SciELO - Scientific Electronic Library Online

vol.41 issue3Medical Doctors’ Knowledge of Libras in the Federal District and Deaf Patient Health CareMaliandi's Bioethics in undergraduate medicine Courses author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links


Revista Brasileira de Educação Médica

Print version ISSN 0100-5502On-line version ISSN 1981-5271

Rev. bras. educ. med. vol.41 no.3 Rio de Janeiro July/Sept. 2017 

Original Article

Team-Based Learning: Successful Experience in a Public Health Graduate Program

Aprendizagem Baseada em Equipes: Relato de Experiência em um Programa de Pós-Graduação em Saúde Coletiva

Geraldo Bezerra da Silva JuniorI 

Maria Angelina Silva MedeirosI 

Juliana Gomes Ramalho de OliveiraI 

Ana Maria Fontenele CatribI 

Maria Helena de Agrela Gonçalves JardimII 

IUniversidade de Fortaleza, Fortaleza, CE, Brasil

IIUniversidade da Madeira, Funchal, Portugal



In the review of curriculum matrices, the elaboration of learning strategies that combine theory and practice is extremely important, allowing the building of new concepts and learning methods by the students. Team-based learning (TBL) is growing in academic centers and refers to the pedagogic strategy grounded in constructivism. The aim of this research was to describe the application of TBL in a Public Health graduate program.


TBL was applied in a class with 22 students in the discipline “Quantitative Research in Health” of the Public Health graduate program (Master degree) at the University of Fortaleza, Brazil, in 2016. The discipline was structured in 8 lessons, approaching the thematic of quantitative research. Before each class the students were required to study the contents at home, a test was done for each subject in the beginning of each class (individually and then in teams of 5 or 6 students) and then a brief review was performed by the professor, where the students could ask questions and solve any doubt. At the end of the semester an evaluation questionnaire was applied with objective questions and a qualitative survey.


The application of TBL was done in a class with 22 students of the Public health Master Program, aged 22 to 36 years, and 83.3% were female. The method was well received by the students. All the evaluations and discussions went on without any problem. There were some complaints about the requirement to study at home prior to the classes. Students’ evaluation of the discipline and the TBL method was satisfactory with answers’ average score of 4.7 (scale 0-5). The lowestscore was achieved by the question number 11 (4.3) about the students motivation for their study at home. The comparison with the evaluation of the previous semester (where a traditional method was applied) evidenced higher scores for the TBL method.


The application of TBL was satisfactory and the main difficulty presented by students was the requirement for previous study at home. TBL was better evaluated than the traditional method.

KEYWORDS Teaching; Learning; Methodology; Higher Education; Health Education



Na revisão das matrizes curriculares, a elaboração de estratégias que combinem teoria e prática é extremamente importante, permitindo que os estudantes construam novos conceitos e métodos de aprendizagem. O objetivo deste estudo foi descrever a aplicação do método Aprendizagem Baseada em Equipes (ABE) num programa de pós-graduação em Saúde Coletiva.


O método foi aplicado numa turma de 22 alunosda disciplina “Investigação Quantitativa em Saúde” do Programa de Pós-Graduação em Saúde Coletiva (mestrado) da Universidade de Fortaleza em 2016. A amostra foi constituída por36 pós-graduandos. A disciplina foi estruturada em oito aulas sobre temas de pesquisa quantitativa. Antes de cada aula, os alunos eram solicitados a estudar os conteúdos em casa, sendo feito um teste para cada assunto no início de cada aula (individualmente e em seguida em equipes de cinco a seis alunos); então, o professor fazia uma revisão breve sobre o assunto, quando os estudantes poderiam fazer perguntas e tirar dúvidas. Após as aulas, no final do semestre, foi aplicado um questionário de avaliação das atividades desenvolvidas, com questões objetivas e um item qualitativo.


