Rethinking active learning in medical education: a comparative study of inquiry-based and team-based learning on student performance and satisfaction

Active learning fosters critical thinking, autonomy, and deep learning. Whereas team-based learning (TBL) is common, inquiry-based learning (IBL) offers a more student-centered, inquiry-driven alternative. This study aimed to compare the pedagogical effectiveness of IBL versus TBL in medical education, focusing on academic performance, learner engagement, autonomy, and satisfaction. An innovative IBL framework, grounded in the 5E instructional model, was designed and implemented with first-year medical students (<i>n</i> = 548). The intervention involved five interactive clinical cases, each centered around a core medical concept. Students progressed through the cases using cascading multiple-choice questions with a conditional solution-revealing mechanism ("scratch film"), promoting autonomous exploration. A final gamified synthesis using crossword puzzles reinforced learning. Comparative data were collected across IBL and TBL sessions with quantitative performance metrics, behavioral observation, and student questionnaires. IBL significantly outperformed TBL in terms of retention of key learning concepts (64-100% vs. 14-38%; <i>P</i> < 0.05), as well as in the acquisition of extended concepts, reflecting deeper cognitive processing. Students in IBL groups were more engaged and solved most clinical problems independently, with minimal use of revealed solutions, indicating high levels of autonomy. Questionnaire responses confirmed a high satisfaction rate (66%), a substantial perceived impact on learning (61%), and a reduced tendency toward group cheating (40%), all statistically significant (<i>P</i> < 0.000). Our results suggest that IBL seems to be more effective and engaging than TBL, as it promotes deeper learning, greater autonomy, and increased motivation, with promising potential to support innovation in basic science learning in medicine.<b>NEW & NOTEWORTHY</b> This quasi-experimental study compared inquiry-based learning (IBL) and team-based learning (TBL) in a physiology course for 548 first-year medical students. Using an original 5E-based IBL framework, the study showed that IBL significantly improves content retention, autonomy, and satisfaction and reduces cheating. These findings underscore IBL's relevance for teaching basic sciences and its potential for scalable, ethical, and engaging curricular innovation in medical education.