Small-Group Discussion Versus Lecture Format for Third-Year Students in Obstetrics and Gynecology

Not yet a dinosaur: the chalk talk

This article discusses the chalk talk's potential as an active learning method. Although chalk talks are a form of interactive lecture, they have received little attention in the medical education literature compared with other active learning methods such as team-based learning and simulation. One of the authors (C. K. L. Phoon) has used chalk talks to teach congenital heart defects to first- and third-year NYU medical students for many years. His chalk talks have consistently earned among the highest teaching scores, and students have noted their strengths of being more interesting, clear, and tangible than didactic lectures. Using the teacher and student perspectives, we examine the chalk talk's strengths and weaknesses compared with common passive and active learning methods. Chalk talks create a real-time, shared space that facilitates the active learning goals of helping students build, test, and revise mental models (conceptual frameworks). The limited amount of information that can be presented and the ability to solicit and arrange students' ideas on the board lead to the cocreation of valuable conceptual frameworks. Chalk talks require less restructuring of teaching sessions than other active learning methods and are best suited to topics that hinge on understanding of concepts. We advocate for the chalk talk to be reexamined as a promising educational tool given its strengths and the successes that other active learning methods have shown. Furthermore, we provide guidance to help educators deliver chalk talks and discuss future studies that would advance understanding of this powerful teaching tool.

Harnessing Technology: Using an iPad to Enhance Radiology Medical Student Education

RATIONALE AND OBJECTIVES

Our goal was to determine whether use of the iPad would increase the students' radiologic knowledge, aid in their interpretation of imaging exams, and increase learner satisfaction.

MATERIAL AND METHODS

iPads were pre-populated with ten image data sets, which included plain film, ultrasound, and CT of the head, chest, abdomen, and pelvis. The students, working in small groups, were charged with identifying the salient imaging findings, formulating a differential diagnosis, and choosing the most appropriate imaging modality, if further work-up was necessary. After the student group problem-solved for an hour, a faculty facilitator joined the group and reviewed the cases with them in an interactive fashion. Pre- and post- intervention tests were administered, and statistical analysis was performed.

RESULTS

Student satisfaction surveys were administered to 125 students in the first 2 years of the study. These scores rated their assessment of the iPad exercise and ranged from 4.6 to 4.9 out of 5. The knowledge evaluation group included 219 students, 110 in the study group and 109 in the control group, in the latter 3 years of the study. The average improvement from the initial to the second test was 1.04 points among the control group and 2.32 among the study group, which was statistically significant (p = 0.0001).

CONCLUSION

We demonstrate increased learner satisfaction, as well as improved knowledge acquisition and interpretive skills of third year medical students engaged in hands-on learning using iPads.

Small group discussions as an effective teaching-learning methodology for learning the principles of family medicine among 2nd-year MBBS students

Teaching methodology has a great impact on the learning outcomes in an undergraduate's education.

Lectures versus case discussions: randomised trial of undergraduate psychiatry teaching

Aims and method

To test whether medical students find case-based discussion of child psychiatry more educationally stimulating and more enjoyable, and whether this leads to greater knowledge acquisition than traditional didactic lectures. Four cohorts of Cambridge medical students (n = 54) were randomised to case-based discussion or traditional didactic lectures for two topics in their psychiatry placements. Enjoyment and stimulation were determined by feedback forms; knowledge acquisition was tested by an end-of-placement exam.

Results

Students in case-based discussion groups scored significantly higher than students in the lecture groups in the extent to which they enjoyed the teaching session (P = 0.006); the extent to which they understood the principles of management of real-life patient problems (P = 0.044); and their interest in looking up further information (P = 0.003). There was no significant difference in exam performance (P = 0.9).

Clinical implications

Medical students find case-based discussion more engaging and enjoyable than didactic lectures, with no reduction in exam performance.

Effective physiology teaching methods: from the perspective of first year MBBS students

BACKGROUND

Students who took admission in first year MBBS course used to study physiology, anatomy and biochemistry for one and half years. Since a decade the first year course duration was reduced to one year unaltering the syllabus in the three basic subjects. So students are focusing on the easy ways to clear the university exams by accepting the concise books, which is dampening the real quality of the subject knowledge. This study is aimed at understanding the best methods of physiology teaching in the lecture gallery, from the student's perspective.