A aplicação da ABE foi feita numa turma de 22 alunos do mestrado em Saúde Coletiva, com idades entre 22 e 36 anos, sendo 83,3% do sexo feminino. O método foi bem recebido pelos estudantes. Todas as avaliações e discussões ocorreram sem problemas. Houve reclamações sobre a necessidade de estudar em casa antes das aulas. Na avaliação realizada pelos alunos, o valor médio das respostas foi de 4,7 (escala 0-5). A questão sobre as motivações para estudar em casa foia de menor valor: 4,3 (escala de 0-5).

Considerações finais:

A implementação da metodologia ABE foi muito satisfatória, e a maior dificuldade apresentada foi a solicitação de estudo prévio do conteúdo da aula.

PALAVRAS-CHAVE Ensino; Aprendizagem; Metodologia; Educação Superior; Educação em Saúde


The globalization and dissemination of technology in all the sectors of modern society brought changes in the professional profile requested by the job market. Currently, those with emotional control and ability to work in teams are best rated by the employers. In this context, it is highly necessary to improve the learning process. The new methodologies needs to include a teaching practice with ethics, criticism and able to change realities, providing to the students an opportunity to become efficient leaders1.

In the review of curriculum matrices, the elaboration of learning strategies that combine theory and practice is extremely important, allowing the building of new concepts and learning methods by the students2,3. However, despite the clear necessity for implementing methodological changes, some studies point that new learning methods face resistance by teachers and students4.

Team-based learning (TBL) is gaining space in academic centers and consists in a pedagogic strategy based on constructivism, which values individual students’ responsibility in work groups and stimulates application of acquired knowledge in the solution of problems in the context of professional- practice5. TBL is also characterized by a method centered in the student and based on consecutive activities that includes individual work, team work and immediate feedback6. This is a dynamic teaching and learning resource, creating a motivating environment in which team work is emphasized7.

The aim of this work is to describe a successful experience of TBL in a Public Health graduate program.


Team based learning (TBL) was applied in a class with 22 students in the discipline “Quantitative Research in Health” of the Public Health graduate program (Master degree) at the University of Fortaleza, Brazil, in 2016. The discipline was structured in 8 classes, covering themes of quantitative research. The aim of the discipline was to provide students a general view of quantitative research in health, enable students to have a critical view of different study design using quantitative methods and to plan quantitative studies using good research practices. The classes were divided in: individual study (the student were required to study the contents at home to discuss in the next class), individual evaluation (in which the student answered objective questions regarding the contents of the class), team evaluation (in which the students discussed these question in teams of 5 or 6 students), discussion (a feedback about the questions was given by the teacher and a dialogued class was done to solve any query that still remained about the contents). After these “steps”, an activity was done to apply acquired knowledge: a problem in the field of Public Health was given, and the groups were asked to plan a research, based on a specific study design using quantitative methods to investigate and solve that problem. At the end of the semester an evaluation questionnaire was applied with objective questions and a qualitative survey. The protocol of this study was reviewed and approved by the Ethics Committee of the University of Fortaleza.


The application of TBL was done in a class with 22 students of the Public health Master Program, aged 22 to 36 years, and 83.3% were female. They were all health professionals (Physicians, Nurses, Physiotherapists, and Psychologists). The method was well received by the students. All the evaluations and discussions went on without any problem. There were some complaints about the requirement to study at home prior to the classes. However, the implementation of this method enables the students to acquire and apply knowledge through an activity itinerary that include individual study before the classes5. Hence, compliment of all “steps of this method is very important to achieve satisfactory results.

In a recent review it was observed that despite presenting better performance in knowledge acquisition, students subject to TBL did not manifest preference for this method, which can be related to higher demands and workload over the students6.

In the present study, the discussions in teams provided higher interactions between the students through knowledge exchange. According to Borges & Alencar7, the use of active methodologies can contribute to student's autonomy, rising curiosity and stimulating decision making, individually and in groups.

