|MEDICAL EDUCATION: BACK TO BASICS
|Year : 2015 | Volume
| Issue : 4 | Page : 301-304
Evaluation of effectiveness of syndicate learning in oral medicine and radiology: Cardinal findings in a batch of final-year students
Vidya K Lohe1, Adarshlata Singh2
1 Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed University), Sawangi (M), Wardha, Maharashtra, India
2 Depertment of Dermatology, Jawaharlal Nehru Medical College and Hospital, Faculty of School for Health Professionals Education and Research, Datta Meghe Institute of Medical Sciences (Deemed University), Sawangi (M), Wardha, Maharashtra, India
|Date of Web Publication||28-Jul-2015|
Dr. Vidya K Lohe
Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed University), Sawangi (M), Wardha, Maharashtra
Source of Support: None, Conflict of Interest: None
Introduction: Syndicate learning is a form of peer learning involving small groups of 5-6 students working in semi-independent groups toward achievement of a collective goal. Methods: Eighty final Bachelor of Dental Surgery (BDS) students were enrolled. Pre-test was conducted for regular batches posted for clinical posting in Oral Medicine and Radiology. Each batch was randomized into two equal sub-groups. Sub-group A and B were exposed to syndicate and traditional learning methods, respectively. Post-test was carried out. Crossover was done. Pre-test was again conducted. Sub-group A and B were exposed to traditional and syndicate learning, respectively. Post-test was again carried out. Results: In round one, scores of post-test were significantly better than pre-test in both subgroups A (pre-test - 2.40 ± 0.98, post-test - 4.45 ± 0.71) and B (pre-test - 2.47 ± 0.96; post-test; 3.57 ± 0.87). In round two after crossover, scores of post-test were significantly higher in both subgroup A (pre-test-2.30 ± 1.09; post-test-3.72 ± 0.84) and subgroup B (pre-test - 2.37 ± 1.12; post-test - 4.50 ± 0.59). Further, when subgroup A was compared with B, scores of post-test were significantly higher in the syndicate group compared with traditional group, before and after crossover. Conclusions: Syndicate groups can make learning experience more interesting; generate many opportunities for creative interchange of ideas and lively, meaningful participations and discussion among students.
Keywords: Crossover, post-test, pre-test, students perception, syndicate, traditional
|How to cite this article:|
Lohe VK, Singh A. Evaluation of effectiveness of syndicate learning in oral medicine and radiology: Cardinal findings in a batch of final-year students. Astrocyte 2015;1:301-4
|How to cite this URL:|
Lohe VK, Singh A. Evaluation of effectiveness of syndicate learning in oral medicine and radiology: Cardinal findings in a batch of final-year students. Astrocyte [serial online] 2015 [cited 2019 May 22];1:301-4. Available from: http://www.astrocyte.in/text.asp?2015/1/4/301/161625
| Introduction|| |
At graduation, a dental graduate must exhibit the competencies like knowledge, skills, and attitudes. The dental graduate must have a sound theoretical knowledge and understanding of key principles relating to radiographic interpretation and formulating a treatment plan and they should be able to apply these clinically. To meet this clinical requirement, dental colleges can have choice to select instructional approaches they consider most effective. Learning is an active and constructive process. The responsibility of a teacher is to provide an environment in which students are able to actively engage with subject matter in order to learn it.
Traditionally, during the clinical posting of Oral Radiology, final BDS students are taught about skills of radiographic interpretation in a batch of 10-12 students by the tutor. This type of learning is a passive and teacher centered and therefore the students may develop a minimal capacity for adopting a deep approach to learning, searching for deeper meaning and personal relevance in the topic and are therefore unable to apply learned concepts in new situations competently. Syndicate learning is a form of peer learning involving small groups of 5-6 students working in semi-independent (tutor-less) groups toward the achievement of a collective goal or task.  In this method students are likely to need to adopt an enquiring, problem-solving approach to collaboratively achieve the set task. The groups are focused on achieving a shared task rather than necessarily solving a problem. In syndicate learning groups, in order for groups to achieve their set task, students learn by actively listening to alternative arguments and by becoming open minded to assimilate others' ideas within what they already understand. Teaching peers and being taught by peers is a powerful way of deepening understanding. , The implementation of syndicate group working to teach the basic principles and skills of radiographic interpretation covered in Oral Radiology to dental undergraduates may offer some valuable benefit to the undergraduate students.
