Innovative teaching methods?

[IgD]

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I'm serving on a committee looking at innovative medical education teaching methods. I'm looking for feedback about what is being done in this area that works. For example are you guys learning from videos, web based courses, teleconf etc? Please write back with your experiences.

 

[DogFaceMedic]

I'm serving on a committee looking at innovative medical education teaching methods. I'm looking for feedback about what is being done in this area that works. For example are you guys learning from videos, web based courses, teleconf etc? Please write back with your experiences.

Residents, Med Students, or both? I have opinions on everything -- occasionally constructive.

 

[IgD]

Both

 

[DogFaceMedic]

I believe in two principles: primarily clinical experience and, secondly, exams that force students to learn.

THere is no substitute for clinical practice with real patients. I have a short attention span with "innovative" "technology driven" "concepts" designed to "enhance" the "learning environment". Equally troublesome are the fake patients used with the step II CS and OSCE's. They do not react like normal patients.

Grand rounds presentations that supplement clinical experiences I find to be the most helpful. Specifically, experienced clinicians talking through how they approach clinical problems for residents and med students who have a little experience under their belt for reference. But, these presentations take time to prepare, which is why good ones can be few and far between. In short, the clinical experience becomes the basis of lifelong learning rather than the memorization which is the norm as undergrads and MS1-2.

For the younger med students, learning the basic principles of physical diagnosis and then practice, practice, practice with real patients. In the first two years the students can go along with the Medicine teams on rounds 1-2/week before lectures so that they see the reality of medicine and a reference point in reality for what they are studying. As for the lectures, I actually found them useful, but always took something to study in case the lecture was no good. No matter what I still needed to understand the material.

A word on exams: preparing good exams that prepare for USMLE and shelf exams is time consuming, but is very important in order to hold the student accountable for actually studying the material by whatever methods works for them.

 

[DogFaceMedic]

I should also add that practice for the boards has to be done and is valuable, even though the scenarios are often imperfect reflections of real cases. We still have to pass them.

 

[BrickHouseMD]

I'm currently MS2. My class is huge (317 students) so requiring students to attend lecture (when the lecture hall only holds 300) and then enforcing it is nearly impossible. The work-around, which now seems to be a recruiting pillar, is that every lecture is recorded and webcast. So instead of wasting an hour each day commuting, lost time at lunch and in between classes, and the distractions of my fellow students, I can watch everything from my house and use my reclaimed time to study for the boards or upcoming tests. If I don't get something the first time, I just pause and rewind. If they're talking too fast, I can slow it down. If they're like most of the lecturers, I can double speed them and free up an additional couple hours (we have 5-7 hrs of scheduled lecture a day). If the weather's bad, no worries. If I need to make a doctor's appointment during the week, no problem. It has given us the freedom and responsibility to tailor our schedules to what works best (some of the students fresh out of undergrad still like to sleep until 11 and stay up late, others who took time off like to get up and be working by 7). We still have 2-3 required hospital/clinic events and/or pathophys. labs a week so it's not like we've fallen off the face of the earth. I think it gives us a real advantage mentally to be able to feel like we have some control over our lives still.

 

[IgD]

That's interesting about the class size and webcast. I think that during residency attendance for didactic sessions has to be tracked. I wonder if there is a way to require independent study. The problem is people would just click through the powerpoint presentation/videos and answer the questions. Do you think webcasts would work for residents?

 

[BrickHouseMD]

Not sure. My guess would be that if it were a didactic session and the goal was for providing information (think 1st/2nd year med school type lectures, as opposed to case discussion, etc) then there shouldn't be any problem. Our lectures are also archived so I can go back and re-watch any lecture I want. Say I'm in the clinic and see a real interesting case, I can go back and pull up the basic sciences lectures pertaining to it and refresh myself on the pathophysiology of what's going on. Also makes for great board studying in high-yield topics like pharmacology. Those of you that have been through it will have to be the ones to decide the usefulness during residency. I can imagine, however, pre-recording a lecture and posting it to the site and saying, ok, you have 3 days to view it, do it when you have a break in clinic.

 

[ieatpizza]

That's interesting about the class size and webcast. I think that during residency attendance for didactic sessions has to be tracked. I wonder if there is a way to require independent study. The problem is people would just click through the powerpoint presentation/videos and answer the questions. Do you think webcasts would work for residents?

No way that this would work for residents. Residents are too busy with clinical duties and would simply put it off and then cursorily go through any required questions or exercises (think of those required DoD things you had to do). I think protected and mandated didactic time for residents is important for these reasons. Video lectures work in med school because there is an exam at the end of the course that really counts, and the med student's only job the first two years is to study. Even then, I chose not to watch some lectures in certain instances (i.e. not high yield or just read the notes).