Microteaching revisited! A tool for improving undergraduate student seminars

INTRODUCTION

Self-directed learning is one of the important components proposed in the new Graduate Medical Regulations of 2019.^[1] Nowadays, a deluge of techniques is encouraged to increase the interest of students in learning.^[2] Student centred learning encourages active participation from the students and the results are better learning outcomes.^[3] As per the learning pyramid proposed by NTL, the highest retention rate for a student is by teaching others as compared to listening to lectures, reading and group discussions.^[4] There are multiple reasons why medical students must be trained in educational principles, some of them being effective communicator with patients, better learner and also an effective teacher in their future.^[5]

Student seminars are now a routine in medical institutes as a small group teaching method.^[6] Seminar is a small group teaching-learning (T-L) session, in which the participants discuss under the guidance of an expert. The instructor, the students, preparation, content, group dynamics, course coherence and facilities are key factors in seminar learning.^[7] Unfortunately, majority of the student-led seminars (SLS) remain to be passive with no interaction or incentive for active participation.^[7]

Microteaching was originally created in the early 1960s by Allen at Sanford University as a type of scaled-down simulation activity to help teacher candidates learn to teach. It was designed as a brief but structured practical experience in which prospective teachers would begin to bridge the theory-practice gap by planning and presenting a 5–10-min lesson in which they were to apply specific instructional skills or tasks previously studied in the class.^[8] Recently, microteaching was implemented in different curricula as a useful self-learning instrument for undergraduate and postgraduate students. As it is well known, self-learning involves the active participation of the students and encourages them to construct their own learning program.^[9] Microteaching-microlearning exercises are effective methods to enhance and develop communication, problem-solving and critical-thinking skills in students.^[10]

Besides, the methodology of microteaching involves active participation of learners with interaction. There are studies on applying the methodology of microteaching for student seminars in non-medical field among the engineering students, whereas there are very few studies among the medical undergraduates. With this background a study was designed to assess the effectiveness of student seminar presentations following training them through microteaching methodology.

MATERIALS AND METHODS

An interventional study was conducted among 1^st year MBBS students of a medical college located in Bengaluru, Karnataka, between March and April 2017 after obtaining institutional ethics committee approval. Among 150 students, 50 students consented to participate. After obtaining the written informed consent, those 50 students were assessed for their pedagogical skills and academic performance using a checklist following which 20 participants were similar in their ability scores. For the purpose of the study, ten students were selected by simple random sampling. They were assigned to conduct seminars with pre-discussed topics from the subject of physiology after taking into consideration the difficulty index. They were allotted facilitators to guide the students for preparation of seminars. The study subjects were randomly allocated into two groups, the intervention and the control group of five members each. One group was trained in the microteaching methodology by conducting 1 day workshop. The workshop consisted of an initial orientation of the students to concept of microteaching along with a microteaching demonstration session. Following this, the students made a 5 min microteaching session which was evaluated and feedback provided by the faculty of Medical Education Unit.

The participants from both the groups were allotted a time of 20 min each for seminar presentation. Each presentation was assessed by independent faculty members (n = 13) and students (n = 12) who were blinded for the study objectives. The assessment was done using a standardised checklist provided, which objectively assessed the various components of a good presentation.^[6] The components included were: Lesson planning, set induction, presentation – skill of describing, narrating and making the topic interesting, stimulus variation, proper use of audio-visual aids, reinforcement of student participation, fluency in questioning, body language, liveliness, closure – method of concluding a lesson summarising and highlighting the important points, take home message. Each presenter was scored on a scale of 0–10 by each of the assessor. The perception of the students who underwent training in microteaching methodology was noted by conducting a focused group discussion.

RESULTS

A total of ten students were included in the study, five in the intervention group who were trained using microteaching methodology and five of them in the control group who were untrained. Each student was assessed by 25 members with 13 faculty and 12 students. Thus, 25 assessment responses were obtained for each candidate resulting in 125 responses from each group. All the students belonged to the same class and Phase I of MBBS. The ratio of males to females was 2:3 in intervention group and 3:2 in control group. The median score for all the components in the assessment was significantly higher in the intervention group as compared to the control group [Table 1].

On exploring the various components of the presentation, more assessors felt that the students in intervention group made a better set induction in terms of arousal of interest, to bring out relevance and mentioning of specific objectives. There was also significant difference in presentation skills including involving the audience, questioning and providing clues. However, there was no significant difference in the nonverbal cues such as appropriate gestures and eye contact between the two groups. The intervention group also fared better in use of audio-visual aids and in closing the seminar appropriately [Table 2A and B].

Focused group discussion was conducted for the intervention group regarding their perceptions on microteaching as a method to improve seminar presentations. The discussion was routed through their perceptions about the effort involved, usefulness and the difficulties in the programme. All the students in the intervention group felt that the training was very useful and were willing to undergo such trainings further. Three students opined that lack of time and motivation in undergoing training was a hindering factor.

