.18 to 1.94; P=.12). Learner satisfaction favored F2F learning across multiple domains, including overall course satisfaction. Overall satisfaction favored F2F learning (mean difference 0.42, 95% CI 0.07-0.77; P=.01). Both groups ran as planned. No adverse events were reported. No technical failures occurred in the WBVE group. Conclusions In this trial, WBVE-delivered TBL produced similar short-term knowledge gains to F2F delivery, but learner satisfaction was lower in the WBVE group. Unlike many previous studies, this trial compared WBVE and F2F delivery while keeping the TBL curriculum and prespecified outcomes identical across groups. These findings support WBVEs as a scalable option when physical space, learner volume, or constraints are present. However, lower satisfaction in the WBVE highlights the real-world need for improved facilitation, user experience design, and technical readiness before broader implementation. Trial Registration Thai Clinical Trials Registry TCTR20240708012; https://www.thaiclinicaltrials.org/show/TCTR20240708012
Sripadungkul et al. (Thu,) studied this question.