An interactive problem-solving approach to teach traumatology for medical students

Research article Open Access An interactive problem-solving approach to teach traumatology for medical students Fikri M Abu-Zidan1, 2Email author and Margaret A Elzubeir3 World Journal of Emergency Surgery20105:24 https://doi.org/10.1186/1749-7922-5-24 ©  Abu-Zidan and Elzubeir; licensee BioMed Central Ltd. 2010 Received: 22 February 2010Accepted: 13 August 2010Published: 13 August 2010 Abstract Aim We aimed to evaluate an interactive problem-solving approach for teaching traumatology from perspectives of students and consider its implications on Faculty development. Methods A two hour problem-solving, interactive tutorial on traumatology was structured to cover main topics in trauma management. The tutorial was based on real cases covering specific topics and objectives. Seven tutorials (5-9 students in each) were given by the same tutor with the same format for fourth and fifth year medical students in Auckland and UAE Universities (n = 50). A 16 item questionnaire, on a 7 point Likert-type scale, focusing on educational tools, tutor-based skills, and student-centered skills were answered by the students followed by open ended comments. Results The tutorials were highly ranked by the students. The mean values of educational tools was the highest followed by tutor-centered skills and finally student-centered skills. There was a significant increase of the rating of studied attributes over time (F = 3.9, p = 0.004, ANOVA). Students' open ended comments were highly supportive of the interactive problem-solving approach for teaching traumatology. Conclusions The interactive problem-solving approach for tutorials can be an effective enjoyable alternative or supplement to traditional instruction for teaching traumatology to medical students. Training for this approach should be encouraged for Faculty development. Keywords Medical StudentFaculty DevelopmentEducational ToolInteractive ApproachMedian Rank Introduction Students often criticize lectures for limited opportunities for active involvement, interaction with the instructor, task-centered problem-solving opportunities, variation of activities and feedback on efforts [1, 2]. The interactive approach for teaching however, involves an increased interchange between lecturer, students and the lecture content; promoting active involvement of students [3]. They are among innovative approaches for teaching and learning in medicine underpinned by adult learning principles [4] and are increasingly considered best educational practice that medical schools internationally are adopting as they revitalize their curriculum and shift to a learner-centered focus. While this is important, it is equally imperative to seek students' input regarding quality of teaching and learning approaches experienced. The most often used evaluation tool is student ratings on different dimensions of the instructional process and presentation style [5]. We aimed to evaluate an interactive problem-solving approach for teaching traumatology from perspectives of students and consider its implications on Faculty development. Subjects and methods Educational material A two hour problem-solving, interactive tutorial on traumatology was structured to cover main topics in trauma management. The tutorial was based on real cases that demonstrated core learning objectives. The first author (FAZ) was personally involved in the management of these cases. The tutorial was built up to be standardized in a semi-controlled situation. All tutorials were done by the same tutor (FAZ) who had developed the educational material, covering the same cases, in the same format, sequence, and structure, and having specific objectives (Table 1). Figures 1, 2, 3 and 4 demonstrate some of these cases. Slide projectors were used without animation. The tutorial was structured to show a visual aid (slide), ask the question, define the problem, let students enquire and debate; even sometime in small groups, before a solution is reached. Slides were prepared according to scientific advised standards [6, 7]. Table 1 Structure and objectives of the interactive problem-solving trauma tutorial Case Clinical hsitory Questions asked Objectives of the case 1 A 58-years old male fell on his left heel from 15 meters high. What are the possible injuries of this patient? Understand the biomechanics of blunt trauma; anticipate injuries depending on mechanism including pelvis, spine and abdominal organs. 2 A 20-years old male shot by a high energy bullet at right side of chest with an exist in the left loin (Fig 1). What are the possible injuries of this patient and how would you manage him? Understand the biomechanics of ballistic injuries, draw the track of the bullet, appreciate the devastating severity of injury, and understand the need to stop bleeding and contamination. 3 30-years old front seat passenger with severe wind screen facial injury. What do you think has happened? What are your priorities in management? Understand the biomechanics of deceleration injuries of road traffic collisions, the importance of seatbelts and the need for airway protection. 4 A 30-years old soldier had a penetrating missile injury to his left chest and presented in shock. What is shock and how can we find its cause? To differentiate between different causes of shock (hypovolemia due to thoraco-abdominal injury, tension pneumothorax or pericardial tamponade), be able to systematically read a trauma chest X-ray. 5 45-years old male having a chest tube who developed severe hypoxia while being on ventilation (Fig 2). What are the possible reasons for hypoxia in this patient? Understand causes of hypoxia in ventilated patients; stress the importance of logical analytical thinking to be able to solve this difficult problem. 6 An 18-years old male involved with a quarrel, hit on the left side of the head, in coma. Can you read this brain CT scan (extradural haematoma) Be able to identify acute intracranial bleeding, differentiate between extradural, subdural and intra-cerebral bleeding, and correlate the injury with neuroanatomy. 7 A 27-years old male involved with a car accident, has coma and pin point pupils, normal CT scan of the brain. Why is the patient in coma? Where is the injury? Appreciate the need to manage the patient and not the CT scan, limitations of trauma brain CT scan, importance of neurological examination to diagnose brain stem lesions. 8 A 24-years front seat female passenger involved in a car accident complaining of severe pain and deformity of the right thigh (Fig 3). What is the cause of pain in this patient? How can she be managed? Appreciate the need to control pain in the trauma patients and know its cause, evaluate an extremity for neurovascular injury, appreciate the value for fasciotomy. 9 25-years old laborer fell from 3 meters high on his left forearm, had radial neck fracture and drop wrist ( (...truncated)