MATERIALS AND METHODS

The present study was undertaken at a private medical college in southern part of India in Telangana state, on 100 students who took admission in first year MBBS course, in the academic year 2015-2016. Out of 100, 36 are boys and 64 are girl students. Distributed a question paper which is having 2 sets of questions. First question is having three statements regarding the teaching methods namely; chalk and blackboard teaching, over head projection teaching and power point teaching. Students were asked to choose the best statement which they prefer. Second question is consisting of combination of teaching methods and they are; chalk and blackboard with over head projection teaching method, chalk and blackboard with power point presentation. Again the students were asked to choose one of the 2 statements in 2^nd question.

RESULTS

Students preference of teaching methods for understanding of physiology in percentage; chalk and blackboard-54, over head projection teaching-4, power point presentation-32, chalk and blackboard with over head projection-26, chalk and blackboard with power point presentation-64.

CONCLUSION

Majority of the students are in favor of a combination of chalk and blackboard with power point presentation for better understanding of physiology, next is chalk and blackboard teaching alone.

Integrating the ACR Appropriateness Criteria Into the Radiology Clerkship: Comparison of Didactic Format and Group-Based Learning

PURPOSE

The aim of this study was to determine whether group-based or didactic teaching is more effective to teach ACR Appropriateness Criteria to medical students.

METHODS

An identical pretest, posttest, and delayed multiple-choice test was used to evaluate the efficacy of the two teaching methods. Descriptive statistics comparing test scores were obtained.

RESULTS

On the posttest, the didactic group gained 12.5 points (P < .0001), and the group-based learning students gained 16.3 points (P < .0001). On the delayed test, the didactic group gained 14.4 points (P < .0001), and the group-based learning students gained 11.8 points (P < .001). The gains in scores on both tests were statistically significant for both groups. However, the differences in scores were not statistically significant comparing the two educational methods.

CONCLUSIONS

Compared with didactic lectures, group-based learning is more enjoyable, time efficient, and equally efficacious. The choice of educational method can be individualized for each institution on the basis of group size, time constraints, and faculty availability.

Involving postgraduate's students in undergraduate small group teaching promotes active learning in both

BACKGROUND

Lecture is a common traditional method for teaching, but it may not stimulate higher order thinking and students may also be hesitant to express and interact. The postgraduate (PG) students are less involved with undergraduate (UG) teaching. Team based small group active learning method can contribute to better learning experience.

AIM

To-promote active learning skills among the UG students using small group teaching methods involving PG students as facilitators to impart hands-on supervised training in teaching and managerial skills.

METHODOLOGY

After Institutional approval under faculty supervision 92 UGs and 8 PGs participated in 6 small group sessions utilizing the jigsaw technique. Feedback was collected from both.

OBSERVATIONS

Undergraduate Feedback (Percentage of Students Agreed): Learning in small groups was a good experience as it helped in better understanding of the subject (72%), students explored multiple reading resources (79%), they were actively involved in self-learning (88%), students reported initial apprehension of performance (71%), identified their learning gaps (86%), team enhanced their learning process (71%), informal learning in place of lecture was a welcome change (86%), it improved their communication skills (82%), small group learning can be useful for future self-learning (75%). Postgraduate Feedback: Majority performed facilitation for first time, perceived their performance as good (75%), it was helpful in self-learning (100%), felt confident of managing students in small groups (100%), as facilitator they improved their teaching skills, found it more useful and better identified own learning gaps (87.5%).

CONCLUSIONS

Learning in small groups adopting team based approach involving both UGs and PGs promoted active learning in both and enhanced the teaching skills of the PGs.

A comparison of Web-based and small-group palliative and end-of-life care curricula: a quasi-randomized controlled study at one institution

PURPOSE

Few studies have compared the effect of Web-based eLearning versus small-group learning on medical student outcomes. Palliative and end-of-life (PEOL) education is ideal for this comparison, given uneven access to PEOL experts and content nationally.

METHOD

In 2010, the authors enrolled all third-year medical students at the University of California, Davis School of Medicine into a quasi-randomized controlled trial of Web-based interactive education (eDoctoring) compared with small-group education (Doctoring) on PEOL clinical content over two months. Students participated in three 3-hour PEOL sessions with similar content. Outcomes included a 24-item PEOL-specific self-efficacy scale with three domains (diagnosis/treatment [Cronbach alpha=0.92; CI: 0.91-0.93], communication/prognosis [alpha=0.95; CI: 0.93-0.96], and social impact/self-care [alpha=0.91; CI: 0.88-0.92]); 8 knowledge items; 10 curricular advantage/disadvantages; and curricular satisfaction (both students and faculty).

