Balancing Engagement and Integrity: Rethinking Assessment Strategies in Team-Based Learning

Team-based learning (TBL) has become a widely adopted approach for enhancing student engagement and assessment in medical education. Considering TBL as an assessment tool, maintaining academic integrity and ensuring assessment validity are crucial during TBL sessions. In this study, we examined the use of two assessment modalities—audience response systems (ARS) and computer-based testing (CBT)—in a newly established medical school. We explored student and faculty perceptions of these tools and their implications for academic integrity and assessment validity. Using a mixed-methods approach, we gathered data from 240 medical students (92.3% response rate) and conducted focus group discussions with the faculty. ARS obtained a higher global score (34.3±9.26) than CBT (28.3±10.1; p < 0.05), yet no significant difference was noted in TBL performance scores between modalities (CBT = 8.58±1.36; ARS = 8.83±1.60). The results indicated that while student satisfaction was similar across both modalities, ARS were preferred for its ease of use and engagement. However, both students and faculty perceived CBT as a valid tool that better supports academic integrity by reducing opportunities for cheating. The faculty also favoured CBT for its cost-effectiveness, technical reliability, and reduced workload. These findings suggest that while ARS and CBT have their own merits, CBT may better align with institutional goals of ensuring fairness and rigour in assessments. This study provides insights that could inform broad discussions on the effectiveness and implementation of assessment tools in medical education.