Impact of Team-Based Learning on the Clinical Reasoning and Critical Thinking Skills Among Undergraduate Medical Students.

Introduction Critical thinking and clinical reasoning are two core competencies essential for medical students in their evolution from passive learners to proficient future clinicians. These competencies require higher-order cognitive skills which cannot be accomplished through conventional lectures. In contemporary medical education, team-based learning (TBL) has emerged as an active innovative instructional strategy which promotes active participation, accountability, problem-solving, and higher-order thinking. The California Critical Thinking Skills Test (CCTST) assesses critical thinking, while the Script Concordance Test (SCT) measures clinical reasoning under uncertainty. The study aimed to evaluate the effectiveness of TBL in improving critical thinking and clinical reasoning among first-year MBBS students. Method An educational interventional study was conducted among 152 first-year MBBS students during a TBL session which included their pre-class preparation, Individual Readiness Assurance Test (IRAT), Team Readiness Assurance Test (TRAT), and application exercises with immediate facilitator feedback. To assess critical thinking, a 20-item questionnaire called the Critical Thinking Assessment Test (CTAT) on adrenal cortex disorders was constructed based on the domains described in the CCTST. To measure clinical reasoning, a 30-item questionnaire was developed on the same topic based on SCT. The two questionnaires which were developed by the investigator and validated by an expert panel were used before and after the TBL session. Result A substantial improvement was observed in SCT (Cohen's d=0.89) in comparison to CTAT scores (Cohen's d=0.73) after the TBL session. The TBL intervention strengthened the relationship between clinical reasoning (SCT) and critical thinking (CTAT) transforming a weak correlation (r=0.163; p=0.045) into a moderate, statistically significant correlation (r=0.369; p<0.0001). Student performance increased progressively from IRAT (3.27±1.68) to TRAT (8.97±0.87) to application exercises (11.36±1.35) (p<0.0001). Conclusion The study indicates that the implementation of TBL sessions in the early stage of medical training of students can bridge the gap between basic science concepts and clinical applications enhancing both critical thinking and clinical reasoning.