Active learning modalities for learning clinical problem solving in the classroom: which aspects do Family Medicine students find most useful?

Abstract

Background Problem solving is an essential clinical skill which medical students find challenging, particularly in Family Medicine settings where patients present with a wide range of undifferentiated problems. Objectives To explore student perceptions of two contrasting active learning modalities to examine which features were most useful in helping them learn how to problem solve. Methods All Year 4 Family Medicine students (n=210) participated in two workshops. Workshop A used Team-based Learning (TBL). Workshop B used role-plays with surrogate patients (SPs). Both workshops were case-based using common problems encountered in primary care. Students completed the Classroom Engagement Scale and provided feedback on which workshop they preferred and why. Results 201 and 178 surveys were returned after Workshop A and Workshop B respectively. Classroom engagement scores were similar for both activities. Beneficial features of TBL included pre-reading for knowledge acquisition, small group brainstorming to broaden thinking, and gamification for engagement. Beneficial features of role-play included having a range of realistic cases to practice history-taking and problem-solving, a medical record template to prompt decision-making, and a systematic guided dissection of model answers. Conclusions Although student engagement was similar for both activities, more students preferred the learning experience of roleplay over team-based learning for its better authenticity and ability to help them develop skills in both history-taking and problem-solving. Acquisition of content knowledge, sufficient diversity of problems, provision of a structured problem-solving model, and modelling of solutions were perceived by students as being the key facilitators of learning how to problem solve.