Interactive learning - PSG-FAIMER-2007

Report on the M-L Web Assignment of the 

PSGFAIMER 

Regional Institute 

January 2009 

Interactive learning 

Dr. Vasanta Leela 

PSGFAIMER Fellow 2007 

Associate Professor 

Department of Anatomy 

Deccan College of Medical Sciences 

Hyderabad. 

India

FAIMER FELLOWSHIP- SCHOLARLY REPORT 

INTERACTIVE TEACHING 

FOREWORD 

Interactive teaching is just giving students something to do, getting back what they have done, 

and then assimilating it yourself, so that you can decide what would be best to do next. 

- Dr. Louis Abrahamson 1 

Dear FAIMERly, 

While Dr. Abrahamson makes this topic sound so easy and straightforward, our January 2009 discussion 

group sourced many angles, opinions, guidelines, methodologies, and perspectives about it : from 

literature, including scholarly theory and the newest experimental work, from well-documented recentlyadopted 

processes, and from their own teacher-training and experiences. 

It was a thoughtful, lively and well-rounded discussion, which it is my privilege to reflect on and to 

summarize here; hoping to provide rich food for thought, word, and action for all of us on the ML-Web, who 

are committed to forwarding the cause of effective high-quality Medical Education, in our world. 

I am deeply appreciative, and grateful, for the guidance, encouragement and patience of all my PSG-FRI 

mentors, whose messages, words, and steady friendship, have been instrumental in helping this Scholarly 

Report see the light of day. 

With Regards, 

Dr. Vasanta Leela


Table of Contents 

Topic 

Page number 

Introduction 4 

Methodology 5 

Summary of discussions 6 

First week 6 

Second week 8 

Third week 12 

Fourth week 16 

Survey 16 

Reflection on the discussion and the ML-web experience 18 

Conclusion 19 

Acknowledgements 20 

References 21


INTRODUCTION 

Classically & ideally, ALL teaching is done toward three main goals: the summative, to 

discover what the student already knows; the formative, to guide student learning on a 

particular path; and the motivational, to empower and encourage the student in setting 

his/her own future learning goals . 

While all types/systems of teaching succeed in those three objectives to some extent or 

other, the concept of “interactive” puts greatest emphasis on the teacher modifying his 

or her approach in response to the needs of the learners, through adopting a continual 

two-way process of communication and assessment. 

Learners in the learning environment can interact with the lecturer/teacher, peers, 

resources, or all three. The last, where the virtual resource becomes the ‘teacher’, then 

overlaps into the area of Technology in Medical Education. The present discussion did 

dovetail with other areas, but it was all wisdom gained from the year’s good work which 

had gone ahead, in the work of the previous groups and the excellent summaries of 

their moderators. 

The January 2009 discussion group, comprised 2008 fellows leading viz. Padmavathy 

and Muhammad, 2007 fellows moderating viz. Leela and Ravi, & faculty mentors 

Professors Arun, Marina and Seetha. 

Drs. Muhammad and Padmavathy from the 2008 Fellows, had hitherto signed up for 

this group ‘Small and Large- group Interactive Teaching’, and we 2007 ‘seniors’ added 

in our names, myself choosing it for the timing more than the topic, planning to be 

“freer” from professional and personal pressures during that month; my own project 

was about non-interactive, in fact “teacher-less” learning, and as it has turned out, it 

was most appropriate, and rewarding, for me to study the apparently ‘opposite’, and in 

depth, through this forum.


METHODOLOGY 

Pre-planning: 

The group had earlier divided the main theme into weekly topics which would form the 

focus of one week’s discussion each. The ‘conversation’ was to then be primarily 

conducted by Drs. Padma and Muhammad, and the 2007 fellows were to comment on, 

and facilitate the discussions where and when required. 

The distribution of weekly topics was as follows: 

Format adopted for Month’s discussion: 

The group posted articles from various sources, asked stimulating questions, and also 

conducted surveys, to elicit responses from all Fellows; and periodic reflections by the 

moderators were added, to guide the discussion forward. 

Learning from preceding groups, we kept the web- deliberations focused around the 

week’s topic, but social comments and interesting ‘asides’ would of course happen, and 

were important to keep the thread light and lively.


SUMMARY OF DISCUSSIONS 

The first week’s discussion as planned earlier, was on: 

“What is Interactive teaching? Methods used in medical education.” 

