Enhancing Immunology Learning through Team-Based Learning (TBL): A Multi-Cohort Study in Undergraduate Medical Education 2267327

Abstract Introduction Immunology is perceived as a challenging subject in medical education due to its abstract concepts, cross-disciplinary integration, and evolving clinical relevance. Traditional lectures may not effectively support the development of higher-order thinking or clinical reasoning. Team-Based Learning (TBL) offers a structured, active learning strategy designed to foster critical thinking, collaboration, and applied understanding. This study evaluated the impact of TBL on student performance in immunology across the preclinical years of a six-year undergraduate medical program. Methods Data were collected from four student cohorts (2019—2023). Weekly TBL sessions were integrated into years 2—4, covering foundational topics (innate/adaptive immunity) and system-based modules (e.g., respiratory, renal, gastrointestinal, hematologic, and body defense). All sessions and assessments were administered via ExamSoft. Students were grouped as Regular Attendees (≥80% TBL attendance) or Non-Regular Attendees (< 60%). Performance was assessed using internal end-of-semester immunology assessments and the IFOM exam at year 4.5, focusing on immunology-specific items. Statistical analyses included t-tests and multivariate regression. Results Among 362 students (132 Regulars, 230 Non-Regulars), Regular Attendees scored significantly higher across internal assessments and showed >30% higher immunology scores on IFOM (p < 0.001). Their IFOM performance also exceeded the global average for international medical graduates. TBL participation was an independent predictor of improved performance, even after adjusting for GPA and prior academic achievement. Conclusion Structured TBL significantly improves immunology understanding, as evidenced by higher internal assessment scores and superior outcomes on the standardized IFOM examination. These findings support the use of TBL as a pedagogical approach to improve comprehension in complex and concept-heavy disciplines like immunology in medical education. Funding Source n/a Topic Categories Immunology Education and Communication (EDU)