Teacher questions and student responses in case-based learning: outcomes of a video study in medical education

Online case-based learning for medical students as a teaching method for biochemistry at King Abdulaziz University amid COVID-19 pandemic (a study conducted in 2021)

Online case-based learning (CBL) is a method used by King Abdulaziz University to teach medical students in their preclinical years. The use of CBL in basic sciences is important for enabling medical students to correlate basic sciences with future clinical practice. This study implemented online CBL for biochemistry teaching as part of the medical genetic module for 3rd-year preclinical students. Teaching during the study was completely online because of restricted precautions caused by the COVID-19 pandemic, except for practical sessions that were held on campus. The case was presented to the students involved in prenatal screening and diagnosis. Students were guided to learn and discuss the biochemical tests used for prenatal screening and diagnosis and their clinical importance. They were divided into two groups: the control group was given an online lecture and the intervention group was given an online CBL session before the lecture. The online lecture was given to both groups simultaneously by the same instructor, and then 10 MCQs tests were distributed to both groups after the lecture, and their test scores were compared. A 10-question survey was administered to the intervention group to assess their perception of the online CBL session after the test. A significant difference was found between the intervention and control groups regarding test scores (p < 0.001), and most students found the online CBL session enjoyable and motivating.

WeChat as a platform for blending problem/case-based learning and paper review methods in undergraduate paediatric orthopaedics internships: a feasibility and effectiveness study

BACKGROUND

Paediatric orthopaedics is a significant and difficult for undergraduate students to master. During the COVID-19 pandemic, we used the WeChat platform to combine the advantages offered by problem-based learning (PBL), case-based learning (CBL) and paper review teaching methods to establish a new blended online teaching model and demonstrated its feasibility and effectiveness.

OBJECTIVE

This study aims to demonstrate the feasibility and effectiveness of a new blended pedagogical method that uses the WeChat platform and combines PBL, CBL and paper review.

METHODS

We enrolled 22 students participating in the Department of Paediatric Orthopaedics. They participated in the WeChat blended pedagogy mode. Their departmental rotation examination scores were compared with those of 23 students who participated in the traditional teaching method. Moreover, an anonymous questionnaire was used to evaluate students' perceptions and experiences.

RESULTS

The total average scores of students who participated in the WeChat blended pedagogy mode and the traditional teaching method were 47.27 and 44.52, respectively. There were no statistically significant differences between the online teaching mode and the traditional teaching method in terms of possessing professional accomplishment, gaining knowledge and promoting interpersonal skills (P = 0.07, P = 0.12 and P = 0.65, respectively). In terms of independent clinical thinking, self-improving capability and improving clinical skills, the scores associated with the WeChat blended pedagogy mode were 8.00, 8.00 and 6.00, whereas those associated with the traditional teaching method were 6.70, 6.87 and 7.48. The overall satisfaction with the WeChat blended pedagogy mode reached 100%. A total of 64%, 86%, 68%, 64% and 59% of students chose very large or large in response to the items concerning professional accomplishment, knowledge absorption, independent clinical thinking skills, English reading and literature exploring capacity, as well as interpersonal skills, respectively. Fifteen participants claimed that the WeChat blended pedagogy mode was less helpful to them with regard to promoting the improvement of their clinical skills. Nine students claimed that the WeChat blended pedagogy mode was time-consuming.

CONCLUSIONS

Our study verified the feasibility and effectiveness of the WeChat blended pedagogy mode for undergraduate paediatric orthopaedics internships.

TRIAL REGISTRATION

Retrospectively registered.

Is there an increase over time in the complexity of teacher questions and student responses in case-based clinical seminars? A cross-sectional video study

BACKGROUND

Case-based group discussions (CBGD) are a specific, interaction-focused format dedicated to fostering medical students' skills in applying basic biomedical knowledge to patient cases. Existing conceptions of CBGD suggest that a gradient towards increased opportunities for students to make elaborative verbal contributions is an important element of such seminars. To verify this assumption, we investigate empirically if clinical teachers progress from more basic, knowledge-oriented questions towards more advanced, elaboration-oriented questions in such seminars.

METHODS

We videotaped 21 different clinical teachers and 398 medical students in 32 CBGD-seminars on surgery and internal medicine. We coded closed-reproductive and open-elaborative teacher questions as well as reproductive and elaborative student responses to these questions. Inter-rater reliability was satisfactory. To determine trends regarding the teacher questions / student responses, we compared eight time-segments of equal duration per seminar.

RESULTS

Overall, clinical teachers asked more closed-reproductive than open-elaborative questions. Students gave more reproductive than elaborative responses. Regarding the frequencies of these forms of teacher questions / student responses, we found no significant differences over time.