During the feedback and dialogued classes there was a higher participation of the students, due to the fact that they have already studied the contents and discussed in groups, associated to the curiosity about the themes during the previous activities. In a study conducted in Malaysia, application of TBL made students more active and improved performance in write tests, suggesting that this technique improves teaching quality and optimizes learning results8.

Practical activities, about research planning based on Public Health problems, were also very productive, providing students the opportunity to plan investigations of real problems in the regional context, which can also contribute to their Master's dissertation and their professional practice. This is one of the few studies to describe active methodologies in the scenario of graduate classes (Master course). The selection of contents should be compatible to the reality that the student will face in the “real world” because during all TBL process the students use their previous experience and knowledge to search and acquire new information, assuming a critical attitude when facing and discussing real problems9.

The evaluation of the discipline was very satisfactory, with a global score of 4.7 (in a scale from 0 to 5), as illustrated in Figure 1. Comparing to the evaluation of the same discipline in the previous semester (where a traditional method, based on expositive lectures and seminars), it was observed higher scores in the discipline using TBL. The mean score of the previous semester was 4.3±0.13, significantly lower than the evaluation of the present semester, which had a mean of 4.7±0.4 (p=0.0002).

Figure 1 Scores (mean and standard deviation) according to the students evaluation of the discipline “Quantitative Investigation in Health” of the Public Health graduate program at the University of Fortaleza, Brazil, in 2015 (traditional methodology) and 2016 (TBL) 

The question with the lowest score (4.3) was the number 11, which refers to student's motivation to study at home, but even being the question with the lowest score, it was also higher than the achieved in the previous semester (3.9), but without statistical significance (p=0.06). The questions with higher scores (4.9) were the number 3,8 and 9, which refers to the presentation of the discipline's objectives, applied methodology (TBL) and student's motivation to participate in classes.

The qualitative evaluation was also positive, according to the discourses below:

Good methodology. Accessible professor. Good interaction with the students.

The teacher is a fundamental key in the process of building knowledge, becoming a learning facilitator7. It is important to highlight that active methodologies require changes for its implementation, including teachers training, once higher teachers involvement is necessary4. Other students points out:

I considered the classes very relevant because it allowed me to expandmy knowledge, without the need to present a seminar of a subject that I am not sure about.

In a study conducted in an undergraduate Fonoaudiology course, Guedes-Granzottiet al.9concluded that the use of active teaching methodologies aims to capacitate professionals to be resolutive and able to continuously improve their knowledge and practice their activities according to standard Public Health guidelines. Other discourses about the method used in our course were:

The discipline was great and the teaching process too. It was easy to understand the contents and the classes spent fast. It was good to participate.

I praise the applied methodology because it estimulates reading and criticism.

The method allowed a better learning of the contents.

I consider the applied method excellent because do not overload students, in comparison to seminars and other activities used in other disciplines.

Rodrigues et al.4 points that expositive classes and seminars reinforces a more conservative tendency of knowledge transfer, which is not adequate to the current students’ profile, characterized by early immersion in technology universe, with unlimited access to information and intense participation in social networks3. In this regard, the students suggest application of active methods in other disciplines:

I suggest adopting this method by other teachers.

Similar to the results of the present study, Burgess et al.10 found that in great part of the studies using TBL the students considered this as a good experience. Early application of TBL can bring benefits that will long for the rest of the course, and also enables students to become the professional with the profile required by current job's market (a professional that can easily work in teams, that can search for solutions and share experience with colleagues).


Traditional learning and teaching methods do not comply with current requirements of modern society. In the past, employers seek for people with high scientific knowledge. Nowadays they seek for open-minded professionals, flexible to changes, with good ability to work in groups. Active methodologies give students the opportunity to develop and improve these abilities because stimulates them to think and reflects about different problems related to their reality and to share experience with colleagues.

