Igniting minds: Debates enhance engagement in small group teaching for postgraduates

Debates consist of constructive argument between two persons or teams that defend opposing positions.¹ The topic is framed as a closed question that can only be answered in the affirmative or in the negative. Each position is defended by a team consisting of 3–5 members, typically. The team prepares beforehand the question of the debate from both positions (for and against).² The debate is divided into three types of turns, each with different functions: introduction or affirmative (introduction of the topic and line of argument), rebuttal (defence of one team’s arguments and rebuttal of those of the opposing team) and conclusion (summary of interactions and arguments proposed in the debate).² Usually, the debate lasts for half to one hour.^1,2

The learning activities that require students to work together, share and apply information and reflect on their interactions with peers provide opportunities to enhance clinical reasoning and professional behaviours.³ Debates provide opportunities for participation, active learning, cooperative learning and development of critical thinking.^3–5 We examined the feasibility of using debate as a part of a seminar to enhance learning for postgraduates.

Participants comprised 16 postgraduate psychiatry residents attending the debate on ‘legalization of cannabis’. Two residents were assigned to prepare ‘for’ and ‘against’ the topic, and all others were randomly divided into either of the two groups. Five key learning points each were identified before the debate. All the participants received relevant study materials. Debate included short PowerPoint presentations of 10 minutes each (i.e. the affirmative), ‘for’ and ‘against’ the topic. Thereafter, comments were solicited from the team members. Any point raised by the participant from one group was followed by a rebuttal from the other group. The discussions were actively facilitated and moderated. Finally, all the learning points were summarized by the residents who made the presentations. Feedback was obtained from all the participants after the session.

On the day of the debate, 14/16 (88%) participants were present; of them, 6 (43%) were in the ‘for’ group and 8 (57%) in the ‘against’ group. All the participants returned the completed feedback forms. Of the 14 participants, 9 (64%) had read the study materials provided, and 6 (43%) had looked at other sources for additional information. All agreed that they learned from the session; the reasons cited were ‘more interaction’, ‘less presentation, more discussion’, ‘learnt more information’ and ‘new concept, interesting’. All the participants reported this method of learning to be better than conventional seminars. The reasons cited included ‘more preparation/self-reading’, ‘active participation’, ‘more opportunity for involvement’ and ‘different than usual/not monotonous’.

The positive aspects of this experience were stated as, ‘everyone participated’, ‘interactive’, ‘more opportunity to participate’ and ‘different from regular academics’. The negative aspects reported were ‘deviation from topic’, ‘chaos during arguments/everyone speaking at once’ and ‘presenting arguments without giving facts’. The overall experience was felt to be satisfactory by 11 (79%).

Although many researchers view debates as more adversarial than other teaching methods, we found the experience more satisfying. The majority (79%) of our participants found it to be satisfactory and better than usual seminars. Participating in a debate enhances learning, whereas observing a debate does not.⁶ In our debate, all the participants had the opportunity to put forth their points, thus ensuring active participation. Debates enhance active learning as they encourage listening, reflecting on what others say and speaking.³ This type of learning follows the principles of adult learning and was well appreciated than the conventional seminars, which have fewer opportunities for interaction. Furthermore, debates have been found to enhance critical thinking among the participants.^3,4

Three-fourths of the students read the specific reading material provided to them and two-fifths looked up additional reading materials. Thus, the debate also encouraged self-directed learning, which is a step forward to life-long learning. Handouts that highlight key learning points can be distributed during or immediately after the debate to aid learning.

We choose to debate on ‘legalization of cannabis’, which is a controversial topic with advocates for and against it.^7–9 Several such topics have been used in ‘Controversies in Psychiatry’ debate seminars at Pittsburgh School of Medicine.¹⁰ The students are motivated to search the recent literature to understand the pros and cons of the topic. The presenters identified key learning points and ensured that these are understood by all the participants. Such practice of ‘trainees as teachers’ has been shown to enhance team-based learning and is considered an essential component of postgraduate curriculum.^11,12

However, the downside was some chaos and deviation from the topic when participants argued. Therefore, the moderator should be mindful of unnecessary digressions from the topic by providing opportunities for everyone to participate and not letting a few to dominate the discussions. The topic for the debate should be carefully chosen as not all topics are suitable for debating. If there is some controversy around the topic, students are likely to actively participate as was seen in our case. Nevertheless, debates have been extended to several areas of learning, for example, what tests to order in case-based debates.¹³ Limitations of our study include a small sample, and that the learning method was tried only once.