Implementing digital-supported team-based learning for large undergraduate cohort in a resource-limited setting: a pilot study developed through an international academic partnership

BACKGROUND: Growing student numbers and limited teaching resources, especially in low- and middle-income countries (LMICs) such as Sri Lanka, hinder the delivery of interactive, student-centred medical education. Traditional lectures alone do not adequately support clinical reasoning, pointing to the need for active, application-focused methods aligned with technology-shaped learning expectations. Team-based learning (TBL) encourages collaboration and accountability, but can be resource-intensive and is not well-documented in large cohorts in LMIC settings. This study investigates a technology-supported TBL session delivered by a single lecturer, focusing on student perceptions and the mentoring within an international academic partnership. METHOD: After a faculty development programme with the University of Illinois Chicago introduced staff to TBL principles, a single-session pilot TBL intervention was implemented at the Faculty of Medicine, University of Peradeniya, as a descriptive service evaluation at Kirkpatrick Level 1. An existing lecture for third-year medical students was redesigned as a TBL session using the available infrastructure. In line with TBL principles, 252 students were assigned to 20 balanced teams. Eight abnormal uterine bleeding case scenarios and preparatory materials were provided two weeks in advance. During the session, students completed individual and group readiness assurance tests using Pear Deck for real-time interaction. One lecturer facilitated the discussion and completed it within two hours. Student perceptions were collected using a ten-item Likert-scale questionnaire and free-text comments. RESULTS: Among 252 students, 209 participated (82.9%), and 191 of them completed the survey (91.4%). The median Likert-scale score was 4 or higher for engagement, teamwork, and use of the digital platform. Preparation-related items were scored lower. Free-text responses described the session as interactive, engaging, and helpful for maintaining attention and encouraging reflection. DISCUSSION: This pilot study indicates that a technology-supported TBL session is feasible for a large cohort in a resource-limited setting, with strong reported engagement. Students responded positively, despite varying levels of preparation, and the digital platform was a feasible and acceptable tool for teamwork. Limitations included large team sizes, fixed seating, and the inability to use certain standard TBL tools. Further refinement, faculty development, and curricular integration are considered.