A Trial of Team-Based Versus Small-Group Learning for Second-Year Medical Students: Does the Size of the Small Group Make a Difference?

BACKGROUND: Team-based learning is a large-group instructional modality intended to provide active learning with modest faculty resources. PURPOSE: The goal is to determine if team-based learning could be substituted for small-group learning in case sessions without compromising test performance or satisfaction. METHODS: One hundred and sixty-seven students were assigned to team-based or small-group learning for 6 case discussion sessions. Examination scores and student satisfaction were compared. RESULTS: Instruction modality had no meaningful effect on examination score, 81.7% team based versus 79.7% small-group, p=.56 after multivariate adjustment. Student satisfaction was lower with team-based learning, 2.45 versus 3.74 on a 5-point scale, p<.001. Survey responses suggested that the very small size (8-10 students) of our small groups influenced the preference for small-group learning. CONCLUSIONS: Team-based learning does not adversely affect examination performance. However, student satisfaction may be inferior, especially if compared to instruction in very small groups of 10 or fewer students.