As I work in academic medical center and spend a lot of time with students, residents and fellows, I read with interest an article on active learning on the wards published in Medical Education.
The investigators aimed to compare the educational effectiveness of ward rounds conducted with two different learning methodologies. 72 students in a pediatric rotation were first tested on 30 true/false questions to assess their initial degree of knowledge on pneumonia and diarrhea. Afterwards, they attended ward rounds conducted using an active and a traditional learning methodology. The participants were submitted to a second test 48 hours later in order to assess knowledge acquisition and were asked to answer two questions about self-directed learning and their opinions on the two learning methodologies used.
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The active methodology proved to be statistically more effective for the three outcomes considered: knowledge acquisition, self-directed learning and student opinion on the methods.
I have always felt that active teaching in clinical setting leads to better knowledge acquisition and likely better clinical skills. This study provides some empiric evidence to that effect.
I struggle, however, with how to best implement this teaching method in our Internal Medicine Service. With heavy patient loads, mandatory teaching conferences, clinic sessions, days off and disposition/social work rounds, the day (and rounds) has become so fragmented that simply completing bedside assessments with a proper team has become nearly illusory.
I am open to any suggestions that you may have.