Therefore the present study was undertaken with the following aim and objectives
"To evaluate effectiveness of syndicate learning in Oral Radiology designed for final BDS students".
- To evaluate effectiveness of syndicate learning in Oral Radiology designed for final BDS students
- To compare efficacy of syndicate learning with traditional learning.
| Materials and Methods|| |
This comparative, prospective, and interventional study was conducted after obtaining the prior approval from the institutional ethical committee of Datta Meghe Institute of Medical Sciences Sawangi (Meghe), Wardha in the department of Oral Medicine and Radiology, Sharad Pawar Dental College. All students of final BDS willing to voluntarily participate in the study were included. Students who were absent or not willing to voluntarily participate in the study were excluded. Total study duration was one year.
Eighty final BDS Students were enrolled as they came for their regular clinical posting in Oral Medicine and Radiology. All the participants already had the basic theoretical knowledge about the principles of radiographic interpretation and radiological features and differential diagnosis of important radiolucent bony lesions (core area) covered in regular theory classes. The skills of radiographic interpretation and the departmental standard reporting method were already discussed during their final year first term clinical postings. Informed consent was taken from all 80 final BDS students enrolled for this study. In the final BDS second term clinical posting of Oral Medicine and Radiology, a pre-test was conducted for the posted batch and then the batch was randomized by using systematic sampling into two equal sub-groups, that is, Group A and B (5-6 students per group).
Groups of students were briefed with a task and given background information and useful resources. Specific learning objectives were set. The students of Group A were exposed to the syndicate learning method by giving five radiographs having bony lesions for discussion. The students were free to use various resource materials like class notes, books, internet, etc., They had to complete the interpretation of the given radiographs by using the standard departmental reporting method in about 2 h during their clinical posting. Then the students presented the report of given radiographs to the tutor who gave constructive feedback followed by active discussion of the required areas for interaction. This was followed by post-test.
For comparing between syndicate and traditional learning methods, the students of Group B were exposed to the traditional learning method. Traditional learning method is a teacher-centered small group method wherein the students remain comparatively passive. Specific learning objectives were set. The students of Group B were exposed to the traditional learning method by using same five radiographs having radiolucent bony lesions. This was a tutor-led method in which these radiographs were directly discussed by the tutor. The students were free to interact with the tutor but not among the peers. This was followed by post-test.
For exposing both the batches to both syndicate and traditional learning method a crossover was done. A pre-test was conducted and the students of Group A were exposed to the traditional learning and Group B were exposed to the syndicate learning modality by using different five radiographs having radiolucent bony lesions. This was followed by post-test. This process was carried out for all the batches subsequently posted during their second term posting of final BDS.
Pre-test and post-test
Questions in pre-test and post-test were similar. Multiple choice questions were linked to learning objectives to assure content validity.
Analysis of the pre-test and post-test scores was done. The cognitive learning gain was calculated using the following formulae: ,,
- Absolute learning gain = [(% post-test)-(% pre-test)]
- Relative learning gain = [(% post-test)-(% pre-test)]/(% pre-test) Χ100
- Normalize gain g= [(% post-test-% pre-test)]/100-(% pre-test)]
Effectiveness of intervention was determined if the range of 'Normalize gain g' is as: 0-0.29 - Low Gain; 0.30-0.69 - Medium gain; 0.70-1.0 - High gain. Data gathered was tabulated and analyzed using paired and unpaired 't' test.
| Observations and Results|| |
The mean pre- and post-test scores of 40 students subjected to syndicate learning method were 2.40 ± 0.98 and 4.45 ± 0.71, respectively. The mean pre- and post-test scores of 40 students subjected to traditional learning method were 2.47 ± 0.96 and 3.57 ± 0.87, respectively [Table 1], [Graph 1 [Additional file 1] ].
|Table 1: Mean Pre-Test and Post-Test Scores in Syndicate and Traditional Methods |
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For exposing both the batches to both syndicate and traditional learning methods, a crossover was carried out. After a crossover, the mean pre- and post-test scores of 40 students subjected to traditional learning method were 2.30 ± 1.09 and 3.72 ± 0.84, respectively, and the mean pre- and post-test scores of 40 students subjected to syndicate learning method were 2.37 ± 1.12 and 4.50 ± 0.59, respectively [Table 2], [Graph 2 [Additional file 2] ].
