As shown on the Reading
Quiz Performance Graph 
the changes I made in 2005 appeared to improve student performance
on reading quizzes. In
2004, 25% of students earned an A average on reading quizzes, 50%
of students earned a B, and 25% earned a C. In 2005, 86% of students
earned an A average with the majority of these being an A+. The
remaining students earned a B+ average on reading quizzes. Moreover,
student comments in class and on course evaluations suggested that
they transferred these skills to other assignments beyond my course.
Several students commented that they used the handout that I provided
to read articles for their masters theses or for other courses.
This higher performance on reading quizzes translated into more in-depth in-class discussions in 2005. Students came to class with a firm understanding of the design and results of the research study, so this basic information rarely required review. Students also came to class with ideas about the strengths and weaknesses of the study. This resulted in more extensive discussion of the merits of each study as well as a more general discussion of what is "good" clinical research.
Clinical cases
In 2004, students orally presented a clinical case at the end of the semester, providing both a diagnosis and a treatment plan. In 2005, students provided a diagnosis and a treatment plan for a clinical case in written form at the midpoint of the semester. They were given written feedback and a class session was devoted to a group discussion of each case. In 2005, students also orally presented a second clinical case at the end of the semester, following the same format as the written case.
As shown on the Clinical Case Performance
Graph the changes I made in 2005 appeared to affect student
performance. In 2004, 38% of students
earned As, 50% earned Bs, and 13% earned Cs. Performance in 2005
at the midterm written case was similar to 2004 with 29% As and
71% Bs. In contrast, final performance on the oral case in 2005
showed marked improvement with 86% As and 14% Bs. Completing the
written case, obtaining specific feedback on that case, and the
in-class discussion of the written cases seemed to help students
understand how to integrate and apply research evidence to clinical
cases, which they were then able to do independently on their final
case oral presentations.
Closer examination of case discussions
shows further qualitative differences between 2004 and 2005 performance.
In 2004, even students
earning an A had difficulty integrating and applying all the
evidence discussed in class to their
assigned clinical case. (See examples
of my feedback on case presentations.) Students earning
lower grades had even greater difficulty integrating
and applying the evidence and also demonstrated fundamental misunderstanding
of some pieces of evidence. In the 2005 written cases, students
earning an A- were able to integrate and apply multiple pieces
of evidence to
their assigned clinical case. (See
examples of my feedback on written cases). Small problems in accuracy were still
noted for
these students. Students earning Bs on the written cases showed
similar problems as the 2004 students, demonstrating problems
with integration and application as well as fundamental misunderstandings.
In the 2005 oral cases, students earning an A considered all
evidence
reviewed in the course and accurately applied this evidence to
their clinical case. These students may have shown small confusions
that were resolved with questioning during their oral presentation
but on the whole, their integration and application of evidence
was solid. Not only did the number of students earning a grade
of A increase from 2004 to 2005 but the quality of student understanding
indexed by a grade of A also improved.
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