Confrontational small group teaching

Was introduced to an interesting small group technique by one of the physicians at Truro in the Friday lunchtime meeting.

She circulated an article on Parkinson's disease in the acute hospital (1) prior to the meeting and then formed three small groups of about 5 or 6. Within the groups we had to quiz each other to see if we had read and understood the article.

It certainly worked for me - though it would have helped even more if I had read the article ahead of the meeting. I updated myself on a number of things and have been searching on PubMed for some other reviews:

• the importance of early consideration of alternative routes for medication during an acute admission for another illness especially on surgery
• the use of rotigotine patches (2) as a logistically easier alternative to subcutaneous apomorphine
• the Parkinsonism-hyperpyrexia syndrome (3) which none of us were aware of but several could recognise past patients that may have had it
• Deep Brain Stimulation (4)
• Duodopa (5)

All in all I think I learnt a lot more from this session on Parkinson's disease than any other I've sat through before. Confrontation stimulates learning and especially if it is done in such a friendly way. Some may find it quite challenging though.

1) Jones SL, Hindle JV. Parkinson's disease in the acute hospital. Clinical Medicine 11(1);84-8: 2011. Available at: http://www.rcplondon.ac.uk/sites/default/files/clinical-medicine-11-1-pp84-88.pdf [Accessed March 19, 2011].

2) Wüllner U, Kassubek J, Odin P, et al. Transdermal rotigotine for the perioperative management of Parkinson's disease. J Neural Transm. 2010;117(7):855-859. Available at: http://www.ncbi.nlm.nih.gov/pubmed/20535621 [Accessed March 19, 2011].

3) Newman EJ, Grosset DG, Kennedy PGE. The parkinsonism-hyperpyrexia syndrome. Neurocrit Care. 2009;10(1):136-140. Available at: http://www.ncbi.nlm.nih.gov/pubmed/18712508 [Accessed March 19, 2011].

4) Okun MS, Foote KD. Parkinson’s disease DBS: what, when, who and why? The time has come to tailor DBS targets. Expert Rev Neurother. 2010;10(12):1847-1857. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21384698 [Accessed March 19, 2011].

5) Karlsborg M, Korbo L, Regeur L, Glad A. Duodopa pump treatment in patients with advanced Parkinson's disease. Dan Med Bull. 2010;57(6):A4155. Available at: http://www.ncbi.nlm.nih.gov/pubmed/20515603 [Accessed March 19, 2011].