Develop a TBL Session

A team-based learning session requires special preparation as it involves elements that are not found in traditional pedagogies. Below is a brief description of these elements and a guide to developing materials for them. For those new to team-based learning, we highly recommend a consultation with the Teaching and Learning Center

Step 1: Learning Outcomes

The goal of a team-based learning session is for students to apply recently learned content to solve relevant problems. The students will work in teams to answer questions that present a challenging problem within a real world scenario. Because the main focus is the application of knowledge, one should think first about the skills, intellectual or physical, that the students should learn by the end of the session. Defining the learning outcomes of the session will help guide the development of the other elements of the session.

Step 2: Write the Application Questions

The application questions are the heart of a team-based learning session. These questions should challenge students to apply the content they have learned to solve real-world problems. In addition, the questions should be relevant to the students’ educational goals of becoming physician-scientists. The students will work in teams to answer the questions, so the questions should be sufficiently complex to engage all students on the team and force teams to draw on all their available resources.

Clinical cases can make good application questions because they present a real-world problem, are relevant to students and are often sufficiently complex to provide an appropriate level of challenge to the teams. Because complicated clinical cases integrate content from a variety of different domains, it’s important to pick a case whose range of content is encompassed by what the students have learned before coming to the in-class session. The students could have learned this content either in the pre-session materials or in a previous session (e.g. lecture or workshop).

Research problems can also be used to develop application questions. Because they ask students to interpret data and judge whether experimental results support hypotheses and models, research questions promote essential skills for physician scientists. Selection of the area of research is critical as it should align with what students are currently learning and be meaningful for the practice of medicine.

Applications questions should be multiple choice because they facilitate team discussion and dynamics. By presenting teams with a list of potential correct answers, multiple choice questions focus the discussion on a limited set of topics and force teams to make a decision on which option they think best. The difficulty of the application questions can be increased by presenting a list of choices all of which are plausible. In fact, it often helps both intra-team and inter-team discussion to include at least two options for which strong arguments can be made in support of them being the correct answer. Having teams arrive at different answers facilitates discussion between teams because the teams will present their reasons for selecting their answer. Hearing different lines of reasoning strengthens students' understanding of the material and helps them identify misconceptions and faulty logic either in their team or other teams.

The application questions are usually open-book, giving students the opportunity to consult other resources to answer the questions. Thus, the questions can cover content or information that students can readily find online or in a reading.

Step 3: Develop the Pre-Session Content

The pre-session content should be sufficient to give the students a base of knowledge to answer the application questions, but it can also include some material beyond what is needed to answer the application questions. It’s critical, however, to avoid overloading the students with outside class work because they will likely have other classes for which they need to prepare and study, and it’s critical that they complete the pre-session assignments before coming to class. Students are less likely to finish a pre-session assignment that seems excessively burdensome. There is no set rule for how much time students should be expected to spend on the pre-session material, but a reasonable estimate is half of the length of the in-class session.</p>

Learning objectives

Similar to other pedagogies, one should start the development of the pre-session content by writing learning objectives. Learning objectives focus the students’ attention on what is most important to learn from the pre-session content and help faculty keep the content organized into logical blocks. For help writing learning objectives, please visit:


The pre-session content can be delivered in a variety of formats. The best choice is a video lecture. Students are significantly more likely to watch a video of a lecture over reading the same content either in lecture notes or in a textbook. Preparing a video lecture requires some investment of time, but the Teaching and Learning Center can provide guidance for developing the content for a video lecture, and the medical library can assist with the technical part of recording the lecture.

If a video seems like too much work, the next best choice is to write lecture notes. These can be distributed as PDF or even better, converted into online format. The online format is preferred because the material can be formatted to be viewed on any sized device. PDFs or Word documents only format well on laptops or iPads

Lastly, students can be readings from a textbook or a journal article that cover the pre-session content. These readings must be chosen with care to ensure that they focus on the content that the students will need to answer the application questions and contain only a limited amount of extra material.

Step 4: Write the Readiness Assessment Questions

The purpose of these questions is to assess whether a student sufficiently understands the pre-session content and is ready to answer the application questions. The questions should directly address the content in the pre-session assignment. Students will first take the quiz as individuals and then as a team.

Style of the Questions

These questions should be multiple choice. As mentioned above, multiple choice questions facilitate discussion between students and in part of the readiness assessment quiz students within the same team will discuss each question and come to a consensus answer. Multiple-choice questions are also ideal because they allow teams to use the scratch-off cards when selecting their answer. The scratch-off cards have been shown to improve team dynamics, and students enjoy using the cards.

Because they primarily serve to assess whether students recall the pre-session content, the questions should have one best answer.

For help developing readiness assessment questions, please contact Michael Green in the Teaching and Learning Center