Abstract

ContextBite-sized learning is an instructional method that utilizes brief, focused learning units. This approach may be beneficial in medical education given demands on learner time and cognitive load. This study aims to assess the impact of this approach on knowledge acquisition and learner attitudes in postgraduate medical education.MethodsAn instructional method, termed Bite-Sized Teaching (BST), was implemented within the curriculum at a US Internal Medicine postgraduate training program. In BST, content is distilled into manageable units focused on relevant schemas and delivered via brief peer teaching. A two-fold assessment of BST was performed that included cross sectional survey to assess learner attitudes and experiences and a controlled study to assess knowledge acquisition with BST and case-based teaching control.ResultsOne hundred and six of 171 residents (62% response rate) completed the survey. Most residents (79.8%) reported BST was among the best conference types in the curriculum. Important components of BST cited by residents include the distilled content, multiple short talk format and peer teaching. Residents report incorporating what they learned via BST into their teaching (76.1%) and clinical practice (74.1%). Resident who had participated as speaker were significantly more likely to report incorporating learning from BST into their teaching (87.2% vs 63.0%, p < 0.01, Cramer’s V effect size = 0.37) and clinical practice (89.7% vs 65.3%, p = 0.02, Cramer’s V effect size 0.28).Fifty-one residents participated in the knowledge assessment. Residents taught via BST scored significantly higher on immediate post-test compared to case-based teaching (score [SE] 62.5% [1.9] vs 55.2% [2.4], p = 0.03, Hedges g effect size 0.66). While both groups improved over pretest, there was no significant difference in scores between BST and case-based teaching at two (score [SE] 57.1 [2.1] vs 54.8 [2.5], p = 0.54) and six weeks (score [SD] 55.9 [2.1] vs 53.0 [2.9], p = 0.43).ConclusionsTeaching via brief, focused learning units delivered by peers is well received by learners and appears to have a significantly greater impact on immediate knowledge recall than case-based teaching. Further study on long term knowledge retention and behaviors is needed. Bite-Sized Teaching may be a promising instructional approach in medical education.

Highlights

  • Health professions education programs are charged with effectively teaching extensive and complex content

  • This study aims to assess the impact of Bite-Sized Teaching (BST) on learner attitudes, experiences and knowledge acquisition in postgraduate medical education

  • Majority of residents (79.8%) reported BST was one of or the best conference type used in the Internal Medicine (IM) curriculum

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Summary

Introduction

Health professions education programs are charged with effectively teaching extensive and complex content. Educational programs need to consider a variety of instructional methods to meet this challenge [2]. Learners must contend with multiple competing demands on their time and mental bandwidth and content is vast and complex. Working memory is divided between attending to the complexity of information to be learned (intrinsic load), the demands imposed by distractions not critically relevant to what you are learning (extrinsic load) and effort needed to build schemas for storing information as memory (germane load) [6, 7]. Instructional strategies that manage cognitive load including how content is presented and received have the potential to optimize translation of content into knowledge retention [5,6,7]

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