[/B]
Inductive teaching method – an alternate
method for small group learning[/B]
VINCI S. JONES, ANDREW J.A. HOLLAND & WENDY OLDMEADOW
University of Sydney, Australia
Abstract[/B]
Background[/B]: Different forms of small group interactive
teaching have found an increasing role in medical education in
therecent past.
Objectives:[/B] This study aimed to evaluate the efficacy of
topic-based small group tutorials and compare between two such
tutorials, the directed tutorial where the tutor takes the
initiative and the inductive tutorial which places the initiative
on the student.
Methods:[/B] Final-year medical students were exposed to
alternate sessions of directed and inductive teaching during their
rotation in paediatric surgery. For inductive teaching, the topic
was announced and the students took turns in asking questions and
answering them, the tutor stepping in only when required. The tutor
both initiated and guided the discussion in the directed method.
Students assessed the tutorials and compared the two learning
methods evaluating eight different parameters using a Likert scale.
Statistical significance was tested using the Wilcoxon signed ranks
test.
Results:[/B] Feedback was available from 49 out of 52
students. The tutorials were ranked highly for all parameters
studied. The inductive method was better for comfort, interest,
memory, inspiration to read more, comprehension and for correlation
with previous knowledge (P50.05). The directed method was superior
for the content covered in a given time (P50.001).
Conclusions[/B]: The topic-based tutorials were effective.
The inductive method by adding a reflective component, appeared to
facilitate deep learning. Further research will determine its
suitability for formal introduction into the curriculum.
Introduction[/B]
Small group interactive teaching has found an increasing role in
medical education in the recent past (Vernon & Blake 1993;
Jaques 2003; McParland et al. 2004; Landry et al. 2007; Srinivasan
et al. 2007). Some studies have found small group tutorials which
have mainly been studied in the context of problem-based learning
(PBL), to be superior to traditional lectures for deep learning,
creating favourable student attitudes and performance in clinical
examinations (Vernon & Blake 1993; Albanese 2000; McParland et
al. 2004). Concerns with various lacunae in PBL however, have led
many academicians to resurrect the case-based method wherein an
expert directs the small group to learn in a guided fashion
(Shanley 2007; Srinivasan et al. 2007; Tarnvik 2007). While this
can overcome the problems with the open enquiry method of PBL,
concerns with a lack of defined syllabus and knowledge gaps still
remain (Hsu & Ong 2001; Maudsley et al. 2007). We have
traditionally used the topic-based tutorials for students rotating
to our department. In addition, we developed and introduced the
inductive method of teaching to combine the advantages of
reflective learning with guided enquiry in a small group teaching
scenario. Our study sought to evaluate topic-based small group
learning methods. We also describe the structure of the inductive
method, an alternate way of small group learning and compare it
with a more directed approach to small group learning, the crucial
difference between the two methods being in handing over the
initiative from the tutor to the students. The inductive method was
developed on the premise that
additional stimulation of student initiative would further
enhance the learning experience. The basis for the inductive method
is the intuitive theory. This involves a system of related
concepts, together with a set of causal laws, structural
constraints or explanatory principles that guide inductive
inference in a particular domain (Tenenbaum et al. 2006).
[tr]
| [td]
| Practice points[/B]
| . Topic-based small group tutorials combine the effectiveness of
| small group learning with ensuring coverage of a pre-defined
| syllabus.
| . The inductive teaching method, an alternate method of
| topic-based small group tutorial promotes asking of relevant
| questions, drawing of information from memory to answer them and
| reasoning by a process of induction through causal cognition, under
| guidance from an expert.
| . Students rated the topic-based small group tutorials highly
| for all the parameters studied. The inductive method in addition
| suggested an increase in deep learning, though it required more
| time compared to the directed topic–based small group tutorial.
|
| [/TD]
| | [/TR] |
This process which is intrinsic to human learning is applied to
medical learning in the inductive method. In most traditional small
group methods, the learning process is directed by the teacher.
Students may then follow or build on this initiative. The inductive
method, however, requires the students to take the initiative, ask
all the questions and also develop the answers for a given topic.
The teacher continues to participate as a facilitator, stepping in
to answer when doubts or factual information cannot be correctly
resolved by the students.
