Monday, June 23, 2008

The Evidence-Based Teaching Program, Part 2

During the course of the training program at McMaster University, we had both large-group and small-group sessions. Since the primary goal of the program was to provide skill sets for physicians and others involved in health care for use in training either faculty or medical residents, these small and large-group meetings were showcases for various teaching methodologies. I thought I would discuss in brief some of the tactics that were used.

The large-group sessions were held in a standard teaching classroom. At each session, there were approximately 100 people in attendance, and each instructor used various methods for involving and engaging the audience. For example, all instructors commonly asked directed questions at the audience, and allowed time for a number of responses to be received, to be recognized and to be debated. Even when an audience member was way off the mark on a response, their answer was treated with respect, and they were questioned to guide them toward a more proper response. In this way, the fear of being wrong was reduced and this led to more people willing to offer their thoughts.

In the small group sessions (approximately 10 people per group), the main tactic was to ask each participant to present a scientific paper. The paper was organized according to type- therapy, prognosis, diagnosis, systematic review, meta-analysis- and to then discuss that paper with the group via a presentation. There was a checklist provided with each paper that guided, or could help guide, the discussion. In each case, a clinical scenario was used to drive the presentation. For example, we might have been addressing a case where a patient appears to have a condition, and there is a new paper about a new diagnostic test that could be used- for example, beta-natriuretic peptide for differentiating congestive heart failure from lung disease in patients who have dyspnea. What made this challenging is that we had to resolve the clinical question by analyzing the paper for concepts, and then present that to the small group. And we could not use PowerPoint, just a white board. As time went on, presentations became more and more novel, so as not to repeat a method someone else had used. At the end, each presenter was asked to self-critique their performance, then heard the thoughts of the other participants, and finally received comments from group facilitators.

I should note the use of what is called educational gaming. This was an aid in large-group sessions. In simple, it is the use of a “game” in the classroom. In one care, we were all given red and pink index cards, and these were initially used to write short answers to questions, which were then shared with someone not sitting right next to you. These were later used to hold “votes” about the answers to various questions. Another use of a game was an instructor awarding “prizes” to people who correctly answered questions asked of the large group. The prizes were silly, ranging from a pack of gum to, as time went on, a roll of toilet paper, but it engaged the audience for all its simplicity.

The point here is simply that everything that was done in the classroom setting, whether in large or small group, had purpose and truly engaged the learner. It was not a passive learning experience, not at any time.

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