CONCLUSIONS

Clinical teachers did not deliberately modify the types of questions over time to push students towards more elaborative responses. We conclude that the critical question to which degree promising teaching approaches are actually put into clinical teaching practice should be raised more purposefully in medical education research.

The Use of Blended Teaching in Higher Medical Education during the Pandemic Era

OBJECTIVE

This study aims to compare the effect of blended teaching and traditional teaching in higher medical education during the pandemic era.

METHODS

Taking the teaching of neurology as an example, 293 Yangzhou University Clinical Medicine 2016 undergraduate students were selected as the research subjects, and were randomly divided into 2 groups a blended teaching group (n = 148) and a traditional teaching group (n = 145), and received blended teaching and traditional teaching, respectively. The blended teaching was based on a Massive Open Online Course, problem-based learning, and case-based learning and supplemented by Tencent video conferences, QQ messaging groups, and other auxiliary teaching tools. At the end of the course, the teaching effect and satisfaction rate were evaluated through theory assessment, practical skills assessment, and an anonymous questionnaire survey.

RESULTS

There were significant differences in theoretical achievements (81.83 ± 6.23 vs 76.79 ± 6.87, P < 0.001) and practical skill achievements (84.74 ± 6.50 vs 78.48 ± 6.53, P < 0.001). In addition, significant differences in all aspects of satisfaction rate were observed between the two groups (all P < 0.001).

CONCLUSION

Blended teaching is beneficial to students' learning and stimulates their enthusiasm, cultivates clinical thinking ability, and improves teaching quality. Thus, it has played a positive role in the reform of higher medical teaching during the pandemic era.

Application of online case-based learning in the teaching of clinical anesthesia for residents during the COVID-19 epidemic

OBJECTIVE

COVID-19 prevention and control demand a reduction in crowd gathering, which has a significant impact on traditional teaching and offline case-based learning (CBL). In order to mitigate the impact of the COVID-19 outbreak on clinical teaching, we aimed to compare the effects of an online CBL with traditional teaching model on learning outcomes of anesthesia residents.

METHODS

Residents rotated in the Department of Anesthesiology in Beijing Tsinghua Changgung Hospital from January 2020 to February 2021 were included in Group W (n = 19), which implemented the W-CBL teaching model. The performance of residents was evaluated with theory test and 2 survey questionnaires (A and B) were conducted after 1 month of rotating. All 20 residents rotating in the Department of Anesthesiology at our hospital from January 2018 to December 2019 were included in Group C, which implemented the traditional teaching model. Their examination results were acquired through the teaching files and survey questionnaire (A) were administered through WeChat.

RESULTS

During the 1-month rotation, a total of 10 cases were discussed in Group W. The average score for theory test was higher in Group W than that in Group C (84.57 ± 4.87 vs. 79.35 ± 3.70, P = 0.001). The satisfaction rate was also in favor of Group W regarding to clinical thinking, communication skills, learning interest and self-learning ability (P < 0.05).

CONCLUSIONS

Online CBL based on WeChat platform is an effective and acceptable teaching strategy in comparison to lecture-based learning (LBL) among residents embarking on clinical anesthesia courses.

Effects on applying micro-film case-based learning model in pediatrics education

BACKGROUND

In view of the harsh reality Chinese paediatricians face, the challenge of paediatric education is about instilling not only knowledge and clinical skills but also resilience and beliefs. The aim of the study is to explore a more effective method than the traditional lecture-based learning (LBL) model for optimizing educational outcomes by establishing an innovative, comprehensive, case-based learning (CBL) model combined with the micro-film technique (MF + CBL). This approach has four important components: interests (attraction), knowledge application, competency, and scenario coping skills.

METHODS

Experimental research was conducted via a controlled parallel group study. The total sample of 104 senior-year students (Chinese) majoring in clinical medicine was randomly divided into two groups. The experimental group was exposed to the MF + CBL model and the control group to the LBL model. Overall, the results were assessed after an 8-week course via a student self-assessment questionnaire, a satisfaction survey and the final examination.

RESULTS

The experimental group generally performed better than the control group on the student self-assessment (P<0.05), satisfaction survey (P<0.05), and final examination (80.02 ± 3.77 vs 73.65 ± 3.69, P = 0.000). The open question at the end of the questionnaire revealed that a small number of students did not favour the MF + CBL model due to its time- and energy-consuming features.

CONCLUSIONS

Compared with LBL, the MF + CBL model was an innovative teaching method that promoted more comprehensive quality development. It represents an alternative model for optimizing the capacity of future paediatric doctors.