Previous studies have shown that instructional methods and environment influence self-determination theory constructs, which in turn affect engagement and perceived learning (13, 45). Ours is the first longitudinal study we know of that looked at how the learner’s characteristics are impacted by the type of TBL learning environment over time, and whether the characteristics interact with the self-determination theory constructs to result in changes in engagement and perceived learning.
Although Self-Determination Theory Constructs Were Stable Across Time in an Online Learning Environment, They Were Lower Than In-person
In this study, we show that the learner’s characteristics and self-determination theory constructs did not show changes across time in the in-person learning environment (Table 1). More importantly, these constructs remained stable across time within the online learning environment as well. This is irrespective of the subject matter being learnt, as the participants were undergoing different courses at each survey timepoint. Our observation of the stable behaviours in the online learning environment contrasts with previous studies which showed that online courses often experienced high attrition rates due to reduced learner’s motivation and engagement over time (46–49). As such, we posit that, in an online environment where there is a lack of physical interactions, the TBL instructional method is better than a didactic instructional method, such as lectures, in being able to satisfy the student’s basic needs for learning in a classroom.
When comparing across different learning environments for TBL, we found that self-determination theory constructs, such as autonomy support, perceived competence and needs satisfaction, and perceived learning were significantly higher when students had TBL classes in-person than online (Figure 3B). These three self-determination theory constructs, together with identified regulation and intrinsic motivation, also covaried with one another (Figure 4). In addition, autonomy support and intrinsic motivation positively predicts engagement and hence perceived learning when changing from an online to in-person TBL class (Figure 4). Our observations support the basic tenets of SDT, which are in line with previous research that showed how TBL supports learner’s engagement and perceived learning via SDT (13). Similarly, a recent paper applied SDT framework to demonstrate the importance of autonomy support in enhancing K12 students’ engagement in an online learning environment during pandemic (50).
Notably, our study also showed no significant difference in the levels of engagement between online or in-person TBL classes, whereas engagement in lecture classes is lower than that of in-person TBL classes (13). As such, our findings suggest, whilst online TBL classes cannot support student’s needs satisfaction to the same extent as that of in-person TBL classes, it is still able to maintain student engagement over time. Consistent with this notion, whilst medical schools have adopted different online instructional methods during the pandemic, learner-centered and active instructional method, such as Team-Based Learning (TBL) and Case-Based Learning, has appeared to be more engaging as opposed to didactic remote lectures (5). We now provide further evidence to support the sustained engagement seen in both TBL learning environments, and this is likely to be associated with the overall satisfaction of basic needs mediated by TBL, irrespective of learning environment.
Finally, although learner’s characteristics showed no differences in averages across in-person versus online TBL classes, we found that self-regulation and cognitive strategy co-varied with self-determination constructs. Additionally, resilience and self-regulation positively predicted engagement when changing from an online to in-person class. This suggests that a change in the learning environment of a TBL class can affect the relationships between some learner’s characteristics and engagement. Previous studies have shown that relationships with instructors and peers in the classroom affects students’ resilience and in turn engagement, because these social relationships form the support network for the student that provides a sense of competence, relatedness and autonomy (51–53). Hence, if online TBL classes are to be implemented, instructors should explore ways to support these learner’s characteristics.
Taken together, our findings suggest that using an active instructional method, such as TBL, in an online learning environment, will help instructors to avoid the pitfalls that long-term online courses often face, because an active instructional method is better able to sustain the students’ autonomous motivation across time. The TBL class structure provides opportunities for feedback, collaboration, and greater learning accountability and responsibility during class (54), which respectively increases support for competence, relatedness, and autonomy (13, 55), aligning well with the best practice in creating autonomy-supportive classroom (10). These opportunities are important for creating a sense of belonging to the learning community and is especially important in an online learning environment, where learners may experience social isolation for a long period of time (56, 57). In contrast, didactic instructional methods reduce learner’s responsibility and interpersonal relations and offers fewer opportunities for optimal challenges (58). However, online TBL classes are still unable to replace in-person TBL classes, suggesting that the ‘live’ factor cannot be fully replicated in an online setting. Our findings are supported by other studies which showed that students felt that online lectures should not replace live lectures (59). Hence, we suggest that if classes must be held online, instructors should consider implementing the TBL instructional method. In addition, where possible, a blend of in-person and online TBL classes should be adopted (4).
What do these findings mean for online classes?
Whilst there was no change in the levels of engagement, perceived learning was higher for in-person TBL classes than online (Figure 3B). Consistent with these findings, majority of the students indicated that in-person TBL was a better environment for learning than online TBL (Figure 3C). While there were indirect effects of SDT constructs and learner’s characteristics, such as resilience and self-regulation, on perceived learning via engagement as shown by path analysis, our qualitative analysis also illuminated two main themes that influenced student’s perception of learning (Figure 3D). The first theme was the community of practice. Students supported the in-person opportunities as they valued how it contributed to be part of the community of practice. Being in person allowed them to socialize and interact with their peers, and start to build their teams’ relationships. Importantly, the sense of belonging was promoted when students were physically present to experience common goals during TBL lessons. Similarly, recent studies showed a greater preference for in-person TBL than online TBL, with poorer ratings for teamwork interdependence in online TBL environment compared to in-person TBL (60, 61). Given that the sense of belonging to the community of practice is critical for professional identity formation (62, 63), having a solely online TBL environment might affect this crucial process for physicians’ development.
The second theme, which also interacts with community of practice, is the learning space. The spatial identity of a learning environment influenced the learner’s perceived learning. Previous studies have shown that the design of a learning space was shown to influence engagement, motivation, professional preparation, and knowledge transfer of learners (64–66). Thus, it is conceivable that when a TBL class is conducted in-person, instead of remotely, there is a significant, symbolic meaning on learning. Just as how the results from the survey administered for employees in 29 countries that found two-thirds of people prefer working flexibly, unconfined to just office space (67), our students also welcomed having a hybrid arrangement, as they could benefit from both environments. Therefore, a hybrid type of TBL lesson arrangement, where one half of the class would be attending lessons in-person on a rotation basis, could be a middle ground to address the reduced perceived learning, autonomy support, basic psychological needs that are otherwise observed in an online TBL environment.
There are several limitations to our study. First, our institute’s safe management measures implemented in response to the pandemic precluded an in-person TBL class for the full cohort of students. Hence, the participants would attend in-person TBL on a rotational basis, with some of their classmates being online, in a synchronous hybrid TBL format. We have tried to mitigate the impact of such the hybrid TBL arrangement by ensuring that every participant will have experienced a similar number of in-person TBL classes before responding to the survey. Additionally, we gave explicit instructions in the survey for participants to respond based on their experience from the in-person classes. However, we cannot rule out the possibility of unknown intermediate effects that may have an impact our findings. Second, our study data is obtained from self-reported surveys administered during the COVID-19 pandemic, when the stress due to the general uncertainty of the situation and social isolation could have an impact on students’ psychological states (68). Hence, our data may not be representative of the perception of online and in-person TBL classes during normal times. Third, although subjective data on perceived learning sheds light on students’ overall state of mind during learning, we cannot draw any inference on actual learning gain (69).