Instrumental small-group teaching as a democratic endeavour

This chapter introduces small group teaching as an approach, and describes the key, fundamental principles for establishing and teaching within small groups. Small groups are a valuable setting in which doctors can learn the range of skills required for professional practice. The strength of learning in a small group, compared with a large group, lies in the increased opportunities for interaction, both between teachers and learners, and between the learners themselves. Practical advice for setting up small group teaching courses, and facilitating within small groups is offered. Case examples are utilized throughout to encourage readers to think about small group teaching within their own clinical contexts. Advice on adapting to learners’ needs in small group teaching is offered, including working with students who seem disengaged, underprepared, dominant, and tardy.

Introduction: Small group teaching is an educational strategy that may be used to facilitate learning. Tutorials enable an adult approach toward learning where students take responsibility for their own learning. We aimed to investigate the students’ engagement and perceptions of small group tutorial classes among undergraduate medical students.Methods: A cross‑sectional, descriptive survey was conducted at the Subbaiah Institute of Medical Sciences, where we collected the data from 300 undergraduate students using convenience sampling method. A self‑administered questionnaire consisting of 22 items which was piloted on 20 students, and six experienced medical educators were consulted for face validation. The internal consistency of the questionnaire measured by Cronbach’s alpha reliability test was 0.80. It was used to measure the students’ perception on the effectiveness of tutorials with regard to learning experience, teamwork, confidence, communication skills, and role of the teacher. Statistical analyses included mean and standard deviation for the description of each item, t-test to compare the mean scores for gender and class year, and one‑way analysis of variance between groups for age group comparisons using SPSS version 24 software. Results:Students’ overall perceptions of small group teaching effectiveness showed that tutorials were beneficial to their learning process (mean: 3.61±0.50).The majority of the students have positive perceptions toward small group effectiveness, particularly in learning experience (mean: 3.72±0.68)and teamwork (mean: 3.36±0.59). A significant difference was found between year 1 and year 2 students with regards to learning experience (p<0.001), teamwork (p<0.05),communication skills (p<0.05), and the role of the tutor (p<0.001). Additionally, the mean scores, measuring overall effectivenessof tutorials, for the 2nd year students were significantly higher than that for the 1st year students (3.70± .41 and 3.50 ±0.57, (p<0.001).Conclusions: The data of this study show that tutorial is an effective small group teaching method for medical students compared to large group teaching.

Introduction Small group teaching strategies have been considered more efficient than didactic lectures in motivating trainees. There is a lack of studies focusing on the use of small group discussions for higher surgical training. The aims of the current study were to report the implementation of small group teaching and to move away from didactic lectures for a regional trauma and orthopaedics higher surgical trainee teaching programme. Methods Feedback from the teaching sessions was prospectively collected from trainees regarding the delivery of their surgical curriculum and meeting their training needs using formal feedback forms. Twenty-two consecutive regional teaching sessions were included in the analysis, twelve using a variety of teaching methods including didactic lectures, and ten sessions aiming to focus entirely on a small group format. Comparisons were then made between the two teaching formats. Results A weak correlation was found between the teaching feedback scores and the amount of the session comprised of the small group format as per the published schedules (rs = 0.296) and as rated by the trainees (rs = 0.061). There was a statistically significant positive correlation between the proportion of small group format teaching and how useful the trainees rated this for their education (rs = 0.597, p = 0.005). Conclusions The assessment of small group format teaching in higher surgical trainee education has not been previously reported. The current study shows that trauma and orthopaedics higher surgical trainee satisfaction with Fellowship of Royal College of Surgeons (FRCS) curriculum teaching has a significant correlation with a greater proportion of small group format.

Background: Active learning strategies for understanding the subject like microbiology is need of the hour. Small group teaching is considered to nurture active learning by the students. It is a student centered method and promotes active learning. So by keeping in mind the usefulness of the active learning, the present study was planned to assess the perception of students after introducing small group teaching (SGT) in Microbiology. Materials and Method: The study was conducted on 150 MBBS second year professional students in the department of microbiology of Maharishi Markandeshwar Institute of Medical Sciences & Research, Mullana. Small group teaching method were conducted for all selected topics. At the end of the sessions of SGT, perceptions of students were taken on feedback questionnaire and analysed on 3 point Likert scale. Result: Total 150 MBBS second Professional Students taken part in Study. Out of 150 students, 142 (94%) students took part in the study. Above 90% stated that it is easy and fun filled method, concepts are clearer and stronger, interaction increased with teachers, retention of the subject increased. Above 80% stated that willingness to study increased, doubts cleared easily, attention in the class increased, increased application of knowledge, sharing of ideas. Above 70% stated that clinical correlation, learn team work, self-directed learning. Conclusion: By Small group teaching, students will be apply their knowledge and will be able to provide effective diagnostic services in the community. Small group teaching can be easily adopted in curriculum by proper management of time and by cooperation of faculty and students.