RESULTS

Students were randomly assigned to Web-based eDoctoring (n=48) or small-group Doctoring (n=71) curricula. Self-efficacy and knowledge improved equivalently between groups (e.g., prognosis self-efficacy, 19%; knowledge, 10%-42%). Student and faculty ratings of the Web-based eDoctoring curriculum and the small-group Doctoring curriculum were equivalent for most goals, and overall satisfaction was equivalent for each, with a trend toward decreased eDoctoring student satisfaction.

CONCLUSIONS

Findings showed equivalent gains in self-efficacy and knowledge between students participating in a Web-based PEOL curriculum in comparison with students learning similar content in a small-group format. Web-based curricula can standardize content presentation when local teaching expertise is limited, but it may lead to decreased user satisfaction.

Basic life support is effectively taught in groups of three, five and eight medical students: a prospective, randomized study

BACKGROUND

Resuscitation is a life-saving measure usually instructed in simulation sessions. Small-group teaching is effective. However, feasible group sizes for resuscitation classes are unknown. We investigated the impact of different group sizes on the outcome of resuscitation training.

METHODS

Medical students (n = 74) were randomized to courses with three, five or eight participants per tutor. The course duration was adjusted according to the group size, so that there was a time slot of 6 minutes hands-on time for every student. All participants performed an objective structured clinical examination before and after training. The teaching sessions were videotaped and resuscitation quality was scored using a checklist while we measured the chest compression parameters with a manikin. In addition, we recorded hands-on-time, questions to the tutor and unrelated conversation.

RESULTS

Results are displayed as median (IQR). Checklist pass rates and scores were comparable between the groups of three, five and eight students per tutor in the post-test (93%, 100% and 100%). Groups of eight students asked fewer questions (0.5 (0.0 - 1.0) vs. 3.0 (2.0 - 4.0), p < .001), had less hands-on time (2:16 min (1:15 - 4:55 min) vs. 4:07 min (2:54 - 5:52 min), p = .02), conducted more unrelated conversations (17.0 ± 5.1 and 2.9 ± 1.7, p < 0.001) and had lower self-assessments than groups of three students per tutor (7.0 (6.1 - 9.0) and 8.2 (7.2 - 9.0), p = .03).

CONCLUSIONS

Resuscitation checklist scores and pass rates after training were comparable in groups of three, five or eight medical students, although smaller groups had advantages in teaching interventions and hands-on time. Our results suggest that teaching BLS skills is effective in groups up to eight medical students, but smaller groups yielded more intense teaching conditions, which might be crucial for more complex skills or less advanced students.

Didactic Lecture Versus Interactive Workshop for Continuing Pharmacy Education on Reproductive Health

Pharmacists are routinely providing reproductive health counseling in community pharmacies, but studies have revealed significant deficits in their competencies. Therefore, continuing pharmacy education (CPE) could be utilized as a valuable modality to upgrade pharmacists’ capabilities. A randomized controlled trial was designed to compare the efficacy of CPE meetings (lecture based vs. workshop based) on contraception and male sexual dysfunctions. Sixty pharmacists were recruited for each CPE meeting. Small group training using simulated patients was employed in the workshop-based CPE. Study outcomes were declarative/procedural knowledge, attitudes, and satisfaction of the participants. Data were collected pre-CPE, post-CPE, and 2 months afterward and were analyzed using repeated measure analysis of variance and Mann–Whitney U test. Results showed that lecture-based CPE was more successful in improving pharmacists’ knowledge post-CPE ( p < .001). In contrast, a significant decrease was observed in the lecture-based group at follow-up ( p = .002), whereas the workshop-based group maintained their knowledge over time ( p = 1.00). Knowledge scores of both groups were significantly higher at follow-up in comparison with pre-CPE ( p < .01). No significant differences were observed regarding satisfaction and attitudes scores between groups. In conclusion, an interactive workshop might not be superior to lecture-based training for improving pharmacists’ knowledge and attitudes in a 1-day CPE meeting.

