Background: Team-Based Learning (TBL) is an active instructional approach used in health care education that incorporates group work.

We explored students' views of the value of frames of reference (FoR) as they progressed through the didactic portion of an occupational therapy program. Thirty-four occupational therapy students were provided with a definition of FoR and asked to provide overall thoughts and impressions about FoR and their value 4 times over a period of 15 mo. Data were analyzed using phenomenological traditions, including open coding and analysis of themes. Throughout the program, students' understanding of how to use FoR evolved as they learned to implement them in practice. Opinions of the use of FoR seemed to be influenced by the students' perceptions of the use of FoR by their Level I fieldwork supervisors. Themes from the narrative data are described and their implications discussed.