Keywords
fishbowl - snowball throwing technique - active teaching - dental education
Introduction
For generations, huge classroom lectures that are employed to convey knowledge to
pupils have formed the backbone of education.[1] Although this method is arguably the most efficient for delivering extensive amounts
of complex content to big groups and for introducing new and difficult topics,[2] the classic lecture pattern may not always encourage active engagement with the
matter and learn it.[3]
Not only the health care sector but also teaching institutions around the world are
significantly affected by the novel Coronavirus (COVID-19) pandemic. Owing to the
current pandemic situation, the teaching method has been shifted from the routine
large class room lectures to virtual classes in smaller groups for better understanding
for students.
Active teaching allows pupils to participate in the task of attaining knowledge, shifts
the target from preceptor to pupil, thereby allowing trainees to grasp the concepts
better by completing substantial tasks and improve their comprehension on what they
are doing, which is one alternative to traditional lecturing.[4]
[5]
[6]
[7]
For healthcare education, a variety of activity-based educational approaches have
been put forward. The Fishbowl approach, popularly called the cluster method of teaching,
is one such method.
The basic structure is made up of two concentric circles (groups), which interchange
working (conversation) and observing responsibilities.[8]
[9] While surrounded by an outer circle, pupils belonging to the internal circle review
a particular task or piece of work. Students in the outside circle listen calmly to
the conversation, noting the themes and evaluating the legitimacy and credentials
of the inner group's ideas.[10] When the inner cluster of pupils' assigned time is completed, pupils in the outside
circle may put forward their doubts, offer commentary, and critique the performance
of the members of the internal circle.[11]
To ensure that both groups are equally involved in the interaction, their roles maybe
swapped. A faculty member usually overlooks this activity and has a passive role in
this teaching method by providing inputs at the end of the session.[10]
The fishbowl training style can be used for a variety of purposes; however, its main
objective is to acquaint the students with the framework and quality of a more detailed
interactive discourse.[12]
Snowball throwing technique is a learning strategy that permits pupils to collaborate
in groups and exchange vital information in relation to a selected topic. This technique
requires that each member of the group listen to one another attentively. This is
followed by scrutinization of the information by the other groups. Once the discussion
between the said group is completed, a pupil from the group tosses a ball of paper
without warning to any other member in the group.[13]
As a result, this strategy is used to teach students how to respond more quickly to
messages delivered in the form of paper snowballs by their group member, as well as
to communicate with other students in their group.
There have been a few studies in the literature, which assess the effectiveness of
these active teaching formats; however, there are no studies where a combination of
Fishbowl–Snowball format has been used in dental education. The purpose of this research
was to compare a standard virtual approach with a Fishbowl–Snowball activity for dental
undergraduate students.
Materials and Methods
Two questionnaires were designed for this study. The formal thinking questionnaire
consisted of nine questions designed on the basics of pediatric endodontics and the
second questionnaire was an activity survey questionnaire consisting of three questions.
Several rounds of discussion were performed among the research team members before
achieving consensus regarding the questions. When a consensus was achieved, the two
questionnaires were presented to a panel of five faculty members who are experts in
the field of pediatric dentistry, for validation and applicability of the questionnaire
using the Content Validity Index (CVI).[14] The questionnaires used in this study are as follows:
|
Formal thinking questionnaire
|
Scores
|
|
1. Indication of pulp therapy in children
|
|
|
2. Contraindication of pulp therapy in children
|
|
|
3. Principles of protective base/indirect pulp capping
|
|
|
4. Principles of direct pulp capping
|
|
|
5. Principles of pulpotomy
|
|
|
6. Principles of pulpectomy
|
|
|
7. Principles of extraction and space maintainers
|
|
|
8. Principles of apexification
|
|
|
9. Principles of apexogenesis
|
|
|
Scores: 1/2/3/4/5
Scoring Scale: 1 = Not confident/not sure 5 = very confident
|
|
|
Activity survey questionnaire
|
Scores
|
|
1. This activity helped me in learning better
|
|
|
2. This activity helped me to prepare for exam better
|
|
|
3. This activity helped me to practice pulp therapy better
|
|
|
Scores: 1/2/3/4/5
Scoring Scale: 1 = Not confident/not sure 5 = very confident
|
|
The observational study was performed with the final year undergraduate students (n = 80) in the Department of Pediatric and Preventive Dentistry of the institute. Ethical
approval was obtained from the review board of the institution. Students ready to
participate, present on the day the study and gave informed consent were included.
