A meta-analysis for comparing effective teaching in clinical education

Abstract

Aim: Many factors affect learning outcomes, however studies comparing the effectiveness of different clinical teaching methods are limited. We utilize the list of influences on educational achievement compiled by John Hattie to inform a meta-analysis of learning effect sizes (ESs) associated with teaching-learning factors (TLFs) in clinical education.

Methods: A literature search was conducted in PubMed to identify articles examining clinically relevant TLFs. Selection criteria were applied to identify learner-focused studies, with subsequent categorization by study design (pretest–posttest or controlled group). The Cohen’s ES (d) for each TLF was extracted and a pooled ES determined.

Results: From 3454 studies, 132 suitable articles enabled analysis of 16 TLFs’ ESs. In general, ESs derived from pretest–posttest data were larger than those from controlled group designs, probably due to learner maturation effect. The TLFs of mastery learning, small group learning and goal settings possessed the largest ESs (d ≥ 0.8), while worked examples, play programs, questioning, concept mapping, meta-cognitive strategies, visual-perception programs and teaching strategies demonstrated ESs between 0.4 and 0.8.

Conclusions: This is the first study to provide a rigorous and comprehensive overview of the effectiveness of TLFs in clinical education. We discuss the practical traits shared by effective TLFs which may assist teaching design.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Glossary

Teaching-learning factors: Is a general term referring to any factor that may affect teaching or learning processes. This includes teacher or student individual experiences, attitudes, regulations, strategies, and programs.

Mastery learning: Is a combination of a variety of activities including goal setting, repetitive practice, regular feedback and test and retest with sequential monitoring of learning progress in order to achieve mastery level (Missouri’s Educator Evaluation System).

Goal setting: Refers to the challenging goals the teacher designated according to student levels and expected outcomes (Missouri’s Educator Evaluation System).

Small group learning: Refers to learning and teaching in a small group. In, United Kingdoms, a group of 6–8 students is a common form of small group learning (Edmunds and Brown 2010).

Notes

1 *Studies used in our meta-analysis (References).

Additional information

Funding

This study was supported by a scholarship from Taipei Veterans General Hospital-National Yang-Ming University Excellent Physician Scientists Cultivation Program [105-Y-A-005] (to P.-H H).

Notes on contributors

Pin-Hsiang Huang

Pin-Hsiang Huang, MD, is a former doctor at Taipei Veterans General Hospital in Taiwan. He is currently a research student studying medical education in UNSW Medicine.

Matthew Haywood

Matthew Haywood, MBChB, MRCS (Glas), MRCS (ENT), PgDip MedEd, FHEA, is a former learning and teaching fellow at the University of New South Wales and anatomy fellow at Barts and the London School of Medicine and Dentistry. He currently works as a specialist registrar in Otolaryngology in London.

Anthony O’Sullivan

Anthony O’Sullivan, MB BS, MD, FRACP, MHPEd, is a clinical academic at the St George & Sutherland Clinical School. Professor O’Sullivan is the Program Authority (Head) of the Medicine program in UNSW Medicine.

Boaz Shulruf

Boaz Shulruf, BSc, MPH, PhD, is Professor in Medical Education at UNSW Medicine. His main research interest is in the area of psycho-educational assessment in higher education, particularly within the context of Medical and Health Sciences Education.