The effect of student- and teacher-centred small-group learning in medical school on knowledge acquisition, retention and application

Purpose: To compare the effect of two formats of small-group teaching on retention and application of gastroenterology Knowledge during a gastroenterology pathophysiology course. Methodology: The gastroenterology course was taught to 198 second-year medical students in part using a small-group discussion format. Twelve groups of 16 students and a faculty gastroenterologist discussed two sets of two clinical cases, one set focusing on learning issues concerning intestinal pathophysiology and the other on hepatobiliary pathophysiology. In a randomized cross-over comparison group design, small groups were assigned to cover one set a cases in a student-centered format and the other set of cases in a teacher-centered format. Case-related multiple-choice questions on the final examination documented immediate performance. Delayed performance was assessed in the subsequent year upon completion of the third-year Internal Medicine Clerkship using Diagnostic Pattern Recognition Exam questions pertinent to the cases. Results: The format of the small group in which gastroenterology knowledge was learned had no effect on immediate examination performance, nor on the later ability to apply that Knowledge to problems in clinical diagnosis. However, both the student and teacher-centered small-group formats appeared to augment learning in comparison with lecture-based topics. Conclusions: The specific format of the small-group teaching appears to have little impact on retention or application of gastroenterology knowledge.