Final-year undergraduate students were recruited. The total sample size was 80. Each
student was informed regarding study design and protocol. A lecture on the principles
of Pediatric Endodontics was delivered to the students in small groups using the routine
virtual method.
A pre-test activity questionnaire and formal thinking questionnaire were given to
the students and they were asked to give a single score between 1 being the 'Not confident/not
sure' to 5 being 'Very confident.' The class of 80 was divided into smaller groups
of 4 each and the participants were explained about the Fishbowl–Snowball activity.
Students in each group were divided into an inner circle (the fishbowl), which consisted
of 10 participants who were instructed to hold a discussion on the allotted topic
on the Principles of Pediatric Endodontics with the representative member among them
in time limit of 5 to 7 minutes. The inner circle was enclosed by an external circle
and participants were expected to quietly pay attention to the discussion, noting
and evaluating the legitimacy and merits of the inner group's ideas.
The members of the outside circle asked questions and offered essential input after
the inner group's time allocated had expired.
A post-test activity questionnaire and formal thinking questionnaire were given to
the students and they were asked to give a single score between 1 being the 'Not confident/not
sure' to 5 being 'Very confident.' The pre-test and post-test questionnaire scores
were statistically analyzed using paired t-test by statistical software SPSS version 20. A p-value of < 0.05 was considered significant.
Results
Formal Thinking Questionnaire
A significant change in the mean values (p < 0.001) for all nine questions was present between pre and post activity scores
for formal thinking [[Table 1]].
Table 1
Mean differences between pre-test and post-test questionnaire scores
|
Mean
|
95% CI
|
t-Value
|
p-Value
|
|
Lower
|
Upper
|
|
Pair 1
|
Question 1
|
-2.792
|
-2.968
|
-2.616
|
-31.609
|
< 0.001
|
|
Pair 2
|
Question 2
|
-3.181
|
-3.354
|
-3.007
|
-36.577
|
< 0.001
|
|
Pair 3
|
Question 3
|
-2.806
|
-2.980
|
-2.631
|
-32.007
|
< 0.001
|
|
Pair 4
|
Question 4
|
-2.958
|
-3.118
|
-2.798
|
-36.890
|
< 0.001
|
|
Pair 5
|
Question 5
|
-2.986
|
-3.167
|
-2.805
|
-32.880
|
< 0.001
|
|
Pair 6
|
Question 6
|
-3.125
|
-3.301
|
-2.949
|
-35.383
|
< 0.001
|
|
Pair 7
|
Question 7
|
-3.014
|
-3.188
|
-2.840
|
-34.512
|
< 0.001
|
|
Pair 8
|
Question 8
|
-2.986
|
-3.193
|
-2.779
|
-28.792
|
< 0.001
|
|
Pair 9
|
Question 9
|
-3.236
|
-3.419
|
-3.053
|
-35.290
|
< 0.001
|
Abbreviation: CI, confidence interval
The overall pre-test mean was 1.6034 and the post-test mean was 4.6049 with a standard
deviation of 0.1936 and 0.2229, respectively. The overall mean difference between
pre and post paired t-test formal thinking was –3.00 and was seen to be statistically significant (p < 0.001) [[Table 2]].
Table 2
Paired sample test showing the overall mean difference
|
Mean
|
95% CI
|
t-Value
|
p-Value
|
|
Lower
|
Upper
|
|
Overall pre-test and post-test scores
|
-3.0015
|
-3.0731
|
-2.9300
|
-83.661
|
< 0.001
|
Abbreviation: CI, confidence interval.
Activity Survey Questionnaire
A significant change in the mean values (p < 0.001) for all three questions between pre and post activity scores was seen [[Tables 3] and [4]].
Table 3
Mean values of pre and post-test activity questionnaire for all three questions
|
Paired samples statistics
|
|
Mean
|
S.D.
|
Std. error mean
|
|
Pair 1
|
q1 pre
|
1.73
|
.506
|
.060
|
|
q1 post
|
4.30
|
.619
|
.073
|
|
Pair 2
|
q2 pre
|
1.92
|
.579
|
.069
|
|
q2 post
|
4.46
|
.530
|
.063
|
|
Pair 3
|
q3 pre
|
1.79
|
.505
|
.060
|
|
q3 post
|
4.30
|
.619
|
.073
|
Abbreviation: SD, standard deviation.