|Table 2: Mean Pre-Test and Post-Test Scores in Syndicate and Traditional Methods After Crossover |
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Normalize gain 'g' in syndicate method was 0.78 and in traditional method was 0.43, therefore considered highly and moderately effective, respectively. Normalize gain 'g' in syndicate method after crossover was 0.80 and in traditional method after crossover was 0.52 and therefore considered highly and moderately effective, respectively. Absolute and Relative learning gain was also calculated [Table 3].
|Table 3: Absolute Learning Gain, Relative Learning Gain and Normalize Gain 'G' in Syndicate and Traditional Methods Before and After Crossover |
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The data obtained from the study was tabulated and analyzed using paired and unpaired Student's 't' test. The difference in mean pre- and post-test scores of syndicate method, syndicate method after crossover, traditional method, and traditional method after crossover were subjected to Student's paired 't' test and "P" values were calculated. The difference in mean post-test scores of syndicate with traditional method and syndicate after crossover with traditional after crossover were subjected to Student's unpaired 't' test and "P" value was statistically significant (P < 0.001) [Table 4]. The difference in mean post-test scores of syndicate with traditional method and syndicate after crossover with traditional after crossover were subjected to Student's unpaired 't' test and "P" value was statistically significant (P < 0.001) [Table 4]. Also there was significant difference between mean post-test values of syndicate and traditional methods. When the data was subjected to Student's unpaired 't' te s t the, 'P' value was statistically significant (P < 0.001) [Table 5].
|Table 4: Comparisons of Pre-Test and Post-Test Scores within the Two Groups by Paired 't' Test |
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| Discussion|| |
In the past few decades, changes in health care delivery and advances in medicine have increased demands on academic faculty, resulting in less time for teaching than has previously been the case.  The importance of dental education is operating in an environment that promotes critical thinking and problem solving. Therefore the present study was undertaken.
When the data obtained from the study was subjected to paired 't' test, there was significant difference between mean pre- and post-test scores of 40 students subjected to syndicate method and the 'P' value was statistically significant. Also there was significant difference between pre- and post-test scores of 40 students subjected to traditional method and the 'P' value was statistically significant. Although the above findings suggest that considerable learning has occurred in students subjected to both the methods, it was observed that there was significant difference between post-test scores of students subjected to syndicate and traditional methods. When the data obtained was subjected to unpaired 't' test, the 'P' value was statistically significant (P < 0.001). This implies that although traditional method was also effective, syndicate learning method was certainly more effective than traditional learning method. Similar results were seen after a crossover. This implies that after doing crossover also, although the traditional method was effective, syndicate learning method was undoubtedly more effective than traditional learning method.
This difference can be attributed to the tutor less and student centered quality of syndicate learning method. Syndicate group method is a form of peer learning.  Peer learning encourage students to take more responsibility, become more self-motivated and essentially adopt a more autonomous approach to their learning. In this method, the students are free to discuss among their peers and this interactions allow more active student participation that fosters both activation of prior knowledge, which ultimately helps in articulating previous knowledge, problem solving, and decision making. This method also increases conceptual learning and independent thinking. By its very nature, student-centered learning allows students to shape their own learning paths and places upon them the responsibility to actively participate in making their educational process a meaningful one. One of the strongest arguments in support of syndicate groups is that the absence of tutors in the groups can enable students to take more responsibility for their own learning. Whereas there is passive learning associated with traditional learning method.
Syndicate groups share some characteristics of problem-based learning, and indeed students are likely to need to adopt an enquiring, problem-solving approach to collaboratively achieve the set task.  It uses appropriate problems to increase knowledge and understanding. For teaching radiographs in Oral Radiology, giving real patients radiograph for discussion worked as a direct problem, which was done in the present study. Presentation of clinical material as the stimulus for learning enables students to understand the relevance of underlying scientific knowledge and principles in clinical practice. 
| Conclusion|| |
The current teaching styles and techniques should emphasize on the development of students 'clinical problem solving and decision making' skills that are routinely applied in dental practice. Syndicate groups create many opportunities for creative interchange of ideas and lively and meaningful participations. This approach would ensure that, in addition to gaining subject-specific knowledge, students are also able to apply the obtained knowledge to solve problems. The present study suggests that syndicate group is better than the traditional method and can become an appropriate method as an adjunctive instruction tool.
In the present study, only extra oral radiographs were taught by syndicate group method.
Syndicate group method can replace traditional method for teaching extra oral radiographs. The study can also be extended to teach clinical slides consisting of photographs of pathologic lesions. This new method can become an appropriate method to enable undergraduate students to meet the course objectives.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]