Comparing Active and Passive Learning: What Does the Evidence Really Say?

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I read with interest the article by Dr. Bonnes and colleagues1 on an active-learning “flipped classroom” as a vehicle for quality improvement (QI) education. The transition of residency didactic education to an active-learning model is a topic of major concern for many of us. Even though the authors’ conclusion that the active-learning arm was superior agrees with my preconceived bias, I do not think their conclusions were supported by the evidence.
The control group in a study of active learning such as this should be a concurrent group receiving the same information at the same time, but in a passive, lecture-style setting. In this study, the control group members had received their training one year previously and were not participating in any QI projects which might have consolidated this information for the active-learning group. There was no reason to think that the control group should increase their knowledge of the subject, as they were not receiving any substantial concurrent instruction. Showing that residents learn more after an active-learning encounter than after no instruction at all should not lead to the conclusion that active learning is better than passive learning (even though we all suspect that it is).
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