Clinical discussion groups: verbal participation and outcomes

The author studied both the amount and cognitive level of teacher questions and student discussion in 62 small clinical discussion groups comprising 119 third-year medical students. After analyzing the transcripts from over 75 hours in small clinical discussion groups, the investigator examined in detail how much the "process" of the small group interaction related to certain outcomes, such as the students' critical thinking and their performance on the examinations of the National Board of Medical Examiners. The instrument used for analysis was a modified version of the Flanders System of Interaction Analysis that incorporated Bloom's Taxonomy of the Cognitive Domain. The cognitive level of the teachers' questions had a significant positive correlation with the cognitive level of the students' responses. While there were significant relationships between some aspects of verbal participation and outcome measures, the multiple regression analyses showed that the major contributions to outcomes were the aptitude and previous knowledge that the students already possessed.