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Active learning on the ward: outcomes from a comparative trial with traditional methods


Professor Hegla Prado, Department of Learning, Instituto de Medicina Integral Professor Fernando Figueira (IMIP), 1393, Recife, Pernambuco 50070-550, Brazil. Tel: 00 55 81 2122 4777; Fax: 00 55 81 2122 4122; E-mails:,


Medical Education 2011: 45: 273–279

Context  Academic activity during internship is essentially practical and ward rounds are traditionally considered the cornerstone of clinical education. However, the efficacy and effectiveness of ward rounds for learning purposes have been under-investigated and it is necessary to assess alternative educational paradigms for this activity.

Objectives  This study aimed to compare the educational effectiveness of ward rounds conducted with two different learning methodologies.

Methods  Student subjects were first tested on 30 true/false questions to assess their initial degree of knowledge on pneumonia and diarrhoea. Afterwards, they attended ward rounds conducted using an active and a traditional learning methodology. The participants were submitted to a second test 48 hours later in order to assess knowledge acquisition and were asked to answer two questions about self-directed learning and their opinions on the two learning methodologies used.

Results  Seventy-two medical students taking part in a paediatric clinic rotation were enrolled. The active methodology proved to be more effective than the traditional methodology for the three outcomes considered: knowledge acquisition (33 students [45.8%] versus 21 students [29.2%]; p = 0.03); self-directed learning (38 students [52.8%] versus 11 students [15.3%]; p < 0.001), and student opinion on the methods (61 students [84.7%] versus 38 students [52.8%]; p < 0.001).

Conclusions  The active methodology produced better results than the traditional methodology in a ward-based context. This study seems to be valuable in terms of the new evidence it demonstrates on learning methodologies in the context of the ward round.