Muhammad facilitated the interactions, beginning with defining the overall Topic, from 

Dr. Louis Abrahamson’s seminal work 1 , and collating several published sources. 

Interactive teaching values student's prior ideas and knowledge and aims at 

empowering students to be independent learners. Teachers are offered an opportunity 

to learn along with the students and to use their interactive skills to listen carefully and 

challenge misconceptions where possible. 2 Interactivity can stimulate and challenge 

students, increasing their learning. Models of interaction range from simple, 

“nontechnical” approaches—roundtables, for example—to sophisticated programs 

such as CPR and LON-CAPA. 2 These alternative models emphasize student-to-student 

and student-to-faculty interaction. 

A teacher using interactive methods has the vision of creating a class room where 

students are helped to make sense and reflect on their experiences, to evaluate their 

work and learning and to set future learning goals. 2 Hence, though the teacher sets a 

perimeter within which the class proceeds to achieve the desired learning objectives, 

much more leeway is employed, and enjoyed, in the mentoring strategies used to guide, 

prompt, enthuse and motivate the learner. The degree of interactivity in a course 

content delivery has a strong influence on outcomes. 3 

Pedagogy recognizes several factors which influence and determine how learning is 

attained. These are preconceptions, facts, context, application and use and 

metacognition. 3 All learners have preconceptions which could end in persistent misconceptions 

if not recognized and carefully dealt with. 

Facts and concepts are best remembered if placed in context and the 

relationship between them is clarified. 3 

Our own experiences with classical teaching amply demonstrate that application and 

use are most eagerly sought and valued, by adult learners, and particularly in the 

applied sciences. 

Many modalities for interactive teaching /learning were shared on the M/L web, of which 

a current favorite in the western world is the very versatile electronic whiteboard. 

An electronic whiteboard can serve as an ideal focus for class room discussion and 

provide opportunities to raise questions and stimulate exploratory behavior. 4 With a 

white board you can use a picture as a stimulus for discussion, use written prompts,

support and stimulate brain storming, sort the information, have text disclosure activities 

and share information. 4 Electronic whiteboards can combine the personal computer, 


internet and multimedia technologies for a more powerful and interactive learning 

experience. 5 

Serious games, virtual laboratories, peer- to- peer teaching, peer- ledteam 

teaching, and problem-based learning (PBL) 3 were looked at, being varied 

models for interaction. 

It was recognized that the learning environment itself required many diverse inputs, to 

allow the interactive process to flower. Commitment from institutional leaders, faculty 

development, infrastructure, the nature of learning spaces, assessment, instructional 

support and inputs from the students (learners) are key considerations in building 

interactive learning environments. 3 Creating and sustaining interactive learning 

environments requires communication—about goals, approaches, and results. Even in 

the planning stages, there is the need to communicate openly, effectively, and 

frequently with all stakeholders. 3 

Transfer: is defined as the application of knowledge learned in one situation to 

another and is demonstrated if instruction on a learning task leads to improved 

performance on a transfer task, ideally a skilled performance in a real world setting. 6 

Immersion in a digital environment can stimulate learning by allowing multiple 

perspectives, situated learning and transfer. 

Immersion is the subjective impression that one is participating in a 

comprehensive, realistic experience. 7 Sensory immersion replicates digitally the 

sensation of being inside a three dimensional environment. Actional immersion enables 

the participant to carry out actions in the virtual world. Symbolic immersion draws on the 

participants’ beliefs, emotions and values about the real world to deepen the immersive 

experience. 7 In developed nations, immersive interfaces for learning are becoming 

more common. Guidance and mentoring help the participants to gain the ability to 

change their perspective and frame of reference. Authentic contexts, activities and 

assessment, must be constructed to successfully foster situated learning. 

