title: Challenging students to formulate written questions: a randomized controlled trial to assess learning effects.
abstract: BACKGROUND
  Underutilization of dialogue among students during small-group work is a threat to active meaningful learning. To encourage small-group learning, we challenged students to generate written questions during a small-group work session. As gender differences have been shown to affect learning, these were also inventoried.
  
  
  METHODS
  Prospective randomized study during a bachelor General Pathology course including 459 (bio) medical students, 315 females and 144 males. The intervention was to individually generate an extra written question on disease mechanisms, followed by a selection, by each student group, of the two questions considered to be most relevant. These selected questions were open for discussion during the subsequent interactive lecture. Outcome measure was the score on tumour pathology (range 1-10) on the course examination; the effect of gender was assessed.
  
  
  RESULTS
  The mean score per student was 7.2 (intervention) and 6.9 (control; p = 0.22). Male students in the intervention group scored 0.5 point higher than controls (p = 0.05). In female students, this was only 0.1 point higher (p = 0.75).
  
  
  CONCLUSIONS
  Formulating and prioritizing an extra written question during small-group work seems to exert a positive learning effect on male students. This is an interesting approach to improve learning in male students, as they generally tend to perform less well than their female colleagues.
authors.affiliation: Department of Anatomy, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Marleen.OldeBekkink@radboudumc.nl.|Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Marleen.OldeBekkink@radboudumc.nl.
authors.forename: Marleen
authors.initials: M
authors.lastname: Olde Bekkink
authors.affiliation: Department for Health Evidence, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Rogier.Donders@radboudumc.nl.
authors.forename: A R T Rogier
authors.initials: AR
authors.lastname: Donders
authors.affiliation: Department of Anatomy, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Jan.Kooloos@radboudumc.nl.
authors.forename: Jan G
authors.initials: JG
authors.lastname: Kooloos
authors.affiliation: Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Rob.deWaal@radboudumc.nl.
authors.forename: Rob Mw
authors.initials: RM
authors.lastname: de Waal
authors.affiliation: Department of Anatomy, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Dirk.Ruiter@radboudumc.nl.
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Ruiter
mesh_terms: D002983:Clinical Competence; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D016014:Linear Models; D008297:Male; D009426:Netherlands; D010336:Pathology / Q000193:education*; D018794:Problem-Based Learning / Q000379:methods*; D011446:Prospective Studies; D012577:Schools, Medical / Q000458:organization & administration; D012737:Sex Factors; D013337:Students, Medical / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014956:Writing; D055815:Young Adult