Structures Virtual Review Sessions in a Large‐Group, Interactive Format: a creative solution born from COVID‐19 restrictions.

Abstract

Purpose First‐year medical students (M1s) at the Icahn School of Medicine at Mount Sinai begin their year with Structures course, which opens their medical education, covering gross anatomy, embryology, and histology. Second‐year medical students (M2s) serve as teaching assistants (TAs) for this course and their responsibilities include leading comprehensive review sessions prior to each set of exams. Historically, such reviews have taken place in small‐group classrooms, with groups of 10‐18 M1s rotating through a series of rooms, each hosting a rapid‐fire review of a specific topic, conducted by several TAs. In 2020, the virtual setting imposed by COVID‐19 restrictions demanded creativity to rethink the format of these review sessions, leading to the implementation of a large‐group, interactive format, with all M1s in the same remote video session, covering material at a slower pace. We here examine the effectiveness of this large‐group, interactive format. Methods: The first two review sessions of Structures 2020 mimicked the traditional style, with groups of M1s rotating through a series of 20‐minute Zoom sessions led by M2s TAs. For the last two review sessions, all students remained in one 3‐hour Zoom session, and TAs covered certain material at certain times, with more or less time allotted depending on the difficulty and amount of material. TAs also incorporated more interactivity with real time quizzes on high‐yield topics and direct practical questions through the review. We surveyed M1s regarding which format they preferred and also solicited qualitative feedback from M1s and TAs throughout Structures. Results: 55% of M1s preferred the large‐group format, with 23% preferring the traditional format and 23% expressing no preference. Many TAs also expressed preferences for the large‐group format. Qualitative feedback from M1s indicated that they appreciated the interactivity with quizzes and practical questions. Conclusion: In the remote environment, most students preferred a large‐group, interactive format over the small‐group rotation format. Main advantages observed were: 1) time flexibility: complex components of the session addressing challenging topics were covered more extensively and in‐depth; 2) In the large group, all M1s experience the session equally, including the answers to all questions from their classmates. Such interactivity is not compatible with the small group format and can be challenging in its compressed timeframe. 3) optimization of M2 TAs workforce: in the large session TAs are assigned with a section of the review and lead the review of their only once, for a short period of time, while in the small group format, TAs are required to repeat the review of their topic multiple times. The effectiveness of this format may have implications once in‐person instruction resumes; for example, review sessions could be conducted in a lecture hall, in an in‐person setting, or virtually, in a hybrid learning system, to facilitate the advantages of the large‐group interactive format.