Abstract Title
Combination of Interactive Response System and Forum Curriculum as A New Teaching Technique for Fourth Grade Medical Students


Chin-Sheng Lin12#
Hsin-Hui Chen1#
Cheng-Han Hou13
Meng-Chien Lin13
Chien-Sung Tsai1
Shu-Meng Cheng12
Hung Chang1
Cheng-Yi Cheng13*


3BB The lecture and the flipped classroom


1 School of Medicine, National Defense Medical Center, Taiwan
2 Division of Cardiology, Tri-service General hospital, Taiwan
3 Department of Nuclear Medicine, Tri-service General hospital, Taiwan


Being a physician, it is not uncommon to face the clinical dilemma. Forum, a curriculum prepared for the fourth grade medical students in Taiwan, is to train our students to propose their thoughts regarding a controversial issue and to present the underlying reasons. We have progressed the forum curriculum in fourth grade medical students  in National Defense Medical Center in Taiwan for three years. In 2014, we introduced “Interactive Response System (IRS)” in the forum curriculum to get immediate responses from the participants. With the aid of IRS, the modulator can easily realize the opinions from students and handle the course progress. Combined with forum curriculum and IRS, this study provides a new teaching technique to train our medical students to approach controversial clinical issues.

Summary of Work

An experimental forum curriculum was applied. The course progress is indicated as follows (Figure 1). 

Before class, the course modulator proposed a clinical debatable issue to help the students prepare their background knowledge. As a example, the case is a 50-year-old lady who had non-ST segment elevation myocardial infarction with a 80~90% stenosis of left main coronary artery. The debatable issus is that the patient should undergo percutaneous coronary intervention or coronary artery bypass surgery (Figure 2).

During the class, an IRS was set up to collect the options from all paticipants at each stage immediately (Figure 3). After the modulator introducing the case, participants voted first time to choose their preferring therapeutic strategy. Then the students presented their points of view and the underlying reasons; participants voted again after the presentation. Next, the interdisciplinary teachers demonstrated the correct methodologies for resolving problem by evidence-based medicine, followed by a rebuttal from students before the last voting. Finally, the course was ended by an open discussion of all the participants and closing conclusion from the course director and modulator. 

Summary of Results

In the past three years, surveys were performed after classes. Two major changes in 2014 are the application of IRS and the adjustment of course progress.  Major revised components of the course progress include students debating, followed by teachers demonstrating, and available immediate response from all participants. Compared with previous two years, the satisfaction of forum curriculum in 2014 significantly increased from 69.4% to 82.6% (Figure 4). Moreover, percentages of strong agree and agree significantly increased from 52% to 80% (Figure 5), indicating the promising outcome of the new teaching corriculum. 



By discussing the debatable issues, the students suggested that the new curriculum was interesting, impressive, easy to participate, and helpful to understand the clinical disease course and treatment strategies (Table 1). Furthermore, students indicated that the IRS makes more interaction between all participants and modulators. However,  some students claimed that only a few students or participants joined the class and limited time for discussion in this forum curriculum, which will be taken into account in the future course design. 


With higher participation and teacher-student interaction, our forum curriculum opens new avenues for teaching clinical debatable issues.

Take-home Messages

Forum curriculum with interactive response system may be a promising teaching method for medical students to improve their competence of solving clinical problems.

Summary of Work
Summary of Results
Take-home Messages
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