What strategies can enhance evidence-based teaching in small group case-based learning for medical students?

From the Guidelines

To enhance evidence-based teaching in small group case-based learning for medical students, implement a combination of instructional techniques, including case-based learning, discussion groups, and role-playing, as these have been shown to improve physician knowledge and are supported by the most recent and highest quality study 1. When designing the curriculum, consider the following strategies:

• Use multiple instructional techniques, such as case-based learning, discussion groups, and role-playing, to improve knowledge gain and retention 1
• Incorporate "evidence hunts" where students search medical databases to find answers to clinical questions that arise, and use the PICO framework to help students formulate searchable questions
• Implement journal clubs focused on cases, where students present and critique articles relevant to patient management
• Create evidence summary worksheets that students complete before discussions, documenting key studies supporting different management approaches
• Assign students to be "evidence champions" who track the quality of evidence supporting each decision point
• Use technology like shared documents or apps to compile evidence repositories for each case These strategies work because they make evidence application concrete rather than theoretical, develop critical thinking skills, and create habits of evidence-based practice that will continue throughout students' careers. In terms of group size, training in small groups is probably advantageous, with an optimal size of 4 to 8 participants per skills station 1. It is also important to consider the use of scenario-based teaching, which allows for useful repetition of sequences and variations on themes, and forces the facilitator to prepare for the course 1. Overall, the key is to create an interactive and engaging learning environment that encourages students to think critically and apply evidence-based principles to real-world scenarios, as supported by the American College of Chest Physicians evidence-based educational guidelines 1.

From the Research

Strategies for Enhancing Evidence-Based Teaching

To enhance evidence-based teaching in small group case-based learning for medical students, several strategies can be employed:

• Using digital portals to facilitate self-directed learning and teamwork, as seen in the study by 2, where students used Google groups to discuss case-based teaching and develop teamwork skills.
• Implementing team-based learning (TBL) and case-based learning (CBL) approaches, as explored in the study by 3, which found that CBL built on and complemented TBL experience, providing an emphasis on basic sciences and clinical reasoning skills.
• Providing opportunities for students to practice giving and receiving peer feedback, as described in the study by 4, which developed an exercise for students to practice feedback within case-based learning small groups.
• Fostering a student-centered approach, with the tutor acting as a facilitator rather than a knowledge provider, as discussed in the study by 5, which highlighted the importance of continuous and active participation by learners in small group teaching.
• Utilizing bedside case-based learning to promote clinical problem-solving skills, knowledge application, teamwork, and collaboration, as investigated in the study by 6, which explored the impact of bedside case-based learning on critical thinking and self-directed learning in midwifery students.

Key Elements of Successful Small Group Teaching

The following elements are crucial for successful small group teaching:

• Active participation by learners, as emphasized in the study by 5, which noted that small group teaching fosters lifelong learning skills, motivation, self-confidence, and teamwork.
• The role of the tutor as a facilitator, as discussed in the study by 5, which highlighted the challenges of transitioning from a traditional teacher to a facilitator.
• The use of authentic clinical cases, as seen in the studies by 2 and 3, which used case-based teaching to develop critical thinking and clinical reasoning skills.
• Consistent facilitator guidance and feedback, as noted in the study by 3, which found that the learning environment was enriched by the CBL framework, allowing application of knowledge to solve clinical problems within small groups.
• Opportunities for students to develop self-directed learning and teamwork skills, as explored in the studies by 2 and 6, which investigated the impact of case-based learning on self-directed learning and critical thinking abilities.