Han is a third year Emergency Medicine resident who can’t stand PowerPoint. Every Tuesday, he attends his full academic day from 0900-1700. Almost every lecture is a didactic PowerPoint presentation, and after a few minutes of each presentation his mind starts to wander and he finds the learning style tends to be passive, which tends to be low-yield. Surely all these smart residents can engage their audiences better!
Despite (some) appearances to the contrary, there are many ways to deliver lecture material in Emergency Medicine. This Feature Educational Innovation (FEI), titled “Presentation to peers: above and beyond the Power Point lecture. Experiential approach to different teaching methods by residents in emergency medicine” was originally posted by the CAEP EWG FEI Team on December 15, 2015 and answers the question: “How can we expose and engage our residents to novel teaching strategies?” A PDF version is available here.
Description of the Innovation
Although Health Sciences education is booming in many medical programs, residents are more often exposed to outcomes (curriculum redesign, different course formats) rather than the teaching modes themselves. As part of this project, to expose residents to this field of knowledge and encourage engagement, residents used non-traditional teaching strategies during presentations to their colleagues. They subsequently had to answer short questions about their experience.
Research on various existing teaching strategies led to the discovery of the book by Gilles Chamberland: 20 formules pédagogiques (Presse de l’Université du Québec) as an accessible foundation to the introduction of the subject, the identification of the different strategies, and their use by novices.
During the third year curriculum in emergency medicine (the College of Family Physicians of Canada program), a four-week period is devoted to academic courses and technical activities. Residents have no clinical obligations or duties during this period. This block seemed like an opportune moment for this activity, as residents had time to experience this new approach without the stress and hectic schedule of clinical work.
The goal was to create a favourable climate for this introduction to teaching. Residents in pairs were assigned a subject and a teaching strategy by random draw. The presentation topics covered an academic course in pediatric emergency medicine: stomach pain in children, abuse, febrile convulsions, limping, sudden death syndrome, and ALTE. The teaching strategies used were selected for their compatibility with small group learning: tournaments, programmed teaching, discussion groups, teamwork and case studies. A period of 45 minutes was allocated to each team for their presentation. After each presentation, an assessment was completed by a supervising physician and the other residents. It focused on the quality of the academic content and the use of the teaching formula. Students also made a brief reflection on the teaching strategy used, including strengths, weaknesses, and their overall impressions.
The compilation of student evaluations led to the identification of recurring themes in these non-traditional presentation styles:
Pros: More dynamic; more interactive; increased knowledge sharing; novelty; exposure to a wider spectrum of possibilities for future presentations.
Cons: Labor-intensive; some strategies were less feasible; over-emphasis on the novel strategy rather than the content itself.
Overall, the activity was interesting and inspiring. However, outside the specific context of this academic course, we are not sure that the experiment can be replicated. Despite the benefits, these presentations take longer to prepare and require more time to teach the subject to the audience, especially with regards to short subjects.
However, the goal, which was exposure and an opening to other potential methods, was reached. Residents now have tools at their disposal if they want to experiment with other techniques in a future presentation. And who knows if some of the experimenters have not acquired a taste for medical education!
As an introduction to teaching, residents of the emergency program had to use non-traditional teaching strategies during presentations to their peers. Most of them found the experience rewarding due to the discovery of new, and more dynamic methods. However, the downside to these techniques includes time and resource intensiveness.
Figure 1: Physical organization of the classroom to encourage a debate style discussion.
What are ways that your institution has tried to break up lecture fatigue? What are common pitfalls of PowerPoint lectures and how can we mitigate them?
More About the CAEP FEI
This post was originally authored for the Canadian Association of Emergency Physicians (CAEP) Feature Educational Innovations project sponsored by the CAEP Academic Section’s Education Working Group and edited by Drs. Teresa Chan and Julien Poitras. CAEP members receive FEI each month in the CAEP Communiqué. CanadiEM will be reposting some of these summaries, along with a case/contextualizing concept to highlight some recent medical education literature that is relevant to our nation’s teachers.
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