Some of the common perceptions of the students who underwent microteaching were, they mentioned microteaching as interesting, innovative, interactive method and it improved their presentation skills. However, it needed lot of preparation for its application such as the set induction and exploring for example. The students also perceived that the training helped in increasing the retention of the knowledge, confidence and thorough preparation of the topic given in [Table 3].

DISCUSSION

Active learning as defined in ERIC digest is ‘instructional activities involving students in doing things and thinking about what they are doing.’ Active learning helps students in better retention of knowledge and also improves their learning skills. SLS is one of such methods which are used widely across the universities. They not only enhance the cognitive domain but also serve as an opportunity to enhance their communication skills. There have been various attempts to make seminars more effective and interactive. In one such attempts, Kadayam Guruswami Gomathietal incorporated quiz and provided specific learning objectives for a seminar presentation and observed that the new format was significantly more interesting, interactive, fun and made them feel more like a team and also reported ‘improvement in communication skills,’ ‘learnt to make a formal scientific presentation’ and ‘gained self-confidence after presenting the seminar.’^[11]

The current study was a similar attempt in improving the effectiveness of the seminars by improving the preparation and presentation skills by applying microteaching methodology. The study reported significant difference in presentation skills and interaction following intervention. The response from the intervention group also reiterated the effect of microteaching in their learning skills and improving their confidence in presentations.

In Patel et al. study where they focused only on seminars, they found that students actively research a topic and prepare the PowerPoint presentation to teach the class. Apart from learning, the students acquire other skills such as searching the internet-based materials and preparing presentations which can help them learn in an easier and better way.^[2,12] Indian studies which sought feedback on T-L methodologies in pharmacology state that seminars are largely unpopular and uninteresting T-L methods.^[7] Palappallil stated that only 8% participants showed interest in seminars, 44% participants did external referencing for preparation and 17% considered post seminar tests as an effective method of assessment.^[13] Retention of knowledge through active participation was the most frequently cited reason for preferring small group tutorials, while a dislike of compulsory course components was mentioned more frequently by students preferring interactive seminars.^[14]

A study done at the University of Calgary to evaluate the effect of participation in teaching on the learning of medical students, the author observed that the students who were assigned the role of peer educators performed significantly better as compared to their peers in terms of preparation time and performance in clinical exams.^[15] A study involving medical students in Spain showed that microteaching was effective in developing participant’s self-learning and self-regulation processes.^[6,10] In the field of medicine, a study by Sana reported that microteaching was instrumental in helping medical students enhance their medical teaching abilities^[16] and the same has been noted in a 5 Years study by Ralph on ‘The Effectiveness of Microteaching: In Related Disciplines such as pharmacy, nursing, medical, pre-service undergraduates and in-service graduates.’^[8]

Suryawanshi et al. conducted a study on postgraduate students in improving their presentation skills by incorporating microteaching methodology. They observed that by providing systematic feedback there was significant improvement in the presentation skills of the PGs. They also reported the usefulness of the feedback in improving their skills. This is similar to the present study where the intervention group performed better than the control group and gave a similar feedback in group discussion.^[17]

With regard to perceptions of students on microteaching, Roush RE observed that his participants felt they could improve their presentation skills^[18] and subjects of Handfield-Jones et al. said they were able to use innovative techniques in planning and teaching which was enjoyable and productive.^[19] This is similar to the perceptions of the subjects in the present study.

Similar results were obtained by Omar and Mehdi in Katihar where they mention that there is basically a change in behaviour which can be brought about at any age. When the learner is experienced, learning becomes more effective.^[20] The most important quality of the participants of microteaching sessions is the ability to give and receive constructive feedback with an open mind and achieve appropriate teaching-learning goals.^[21] In this study, the participants of the microteaching group have strongly acknowledged the usefulness of microteaching method and they have perceived that microteaching imparts creativity among students. This is in concordance with study conducted by Shilpashree, where they mentioned that all the students acknowledged the usefulness of feedback and 44.4% felt it as the most useful part of the workshop.^[22]

CONCLUSION

Active learning is a critical tool for facilitating learning in the classroom. Development of critical thinking and interpersonal skills along with communication is the key to efficient learning. The performance and participation of the students were very much encouraging. In the present study, the association of various sub-components of planning, set induction, presentation, questioning, non-verbal clues, use of AV aids and others were significantly associated with the intervention group than the control group which shows the effectiveness of methodology of microteaching in routine seminars which will help in improving the all the domains of learning and delivering the contents. Microteaching methodology facilitated learning as it ensured active participation from the students, was interesting, interactive and innovative. It provoked interest in topic, helped them to come prepared and also improved their presentation and communication skills.