Dramatization of Starling Forces: An Interactive Learning Approach

Purpose VTCSOM is a modern hybrid medical school where student learning is facilitated outside of the traditional classroom setting through active learning approaches such as Problem‐Based Learning, hands‐on workshops and lectures. When students are actively engaged during the teaching/learning process, they understand topics in a more comprehensive fashion. As the amount of information which medical students are expected to master grows, it becomes necessary to develop and implement innovative learning methodologies that help students to retain and apply complex physiological topics, rather than rote memorization. Our goal is to use dramatization to interactively teach the effects of Starling forces in the microcirculation. Methods A brief introduction was given on the topic of Starling forces regulating microcirculation for 23 first year medial students. One half of the group moved to an area representing the lumen of the capillary while the other half moved to an area representing the interstitium. Four to seven other students represented dynamic fluid molecules. They competed to move faster than their peers from circulation (capillary) to the interstitium or vice versa under the influence of hydrostatic and coloidosmotic pressures or a clinical vignette, as they were projected. The task for the students, behaving as fluid, was to move into or out of the space designated as capillary. Results In an anonymous survey, 23 students were evaluated on their knowledge of Starling forces and edema both before and after this kinetic learning approach. The pre and post‐activity surveys, which were evaluated on a 100‐point grading scale, contained the same questions randomized in a different order. An overall improvement was seen from the pre‐activity performance (χ̄ =45.4±sd=25.1; range 9–91%) to the post‐activity performance (χ̄ =77.5±sd=14.1, range 45–100%). Additionally, in a subjective question included in the post‐survey 85% of students found this activity to be an effective way of learning. Conclusion Integrating interactive approaches into teaching in the context of undergraduate medical education can be helpful in demonstrating challenging yet important concepts, such as fluid exchange in the microcirculation. After the activity, students showed a 32% improvement in their understanding of Starling forces and edema with a substantial decrease in variation between students. Thus, our data coincide with literature that shows active learning approaches can be effective in replacing or complementing passive learning in traditional lectures.