Methods[/B]
Study design[/B]
This study sought to investigate the effectiveness of topicbased
small group tutorials and compare inductive teaching with directed
teaching in the setting of paediatric surgical tutorials. The study
was conducted during the academic year of 2007. The study was
approved by the Human Research Ethics Committee of the University
of Sydney (Ref No 07-2007/10170). Informed consent was obtained
from the participating students.
Participants[/B]
The first two authors, both with more than 10 years experience
in teaching medical students, undertook all the teaching sessions.
All student participants were final year graduate medical students
assigned by the Clinical School to these two authors, in groups of
6–8, for their paediatric surgical tutorials. A total of 52
students participated in these tutorials.
Description of tutorials[/B]
The content for the five 1-hour tutorials and the audiovisual
aids provided were standardized for the two tutors. The tutorials
were held at weekly intervals. After the initial introductory
tutorial where the inductive method was revealed and a working
relationship established between the students and their tutor, the
inductive and directed methods were alternately employed over the
next four sessions. Each group of students received two sessions of
inductive and two sessions of directed tutorials. The two tutors
taught different groups of students and used both methods to
prevent tutor preference from becoming a source of bias during
evaluation. For the inductive tutorials, a topic (e.g.
intussusception) was presented, and a given time (approximately 15
minutes) allocated for discussion. Any student could ask a question
about the topic and the other students in the group would be
required to answer it, the teacher stepping in if the explanation
was either not forthcoming or incorrect. All students were then
given the opportunity to ask and explain, the teacher ensuring that
there was no confusion, disparity in involvement or diversion from
the topic. In the directed method, the tutor directed the content
of discussion for the given topic. At the end of the time allotted
for each topic, a series of picture slides were shown summarizing
the topic and reinforcing what was discussed for either method. The
methodology of the tutorials incorporated most of the
recommendations for small group teaching outlined by Jaques and the
flexible questioning employed for the inductive method was a
modification of the circular questioning outlined therein (Jaques
2003).
Evaluation[/B]
A participation information sheet was provided to students which
defined the inductive and directed methods of small group learning,
provided assurance of anonymity, data
protection, responses to the study being de-linked from academic
progress and time taken to complete the questionnaire (510
minutes). At the end of the final tutorial, the students were
requested to fill out a questionnaire evaluating the tutorials and
comparing between the two methods using a fivepoint Likert scale.
The implied consent in returning the questionnaire was mentioned in
the body of the questionnaire. A series of eight statements
investigated parameters including interest, memory, correlation
with previous knowledge, number of topics covered, comfort,
inspiration to read, confidence generated and comprehension of
content. ‘Strongly
agree’ was coded 5 and ‘Strongly disagree’ was 1. Additional
free-text comments were invited from student participants in
relation to their perception of the strengths and weaknesses of the
tutorials together with suggestions for improvement. As students
received additional paediatric surgical input in the form of
lectures and teaching during clinical attachments, assessment using
examinations was not done.
Statistics[/B]
Excel spreadsheets (Microsoft Windows XP) were used to chart the
ordinal data and SPSS v15.0 for Windows was used to test for
statistical significance using the Wilcoxon signed ranks test with
a p value of50.05 considered significant.
Results[/B]
Feedback was available from 49 out of 52 students (94% response
rate). The overall responses showed a median score of four for all
the parameters evaluated. The inductive method appeared to be
better for generating interest (p
process. The most common weakness mentioned was the limited
knowledge about some of the topics hindering the discussion (65%).
This was aptly summed up by one student, If you do not know
anything about the topic, conversation ends early. The directed
tutorials were popular for the structured information given to the
students (47%). A student stated, . . .(directed tutorials) enabled
content to be covered comprehensively and logically in a given time
. . . without going off in a tangent. The major weakness of the
directed tutorial was the passivity involved (34%). One of the
comments read, . . . could not engage more actively in the learning
process. . . less easier to maintain concentration & focus. The
most common suggestion given was to indicate before
hand the topics to be discussed for an inductive tutorial
(60%).
Table 1. Overall evaluation of the topic-based small group
tutorials and comparison between the directed and the inductive
methods using a five-point Likert scale where ‘strongly agree’ was
5 and ‘strongly disagree’ was 1. (n ¼ 49).