Tutorial has embodied a major teaching–learning strategy in basic science of medical education and is widely researched for its effectiveness in learning outcomes. It is a class or short series of classes in which one or more instructors provide intensive instruction on a subject to a small group. Medical students, during tutorials, are trained to develop and test their ideas, clarify concepts taught in lectures, define new problems, seek solutions, cultivate problem-solving skills, and indulge in self-learning. Literature identifies certain important issues with respect to challenges and limitations of conventional tutorial method. Constraints such as lack of structural uniformity, financial and resource limitations for teaching in small groups, and short supply of dependable peer tutors are a few recognized challenges. Available bodies of research also suggest need-based modifications to overcome the operational difficulties without compromising the integrity of tutorial. The proposed alterations can be of consequence in developing professional competencies such as interpersonal and self-directed learning skills. It is apparent that different tutorial formats may be optimal in different fields and levels of study and hence should be piloted as per the local need and relevance.

Introduction: Student driven interactive methods of teaching are a major part of andragogy, which drives them to professional competency. Jigsaw method is one such interactive teaching modality which fosters self-directed learning and peer interaction. The aim of this study is to access the effectiveness of Jigsaw method of interactive teaching qualitatively and quantitatively among 1st year MBBS students. Materials and methods: this study was done in 1st year medical students. The students were exposed to jigsaw method of interactive teaching in small groups and the program was evaluated by assessing the short and long term memory of the students. Feedback also was obtained from the students. Results: There was a statistically significant difference in the mean scores as compared to traditional teaching methods. The perception of students also showed promising results. Discussion: there have been many studies on student perception on such interactive teaching methods which revealed that the students were showing better academic performances. A few studies like the present one, on quantitative assessment of students score after Jigsaw method of interactive teaching has also shown good results. Conclusion: the jigsaw method of interactive teaching encourages student participation and enhances self directed learning and peer assisted learning. KEY WORDS: Neuroanatomy, jigsaw, peer learning, androgogy.

In 2002, the Medical Licensing Board prescribed fundamental changes in medical education. The reformed curriculum set its focus on bed-side teaching in small groups, problem-based courses, and training of communication skills. The previous curriculum did not include the teaching of communication skills to future physicians. Physicians thus felt unprepared for the doctor-patient communication. Within the newly derived Medical Curriculum Munich (MeCuMLMU), the School of Medicine at the Ludwig-Maximilian-University of Munich implemented in 2005 a teaching unit named "Breaking Bad News" in order to train the students' communication skills. Its main elements are videotaped role-plays and the subsequent video-based analyses. In the role-plays, students experience the parts of a physician and a couple of parents. The task of the physician is to break the news of a severe condition to the parents of a child. The teaching units are held by members of the department of child psychiatry together with fifteen members of the department of paediatrics who had been instructed in analyzing videotaped role-plays. A manual was developed to facilitate a standardized approach. The teaching units were evaluated by means of questionnaires filled in by students and tutors. The evaluation showed that "Breaking Bad News" was highly appreciated by both students and tutors. Our experience showed that this type of instruction is suitable to improve the communication skills of medical students, and it is feasible despite the relatively extensive technical and personnel resources needed.

Hands-on, practical teaching in small groups

Objective:The aim of this study was to evaluate if small group teaching in Radiology impacted Anatomy scores in the summative end of year examination.Methods:Small group teaching in Radiology was incorporated into Anatomy of year one medical students during the academic years 2016/17 and 2017/18. Examination outcome for 2 years before and 1 year after the study period were compared.Question papers for end of year summative examinations were retrieved; questions relating to Anatomy were identified and anonymised scores for students were obtained.Results:Student numbers ranged 238 to 290/year. Mean Anatomy scores ranged 62–74%, this compared with mean total exam score of 62–65%. No significant difference in Anatomy and Total examination scores for 2015, 2016 and 2019. Mean (SD) Anatomy scores were significantly higher than the Total examination scores for the study period of 2017 and 2018 [68.97 (17.32) vs 63.12 (11.51) and 73.77 (17.85) vs 64.99 (10.31) (p < 0.001)]. Combined Anatomy scores 2017 and 2018 were significantly higher than 2015 and 2016, difference of 5.50 (95% C.I. 3.31–7.70; p < 0.001).Conclusion:This is the first study to objectively demonstrate Radiology small group teaching significantly improved Anatomy scores for medical students in the summative end of year examination.Advances in knowledge:No evidence in the literature that Radiology teaching improves examination outcomes for medical students.This is the first study to directly link Radiology teaching with improved Anatomy examination result.Small group teaching in Radiology is a feasible way to teach Anatomy.