Educational encounters that are spaced and repeated over time result in more efficient 

learning and greater retention of knowledge. 8 A novel online educational methodology 

termed 'interactive spaced education' (ISE) was seen as a method to teach physical 

examination. Significant improvement in knowledge of the physical examination was 

seen and the method was well accepted by the students. 9 The ‘spacing effect’ has 

shown promise as a method to improve acquisition and retention of learning. 8 

Integrative curricula like problem-based learning formats are becoming 

increasingly common in medical education. The assessment of such integrative 

programs is a challenge to medical educators. 10 OSCE has been used for testing 

clinical skills but has limited validity in assessing diagnostic reasoning. Comprehensive 

integrative puzzle (CIP) is a paper-and-pencil test that combines an assessment of

knowledge in various biomedical disciplines (e.g. biochemistry, microbiology, 

immunology, pharmacology and pathology) with an assessment of diagnostic reasoning 


and clinical problem solving. 10 CIP has the format of an 'extended matching' crossword 

puzzle. Its answer sheet is a grid comprising rows and columns. The left-hand column 

contains diagnoses or brief clinical vignettes. To complete the cells of the grid the 

student is required to match, stepwise, the various 'disciplinary investigations' to the 

diagnoses or clinical vignettes. When the puzzle is completed each horizontal row 

reflects a coherent medical case. 10 

Managing conflicts is of special importance for interactive learning. Groups may not 

achieve their objectives and the group dynamics may not be satisfactory in the 

presence of conflict. An author states that college teachers are not prepared to 

effectively handle conflict in classroom situations. 11 Demonstrating sensitive 

interpersonal behavior, providing clear structure within the courses, and using 

techniques which foster collaboration between students is important 11 to help 

prevent conflict from happening. 

The second week’s web-interaction, steered ably by Padmavathy, was on: methods 

used or useful for teaching/learning in small groups. While the “ideal” number of 

students for inclusion in a “small group” is a matter of continuing debate, some 

authorities suggest 5 while others recommend up to 10 to 15 per group. 

An empirical study elaborates on the relations between the variables comprising 

learning mechanisms in small collaborative groups. 12 

Variables comprising the central learning mechanisms component were: task related 

interactions, knowledge elaborations, and subjective estimation of knowledge 

acquisition. 12 Their findings suggest that a large proportion of collaborative sequences in 

the group, together with a low proportion of dysfunctional behavior and highly facilitative 

behavior of the tutor, will lead to a high proportion of knowledge elaborations. 

Knowledge elaborations positively affect knowledge acquisition which is an important 

determinant of the student satisfaction and motivation. 12 

Another very instructive paper, suggests how the responsibility for group interaction and 

learning can be delegated to the students, and has emphasized that choices are 

available to the teacher in working with groups. 13 Some of these involve more skilled 

and sensitive handling of group process from within the group; others require 

imaginative management in the setting of tasks and the organising of purposeful 

activities for subgroups. The same article elaborates Group round, Buzz groups, 

Fishbowl, Horse shoe seating , among the many methods to promote small group 

discussions. Counting till ten before speaking or interfering with the group dynamics, & 

acting as a source of content are similarly good strategies.


To this we can add the method our FAIMER training had adopted: divide the group 

responsibilities as group leader, recorder, presenter and time keeper. These 

responsibilities should be rotated among various team members during different 

sessions.. 

Another elaborate review gives guidelines for leading a small-group discussion. 14 

A safe environment where students can make mistakes while learning and not be 

ridiculed for it is very necessary. 14 The objectives for the discussion or the interactive 

session should be clear and well-communicated to the students. Sitting among the 

students, getting to know the students’ names, encouraging participation and frequent 

recapitulation of what has been covered are useful. 14 The author urges: ‘Avoid yes/no 

questions. Ask "why" or "how" questions that lead to discussion and when students give 

only short answers, ask them to elaborate.’ 14 Non-verbal communication is also 

important. ‘Don't fear silence. This may be the most difficult thing to do but it's 

absolutely essential.’ 14 Given the shortage of time in our curricula, the facilitator must 

consciously prepare to come up with the right questions, & knowing the areas which the 

student would find difficult, will be useful for that. A good facilitator should be able to 

manage both process and content. 14 Facilitating group dynamics and ensuring smooth 

group functioning is an important role of a facilitator. 

One limb of the week’s discussion led to sharing of participants’ perceptions of the 

process in our South Asian context, where most faculty model themselves on their own 

teachers’ styles. Not trained in facilitation skills, they find it very difficult to let go of their 

role as “teachers” and cannot resist giving advice or answering questions before 

students have had an opportunity to find the answer. Student bodies are also large, and 

student evaluation of the teacher and the course is not common. Due to these reasons, 

interactive learning has not become common, and traditional methods of teaching are 

still dominant. 