[tr]
| [td]
| Comparative responses (teaching method)
|
|
| Directed
| Inductiv
|
| [/TD]
| [/TR]
| [tr]
| [td]
| Parameters evaluated in the questionnaire
| [/TD]
| [td]
| Overall median response
| [/TD]
| [td]
| Median
| [/TD]
| [td]
| Range
| [/TD]
| [td]
| Median
| [/TD]
| [td]
| Range
| [/TD]
| [td]
| p-value
|
| [/TD]
| [/TR]
| [tr]
| [td]
| Generated interest in the topic
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 3-5
| [/TD]
| [td]
| 5
| [/TD]
| [td]
| 3-5
| [/TD]
| [td]
| [/TD]
| [/TR]
| [tr]
| [td]
| Facts covered (content)
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 2-5
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 2-5
| [/TD]
| [td]
| [/TD]
| [/TR]
| [tr]
| [td]
| Facts retained (memory)
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 3-5
| [/TD]
| [td]
| 5
| [/TD]
| [td]
| 3-5
| [/TD]
| [td]
| [/TD]
| [/TR]
| [tr]
| [td]
| A conducive environment for learning was produced (comfort)
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 2-5
| [/TD]
| [td]
| 5
| [/TD]
| [td]
| 2-5
| [/TD]
| [td]
| 0.006
| [/TD]
| [/TR]
| [tr]
| [td]
| Generated confidence in my medical knowledge
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 2-5
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 2-5
| [/TD]
| [td]
| 0.237
| [/TD]
| [/TR]
| [tr]
| [td]
| Helped me to understand the topics (comprehension)
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 2-5
| [/TD]
| [td]
| 5
| [/TD]
| [td]
| 2-5
| [/TD]
| [td]
| 0.034
| [/TD]
| [/TR]
| [tr]
| [td]
| Inspired me to read more (inspiration)
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 2-5
| [/TD]
| [td]
| 5
| [/TD]
| [td]
| 2-5
| [/TD]
| [td]
| [/TD]
| [/TR]
| [tr]
| [td]
| Was able to better correlate with what I already knew
| (correlation)
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 4
| [/TD]
| [td]
| 2-5
| [/TD]
| [td]
| 4.5
| [/TD]
| [td]
| 2-5
| [/TD]
| [td]
| [/TD]
| | [/TR] |
Notes: Wilcoxon signed ranks test; p
*In favour of directed tutorial; others in favour of inductive
method.
Discussion[/B]
Basis for study[/B]
The last two decades have seen an increasing move away from
didactic teaching in medical education to a greater proportion of
small group learning (Albanese 2000; Vernon & Blake 1993).
In addition to PBL, guided methods of small group learning have
been described and espoused by some educational centres (Shanley
2007; Srinivasan et al. 2007; Tarnvik 2007). The small group
methods of learning facilitate self-directed and deep learning,
clinical reasoning skills and help in social and personal
development (Vernon & Blake 1993; Albanese 2000; McParland et
al. 2004; McLean et al. 2006; Tarnvik 2007). The guided case
methods additionally fill knowledge gaps as self directed learning
is guided by an expert (Shanley 2007; Srinivasan et al. 2007;
Tarnvik 2007). These methods are all case/problem based, however,
and still suffer from the disadvantage of lacking a defined
syllabus (Maudsley et al. 2007). The topic-based tutorials ensure
that a predefined syllabus is covered. Whereas in PBL or case
methods, reasoning and self learning is incorporated into the
analysis of the situation vignette, the inductive method promotes
reasoning by a process of induction through causal cognition.
Illustration of the inductive method[/B]
The advantages of inductive method can be understood in several
ways. It does not require prior preparation for the tutorial.
