Background Many pedagogical models have been included to the teaching strategies available in almost all fields of knowledge in the last 20th years. In the field of medicine teaching, the traditional teaching (TT) model based on an expert speech aid by a multimedia slide projection is now only one of many strategies. One of them is the Problem-Based learning (BPL) model, which is one of the most applied in undergraduate education; however the documented experience on residents education with rheumatologic contents in Spain is inexistent. BPL model consist in a lecture based in a clinical case or cases that the students must affront using several tools, most of them provided previously by the teacher, and the opinion of their classmates. Groups are encouraged to try to solve the medical problem while the teacher leads debates among the groups.
Objectives Our goal is to test the impact of PBL model compared to TT among non rheumatology residents who participated in an rheumatology educational program using long term measures in their clinical practice.
Methods We developed an educational program for second year residents of all medical specialties in our teaching hospital. The topic included the assessment and treatment of lumbar acute pain and was programmed in two separated dates using both the TT and PBL models. Students were unaware of the teaching strategy. Contents of both courses were the same and were prepared by two different experts. We reviewed the registries of medical attention performed by all residents for patients who consulted due to acute lumbar pain, and collected data about three aspects: Adherence to image test recommendations (AITR), adherence to treatment recommendation (ATR) and recidivism before the 15th day after the day of consultation (need of further consultation due to the same medical problem). Registries included those generated along the first 12 months after the end of the courses.
Results The TT group generated 175 registries while PBL generated 219. Both groups were formed by 20 non rheumatology second year residents. Proportion of AITR were 73.3 and 60.2% for BLT and TT groups, respectively (P<0.001). Considering only the registries generated in the first trimester after the courses, those proportions were respectively 80.2 and 79.5%. Proportion of ATR were 69.9 and 55.7%, respectively (P<0.001), however when considering only registries generated in the first trimester those proportions were 77.1 and 76.9%, respectively. Global recidivism rate (number of patients who need a further consultation due to the same medical problem or due to the side effects of their treatment among all patients attended) at the first 15th day since the first assessment was 8.7% in the PBL group and 17.5% in the TT group (P<0.001). At the end of both courses a survey to the students were performed. The satisfaction index –measured by a 0–10 progressive ordinal scale- were 9.1 SD 1.3 for the PBL model and 8.2 SD 1.4 for the TT model (P<0.05).
Conclusions The pedagogical PBL teaching method shows a better academic impact in terms of concept retention and appliance into the medical practice along the time. In our opinion and according to our experience, most programs of education on transversal topics of rheumatology should be taught using the PBL method.
Disclosure of Interest None declared