Table 4
Mean differences between the pre-test and post-test scores for three questions
|
Mean
|
95% CI
|
t-Value
|
p-Value
|
|
Lower
|
Upper
|
|
Pair 1
|
Question 1
|
-2.563
|
-2.766
|
-2.360
|
-25.190
|
< 0.001
|
|
Pair 2
|
Question 2
|
-2.549
|
-2.756
|
-2.342
|
-24.553
|
< 0.001
|
|
Pair 3
|
Question 3
|
-2.507
|
-2.681
|
-2.333
|
-28.767
|
< 0.001
|
Abbreviation: CI, confidence interval.
The overall pre-test mean was 1.8122 and the post-test mean was 4.3521 with standard
deviations of 0.3768 and 0.4397, respectively.
The overall mean difference between pre-test and post-test paired t-test for activity scores was –2.53 and was statistically significant (p < 0.001) [[Table 5]].
Table 5
Showing overall pre-test and post-test scores
|
Mean
|
95% CI
|
t-Value
|
p-Value
|
|
Lower
|
Upper
|
|
Overall pre-test and post-test scores
|
-2.5399061
|
-2.6862
|
-2.3936
|
-34.622
|
< 0.001
|
Abbreviation: CI, confidence interval.
Discussion
One of the biggest hurdles faced by an educator in a professional college is the lack
of attentiveness and participation of their pupils/trainees the class.[9]
The fishbowl training style can be used for a variety of purposes; however, its main
objective is to acquaint the students with the framework and quality of a more detailed
interactive discourse.[12]
Snowball throwing technique is a learning strategy that permits pupils to collaborate
in groups and exchange vital information in relation to a selected topic.[13]
Although these two active teaching methods have been used on their own for teaching
students, there has been no study that uses a combination of the two techniques especially
in dental education.
In this study, 80 final-year undergraduate students were recruited to evaluate the
effectiveness of the combination of Fishbowl–Snowball technique. The students were
first given a routine lecture on a specific topic of principles in endodontics. The
students were then explained about the study design and protocol. The fishbowl–snowball
activity was then performed in smaller groups, which was followed by distribution
of two questionnaires to each student, the first questionnaire evaluated the pre and
post formal thinking scores of the students based on nine questions related to the
Principles of Pediatric Endodontics. The second questionnaire evaluated the pre and
post activity scores of each student based on three questions. The students were asked
to give a single score between 1 being 'Not confident/not sure' to 5 being 'Very confident'
for each question in both questionnaires. The results of our study showed that overall
pre-test and post-test mean for the formal thinking were 1.60 and 4.60 respectively
and the overall mean difference was –3.00, which was statistically significant (p < 0.001) and which indicated higher scores given by students to the Fishbowl–Snowball
method of teaching as compared with the routine method.
The results of the activity scores demonstrated that the overall pre-test and post-test
mean was 1.81 and 4.35, respectively, and the overall mean difference was –2.53 and
was statistically significant (p < 0.001) which indicates higher scores given by the students to the Fishbowl-Snowball
method of teaching as opposed to routine method.
The findings of this study are in accordance with Pearson et al,[15] who showed that Fishbowl activity may be a valuable educational tool for the development
of postformal thinking skills. Setiyowati et al[16] reported the positive influence of STT on brushing mannerism of school children.
From our study it was therefore seen that there is a statistically significant difference
in routine virtual teaching method and Fishbowl-Snowball activity method and that
the combination of Fishbowl-Snowball method was significantly better. The feedback
from the students was taken and majority of the students felt that this method of
teaching was innovative and allowed easy learning, there was active participation
by all students, concepts were better cleared, and it helped in developing free thinking.
Hence a hybrid technique of virtual classes with small group discussions by various
methods should be used regularly in teaching class rooms.
Conclusion
The present study concluded that the use of Fishbowl–Snowball method was an effective
method in improving the comprehension and retention of concepts in most participants.
An amalgamation of Fishbowl–Snowball method can be employed to achieve a satisfactory
teaching technique as the students show active participation and the shortcomings
of one approach could be overcome by the other.
