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Updated: Oct 22, 2025

Author Spotlight: Investigating Hepatic Adaptations and Prediabetic Progression in Liver Diseases
Published on: October 6, 2023
Choosing Wisely in Pre-clinical Medical Education: a Direct Comparison of Active Learning Methods for Teaching
Elizabeth Carson1, Rebecca Wilcox2
1Department of Internal Medicine, The Robert Larner, M.D. College of Medicine at the University of Vermont, 89 Beaumont Ave., Burlington, VT 05405 USA.
Background:
With the movement away from lectures and towards active learning sessions, medical school faculty must choose a format that fits the learning objectives and is achievable with available resources. Small groups bring organizational challenges including additional faculty and classrooms. Large groups are an opportunity to conduct case-based active learning exercises with fewer faculty. Our study compares the learning effectiveness of an active learning session on metabolic liver disease conducted in both the small group and large group formats.
Methods:
All MS1 students at University of Vermont Larner College of Medicine (LCOM) (n = 120) were randomized to participate in either the small or large group session. The same pre-learning videos and computer-based active learning module were used for all students in both session types. A post-session questionnaire was administered, and student exam performance was analyzed to evaluate each session type on the following criteria: (1) student preparedness for the session, (2) student perceptions of the session's learning effectiveness, (3) learner knowledge upon completion of the session, and (4) knowledge retention at 10 days.
Results:
No statistically significant differences were found between the large and small group cohorts on student perceptions of learning effectiveness or knowledge assessment, both immediate and delayed. Students assigned to the large group did choose their collaborators differently than those in the small group, tending more often to work with their friends.
Conclusion:
When organized well, a large group active learning format may be used in place of a small group without diminishing the learning effectiveness of the activity.
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Metabolic Regulation:
The liver is the central organ involved in regulating blood composition. It stabilizes blood glucose levels, maintaining them within the range of 70–110 mg/dL. When these levels drop, the liver breaks down glycogen reserves and releases glucose into the bloodstream. It can...