Critical learning skills and the ability to synthesize information can be developed only if 

these are modeled by the teacher and students are given a chance to practice them. 14 

Small group learning should be able to use the resources of all the group members, 

who should also be able to apply the principles which have been learned. 

Another article adds, that the small-group can be used for higher order thinking skills 

and for sharing observations, experiences and feelings. 15 The facilitator should identify 

both quiet and dominant students, and provide concrete and personal examples. 

Different strategies for dealing with the quiet and dominant students should be worked 

out. The learning process should be kept moving and students should be encouraged

and guided to do their own reasoning. Students should not be given information which 

they can obtain on their own. The facilitator should not assess the quality and the 

correctness of student’s comments or contributions. The discussions should not be 


directed towards the group facilitator. 15 Interpersonal problems should be resolved to 

ensure that the group works harmoniously and efficiently towards their objectives. 

Many of our Faimer group, were eagerly forthcoming with their knowledge and 

experience of the Problem-based learning [PBL] format , a well-established version of a 

small-group interactive process . PBL is based on a constructivist theory of learning and 

students construct knowledge based on interactions in the learning environment 

A very thoroughl and comprehensive review of the PBL, from its inception in 1986 to 

date 16 , outlines the Cognitive elements of PBL: 

. The problem comes first; no specific preparation precedes it. 

. Students activate and articulate existing knowledge as the starting point of discussion 

of possible causes. 

. Students engage in systematic reasoning about the problem, including 

applying new learning. 16 

Therefore, In PBL, students confront a tangible problem working in groups. 17 The power 

of PBL lies in its applicability to a number of situations. Also it is fascinating and deeply 

satisfying for a teacher to watch students transfer to themselves, the onus of their own 

learning. PBL revolves around a focal problem, group work, feedback, class discussion, 

skill development, and final reporting 

In this setting teachers become mentors and facilitators. They move among groups, 

directing students' discussions and energies when appropriate. Rather than lecture 

information or manage behavior, teachers cultivate skills, focus effort, foster 

resourcefulness, and maintain an interactive climate of learning. 

PBL is a method of decentralizing learning so that students take increasing 

responsibility for their own learning. 17 The PBL facilitator should develop strong 

facilitation skills and continuously assess his/her performance to act as a role model for 

students with regard to self-assessment 

Gender-related differences in learning, in student-led PBL tutorials were noted 

In one Asian study. 18 At the Arabian Gulf University in Bahrain, PBL groups are 

composed of either all-male or all-female students according to University regulations. 

It was noted that there was significantly higher performance in female- led groups. 18 

Very interesting questions are raised here, but validation of this result by corroboration 

with more studies would first be required. 

Most medical schools have groups comprising students from both genders. 

A checklist for assessing preparedness for small group teaching looks at six main 

components of the small group process. 19 These components are: 

general tasks in preparing for small groups,

preparing one self to lead small groups, 

conducting small group sessions, 

special tasks for co-leaders, 


planning and conducting discussions and 

planning and conducting PBL. 

The interrelated checklist will be useful for planning and conducting PBL sessions. 19 

In many programs the students assess the sessions and the facilitators. The success of 

small group teaching particularly, depends on the quality and quantity of the interaction 

between the facilitator/s and the participants. Therefore methods to measure 

“interaction” have been evolved : student-teacher interaction has been monitored using 

various techniques like video taping, the 1- minute-paper and the buddy- system. 20 

The authors of another paper had looked at two simple methods of monitoring 

levels of student-teacher interaction namely, real-time analysis of individual 

contributions by an observer and automated analysis of audio tapes by an off line 

computer. 21 

The second method gives feedback in a graphic format and can give teachers 

rapid objective feedback on their teaching style. 

When these methods are combined with knowledge at the end of the session using 

short quizzes the value of these methods of assessing participation as a measure of 

efficiency of small group sessions can be assessed. 21 

Video supported small group learning on problem solving and clinical reasoning 

has been used 22 . The sessions are in four stages. 

The first stage consists of video presentation of the case with history-taking and 

physical examination. The students and tutors can perform additional physical 

examinations and ask further questions. 

The second stage consists of making a problem list by integrating the history and 

clinical examination, a differential diagnosis list and a list of required investigations for 

confirming the diagnosis. 22 

In the third stage, the three small student groups discuss the three lists and 

come to a consensus list. 

