Purpose
Active learning techniques are an emerging trend in medical education in Africa, where traditional didactic methods still dominate. Students are often treated as passive recipients of knowledge, limiting engagement and critical thinking. In response, some medical colleges in East Africa are integrating active learning approaches, particularly group-based cooperative learning. However, faculty resistance, due to the time and energy required to design and facilitate engaging activities, and student concerns about group dynamics pose challenges.

Methods
We implemented cooperative learning for 60 first-year nursing students in a new undergraduate program in East Africa. Students were divided into eight clusters, collaborating throughout the course. Initially resistant, due to unfamiliarity with active learning, students gradually adapted to the approach. Mid-trimester, a Multiple Response Question (MRQ) test was administered to assess learning outcomes.

Results
All students passed the assessment, with a class mean score of 70.6 ± 0.8% and the lowest group mean of 67.50 ± 2.40%. Students reported a greater sense of involvement in their learning and improved understanding of Physiology, attributing these outcomes to the active learning process.

Conclusion
This study underscores the transformative potential of active learning techniques in Physiology education. Despite initial resistance from educators and students, the academic gains and enhanced engagement demonstrate the value of adopting such methods in medical education across East Africa.