Is there an increase over time in the complexity of teacher questions and student responses in case-based clinical seminars? A cross-sectional video study

Abstract

Background Case-based group discussions (CBGD) are a specific, interaction-focused format dedicated to fostering medical students’ skills in applying basic biomedical knowledge to patient cases. Existing conceptions of CBGD suggest that a gradient towards increased opportunities for students to make elaborative verbal contributions is an important element of such seminars. To verify this assumption, we investigate empirically if clinical teachers progress from more basic, knowledge-oriented questions towards more advanced, elaboration-oriented questions in such seminars. Methods We videotaped 21 different clinical teachers and 398 medical students in 32 CBGD-seminars on surgery and internal medicine. We coded closed-reproductive and open-elaborative teacher questions as well as reproductive and elaborative student responses to these questions. Inter-rater reliability was satisfactory. To determine trends regarding the teacher questions / student responses, we compared eight time-segments of equal duration per seminar. Results Overall, clinical teachers asked more closed-reproductive than open-elaborative questions. Students gave more reproductive than elaborative responses. Regarding the frequencies of these forms of teacher questions / student responses, we found no significant differences over time. Conclusions Clinical teachers did not deliberately modify the types of questions over time to push students towards more elaborative responses. We conclude that the critical question to which degree promising teaching approaches are actually put into clinical teaching practice should be raised more purposefully in medical education research.

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Maturity Model for Assessing the Medical Humanities: a Delphi study

“…Since its inception, the medical humanities have had a tremendous mission: to soften the rough edges of medicine, harmonize the relationship between technology and the humanities, and mend the emotional rift brought about by biomedicine [2]. As society develops, issues such as homosexuality, reproductive rights, abortion, and gene editing require medical humanities solutions [3,4]. A practical, concrete and complete theory is needed to support it.…”