Comparison between lecture-based approach and case/problem-based learning discussion for teaching pre-anaesthetic assessment.

BACKGROUND AND OBJECTIVE The case/problem-based learning discussion method was recently introduced into the theory-based training program for residents run by the Catalan Society of Anaesthesiology. This study was designed to assess and compare its effectiveness with that of the lecture-based approach for teaching pre-anaesthetic assessment, applying an objective tool for knowledge evaluation before and after teaching. METHODS A prospective randomized study of two consecutive year groups of first year anaesthesiology residents was conducted. Twenty-nine residents attended a lecture, and 25, a case/problem-based learning discussion session. Their knowledge of pre-anaesthetic assessment was assessed before and after the teaching session with tests on four different clinical cases measuring six fields: (1) 'recognizing clinical data with anaesthetic implications'; (2) 'reasoning clinical data with anaesthetic implications'; (3) 'ASA class'; (4) 'Mallampati class'; (5) 'choice of anaesthetic technique'; (6) 'reasoning choice of anaesthetic technique'. RESULTS Before the teaching session, the lecture group scored significantly higher on field 1 (P = 0.006). Both teaching methods improved scores on fields 1, 2 and 4. The case/problem group also improved on fields 3 and 6. After the teaching session, the field 1 score was still significantly higher in the lecture group (P = 0.005), and the field 3 score was significantly higher in the case/problem group (P = 0.044). CONCLUSIONS The effectiveness of lecture and case/problem-based learning discussion differed little in terms of improving participants' immediate knowledge of 'pre-anaesthetic assessment'.