In the fourth stage, the three groups meet together and the three lists are discussed 

and compared with the aim of coming to an overall agreement. 22 

These sessions have been positively appraised by the students, teachers and the 

medical faculty and have promoted enjoyable learning for students and teachers. 

This 2 nd week’s conversation expectedly brought up the important determinant of 

Learning style. 

While this is a determinant of any format of learning, (including large-group), 

participants reviewed the well-known, Kolb learning cycle 23 with reference to small 

group planning.

The Kolb postulation, is based partly upon situated learning experiences to which are 

added reflection, conceptualization and action. 

Conceptualization, active experimentation, concrete experience and reflection are the 

steps enumerated in this cycle. 23 


Learners need support for risk taking, advice on various ways of dealing with 

challenges, feedback and encouragement to continue with their learning. 

Kolb has identified four learning styles - observers, thinkers, deciders and doers. 

Observers tend to focus on factual information and learn much from seeing events, 

listening to the experiences of others and thinking about them. 

Thinkers like to read theory, do research and to have the opinion of experts. 

Students with a decider learning style like to know about rules and theory and how to 

apply them. They enjoy working in a practical manner. 

Doers learn by making mistakes and by discovering things for themselves. These are 

'risk takers' and like to explore. 

Different learning strategies can be adopted for these learners and they can be 

paired taking advantage of strengths and weaknesses. 23 

Additionally, strategies for dealing with slow learners or disinterested learners in a 

group should also be worked out. 

Assessment of this form of learning was looked at in the next weekt, and it was agreed 

that the knowledge gained through a small group process may be different from the 

knowledge needed to pass a theory or even practical examination. Redesigning 

assessments is a challenge and small group learning cannot be really successful until 

we address the assessment equation 

The third week’s discussion was on the topic ‘Teaching methods used or 

useful in large groups’, begun and directed by Muhammad’s inputs. 

 

Lecture is one of the oldest methods of teaching 24 & continues to be popular, as it an 

efficient method of transferring knowledge to a large number of students. 

Before the lecture, the teacher should know how the lecture fits into the students overall 

curriculum, the students’ knowledge of the subject, the method/s of assessment and 

the teaching methods which the students are accustomed to. 

Concrete examples should be given for abstract concepts, hand-outs of the lecture 

slides with space to write notes should be provided, pauses in delivery to allow students 

to write notes and checking for understanding are recommended. 24 

Getting students to interact and playing a more active part in the learning process is 

desirable.

Fear is a major reason why interactive lecturing is not widely adopted, as is evident in 

our own setting. Fear of not being able to cover the course material, fear of nonresponse 

by the student to a question, fear of not knowing the answer to a question 

posed by the student may all be there. It is quite difficult to break out of the ‘transfer of 


knowledge’ behavior, where the majority of learning takes place through didactic 

lectures. Transforming the traditional learning environment is tough, particularly in a 

system where teaching excellence is not generally rewarded with career advancement. 

However, as research amply and reliably proves,the use of interactive lectures can 

promote active learning, heighten attention and motivation, give feedback to the teacher 

and the student and increase satisfaction for both. 28 There is more active engagement 

with the teacher, fellow students and the course material. 28 Since the attention span of 

students is limited (15-20 min at a stretch), effective interaction helps to prolong 

attention. 

Asking questions, getting students to ask questions, brainstorming, buzz groups, mini 

assessments are different methods to encourage interaction. 24 

Think-pair-share is a first-rate strategy to increase interaction during lectures. In this 

each participant thinks about the topic or problem presented and writes his/her ideas. 

Then he/she discusses it another person. This method can serve as a base for a wider 

discussion. Buzz groups and rounds are two other methods. 

In medical education, case-scenarios are widely used. Tell your partner, fishbowl, peer 

evaluation, role plays, presentations and role plays were also mentioned. Student 

teacher role swap is an interesting strategy. Mind-maps is a method of visually 

organizing information and showing the interrelationships between various concepts. 

A related strategy called concept maps at the PSGFAIMER Institute during the on-site 

sessions. 

Large groups present a special challenge for teachers who want the students to be 

engaged in active learning. In South Asia, this is even more so, considering the large 

size of the medical student body and the fact that didactic lectures are still the major 

method of teaching. 

Another technique for successful interactive large group teaching 25 recommends 

starting the lecture with a problem and using student comments regarding solutions to 

the problem to guide the next part of the session. 

