From Illusion of Competence to Productive Uncertainty: A Longitudinal Mixed-Methods Study of Team-Based Learning in Anatomy Education

Team-based learning (TBL) is increasingly being implemented in health sciences education to promote active learning and higher-order cognitive skills. However, the long-term effects of TBL on student performance and perceptions remain unclear. This study evaluated the impact of TBL on veterinary anatomy practical sessions over four academic years (2022/2023–2025/2026) using a longitudinal, mixed-methods design. Quantitative measures included performance across TBL components such as individual and team readiness tests, application exercises, formative assessments, and final scores. Cognitive level analysis was based on Bloom’s taxonomy. Student perceptions were collected through Likert-scale surveys, and qualitative responses were analyzed thematically. The results showed consistently low individual readiness scores, indicating persistent challenges in pre-class preparation. However, team performance improved over time, highlighting the benefits of collaborative learning. Application exercise scores and overall performance increased over time, with notable improvements in higher-order cognitive skills compared to a traditional cohort. Students’ perceptions evolved from initial resistance and perceived difficulty to more positive evaluations, with significant reductions in negative comparisons and metacognitive miscalibration, as well as increased positive perceptions. Overall, TBL supported progressive improvements in academic performance and cognitive development. Collaboration mitigated limitations in individual preparation, and student adaptation enhanced the effectiveness of this pedagogical approach in veterinary education.