Tutorials: an effective and interactive method of teaching undergraduate medical students

INTRODUCTION

Tutorials in its true sense is a small group teaching learning method with the central concept of discussion.¹ Tutorial classes for medical students are imparted to develop and test their own ideas, clarify the material presented in lectures, apply general concepts to the solution of specific problems, define new problems and seek solutions to them, hone problem-solving skills and encourage students in self-learning.

Learning is not uni-directional from teacher to student, but multi-directional, including tutors, other students, and professors. The student receives guidance and support from the others.² Learning occurs through multiple interactions within the learning environment, especially when the students are encouraged and expected to think both creatively and critically.

Responsibility for learning should be placed on the student, with the instructor’s role shifting from lecturer to facilitator. From students’ point of view, the main characteristics for a good tutorial are tutors allowing enough time for discussion, accepting students as partners, refraining from interference and having expertise.³ It has also been found that the components of a rich learning environment are stimulation by classmates, a knowledgeable and creative faculty and a large amount of personal contact between students and instructors.⁴

Most of the current teaching techniques are didactic involving very less student participation and the knowledge is imposed on the students. Using the current techniques, the lesson taught to students is not skill oriented, and therefore, although we are producing good number of health workforce but are unable to meet the needs of the community.⁵

There is growing concern among medical educators that conventional modes of teaching medical students (lecture-based curricula) neither encourage the right qualities in students nor imparts life-long respect for learning.⁶ Undergraduate medical education, as with any other educational programme, needs ongoing improvements to meet the changing demands of medical practice in the present century. Medical education should be given the same emphasis as research and patient care. Hence the present study was conducted to assess the perception of undergraduate medical students about tutorials as teaching learning methods as compared to a traditional teaching learning method (lecture).

METHODS

A tutorial session was conducted among 7^th semester MBBS students of Pondicherry Institute of Medical Sciences. 71 students attended the tutorial session and all the students were divided into six groups comprising of 12 students per group. A pre test was conducted prior to the tutorial to record the understanding of the topic by the students.

Handout of the topic to be covered for the session was prepared well in advance and lesson plan of the tutorial was also made. The handouts were distributed to all the groups. Tutorial was conducted by trained faculty of the department of Community Medicine who had undergone medical education training by MCI. Each group was accompanied by one faculty.

During the tutorial session hand outs were read by students for 30 minutes following which the topic was discussed by the faculty within the same group. Lastly, student representatives from each group were invited for a panel discussion during which one student moderated the session and others discussed the topics among each other, shared their views and asked questions to get clarifications from the faculty.

At the end of the tutorial, a predesigned pretested questionnaire with responses prepared using Likert’s scale was given to all students to record their responses and feedback about the effectiveness of Tutorials as a teaching learning method as compared to Lecture. Also a post test was conducted to assess the understanding of the topic after the tutorial. The data was entered in Microsoft excel 2007 and was analysed using SPSS version 16. Proportions of students’ response for various items were calculated.

RESULTS

Among the students who participated in the tutorial session 45 (63.4%) said that they could understand the topic better in tutorial and 55 (77.5%) expressed that tutorials are more interactive than a lecture. Overall, as compared to lecture, majority of the students (66.2%) rated tutorials as a better teaching-learning method.

Students gave written feedback for the tutorials session. Some of the feedbacks given by students are –

• • “Discussing particular topic makes the subject to be clear.”
• • “Small group; interaction proper with teacher and within groups.”
• • “Was able to ask doubts to assigned tutors.”
• • “Catches attention, sustains interest.”
• • “Very useful, everyone will get the chance to talk.”
• • “Message clearly reached the students.”
• • “Equal involvement amongst all the group members.”
• • “Very interactive; almost like friends teaching us.”
• • “Sustains attention of audience, not monotonous.”

Figures in parentheses are percentages.

DISCUSSION

Today the most common teaching learning method used in medical education is a didactic lecture. A traditional lecture doesn’t encourage a fruitful participation of students and doesn’t promote interaction among teacher and students.⁴ For effective skill learning as well as to create and sustain the active interest of students in learning, the teaching learning method must be interactive and participative in nature. A tutorial is a participative teaching learning method which promotes discussion and better understanding of a topic. In our study, tutorials were conducted using a handout prepared with reference from standard textbooks for undergraduate medical students.

Students were divided into six groups, each group facilitated by a trained faculty who promoted healthy interaction among the students. At the end of the tutorial, students were given the feedback form with questions to be answered for testing the efficacy of a tutorial as compared to a lecture.

In present study majority of the students (77.5%) felt that tutorials were more interactive than lecture and hence tutorials are better able to sustain students’ attention. Raven et al also in their study found that good tutorial must promote students participation and refrain from interference. The study findings in our study are similar to a study conducted by Stalin et al on integrated teaching program among undergraduate medical students.⁷ On the basis of their findings, active teaching–learning method creates interest among students, and it is an effective learning method for them to learn the subject in a better manner.

63.4 % of the students in our study stated that tutorial was better teaching learning method than lecture as regards to the understanding of the topic. Shah et al also in their study observed 65.3% students’ response that tutorials are more useful as compared to lecture to understand any topic.⁸ Majority of the students (66.2%) in our study gave better ‘overall rating’ to tutorial as a teaching- learning method than lecture. MJS Dawane et al and G Sivagnanam also found that students preferred tutorials than a lecture as a teaching learning method.^9,10

CONCLUSION

To conclude, the medical undergraduates felt that tutorial is an effective method of teaching learning process. Group interaction and understanding of subject was perceived to be high among the students with this method. Hence Tutorials need to be included as part of regular teaching schedule for undergraduate medical students.

ACKNOWLEDGEMENTS

Authors would like to thank and acknowledge the contribution of all the undergraduate medical students who consented and participated in this study. We also express our acknowledgment to the post graduate students and other faculty of Department of Community Medicine, who actively supported for the planning, implementation and completion of this study.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not required

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