Haidet Paul, Morgan Robert O, O'Malley Kimberly, Moran Betty Jeanne, Richards Boyd F
Houston Center for Quality of Care and Utilization Studies and the Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Adv Health Sci Educ Theory Pract. 2004;9(1):15-27. doi: 10.1023/B:AHSE.0000012213.62043.45.
To compare the effects of active and didactic teaching strategies on learning- and process-oriented outcomes.
Controlled trial.
After-hours residents' teaching session.
Family and Community Medicine, Internal Medicine, and Pediatrics residents at two academic medical institutions.
We randomly assigned residents to two groups. One group received a didactic lecture on effective use of diagnostic tests; during this session, the teacher spent a full hour delivering content. The other group received the same content in a session structured to foster resident-to-resident interactions. In the latter session, the teacher spent only 30 minutes directly delivering content to residents.
We measured residents' knowledge about and attitudes toward the session content before, immediately after, and one month after each session. We measured residents' perceptions of engagement and session value immediately after each session. We employed blinded observers who used a structured instrument to observe residents' activities during each session. Both teaching methods led to improvements in residents' scores on both knowledge and attitude assessments. The amount of improvement was not statistically different between groups. Residents in the active learning session perceived themselves, and were observed to be, more engaged with the session content and each other than residents in the didactic session. Residents in the didactic session perceived greater educational value from the session compared to residents in the active session.
We reduced the amount of time spent in teacher-driven content delivery by 50 percent and covered the same amount of content with no detrimental effects on knowledge acquisition or attitude enhancement. Teaching strategies that foster learner-to-learner interactions will lead to more active engagement among learners, however, these learners may value the session less. Further research is needed to explore learner perceptions of the teaching process and other outcomes of active learning in medical education.
比较主动式教学策略和讲授式教学策略对以学习为导向及以过程为导向的学习成果的影响。
对照试验。
非工作时间的住院医师教学课程。
两所学术性医疗机构的家庭与社区医学、内科及儿科住院医师。
我们将住院医师随机分为两组。一组接受关于诊断测试有效使用的讲授式讲座；在此课程中，教师花了整整一小时讲授内容。另一组在一个旨在促进住院医师之间互动的课程中接受相同的内容。在后一个课程中，教师仅花了30分钟直接向住院医师讲授内容。
我们在每次课程之前、课程结束后立即以及课程结束后一个月测量住院医师对课程内容的知识掌握情况和态度。我们在每次课程结束后立即测量住院医师对参与度和课程价值的认知。我们聘请了不知情的观察员，他们使用结构化工具观察每次课程期间住院医师的活动。两种教学方法都使住院医师在知识和态度评估方面的分数得到了提高。两组之间的提高幅度在统计学上没有差异。与讲授式课程中的住院医师相比，主动学习课程中的住院医师认为自己更积极地参与了课程内容，并且观察结果也显示他们彼此之间的互动更多。与主动学习课程中的住院医师相比，讲授式课程中的住院医师认为该课程具有更高的教育价值。
我们将教师主导的内容讲授时间减少了50%，但涵盖的内容量相同，且对知识获取或态度提升没有不利影响。促进学习者之间互动的教学策略将使学习者更积极地参与，但这些学习者可能对课程的评价较低。需要进一步研究以探索学习者对教学过程的认知以及医学教育中主动学习的其他成果。
