Education
Attitudes of faculty and students toward case-based learning in the third-year obstetrics and gynecology clerkship

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Objective

This study was undertaken to compare the attitudes of faculty and medical students toward case-based learning and lecture format during the obstetrics and gynecology clerkship.

Study design

For this prospective comparative study, student presentations were alternately assigned to traditional lecture- or case-based format every 6 weeks. Presentations were made to other students and a single faculty. A total of 31 faculty members, 30 student presenters, and 122 student participants completed evaluations. Teaching methods were compared.

Results

Faculty members favored lecture format over case-based learning for “attentiveness and interaction of the group” (3.9 vs 4.5, P < .018) and for “meeting the objectives” (3.7 vs 4.5, P < .002). Student participants favored case-based learning in “understanding the relationship between knowledge and clinical practice” (4.34 vs 4.06, P < .05) and “enjoyed” (4.34 vs 3.90, P < .008). Student presenters showed no differences between groups.

Conclusion

Faculty favored lecture format whereas student participants favored a case-based presentation. Student presenters were comfortable with both formats.

Section snippets

Design

The study is a prospective comparative evaluation of student and faculty attitudes toward CBL and lecture format as presented by third-year medical students to other third-year students with a single faculty member present.

The University of Iowa Institutional Review Board determined that the study did not require review.

In preparation for the study, 13 obstetric topics and 18 gynecology topics were identified. Learning objectives were then written for each topic. Both topics and learning

Statistics

Statistical analysis was performed with SAS 8.2 (SAS Institute, Cary, NC). Student t test was used for comparison of means and χ2 for categorical variables. Alpha coefficients were calculated for each evaluation tool.

Results

Thirty-one faculty members, 30 student presenters, and 122 student participants completed the evaluations.

Student presenter

Of the 30 student presenters, 19 presented with a case and objectives (CBL) and 11 presented with a topic and objectives (lecture format). There was no statistical difference between groups in the 9-item evaluation (Table I). There was a tendency for item 4 “stimulated my interest in learning” to favor CBL (P < .056). Both groups used similar resources in presenting and spent between 3 to 4 hours in preparation.

Student participant

A total of 122 student participants, 90 with CBL and 32 with lecture format, completed evaluations. Of the 9 items, 2 reached statistical significance (Table II). Students participating in CBL were “better able to understand the relationship between knowledge and clinical practice” (4.34 vs 4.06, P < .05) when compared with the lecture format and “enjoyed” CBL more than the lecture format (4.34 vs 3.90, P < .008).

Faculty

A total of 31 faculty members, 19 observed CBL and 12 observed lecture format, completed evaluations. Of the four items, 2 reached statistical significance (Table III). Faculty members favored lecture format over CBL for “attentiveness and interaction of the group toward the leader”(3.9 vs 4.5, P < .018) and for “meeting the APGO objectives” (3.7 vs 4.5, P < .002).

Internal reliability

Alpha reliability coefficients (Cronbach's alpha) were calculated for each of the evaluation tools. For the student observers, the 9-question scale had an alpha coefficient of .87. For the student presenters, the 9-question scale had an alpha coefficient of .84. For the faculty, the 4-item scale had an alpha coefficient of .70.

Conclusions

Integration of PBL into medical student education has met with some controversy. The small group nature of PBL requires far more resources than its traditional counterpart “lecture” and requires different skills from the teacher/tutor. Although it is clear that PBL is more enjoyable and promotes satisfaction among students, it is not clear that it is superior to traditional didactic teaching sessions on traditional measures of knowledge, such as national licensing examinations, on measures of

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Presented at the 2004 CREOG and APGO Annual Meeting, Orlando, Fla, March 4, 2004

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