Team-based learning (TBL) in health professions education: A systematic review on its conceptual elements and outcomes

Team-Based Learning (TBL) is increasingly applied in health professions education (HPE), both offline and online, to stimulate deeper learning and develop of important skills for healthcare. Since research on TBL is accumulating recently, a comprehensive overview of investigated elements and outcomes is necessary. To outline elements of Michaelsen’s conceptual model of TBL that have already been investigated and their outcomes, and to guide future research and practice. PRISMA guidelines were used to conduct and report this systematic review. PubMed, Medline, Embase, ERIC and PsychInfo databases were searched for in-person and online TBL in undergraduate and graduate HPE published between June 2016 and June 2023. Two authors independently extracted and coded using Michaelsen’s conceptual model for TBL and Kirkpatrick’s New World model for evaluating learning outcomes. JBI checklists were used to evaluate the quality of the selected studies. The search resulted in 1904 studies of which 179 studies met the inclusion criteria. Eight studies examined online TBL (4.47%) Most studies (171, 95.53%) investigated learning outcomes of TBL (element G), demonstrating positive effects of TBL on lower levels such as student experience and academic performance. Higher level outcomes (e.g. communication skills and clinical reasoning) were rarely studied. Moreover, research on elements A through F of the model remains scarce (1.12–12.29%) Much of the existing research on TBL examines the effect of TBL on learning outcomes, leaving the remaining elements of the conceptual model underexplored. This calls for more rigorous and comprehensive investigations to better understand the potential of TBL and to address the gaps in the current literature. Practice pointsMost of the existing research on TBL examines the effect of TBL on learning outcomes, with a focus on the lower levels of the New World of Kirkpatrick.Other elements of conceptual model underexplored.To address the gaps in current literature and to better understand all elements of the conceptual model of TBL more rigorous research is needed. Practice points Most of the existing research on TBL examines the effect of TBL on learning outcomes, with a focus on the lower levels of the New World of Kirkpatrick. Other elements of conceptual model underexplored. To address the gaps in current literature and to better understand all elements of the conceptual model of TBL more rigorous research is needed.

团队学习法（Team-Based Learning, TBL）在卫生专业教育（Health Professions Education, HPE）中的应用日益广泛，涵盖线下与线上场景，旨在激发深度学习并培养医疗领域所需的核心技能。近年来，关于TBL的研究不断积累，因此亟需对已探究的要素与研究结果进行全面梳理。本系统综述旨在梳理已被研究的迈奇森（Michaelsen）TBL概念模型的相关要素及其对应结果，并为未来的研究与实践提供指引。

本研究遵循PRISMA指南开展系统综述并撰写报告。检索了PubMed、Medline、Embase、ERIC及PsychInfo数据库，纳入2016年6月至2023年6月间发表的、针对本科及研究生层次卫生专业教育中线下与线上TBL的相关研究。由两名研究者独立采用迈奇森TBL概念模型与柯克帕特里克（Kirkpatrick）新世界学习成果评估模型，对研究数据进行提取与编码，并使用JBI清单对纳入研究的质量进行评估。

本次检索共获得1904篇文献，其中179篇符合纳入标准。其中仅8篇（4.47%）聚焦线上TBL研究。绝大多数研究（171篇，占比95.53%）均针对TBL的要素G（即学习成果）展开探究，证实TBL对学生体验、学业表现等柯克帕特里克新世界模型中的低阶学习成果具有积极影响，但针对沟通技能、临床推理等高阶学习成果的研究则相对匮乏。此外，针对该模型中要素A至F的相关研究仍十分稀缺（占比仅1.12%~12.29%）。现有TBL相关研究多聚焦于其对学习成果的影响，而对该概念模型其余要素的探究仍存在不足。这表明亟需开展更严谨、更全面的研究，以充分挖掘TBL的应用潜力，并填补当前文献中的研究空白。

【实践要点】现有TBL研究多聚焦于其对学习成果的影响，且集中于柯克帕特里克新世界模型的低阶学习成果维度，对概念模型其余要素的探究仍存在不足。为填补当前文献的研究空白并全面理解TBL概念模型的所有要素，亟需开展更严谨的相关研究。
【实践要点】现有TBL研究多聚焦于其对学习成果的影响，且集中于柯克帕特里克新世界模型的低阶学习成果维度，对概念模型其余要素的探究仍存在不足。为填补当前文献的研究空白并全面理解TBL概念模型的所有要素，亟需开展更严谨的相关研究。