Students however expressed a desire to voluntarily prepare for the
tutorials in our study. The facilitator is always an expert in this
method so that the discussion can be meaningfully directed and gaps
can be filled. For example, when ‘intussusception’ is presented as
a topic for discussion, a typical pattern of questions asked by the
students is something like What is it?, What age-group is it common
in?, Are there pre-disposing factors for it?, What are the clinical
manifestations?, What complications can it cause?, How do you
diagnose it?, What are the treatment options?, What is the long
term prognosis?. At times the questions may be haphazard or
incomplete. Students may not also know all the answers to the
questions they raise and the tutor then steps in to fill the gaps
in knowledge. Nevertheless, students gain the opportunity to ask
questions about the given topic within the frame of the inductive
tutorial in a given time. This enables them to prioritize the
information which they need to know, thereby aiding their clinical
reasoning skills. Answering questions prompts them to draw upon the
information already possessed and verbalize it. Very often, even
when the answers to the questions are not known, students can,
through a process of causal cognition arrive at the required
information. Causal cognition is at the heart of inductive
learning. When students know one aspect of a disease condition,
they can, through an inductive process build knowledge of the
clinical presentation, the complications and the possible
treatment. This is aided by the fact that being final-year medical
students, they have a working knowledge of disease pathogenesis,
clinical manifestations and treatment concepts in general. It is
not difficult for a final-year student to ‘induce’ that mechanical
obstruction and bowel ischaemia follow a telescoping of one part of
the bowel into another in intussusception and that vomiting and
bloody stools are the respective sequelae of mechanical obstruction
and bowel ischaemia. That dehydration follows and fluid
resuscitation is required is easily understood by the student. The
logic of non-operative reduction of intussusception failing[/I]
which surgery is performed is again induced by the student.[/I]
The process of asking relevant questions, drawing of information
from memory to answer them and making inferences based on what is
already known under guidance from an expert in a given time makes
the inductive tutorial effective, more so for final-year students
who have a baseline knowledge to which further information can be
added. It remains to be seen how well this method can be adapted to
students early in their course.
Interpretation of findings[/B]
The overall high scores in the assessment of the topic-based
small group tutorials indicate the necessity of refocussing on the
topic-based methods in the current post PBL scenario (Tarnvik
2007). The inductive method retains the reflective element
introduced by the PBL, though in a topic-based scenario. Comparison
between the inductive and the directed methods indicates the
superiority of the former for deep learning but it falls short in
terms of time constraints. The potential superiority of the
inductive method in generating interest, aiding memory,
comprehension and correlation leading to deep learning can be
understood as sequelae of learning through induction. The
inspiration to read more can be understood by the sense of
inadequacy created when the situation demanded the asking or
answering of questions about a topic of which little was known.
Failure to find any difference in the confidence generated may
possibly be explained by the positive trend when students were able
to build up a discussion being offset by the negative trend when
they were not able to do so. At times the students found the line
of discussion during the inductive method confusing because it was
initiated by students with a limited knowledge of the subject. It
was far more orderly when the tutor guided the discussion. This may
explain the less obvious difference in the comprehension component.
Student comfort increased during the inductive sessions probably
because the students felt the freedom to discuss and learn with
their peers. The limitation of the inductive method was the
decreased number of topics covered in a given time as compared to
the traditional method. The evaluation in this study was based on
student opinion and not on formal examination of the students.
Further research with randomized groups receiving either directed
or inductive teaching with examination to test knowledge base may
provide a more formal evaluation of the inductive method of
learning.
Conclusions[/B]
Our study suggests that the topic-based small group tutorials
can be effective. The inductive method, in addition gives a
reflective flavour to these tutorials, promoting deep learning
and hence would warrant consideration as an enhanced teaching
methodology.
Acknowledgements[/B]
We acknowledge the support by the participating students,
Cornelis Biesheuvel, Hospital Statistician, The Children’s Hospital
at Westmead (CHW). Declaration of interest: The authors report no
conflicts of interest. The authors alone are responsible for the
content and writing of the paper.
Notes on contributors[/B]
VINCI S JONES, MBBS, MS, MCh, is a Fellow in transplant and
general paediatric surgery at CHW and is also a lecturer of the
University of Sydney.
ANDREW GA HOLLAND, BSc (Hons), MBBS, FRCS, FRACS, PhD, Grad Cert
Ed Studies (Higher Ed), is an Associate Professor of Paediatric
Surgery at CHW and is also the Director of the Burns Institute at
CHW. WENDY OLDMEADOW, MEd, is a Lecturer in
Education at the Clinical School at CHW.
