Introduction: Developing communication skills is essential for medical students to work in modern medical practice. A collaborative learning environment, such as Team-Based Learning (TBL), is a promising environment for developing communication skills. In this study, we investigated 1) how medical students self-report their communication skills in a TBL environment and 2) to what extent students perceive a TBL environment as contributing to their communication skills development.

Method: We conducted a quantitative study with a qualitative element involving Brazilian undergraduate medical students from one Medical School. Participants completed the Interpersonal Communication Competence Scale and the Team-Based Learning Environment Scale, including an open-ended question. We used ANOVA to compare responses across the seven semesters and thematic analysis for the open-ended responses.

Results: Of the 416 students invited, 307 (74%) responded to both scales. Students had high scores on communication skills. Students highly valued the contribution of five domains of the TBL learning environment: teachers’ decisions, teachers’ attitudes, students’ characteristics, team characteristics, and contextual factors. The sixth domain, formative assessment, was highly valued by first-year students with a downward trend across semesters. Key factors contributing to communication skills development were teachers’ alignment with the educational methodology and students’ attitudes within teams. Additionally, students noted that their perception of safety and trust to provide feedback influenced their communication skills development.

Conclusion: These findings suggest that a TBL environment can maintain students’ communication skills. Various elements of the TBL environment play a role here, particularly teachers’ alignment, students’ attitudes, and a supportive classroom atmosphere.