Innovative concepts for small group teaching in clinical skills:: diagnostic imaging procedures:: results of a longitudinal two cohort study of medical education pilot project, H. Heine university Dusseldorf

Background and objective: Medical students in Germany often criticize the anonymous and not practice-orientated way they are taught. It was the aim of this study to develop, try out and evaluate cost-effectiveness of practice-oriented interdisciplinary teaching in small groups. Patients and methods: The study was based on ca. 300 medical students/year, a practicable number in relation the average annual total intake by German medical schools. Between 1995 and 1998, 300 medical students annually, chosen by lot, were offered voluntary additional teaching of imaging methods (computed tomography, endoscopy and sonography), from a total of 2485 students (1276 females, 1209 males; mean age 25.8 years), the reminder serving as controls. After lecture-demonstration to all, the selected small groups were separately taught. They performed sonography on each other in small cohorts of 5 or they practised endoscopies on phantom models under supervision of a student tutor. In addition, lecturers circulated among the groups to answer additional questions and provide further help. All participants evaluated the course concept and the instructors on a questionnaire provided by the interdisciplinary centre for tertiary education. The effects of teaching on the participants were tested by a practical test in the form of an objective structured clinical examination (OSCE). Results: Ca. 80% of course participants reached the intended aim and passed the OSCE examination. They gave the instructions in the pilot project highest marks, in all its criteria nearly one mark higher than those of other evaluated teaching sessions. Pre-clinical students judged the programme even more favourably than those in their clinical years. The additional cost incurred was moderately low at ca. DM 67 per year per student. Conclusion: Modern practice-oriented small group teaching will provide high quality results even with large numbers of students. The concept has already been taken over by other medical faculties.