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归纳式教学方法——小组学习的另一种方法[/B]
摘要[/B]
背景：[/B]在过去的几年里，小组交互学习的不同形式在医学教学中起着越来越重要的作用。
目标：[/B]该研究的目的在于评价基于主题的小组学习的有效性，并比较以下两种学习，其中定向专题教学中教师有主动权而归纳式专题教学中学生掌握主动权。
方法：[/B]应届医学毕业生在小儿科科目的循环学习中被用来作为定向和归纳式教学的一部分。对于归纳式教学，主题已经告诉学生，学生轮流提出问题并解决问题，教师只有在需要的时候才参与进教学活动。在定向专题教学中，教师掌握主动权并指导整个讨论。学生使用包含8个不同参数的里克特量表来评价和比较这两种教学，并使用Wilcoxon符号秩检验来检验显著性差异。
结果：[/B]在所有参与的52个学生中有49个给出了反馈。教学研究中所有的参数等级都挺高。归纳式的教学方法在舒适度、兴趣、记忆、更多阅读灵感、理解和与先前知识的关联等方面更好一些。定向教学方法对给定时间内所涵盖的教学内容方面更胜一筹。
结论：[/B]基于主题的教学是行之有效的。具有沉思性质的归纳式教学方法看来可以促进深入学习。我们还需要更进一步的研究来确定将该方法引入到正式课程中的适用性。
[/B]
引言[/B]
[/B]
小组交互教学最近几年在医学教育中起着越来越重要的作用。一些研究已经发现在基于问题学习情景下进行的小组教学，对深入学习来说比传统课堂教学要优越。它能使学生在临床实验当中有良好的态度与表现。但是对基于问题学习的空白或缺陷的考虑，导致许多教师重新启用病例教学法，在该教学中教师直接定向学生，也就是小组在一个教师的指导占主导地位的模式中学习。尽管这可以克服基于问题学习的开放性引起的问题，但是对缺乏教学大纲和知识鸿沟定义的考虑仍然存在。我们通常对我们院的学生试行基于主题的教学方法。而且，在小组教学方案中，我们开发和引进了与指导-询问反馈学习的优势相结合的归纳式教学方法。
我们的研究旨在评价基于主题的小组学习方法。我们也把归纳式教学方法描述为小组教学的另一种途径，并将该方法与定向教学方法相比较。我们比较之后可知，两种方法的重要区别中首要的就是主动权从教师转移给了学生。归纳式教学方法建立在学生主动权的额外刺激会进一步增强学习经验的前提之上。归纳式教学方法的基础是直觉理论。这牵涉到一系列相关概念，因果律，结构限制或解释性原则，这些构成一个系统用来指导特定领域的归纳推理。这一本质上就符合人类学习的过程被应用在归纳法医学教育中。在大部分传统小组学习方法中，学习过程是由教师直接引导。然后学生跟随或在此主动权的基础上学习。但是，归纳式教学法要求学生掌握主动权，对于一个给定的主题提出问题并解决。教师继续以一个促进者的身份参与教学活动，当学生不能正确解决一些疑问或事实概念时，教师可以给出一些相应的启示或回答。
方法[/B]
研究设计
这项研究旨在评价基于主题的小组学习的邮箱性，并比较在小儿外科专题中设置的归纳式教学和定向教学。这项研究是在2007年实行的，经过悉尼大学的人类研究伦理委员会批准，也获得了参与学生的知情同意。
参与者
前面两位作者在医学教学方面都有着10年以上的教学经验，在研究过程中承担了所有的教学部分。参与的学生都是应届生，由临床医学院分配给这两位作者，每组6-8人学习小儿外科教程。一共有52名学生参与了该专题教学。
教程描述
给两位教师提供同等标准的5小时教程内容和视听辅助教具。课程每次为1小时，一周一次。第一次课介绍归纳式教学方法并建立学生与教师之间的互动关系，之后的四节课就要交替实行归纳式教学方法和定向教学方法。每一小组的学生都要经历两节归纳式教学和两节定向教学。这两个作者教授不同小组的学生，并要使用两种不同的方法，以防止在评价环节由于教师偏爱而成为偏见的来源。在归纳法教程中，主题（例如，肠套叠）公示出来，分配给每个讨论小组的时间也是有限的（15分钟左右），任何一个学生可以提出关于该主题的问题，该组的其他同学就需要回答它，如果得出的答案不恰当或不准确，教师就会给出相应的指导。在教师确保所牵涉的内容没有疑惑或者分歧或没有偏离主题的过程中，所有学生都有机会提问和解释。在定向教学中，教师控制所给课题讨论的方向。在每个主题讨论结束时，教师会用一系列的图片幻灯片来总结主题，并使用两种方法中的任何一个来巩固讨论过的内容。方法论的教程包含了大部分李艺概述的关于小组教学的建议，而且应用在归纳法教学中的灵活问题是对其中概述的循环提问环节的改动。
