Abstract
BackgroundThe traditional lecture is used by many residency programs to fulfill the mandate for regular didactic sessions, despite limited evidence to demonstrate its effectiveness. Active teaching strategies have shown promise in improving medical knowledge but have been challenging to implement within the constraints of residency training. We developed and evaluated an innovative structured format for interactive teaching within the residency noon conference.MethodsWe developed an ACTIVE teaching format structured around the following steps: assemble (A) into groups, convey (C) learning objectives, teach (T) background information, inquire (I) through cases and questions, verify (V) understanding, and explain (E) answer choices and educate on the learning points. We conducted a prospective, controlled study of the ACTIVE teaching format versus the standard lecture format, comparing resident satisfaction, immediate knowledge achievement and long-term knowledge retention. We qualitatively assessed participating faculty members’ perspectives on the faculty development efforts and the feasibility of teaching using the ACTIVE format.ResultsSixty-nine internal medicine residents participated in the study. Overall, there was an improvement in perceived engagement using the ACTIVE teaching format (4.78 vs. 3.80, P < 0.01), with no increase in stress or decrement in break time. There was an improvement in initial knowledge achievement with the ACTIVE teaching format (overall absolute score increase of 11%, P = 0.04) and a trend toward improvement in long-term knowledge retention. Faculty members felt adequately prepared to use the ACTIVE teaching format, and enjoyed teaching with the ACTIVE teaching format more than the standard lecture.ConclusionsA structured ACTIVE teaching format improved resident engagement and initial knowledge, and required minimal resources. The ACTIVE teaching format offers an exciting alternative to the standard lecture for resident noon conference and is easy to implement.
Highlights
The traditional lecture is used by many residency programs to fulfill the mandate for regular didactic sessions, despite limited evidence to demonstrate its effectiveness
Traditional lecture within a noon conference setting has been the standard format for fulfilling the Accreditation Council for Graduate Medical Education (ACGME) mandate [3]
Because of the limitations of using the standard lecture and the challenges with other active teaching formats, we developed a new structured ACTIVE teaching format that would be easy to implement within resident noon conference
Summary
The traditional lecture is used by many residency programs to fulfill the mandate for regular didactic sessions, despite limited evidence to demonstrate its effectiveness. To achieve the milestones for medical knowledge, the ACGME common program requirements mandate regularly scheduled didactic sessions, but allow flexibility for innovation in this area [2]. There has been little data to support the lecture format, and most studies evaluating noon conference have shown no improvements in knowledge retention [4,5,6] or scores on national standardized exams [7,8,9,10,11]. We know that residents desire an alternative to the traditional lecture that is more consistent with adult learning theory [12]. This lack of support has stimulated educators to develop new teaching strategies
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