The use of specially designed tasks to enhance student interest in the cadaver dissection laboratory

Cadaver dissection is a key component of anatomy education. Unfortunately, students sometimes regard the process of dissection as uninteresting or stressful. To make laboratory time more interesting and to encourage discussion and collaborative learning among medical students, specially designed tasks were assigned to students throughout dissection. Student response and the effects of the tasks on examination scores were analyzed. The subjects of this study were 154 medical students who attended the dissection laboratory in 2009. Four tasks were given to teams of seven to eight students over the course of 2 weeks of lower limb dissection. The tasks were designed such that the answers could not be obtained by referencing books or searching the Internet, but rather through careful observation of the cadavers and discussion among team members. Questionnaires were administered. The majority of students agreed that the tasks were interesting (68.0%), encouraged team discussion (76.8%), and facilitated their understanding of anatomy (72.8%). However, they did not prefer that additional tasks be assigned during the other laboratory sessions. When examination scores of those who responded positively were compared with those who responded neutrally or negatively, no statistically significant differences could be found. In conclusion, the specially designed tasks assigned to students in the cadaver dissection laboratory encouraged team discussion and collaborative learning, and thereby generated interest in laboratory work. However, knowledge acquisition was not improved.

The audience response system and knowledge gain: a prospective study

INTRODUCTION

The introduction of an audience response system (ARS) in the obstetrics and gynaecology course for medical students at The University of Western Australia provided an opportunity to measure knowledge gain by ARS lecture formats compared with didactic lectures.

METHODS

The study was conducted over four obstetrics and gynaecology terms, alternating the ARS and didactic format between two selected lectures each term. Students completed multiple-choice quizzes immediately post-lectures and 5 weeks later.

RESULTS

Immediate post-lecture quiz mean scores for the ARS lectures were significantly higher compared with scores for the didactic lectures (7.5 vs. 6.7, p < 0.001). Pairwise comparisons between ARS and didactic lectures for each lecture topic showed significantly higher quiz scores for ARS lectures (preterm labour 8.3 vs. 7.4, p = 0.032; and prenatal diagnosis 6.9 vs. 6.0, p = 0.014). Quiz scores for the didactic preterm labour lecture were significantly higher than scores for the didactic prenatal diagnosis lecture (6.0 vs. 7.4, p < 0.001). Quiz results at 5 weeks showed no differences in scores between the ARS and the didactic lectures and no differences between lecture topics.

CONCLUSIONS

Use of the ARS in lectures appeared to improve knowledge gain immediately post-lecture but no difference was found after retesting at 5 weeks.

To determine the level of satisfaction among medical students of a public sector medical university regarding their academic activities

Background

An ongoing evaluation system is essential to determine if the academic system in place has worked to produce a better product, hence the objective of our study was to evaluate the satisfaction level among medical students regarding their academic teaching and assessment method and what measures will they suggest for the future to rectify the current situation.

This questionnaire based cross sectional study was conducted in a public sector medical university from February to July 2010. A well structured questionnaire was administered to a random sample of 375 final year medical students. However 292 of the students provided informed consent and filled in the questionnaire which included their demographic profile as well as questions in line with the study objective. Data was entered in a Statistical Package for Social Sciences (SPSS version.16) and analyzed using descriptive statistics.

Findings

The male to female ratio in our study was 1:2. Most of the students (57.2%) were dissatisfied with the quality of teaching in the university. Fifty-seven percent of the participants believed that the current standard of their institute were not at par with those of international medical universities. BCQ's were the mode of examination questions preferred by the majority of the students. Most of the students (66.1%) wanted the university to conduct career planning seminars to help them plan their career.

Conclusions

These results suggest that the students of public sector medical universities are unsatisfied from current academic facilities and teaching activities. Students recommend increased emphasis on better lectures and practical training as well as a need to incorporate career planning sessions for the students to help plan them their future career paths.

Improving education under work-hour restrictions: comparing learning and teaching preferences of faculty, residents, and students

BACKGROUND

Faced with work-hour restrictions, educators are mandated to improve the efficiency of resident and medical student education. Few studies have assessed learning styles in medicine; none have compared teaching and learning preferences. Validated tools exist to study these deficiencies. Kolb describes 4 learning styles: converging (practical), diverging (imaginative), assimilating (inductive), and accommodating (active). Grasha Teaching Styles are categorized into "clusters": 1 (teacher-centered, knowledge acquisition), 2 (teacher-centered, role modeling), 3 (student-centered, problem-solving), and 4 (student-centered, facilitative).

STUDY DESIGN

Kolb's Learning Style Inventory (HayGroup, Philadelphia, Pennsylvania) and Grasha-Riechmann's TSS were administered to surgical faculty (n = 61), residents (n = 96), and medical students (n = 183) at a tertiary academic medical center, after informed consent was obtained (IRB # 06-0612). Statistical analysis was performed using χ(2) and Fisher exact tests.

