Enhancing Team-Based Learning in Medical Education: Integration of Multidisciplinary Scenarios and Objective Structured Practical Examination (OSPE) in a Retrospective Study at the College of Medicine, Qassim University, Saudi Arabia.

Background Traditional team-based learning (TBL) in medical education often lacks multidisciplinary integration and practical skills assessment, typically relying on multiple-choice questions without clinical competency evaluation. Objective To evaluate our re-engineered (redesigned), multidisciplinary TBL model, incorporating objective structured practical examination (OSPE) assessments, and its impact on student engagement, performance, and gender achievement gaps. Methods This descriptive, cross-sectional, mixed-methods observational study included all preclinical medical students (n = 437; 292 males, 145 females) for two academic years (2016-2017) at the College of Medicine, Qassim University, Saudi Arabia. Most students had traditional medical education and were from similar educational and socioeconomic backgrounds, with a gender ratio of approximately 2:1 across all cohorts. The re-engineered model integrated clinical scenarios in pathology, pharmacology, anatomy, histology, microbiology, biochemistry, and physiology. Students answered OSPE-style image-based questions, followed by real-time structured feedback from specialists in each field. Quantitative analysis compared scores on the Individual Readiness Assurance Test (iRAT) and the Team Readiness Assurance Test (tRAT) using nonparametric and parametric tests. Student perceptions were assessed using a cross-sectional survey (n = 360, 72% response rate) with a Likert scale and open-ended questions. Qualitative responses were analyzed thematically: two researchers independently coded the responses (intercoder reliability: Cohen's α = 0.85), and a third corrected discrepancies to ensure analytical rigor. Results Team scores (M = 69.8, SD = 10.8) significantly exceeded individual scores (M = 43.0, SD = 7.3) in all courses (p < 0.001, d = 3.00, 95% CI (2.92, 3.08)). The observed gender achievement gap in individual assessments (mean difference = 4.4 points, p < 0.001) significantly decreased in collaborative settings for both Years 1 and 2 (effect size decreased from d = 0.62 to d = 0.22, 95% CI (0.14, 0.30)). Year-level comparisons showed significant performance differences across all cohorts (Year 1 vs. Year 2: p = 0.003; Year 1 vs. Year 3: p = 0.011; Year 2 vs. Year 3: p = 0.023). Student satisfaction was high (Years 1 and 2: M = 4.00, SD = 0.89; Year 3: M = 4.30, SD = 1.05), with third-year students showing the strongest preference (88% agreement) for the new approach. Conclusion The OSPE-integrated TBL model promises to improve student engagement and reduce achievement gaps in the early stages of medical education. These findings suggest potential benefits of integrating this approach into summative assessment frameworks for comprehensive competency development, although further controlled studies are needed. This study contributes to the medical education literature by demonstrating how culturally responsive collaborative learning frameworks can improve educational equity while addressing the practical skills gap in traditional TBL. The pedagogical impact extends beyond content knowledge to include improved collaborative reasoning and the integration of clinical skills, providing a pragmatic framework for institutions seeking to enhance preclinical education in culturally diverse settings.