Table 1.

Core design elements of Team-Based Learning showing their effects on learner engagement with content and peers

Core design element	Rationale/TBL principle	Effect on learner engagement with content	Effect on learner engagement with peers
1. Judicious team formation performed by instructor	Optimal team size and intellectual resources (brain power) to be distributed equally across teams. This does not typically occur when learners are allowed to form their own teams.	Teams with too few learners (e.g. less than 5) lack sufficient ‘intellectual assets’ to tackle complex problems; too many learners (e.g. more than 8) permits ‘social loafing’	Team motivation to work together increases when learners believe their collective brain power matches that of other teams
2. Readiness Assurance	Allows the instructor and team members to verify that all learners are prepared to apply course concepts to solve real-world, or complex tasks.	Individual and team accountability motivates learners to prepare by acquiring background knowledge before coming to class	During group discussions, learners teach each other, often using language that is more familiar than that of the instructor
3. Immediate feedback	Immediate feedback enhances both individual learning and team communication processes by allowing teams to constantly assess the effectiveness of their problem-solving and communication strategies.	Obtaining answers to questions following the group test allows individual misconceptions to be clarified before they are entrenched	Reinforces to team members the value of collaboration. Also provides a disincentive for poor team communication behavior (e.g. poor listening or overassertiveness)
4. Sequencing of in-class problem solving	Proper sequencing of activities- i.e. intrateam followed by interteam activities; enables learners to deepen their level of thinking and can positively affect the team development process	Multiple opportunities to discuss and apply knowledge to solve a problem fosters greater depth of engagement with course concepts and promotes long-term knowledge retention 46	Interteam discussions solidify group identity and cohesiveness. Teams want to use their intrateam discussion time effectively to avoid embarrassment during interteam discussions
5. The four Ss	Attention to the 4S structure (i.e. significant problem, same problem, specific choice, simultaneous reporting) fosters individual and team motivation, a common frame of reference, critical thinking and conceptual depth, and vigor during whole class discussions	A significant problem with real-life relevance increases interest during team discussions. Same problem for all teams increases interest during interteam discussions. The requirement to make a specific choice fosters conceptual depth in intra- and interteam discussions.	Simultaneous reporting of specific choice enhances recognition of controversy across teams. Constructive controversy across teams motivates collaboration within teams to defend points of view 41
6. Incentive structure	As in any teaching endeavor, the incentive structure has powerful effects on the achievement of course goals	Grading individual performance motivates out-of-class preparation	Grading team performance provides a clear incentive to maximize collaboration
7. Peer evaluation	This is especially critical in a longitudinal TBL curriculum. Feedback from peers may have effects that other forms of feedback may not because peers have a unique relationship with each other as learners	The possibility of a negative review from peers motivates learners to prepare for and participate in class. Peer feedback also shapes specific learner behavior such as over assertiveness and collaboration	Promotes individual learners’ accountability to the team. It also reinforces the importance of every individual’s preparation and participation, as these affect overall team performance.

(Adapted with permission from Haidet et al. [41])