PurposeConventional medical curriculum is the rule of medical teaching in Greek Medical Schools. Medical students are often taught irrelevant details with little or no reference to their potential clinical significance. Alternatively, integrated teaching warrants that the complete teaching material is covered by each faculty member not considering areas of personal expertise. The aim of this study was to evaluate the implementation of integrated teaching in ophthalmic training.MethodsThe main outcome measures of this retrospective study were a) comments and recommendations made anonymously by the fifth-year medical students in the evaluation questionnaires filled in at the end of their training, and b) scores obtained by students in their final examination at the end of their training in the 2nd Department of Ophthalmology as part of the core Curriculum of the Medical School of the Aristotle University of Thessaloniki. The latter outcome was analyzed with respect to the implementation of integrated teaching.ResultsThe score obtained by students in the final examination, which is an objective outcome measure, increased significantly after the implementation of integrated teaching. The final grade (scores out of 10) of students who were trained with the integrated system (6.17±1.67, mean ± standard deviation) was significantly higher compared to those (5.52±2.20) trained with the conventional system (P<0.001). The positive outcome of this process was evident as there was a significant increase in the number of students satisfied with the teaching process compared to previous academic years.ConclusionBased on the experience of eight academic years and as a result of interactive assessment process our department has modified its medical student teaching process from conventional to integrated; all teaching staff members are involved in the teaching process, while students are divided in small groups. In conclusion, integrated teaching in small student groups appears to be an efficient teaching method (for both theoretical and clinical skills) of ophthalmic training for medical students.

ObjectiveDevelopmental assessment is a core paediatric competency, but research demonstrates teaching gaps. This single-blinded, randomised controlled study compares three teaching approaches to developmental assessment in a large group setting based...

Valuing the Education Mission: Implementing an Educational Value Units System

IntroductionLectures and small group teaching are useful to transfer conceptual knowledge. Anatomy is the foundation of medical sciences, but it is perceived to be difficult to comprehend and recall. For such clinically relevant aspects of medical education that require memorization, educational card games can be very effective. As the complex concepts and terminology of Embryology are difficult to follow and retain, we designed a card game “MedFc” for a topic on pharyngeal arches. This study was planned to determine the effectiveness of the card game on curriculum comprehension, recall of factual topics among medical undergraduates, and its utility as a supplement to interactive lecture sessions.MethodsThe mixed method study was conducted in the Department of Anatomy of an undergraduate medical college. Ethical approval was obtained prior to beginning the study. Convenience sampling was done. From a batch of 50 first-year medical students, a total of 40 students consented to participate in the study, 24 (60%) were males and 16 (40%) were female participants. A lecture on the pharyngeal arches was conducted for the entire batch of 50 first-year medical students. After three weeks, the students who consented to participate in the study were randomly grouped into two groups of 20 each. The groups were the game group (which played the card game in teams of five) and the control group (which discussed the same topic in small groups of five). For both the group's pretests and posttests, 10 higher order multiple choice questions, were conducted and students’ feedback regarding the effectiveness of the teaching technique was obtained.ResultsStudents opined that playing the card game was a superb experience, a positive use of time, and a very effective method of comprehension and memorizing complex topics. The scores increased from the pretest to the posttest indicating that both methods effectively reinforced the embryological concepts, but a t test showed that card game is more effective than small group discussions, with p-value = 0.008. The improvement in scores of students who had achieved <50% in pretest for the game group was statistically significant with t-value = 0.0023, when compared with the improvement in scores of similar students from the control group.ConclusionsThe study has demonstrated the effectiveness of “MedFc” card game in the recall of factual topics and can be used as supplementary material for enhancing learning amongst medical graduates. This educational card game applies gamification to Anatomy education to create a fun filled learning experience and is a valuable addition to the learning resources.

A medical curriculum may have teaching learning modalities involving both large group and small groups. Fostering student Interaction, engagement and collaboration is relatively easier in small group. Many of the small group teaching strategies are also applied for effective collaboration and communication to a large group. However, student motivation is the key to student engagement and learning. This editorial explores some of the very simple strategies which allow students opportunities to prepare for their learning as well as to reflect upon their learning. The activities enlisted are simple methods like quiz, practice test, providing lecture slides and lecture videos and giving assignments to students. What is emphasized here is to carry out these activities in a nonthreatening manner without pressure of ‘grades’.The best way would do this is through an online platform hence the provision of learning management system in a teaching institute is emphasized. Using online medium for these activities has two advantages: (i) it will allow the students to carry out the given work in solitude and it will enable us teachers to give one to one feedback or feedback in the form of corrected response. (ii). There is also an advantage of students getting exposed to a blend of both physical teaching learning, during lectures and small group teaching and an opportunity for using online platforms for activities.

Weill Cornell Medical College of Cornell University