Grassroots democracy: the impact of asking learners what they want to know on attendance and learning

Abstract

Abstract Background: The General Internal Medicine Acting Internship (GIM AI) at our school is a compulsory, month long experience. Core teaching sessions are conducted on a weekly basis as part of the acting internship and were poorly attended. Objective: We sought to redesign our academic half day didactic curriculum and increase voluntary student attendance by allowing students to actively participate in determining the content of the acting internship academic half day. Intervention: Prior to the beginning of the acting internship, students were sent an email survey listing seven inpatient topics to rank on a scale of 1 to 5 (1=not at all interested, 5=very interested). Based upon student feedback, one additional topic was added: antibiotic use for common inpatient diagnoses. A total of 32 sessions were conducted over 8 months. Student attendance at these sessions was voluntary. Dates were randomized between "case-based sessions" (control) and "topic-based sessions". Topics that received the highest score were selected for topic-based sessions. Main measures: Student attendance at topic-based sessions versus case-based sessions Key results: Case based discussions had the lowest preference ranking (N 94, mean 2.9), while cross cover-based discussions (N 94, mean 4.3, p 0.001) and antibiotic use (N 52, mean 4.3, p 0.001) received the highest scores. 34% of possible learners attended case-based discussions, while 78% of possible learners attended topic-based sessions (p<0.001). Learners reported a statistically significant improvement in comfort level with recognizing or managing 74% of the sub-topics discussed (31 out of 42) Conclusions: A learner centered approach to curriculum design led to robust student engagement in our acting internship academic half day. Fourth year students prefer specific topic-based teaching sessions over case based, morning report style sessions. Learner preferences around content areas that were generated at our school can inform similar efforts at other institutions.