Based on the evaluation conducted with the students, we can conclude that TBL was very satisfactory in the graduate course and that the main difficulty presented by the students were related to the requirement to study at home, which is understood by the fact that they have multiple activities besides the graduation course, including practical professional activities outside the university.

It is very relevant to apply new teaching methodologies, including in the graduation courses, always keeping in mind that constant changes occurs in our society. This study also evidences the importance of teachers to be alert of the students’ needs, which can change over time, and reinvent teaching methods aiming to dinamyze classes and optimize knowledge exchange between students and teachers.


1. Mitre SM, Siqueira-Batista R, Girardi-de-Mendonça JM, Morais-Pinto NM, Meirelles CAB, Pinto-Porto C, Moreira T, Hoffmann LMA. Metodologias ativas de ensino-aprendizagem na formação profissional em saúde: debates atuais. Ciênc. Saúde Coletiva 2008; 13(2):2133-2144. [ Links ]

2. Freitas CM, Freitas CASL, Parente JRF, Vasconcelos MIO, Lima GK, Mesquita KO, Martins SC, Mendes JDR. Uso de metodologias ativas de aprendizagem para a educação na saúde: análise da produção científica. Trab Educ Saúde 2015;13(2):117-130. [ Links ]

3. Silva SL, Silva SRF, Santana GSM, Nuto SAS, Machado MFAS, Diniz RCM, Sá HLC. Estratégia Educacional Baseada em Problemas para Grandes Grupos: relato de experiência. Rev Bras Educ Med 2015; 39(4):607-613. [ Links ]

4. Rodrigues JA, Rocha LS, Anjos DS, Cavalcante LPF, Ro- zendo CA. TendênciasPedagógicas: Conflitos, Desafios e Perspectivas de Docentes de Enfermagem. Rev Bras Educ-Med 2013;37(3):333-349. [ Links ]

5. Bollela VR, Senger MH, Tourinho FSV, Amaral E. Aprendizagem baseada em equipes: da teoria à prática. Medicina (Ribeirão Preto) 2014;47(3): 293-300. [ Links ]

6. Fatmi M, Hartling L, Hillier T, Campbell S, Oswald AE. 2013. The effectiveness of team-based learning on learning outcomes in health professions education: BEME Guide No. 30, Med Teach 2013; 35(12):e1608-e1624. [ Links ]

7. Borges TS, Alencar G. Metodologias ativas na promoção da formação crítica do estudante: O uso das metodologias ativas como recurso didático na formação crítica do estudante do ensino superior. Cairu Rev 2014;3(4):119-143. [ Links ]

8. Ismail NAS. Effectiveness of Team-Based Learning in teaching Medical Genetics to Medical Undergraduates. Malays J Med Sci 2016; 23(2):73-77. [ Links ]

9. Guedes-Granzotti RB, Silva K, Dornelas R, Cesar CPHAR, Pelicano AD, Domenis DR. Situação-problema como disparador do processo de ensino-aprendizagem em metodologias ativas de ensino. Revista CEFAC 2015;17(6):2081-2087. [ Links ]

10. Burgess AW, McGregor DM, Mellis CM. Applying Established Guidelines to Team-Based Learning Programs in Medical Schools: A Systematic Review. Acad Med 2014;89(4):678-688. [ Links ]

Received: January 10, 2017; Accepted: July 27, 2017

POSTAL ADDRESS Geraldo Bezerra da Silva Junior, Programa de Pós-Graduação em Saúde Coletiva - Universidade de Fortaleza, Av. Washington Soares, 1321 - bloco S - sala S-01 - Fortaleza, CEP 60811-905 - CE - Brazil


Geraldo Bezerra da Silva Junior

Maria Angelina Silva Medeiros

Juliana Gomes Ramalho de Oliveira

Ana Maria Fontenele Catrib

Maria Helena de Agrela Gonçalves Jardim


Não existe conflito de interesses.

Creative Commons License This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.