评价
要求学生填写一个参与信息表，该表中包含小组学习归纳法和定向法的定义，保证匿名，数据保护，保证该研究与学术成绩无关，以及填写问卷的限定时间（
数据统计
我们使用电子表格绘制有次序的数据图表，并使用SPSS来检验显著性差异，过程中用到Wilcoxon符号秩检验来确定一个P值，如果P
结果[/B]
在52个学生中有49个给出了反馈（反馈率94%）。总体回应显示出所有评价参数中的一个中位值4.归纳法在激发兴趣，记忆概念事实，提供更多阅读灵感，理解，学生舒适度和与先前知识的关联等方面看起来比较好一点。两种方法在生成自信心方面没有大的差异。定向方法在给定时间内可涵盖较多的内容。在自由书写评论中，提到关于归纳式教学最多的优点是激发兴趣和促进良好交互。正如一个学生所说，归纳法专题教学让我们思考我们需要知道什么，使我们一直参与在内并集中我们的注意力。它能使我们有逻辑地思考信息推理过程。提到次数最多的不足就是与主题相关并阻碍讨论的一些限制性的知识。这正好如一个同学的恰当总结，如果你不知道关于主题的任何事，讨论或交流将会很快结束。定向专题教学法普遍用于向学生传授结构化的内容。一个学生说，定向专题教学在给定的时间内可全面的和有逻辑地涵盖教学内容。定向专题教学的最大的一个缺点就是学生的参与很被动。其中一条评论写道，定向专题教学在学习过程中不能保持活跃，不能集中学生的注意力。给我们提出最多的建议就是在归纳式教学方法中向学生呈现主题前先向学生或多或少的暗示一些内容。
讨论
研究基础
在过去的二十年里在医学教学方面已经逐渐从单纯的说教教学转移到很大比例的小组学习的方式。除了基于问题的学习之外，小组学习的指导方法由一些教育中心所描述和支持。小组学习可以促进自我导向和深入学习，临床推理技能以及社交和自身发展。而且指导方法还可以填补知识空缺如自我导向学习是由一个专家指导一样。但是这些方法都基于案例或问题，仍然受到没有教学大纲定义的限制。基于主题的专题教学确保预先定义的教学大纲是所涵盖其中的。然而在基于问题或案例方法中，推理的自身学习被合并为情景分析小插曲中，归纳式方法可以通过因果认知的归纳过程促进推理。
归纳法的说明
归纳法的优点可以通过多种方式来理解。它在教程之前不需要做先前的准备。但是在我们的研究中，参与的学生都表现出积极自愿为教程做准备的现象，促进者往往是这种方法的专家，因此能够有意义的指导讨论和填补讨论空白。例如，当“肠套叠”作为讨论主题时，学生问问题的典型模式就如它是什么？什么年龄群体通常患此病？它是否有前兆？它有什么临床上的表现？它能引起什么并发症？如何诊断出它？有哪些治疗方案？它有什么长期的后遗症？有时这些问题可能是随意提出的或者是不完全的。学生也可能不知道他们提出的这些问题的答案，这时教师就要参与进来解决。虽然如此，学生在给定的时间内在归纳法专题教学的环境下获得了提问与主题相关的问题的机会。这让他们事先了解要掌握的信息，因此增强了他们的临床推理技能。回答问题可以提升他们对预先处理好的信息的总结能力并用言语表述出来。即使学生不知道问题的答案，但通过因果关系的认知过程也可以获得所需要的信息。因果关系认知是归纳法学习的核心。当学生知道了疾病的一个方面后，他们可以通过归纳过程推理该病的临床表现，并发症和可能治疗的方案。作为应届医学毕业生，他们有一定知识框架来明白疾病的发病机理，临床表现和大体治疗方案。……提问相关问题，整理相关信息来回答问题，以及在给定时间内在一个专家指导下获得的基于已知信息来推理的过程，使归纳专题教学法行之有效，而且，对应届生来说，他们有一定的知识基底来获得更进一步的信息使之提高。这种方法适用在学生早期的课程学习中的合适性还需要进一步的确定。
结论[/B]
我们的研究显示基于主题的小组专题教学是有效的。另外，归纳法给这些专题教学增添了一些沉思性的味道，还可以促进深入学习，在今后可以考虑作为加强教学的方法论。
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