Most students who ever attended the School of Medicine were taught using traditional lectures. In recent years, educators began experimenting with new, interactive teaching methods. Since technology is second-nature to current students, using it to foster more classroom interaction has made a challenging learning experience more engaging, effective — and enjoyable.
Interaction and application are the keys to truly learning the presented material, says David W. Windus, MD, associate dean for medical education and professor of medicine. In the traditional lecture-based format, he says, only a handful of students typically raises their hands to comment or ask a question; others passively take notes.
That was frustrating to Windus for two reasons: It was hard to know what students were getting out of the lecture, and it also seemed to encourage last-minute cramming to learn the material just before a test. So he turned to team-based learning, a concept he says was borrowed from the business school environment.
“In medicine it’s also absolutely critical to learn how to work in teams,” says Windus. “If you can’t do that successfully, you’re not going to do as good a job with patient care.”
How does team-based learning work? In a typical scenario, students are given a preparation assignment to complete outside of class. In the first hour of the next two-hour class, students must demonstrate they learned the material by taking a short, multiple-choice quiz. Then, the larger class is broken into smaller teams to work together on the same questions. As the instructor electronically monitors both individual and team responses, he or she is able to build a discussion using those responses as a springboard.
The results bear out the method. According to Windus, individual results typically average 80 percent correct, while the average team rate is 100 percent. “In other words,” he says, “they teach each other the correct answer.”
Next, after completing the first hour’s material, the teams now tackle a more difficult set of questions that require critical thinking. They might be asked to design questions for the clinical study of a disease or to study a published article and interpret a figure or data. While the first hour of the course is closed-book, in the second hour students can use any means at their disposal to research, answer and ultimately defend their team response.
Other instructors have begun to use the team-based learning approach in their courses as well. Amanda R. Emke, MD, instructor in pediatrics, has been using the audience response system since she became course master for the second-year preclinical pediatrics course three years ago. She incorporates the method into a couple of lectures each term, and this year she used it as part of team-based learning sessions.
“The audience response system makes students more engaged with the material to be learned and this transforms the learning process from passive to active,” says Emke. “It improves retention.”
But the interactive method isn’t just for use in the lecture format. Paul C. Bridgman, PhD, professor of neurobiology and course master for the Histology section of Cell and Organ Systems Biology, uses team-based learning with clickers not only in his lectures, but also in the laboratory.
“We’ve been using the clickers for about five years for each topic that we cover in a lecture and corresponding laboratory,” says Bridgman. “Students like to know how they are doing relative to their peers. The instant display of a graph showing how the respondent answered, along with the correct answer, gives them valuable feedback. And, since the responses to questions are anonymous, students are not reluctant to give answers.”
According to first-year student Dorothy van Oppen, using the clickers keeps students engaged. “I like them because it is a good indication of whether or not I am understanding the lecture. In the lab, we use them as group discussion tools.”
Other nontraditional methods are also gaining ground. Dyads — short breaks mid-lecture during which groups of two students confer about questions — are being used by Bridgman and others after being introduced at a curriculum meeting by second-year student David M. Levine, a former Chicago Public Schools high school teacher. Levine, the medical education representative for his class, notes that dyads require students to be active learners. In addition, the short “breaks” during a lecture can have the effect of regaining students’ attention if it has started to wane.
Allyson R. Zazulia, MD, associate professor of neurology and radiology, has incorporated two non- traditional methods into her teaching (see sidebar).
“I am always looking for different techniques to enhance learning,” says Zazulia, who also assigns students to work on a patient diagnosis and management plan outside of class. “Though students sometimes complain about how much time they spend on it, they appreciate the opportunity to work together on the assignment. It also lets them feel like real doctors.”
While the School of Medicine is embracing new methodologies when they are a good fit, it is not making them mandatory for all courses. A committee of course masters meets regularly and every course comes under review at least once every two years. Student representatives also serve on the committee, and it is this collective input that often convinces instructors to try something new.
“Students are principally here to learn and faculty principally to teach, but we do learn from each other,” says Windus. “We’ve created an environment in which students are very involved with how courses are evaluated. It’s a two-way street.”