RESULTS

Surgical residents preferred active learning (p = 0.053), whereas faculty preferred reflective learning (p < 0.01). As a result of a comparison of teaching preferences, although both groups preferred student-centered, facilitative teaching, faculty preferred teacher-centered, role-modeling instruction (p = 0.02) more often. Residents had no dominant teaching style more often than surgical faculty (p = 0.01). Medical students preferred converging learning (42%) and cluster 4 teaching (35%). Statistical significance was unchanged when corrected for gender, resident training level, and subspecialization.

CONCLUSIONS

Significant differences exist between faculty and residents in both learning and teaching preferences; this finding suggests inefficiency in resident education, as previous research suggests that learning styles parallel teaching styles. Absence of a predominant teaching style in residents suggests these individuals are learning to be teachers. The adaptation of faculty teaching methods to account for variations in resident learning styles may promote a better learning environment and more efficient faculty-resident interaction. Additional, multi-institutional studies using these tools are needed to elucidate these findings fully.

Internal medicine clerkship characteristics associated with enhanced student examination performance

PURPOSE

To determine which internal medicine (IM) clerkship characteristics are associated with better student examination performance.

METHOD

The authors collected data from 17 U.S. medical schools (1,817 students) regarding characteristics of their IM clerkships, including structural characteristics, pedagogical approaches, patient contact, and clinical teacher characteristics. Outcomes of interest were postclerkship National Board of Medical Examiners (NBME) subject examination score, United States Medical Licensing Examination (USMLE) 2 score, and change in score from USMLE 1 to 2. To examine how associations of various clerkship characteristics and examination performance may differ for students of different prior achievement, the authors categorized students into those who scored in the top (1/4) of the cohort on USMLE 1 and the bottom (1/4). The authors conducted analyses at both the school and the individual student levels.

RESULTS

In school-level analyses (using a reduced four-variable model), independent variables associated with higher NBME subject examination score were more small-group hours/week and use of community-based preceptors. Greater score increase from USMLE 1 to 2 was associated with students caring for more patients/day. Several variables were associated with enhanced student examination performance at the student level. The most consistent finding was that more patients cared for per day was associated with higher examination performance. More structured learning activities were associated with higher examination scores for students with lower baseline USMLE 1 achievement.

CONCLUSION

Certain clerkship characteristics are associated with better student examination performance, the most salient being caring for more patients per day.

Does teaching style matter? A randomised trial of group discussion versus lectures in orthopaedic undergraduate teaching

OBJECTIVES

Educational theory suggests that lectures may not be the best way to impart knowledge to students. The aim of this study was to compare the use of didactic lectures with that of interactive discussion sessions in undergraduate teaching of orthopaedics and trauma.

METHODS

A total of 77 medical students were assessed in 3 consecutive cohorts. The students were randomised into 2 groups. The first group received a series of 12 formal lectures. The second group covered the same topics in 12 group-discussion sessions with self-directed learning.

RESULTS

The students in the interactive discussion group rated the presentation of their teaching more highly than those in the lecture group (P = 0.003). However, there was no difference in their rating of the content of the sessions. The students in the discussion group also performed better on their end-of-placement written test (P = 0.025).

CONCLUSIONS

We found that interactive teaching styles are more popular than didactic lectures in undergraduate orthopaedic and trauma teaching. We also found some evidence that knowledge retention is better following an interactive teaching style.

The influence of an audience response system on knowledge retention: an application to resident education

OBJECTIVE

The purpose of the study was to compare delivery methods of lecture material regarding contraceptive options by either traditional or interactive lecture style with the use of an audience response system with obstetrics and gynecology residents.

STUDY DESIGN

A prospective, randomized controlled trial that included 17 obstetrics and gynecology residents was conducted. Group differences and comparison of pre/posttest scores to evaluate efficacy of lecture styles were performed with the Student t test. Each participant completed an evaluation to assess usefulness of the audience response system.

RESULTS

Residents who received audience response system interactive lectures showed a 21% improvement between pretest and posttest scores; residents who received the standard lecture demonstrated a 2% improvement (P = .018). The evaluation survey showed that 82% of residents thought that the audience response system was a helpful learning aid.

CONCLUSION

The results of this randomized controlled trial demonstrate the effectiveness of audience response system for knowledge retention, which suggests that it may be an efficient teaching tool for residency education.