148 Comparison of Active Learning Techniques: Audience Response Questions vs. Small Group Discussion on Immediate and Long Term Knowledge Gain in Emergency Medicine Sub-Interns and Residents

Abstract

Didactic sessions are a common component of medical education. Active learning techniques have been shown to help with motivation, involvement and retention during didactic sessions but there are limited data comparing different active learning methods on immediate and long term knowledge gain. The objective of this study was to compare two active learning methods, small group discussion vs. audience response questions, on immediate and long term knowledge gain in emergency medicine (EM) sub-interns and residents. This was a prospective observational quasi-experimental study of EM sub-interns and residents. Participants were randomized into two groups and baseline knowledge was assessed with a multiple choice pre-test. Basic demographic data was also collected. Didactic sessions on salicylate toxicity and ocular trauma were given to both groups utilizing either small group discussion or audience response questions. A cross over design was utilized so that both groups received instruction by each method, ie, group A received didactic sessions on salicylate toxicity incorporating small group discussion and ocular trauma incorporating audience response questions, group B received didactic sessions on salicylate toxicity with audience response questions and ocular trauma with small group discussion. A multiple choice post-test was administered immediately following the didactics to assess immediate knowledge gain and again 2 months later to assess long term knowledge gain. Pre-and post-tests were identical. All test items were written by an academic faculty member, with advanced training in medical education, based on the goals and objectives of the session. Test items were piloted with a reference group of learners. Didactic instructors were blinded to test items. Descriptive statistics are reported. Data were further analyzed using a linear mixed effects model. 38 sub-interns and residents participated in the study (19 in group A and 19 in group B), including 11 PGY-4s, 8 PGY-3s, 8 PGY-2s, 3 PGY-1s, and 8 sub-interns. Both instructional methods showed similar immediate knowledge gain (mean gain score of 2.97±1.86 for audience response questions; 3.11±1.82 for small group discussion). This knowledge gain was attenuated at 2 months (mean gain score of 1.89 ±1.70 for audience response questions; 1.48±2.23 for small group discussion). The mixed linear mixed effects model did not demonstrate any significant difference between instructional method on immediate knowledge gain, p= 0.62, or long term knowledge gain, p=0.36. In this study there was no difference between instructional methods (audience response questions compared small group discussion) on immediate and long term knowledge gain in EM sub-interns and residents.