The lecture hall can be divided into quadrants and each small group thus formed works 

on a problem and selects a spokesperson to present their answers. 

Questions should be asked throughout the lecture. Multiple choice questions can be 

projected after major points in the lecture. The students are asked to vote on the correct 

or right answer. Then they are asked to discuss with their neighbor and vote again. 25 

A 60second or 1 minute paper has been recommended as a means of encouraging 

participation and providing feedback to the teacher. 

Creating an atmosphere which encourages students to participate is most important.

There are various means of evaluating a lecture. Asking a sample of students for 

permission to read their lecture notes, asking verbal feedback from individual students, 

asking the students to complete an evaluation questionnaire or a one-minute 

paper are the various methods. 24 


Joyce and coauthors had emphasized the importance of a multiple-models 

approach for teaching students from a variety of backgrounds and with a range of 

skills. 25 

The four models are the social, the information processing, the personal and the 

behavioral. 

The social model emphasizes social interactions to enhance academic 

learning. The focus is on developing a community of learners, resolving conflicts, 

negotiating meanings and cooperating to complete set tasks. 25 These methods may be 

difficult to implement in lectures and may be better suited to small group learning. 

Teaching students how to think and learn is seen as a major goal of information 

processing methods. Students are encouraged to reason causally and master complex 

bodies of concepts by generating, analyzing, applying and evaluating information.24 

Certain methods can be modified and simplified for application to large groups. 

Personal models put the student at the center of learning. The goal is to enhance the 

mental and emotional health of students in order to generate learning needs and 

aspirations. The teacher is seen as a facilitator. This method is also best suited to 

smaller groups. 

The behavioral model sees students as a collection of learned behaviors. As such, 

behaviors can be learned and behaviors that don’t work well can be ‘unlearned’. This 

model has been said to be the one most suited for large groups. 25 

Another method of encouraging interaction has been the use of clickers in large 

classrooms. Audience response system or ARS is being increasingly used in developed 

countries as a method to encourage interaction in large classrooms. 26 

Evidence from the literature shows that the use of ARS clickers has a positive effect on 

student performance in examinations. They introduce a more active and positive 

atmosphere in the large classroom. 

Prior planning before using clickers, communicating with students and designing 

effective questions for clickers are important. 26 

. 

"Quick-thinks" are types of questions designed to break up the monotony of 

lecture and engage students in critical thought. 27 

Select the best response, correct the error, complete a sentence starter, 

compare/contrast, support a statement, re -order the steps, reach a conclusion and 

paraphrase an idea are certain quick-thinks which have been described. 27 

Before the first class meeting in which the teacher plans to use quick-thinks, 

the students will need to be explained to, about the use of this strategy and how it will 

positively affect their learning. There is no set formula for how often to stop and ask

students to think about the content being explained. The authors’ experience and some 

quantitative evidence suggest that a quick-think every fifteen minutes or so results in 

increased attention, interest, and learning. 27 


Students can record their responses individually and explain their answers to a 

neighbor, they can verbally generate an answer with a neighbor, or they can be asked 

to silently think about a possible response. The instructor then needs to provide them 

with feedback. 

In summary, breaking the class into smaller groups 28 , questioning the audience, using 

audience responses, clinical cases, debates, reaction panels and guests, role plays and 

simulations, films and videotapes, proper audiovisual aids 28 , and developing effective 

presentation skills are recommended, to make a success of interactive large-group 

educational interventions.. 

An interesting format was developed for a 'structured integrated interactive' physiology 

session: a two-hour block lecture on growth hormone physiology. 29 Information about 

the content of the previous related lectures (anatomy, physiology, histology and 

biochemistry) was collected. Using this information, the aims and learning objectives of 

the new lecture were determined; a pre-test designed and the contents of the lecture 

were constructed. 

As an advanced organizer, the authors developed a template showing the central 

regulation of growth hormone release and its peripheral effects. 29 

Based on this template, new information was presented in two major parts. In the first 

part, information on the central control and mechanisms of action of the growth 

hormone was given, while associated pathologies were discussed in the second part of 

the lecture. Tasks were interspersed throughout the lecture. 29 Student feedback was 

positive and they performed better in clinical cases. 

