Methods for increasing active medical student participation in their own learning: experience with a single 30-hour...

The traditional method of instruction for preclinical medical students is lecture, where the role of the student is passive. The practice of clinical medicine is a problem-solving endeavor. It requires the accumulation of information from diverse sources, its analysis, synthesis, and application, as well as the ability to work together with other health professionals to communicate critical information to patients. We have, therefore, adopted these activities in the teaching of a neoplastic diseases course. Every student is assigned to a four-member student team which has to organize and present to the entire class a succinct 10- to 15-minute minilecture on an assigned topic, along with a one-page typewritten synopsis. A second assignment for every student is to prepare a five-minute presentation on a specific question for discussion by a small group. Clinical correlation sessions involving analysis of patient problems provide a third teaching method. The course examination is short essay; half of the questions are given in advance. On postcourse evaluations, students have ranked the clinical correlation sessions as most effective, and the discussion groups as least effective. The entire-class presentations were information dense and accurate, but often unclear as to major points and too long, eliciting harsh criticism from colleagues. Students expressed unfounded concern that such presentations missed critical material, and some students felt overly stressed by this assignment, while others felt deprived of being taught by "experts." The lack of uniform answers by discussion group leaders was listed as the major problem with the small group method. The essay examination received high ratings.