During the COVID-19 pandemic, we have witnessed profound health inequities suffered by Black, Indigenous, and People of Color (BIPOC). These manifested as differential access to testing early in the pandemic, rates of severe disease and death 2-3 times higher than White Americans, and now, significantly lower vaccine uptake compared with their share of the population affected by COVID-19. This article explores the impact of these COVID-19 inequities (and the underlying cause, structural racism) on vaccine acceptance in BIPOC populations, ways to establish trustworthiness of healthcare institutions, increase vaccine access for BIPOC communities, and inspire confidence in COVID-19 vaccines.
Context
Bite-sized learning is an instructional method that utilizes brief, focused learning units. This approach may be beneficial in medical education given demands on learner time and cognitive load. This study aims to assess the impact of this approach on knowledge acquisition and learner attitudes in postgraduate medical education.
Methods
An instructional method, termed Bite-Sized Teaching (BST), was implemented within the curriculum at a US Internal Medicine postgraduate training program. In BST, content is distilled into manageable units focused on relevant schemas and delivered via brief peer teaching. A two-fold assessment of BST was performed that included cross sectional survey to assess learner attitudes and experiences and a controlled study to assess knowledge acquisition with BST and case-based teaching control.
Results
One hundred and six of 171 residents (62% response rate) completed the survey. Most residents (79.8%) reported BST was among the best conference types in the curriculum. Important components of BST cited by residents include the distilled content, multiple short talk format and peer teaching. Residents report incorporating what they learned via BST into their teaching (76.1%) and clinical practice (74.1%). Resident who had participated as speaker were significantly more likely to report incorporating learning from BST into their teaching (87.2% vs 63.0%, p < 0.01, Cramer’s V effect size = 0.37) and clinical practice (89.7% vs 65.3%, p = 0.02, Cramer’s V effect size 0.28).
Fifty-one residents participated in the knowledge assessment. Residents taught via BST scored significantly higher on immediate post-test compared to case-based teaching (score [SE] 62.5% [1.9] vs 55.2% [2.4], p = 0.03, Hedges g effect size 0.66). While both groups improved over pretest, there was no significant difference in scores between BST and case-based teaching at two (score [SE] 57.1 [2.1] vs 54.8 [2.5], p = 0.54) and six weeks (score [SD] 55.9 [2.1] vs 53.0 [2.9], p = 0.43).
Conclusions
Teaching via brief, focused learning units delivered by peers is well received by learners and appears to have a significantly greater impact on immediate knowledge recall than case-based teaching. Further study on long term knowledge retention and behaviors is needed. Bite-Sized Teaching may be a promising instructional approach in medical education.
A night-float system that includes on-site attending physician supervision can provide a valuable opportunity for resident education and may help improve the quality of patient care.
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