Some research, apparently goes against the large consensus of findings which favor 

small-group effectiveness. The implication of one study 30 is that lectures have a role in 

CME when the goal is knowledge-retention. Techniques for maximizing the 

effectiveness of lectures have been developed, and should be utilized in the CME 

setting. Lectures and interactive forms of teaching should be examined in different CME 

settings to determine their roles, when the educational objective is knowledgeretention. 

30 

In both large- and small- group arrangements, questions are used, and very useful, if 

judiciously planned and interpolated for maximum learning effect. 

Questions can be challenge questions looking at the evidence in support of a particular 

proposition, action questions regarding what actions would be taken, information 

seeking questions, open ended questions among others.


Individual experiences with applying small and large group interactive teaching 

methods were the focus of the fourth week’s discussions. 

It was gratifying that the 2 batches of the Faimerly shared their many sources, and 

their own applications of the varied formats available and studied over the last many 

days of discussion . These included the teaching of clinical reasoning 31 , developing 

questioning for evidence-based medicine, an interesting idea called “educational 

prescription”, among others. 

Padmavathy KM, summarized from the preceding week, the guidelines for small group 

teaching. 32 

These were 

· Keep the learning process moving. 

· Probe students' knowledge. 

· Avoid expressing an opinion concerning the correctness or quality of any student's 

comments or contributions. 

· Avoid giving students information that they can and should obtain elsewhere. 

· Make sure that all students contribute to the group's discussion. 

· Prevent discussions from being directed toward the group facilitator. 

· Keep the level of the discussion questions - starting at the simplest, most widely 

known and progressing toward the more difficult, less widely known. 

· Recognize potential interpersonal problems in the group and intervene- to maintain an 

effective group process in which all members contribute. 

Continually monitor the progress of each student in the group. 32 

Group members were surveyed on this week’s topic, and individual responses were 

compiled together: 

Survey 

The groups’ experience of small group discussions was surveyed under the following headings: 

1. Can you list the methods you adapt for small group discussion in your College/University? (3 or 4 

methods in order of preference) 

Lectures were the main teaching modality used for large groups. 

Tutorials, Small-group presentations, Interactive exercise demonstration with a student model, 

Problem-stimulated activity-based learning: these were used for small groups 

2. Can you share your experience towards preparation for leading small group discussion? (≥3 points) 

Lesson plans were used to focus preparation for both large and small group teaching. 

Care is taken in preparing the scenarios and problems in small group learning as this will directly 

determine how the students approach the problem and the specific knowledge and skills they will 

develop.

Lecture notes, preparing for the expected questions from students and using and preparing Charts and 

Models for the topic, were also used. 


3. Share the methods /procedure you adopt during conduction of the small group session? (specify which 

session) 

Buzz groups and talking to the neighbor were occasionally used during lectures. The lecture classes are 

conducted in the forenoon and the practical classes in the afternoon. 

For small group discussions, the FAIMER method of having a group leader, a recorder, a presenter and a 

time keeper was found helpful. 

4. Any difficulties you faced while conducting the session and how did you overcome? 

Few students always contributing, and lack of contribution from the rest of them, was felt to be a 

problem. There were occasional disciplinary problems in large groups. Another point: students came to 

class without revising the portions which were already covered. 

Also the end-of-day classes were difficult, as the students were tired and hungry. 

5. How do you assess for each method you adapt for small group discussion? 

For small group learning formal feedback from the students was occasionally taken. A format for 

formative assessment of individual students and of groups was used during practical sessions in one 

institution. Observation, seminars, assignments and problem-solving skills were assessed in another 

institution 

For large group teaching, feedback is obtained by informal interaction with the students. 

From the responses, we uncovered an ambiguity in the wording of the question. One respondent 

concentrated on the process assessment while another discussed the knowledge acquisition by the 

students and its assessment. 

----------------------------------------------------------------- 

The Second Survey asked an open-ended question: 

Are there cultural and social factors in a South Asian context which in your opinion facilitate/hinder 

small group learning? 

A respondent observed that in the sub-continent, there is still lot of emphasis on family/togetherness, 

which makes it easier for people/students to form groups and share ideas with each other. 

On the other hand, social and cultural factors that hinder, or at least slow the process of studentcentered 

self–directed learning, is our revered teacher-pupil (guru-shishya) learning tradition. Emphasis 

is on obedience and unquestioning emulation of the teacher, and that ambience does not encourage 

self-learning and development of individuality. 

