Lynn M. Manfred, and Scott Wellman. University of Massachusetts Medical School and the Departments of Pediatrics and Internal Medicine, Worcester, MA
Purpose: To describe our experience with facilitating active learning in case method teaching conferences.
Methods: As part of a randomized controlled trial of two different conference-teaching methods, case method teaching (CMT) was used as the intervention teaching method. Cases, all real patients whose identities were blinded, were written to address many of the COMSEP learning objectives that were not met by usual clinical experiences. Students received the cases at orientation together with a schedule of when each would be discussed. They were asked to come prepared to discuss the cases. Faculty received a two-hour, small group, facilitator training session that consisted of rational and strategies for promoting student participation. Faculty facilitators initially ran the sessions like PBL. Facilitators recorded their reactions and results of their teaching sessions. They observed each other running sessions and ran some sessions together.
Results: Faculty initially ran the sessions similar to PBL sessions. A brief initial session was used to generate a differential diagnosis and students picked topics to research. Quickly students realized that they then focussed too narrowly and did not read enough to help them solve the case. We then began to run the cases in single sessions. Faculty notes and diaries of sessions showed that faculty felt that good questions which promoted discussion promoted learning. Students in one group even requested to do the initial portion of the case without the facilitator and the brought their questions to the facilitator. This strategy promoted more student participation.
Conclusions: Case method teaching is a viable option for increasing student learning in the pediatrics clerkship. Faculty development for CMT needs to include strategies for asking good questions and promoting active student involvement.