Freeman Kathryn, Brown Kathryn, Miller Laura, Nissly Tanner, Ricco Jason, Weinmann Amanda
University of Minnesota Medical School, Minneapolis, MN.
PRiMER. 2022 Jun 1;6:12. doi: 10.22454/PRiMER.2022.586676. eCollection 2022.
Many residency programs utilize passive didactic lectures despite mixed evidence for knowledge retention. This prospective study investigated the efficacy of "relay," an active-learning technique, as measured by residents' knowledge retention and attitudes compared to traditional format.
Faculty presented lectures to four family medicine residency programs on a randomized schedule. Lectures were followed by a 15-minute question-and-answer (Q&A) session or relay session. A relay is a collaborative, question-based game. The primary outcome was knowledge retention at 3 months, comparing Q&A to relay sessions as measured by a multiple-choice assessment. Responses were only included if a given resident completed knowledge assessments for both Q&A and relay sessions, to allow for intraresident adjustments, in addition to program, training year, and lecturer/topic. Secondary outcomes included residents' self-perceived knowledge and engagement as surveyed by an ordinal scale immediately following the learning session.
The primary analysis included 51 responses from 18 unique residents. The adjusted mean knowledge assessment score at 3 months was not statistically different after the relay sessions compared to Q&A (67% vs 60%, respectively; 7% difference, 95% CI: -4 to 18%, =.20). For the secondary outcomes of learner attitudes (n=143 responses), learners reported greater engagement after the relay sessions compared to Q&A (51% vs 28% "very engaged"; overall =.003), but self-perceived knowledge was not significantly different (overall =.05, rounded down).
The relay technique did not show significant difference in 3-month knowledge retention, nor immediate self-perceived knowledge, despite greater learner self-perceived engagement.
尽管关于知识保留的证据不一,但许多住院医师培训项目仍采用被动式的理论讲座。本前瞻性研究调查了主动学习技术“接力”的效果,通过与传统形式相比,以住院医师的知识保留情况和态度来衡量。
教员按照随机时间表为四个家庭医学住院医师培训项目进行讲座。讲座后紧接着是15分钟的问答(Q&A)环节或接力环节。接力是一种基于问题的合作游戏。主要结果是3个月时的知识保留情况,通过多项选择题评估来比较问答环节和接力环节。只有当特定住院医师完成了问答环节和接力环节的知识评估时,其回答才会被纳入,以便进行住院医师内部调整,同时考虑项目、培训年份以及讲师/主题。次要结果包括学习环节结束后通过有序量表调查的住院医师自我感知的知识和参与度。
主要分析纳入了18名不同住院医师的51份回答。与问答环节相比,接力环节后3个月的调整后平均知识评估得分在统计学上没有差异(分别为67%和60%;差异为7%,95%置信区间:-4%至18%,P = 0.20)。对于学习者态度的次要结果(n = 143份回答),学习者报告接力环节后的参与度高于问答环节(“非常投入”的比例分别为51%和28%;总体P = 0.003),但自我感知的知识没有显著差异(总体P = 0.05,向下取整)。
尽管学习者自我感知的参与度更高,但接力技术在3个月的知识保留以及即时自我感知的知识方面没有显示出显著差异。