----------------------------------------------------------- 

The facilitators had already been uploading weekly overviews of all this interaction, and 

with the month concluding after the surveys were answered, Ravi posted his detailed

and comprehensive topic summation, soon after the following month’s new discussion 

began. 


REFLECTION ON THE DISCUSSION AND THE ML-WEB EXPERIENCE 

The rich interplay of information and ideas over the whole month helped bring home the message that 

Interactive learning does not require sophisticated equipments or 

a state-of-the-art infrastructure. 

Interactive learning is, learning through interaction between the teacher, the student and the learning 

environment., and can be created facilely, given open-ness, ingenuity, and willingness to learn, perhaps 

more required in the “teacher” than the designated “learner”. 

Certain methods discussed do require sophisticated technology, but the majority require only committed 

and enthusiastic facilitators, a clear focus on and delineation of goals and objectives, a willingness to try 

out and develop new ideas and a supportive 

leadership. 

The methods to increase interaction during lectures were especially pertinent 

as lecture continues to be the main teaching-learning modality in our workplaces. Asking questions is an 

important skill. Students know much more than we give them credit for and by asking proper questions we 

can help them to discover, understand and assimilate information. 33 

That students should know what is expected from them and told how they would be tested is important. 

There should be increased emphasis on facilitation skills and its development among medical faculty. 

The ML-web experience was a mixed-bag for me, due entirely to my own reluctant presence on it. 

Drawing upon the five stage model on e-moderation 34 ,[ ‘E-tivity’, coined by G. Salmon of Open University 

(England), which means "task online"] 35, -- 

my slow ponderous journey through the stages has been nevertheless rewarding and one of 1.motivation, 

2.socialization, 3.information exchange, 4.knowledge construction and finally, gratifyingly, 5.holistic 

development. 

Many of the points brought out regarding team- based learning can be illustrated by my own sporadic 

participation on our listserv. The enormous efforts made by my co-facilitators to elicit timely inputs from all 

members, the challenge of holding the group to its own learning objectives, for just this one month, showed 

up directly, in this very experience. 

Notwithstanding that, I and the January discussion group learned so much. The discussion started out 

slowly and then picked up during the second and third weeks. The last week’s deliberations did not bring 

forth many responses, but all of us were able to overview the subject, due to the excellent weekly 

summaries, by my co-facilitators. 

We could perhaps have done better sourcing of references; given everyone’s varied and demanding other 

(than FAIMER) commitments, I am quite happy with the quantum of networking that did happen, though it 

compares poorly with other months.

My late presentation of this scholarly report, is my biggest regret, the more since I so slowly appreciated 

the breadth and depth of so many people’s thought and work in this inspiring field . When I have finally 

made the time and effort , I submit through the inspiration derived from the excellent examples that went 

before, and in gratitude for my colleagues, mentors, and vital-support-system that is Faimerly. 


CONCLUSION 

The January discussion on ‘Interactive teaching’ proceeded to systematically outline 

and then fill-in the extant research, perspective and experience of this vital area in 

Modern Medicine. 

Various methods of interactive teaching in small and large groups were studied; 

challenges, such as in assessment, and satisfactions, as in recently-gaining PBL, were 

shared among all participants. 

Certain approaches while very fruitful, need expensive technology; while the majority 

are very much do-able within infrastructure constraints. viz. the South Asian context.


ACKNOWLEDGEMENTS 

Prof. Thomas Chacko, & Dr. Supten Sarbadhikari for their unwavering calm and smiling 

Faith in me, & the whole PSGFAIMER Faculty Team 

The International FAIMERly, ever-available and reachable on the Web 

Our faculty facilitators for the January 2009 group: Professors Arun, Marina & Seetha 

Fellow- facilitator 2007: Ravi 

The excellent 2008 fellows Muhammad and Padma 

The Management of Bhaskar Medical College, Yenkapally, Moinabad, RR district, A.P. 

for endorsing my FAIMER project 

Professor Dr. Sikander Hayath, erstwhile Principal , Bhaskar Medical College for 

encouragement, steady support through the Project and Fellowship process. 

The students and faculty of all those departments of BMC – Anatomy, Pathology, 

Microbiology, Pharmacology, Ophthalmology, who participated in the 2 phases of the 

Computer-based Classes Project.


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