Using the case-discussion method to teach epidemiology and biostatistics

Medical students must learn the principles of epidemiology and biostatistics to critically evaluate the medical literature. However, this subject has traditionally been difficult to teach. In 1997 at the Albert Einstein College of Medicine, the required first-year course in epidemiology and biostatistics was revised to use the case-discussion teaching method. In preparation for the course, experienced faculty participated in an intensive, two-day training workshop. The course, taught to 163 first-year medical students, was structured in two parts: (1) three lectures complemented by a detailed syllabus, followed by a multiple-choice midterm exam; and (2) six case-discussion seminars, followed by a short answer/essay final exam. There were seven case-discussion groups with 23-24 students each. The program was evaluated using subjective faculty feedback, examination scores, and student evaluation questionnaires. Faculty noted excellent student preparation and participation. Multiple-choice exam scores were comparable to those from earlier years, and a short answer/essay exam demonstrated good student mastery of the required material. Student evaluation was overwhelmingly positive, and significantly improved from prior years of the course. Positive student evaluations of the course using this teaching method continued over the next four years; National Board of Medical Examiners examination scores indicated success in mastery of the material; and student assessment of the course improved on the AAMC Graduation Questionnaire. This favorable experience suggests that case-discussion teaching can be employed successfully in teaching principles of epidemiology and biostatistics to medical students.