Abstract

Knight JR, Frazer CH, Goodman E, Blaschke
GS, Bravender TD, Luoni M, Hall M, Emans SJ. Case-based teaching
by pediatric residents. Presented at the annual meeting of the Ambulatory
Pediatric Association, San Francisco, 1999, Poster Presentation.

Abstract

Background: Case discussion (CD) offers advantages
over lecture for teaching pediatric residents about child growth and development,
behavior problems, and adolescent health. We hypothesized that CD would
be well received, effective, and that resident “teachers” could
effectively lead CD sessions if given written cases, a teaching guide,
and instruction in effective facilitation strategies.

Objective: To measure the effects of resident-facilitated
CD using standardized teaching materials.

Design: Standardized cases, written as part
of a national curriculum development project, included abstract, multi-part
case vignette, guide questions, handouts, bibliography, and teaching guide.
Resident “teachers” attended a preparation session in which
use of materials was modeled, then used materials to facilitate CD during
pre-clinic conferences at a large tertiary-care teaching hospital. Each
case was taught for 1 week (5 sessions). Evaluation forms included Likert
ratings (1=poor/5=excellent) and were completed after each session by
facilitators and learners. Learners were administered a 10-item knowledge
assessment pre/4-6 months post one session on developmental screening.
Data were analyzed on 11 different cases for which at least 4/5 resident
teachers completed forms.

Results: Learners (n=512) highly rated case
vignettes (4.24±0.73), the CD method (4.25±0.78), and resident
facilitators (4.36±0.74). Facilitators (n=53) highly rated case
vignettes (4.29±0.60), handouts (4.16±0.75), and teaching
guide (4.23±0.75), and reported more comfort with the CD method
as a result of their experience (pre=3.47±0.96 vs post=4.12±0.73,p<.0005).
Residents’ (n=13) knowledge in interpreting developmental screening tests
increased significantly (% correct pre=50.6±22.9/post=77.7±8.3,
Wilcoxon Sign Rank Test p=0.003).

Conclusion: Standardized written cases were
well received by resident facilitators and learners, and effective in
increasing knowledge. Facilitators became more comfortable with the CD
approach. Further study is needed, but peer teaching using standardized
written cases appears promising for educating pediatric residents.