Education research: An exploration of case-based learning in neuroscience grand rounds using the Delphi technique

Background: Neuroscience grand rounds (NSGR) is a key educational exercise in most academic medical centers. Despite its importance, there are few published studies evaluating the manner in which it is conducted. Our objective was to obtain consensus opinion from staff neurologists, neurosurgeons, neuroradiologists, and neuropathologists on the features that best characterize a highly educational NSGR. Methods: Using the Delphi technique, multiple rounds of questionnaires were presented to a panel of neurologists, neurosurgeons, neuropathologists, and neuroradiologists. The anonymous responses were analyzed and fed back to participants. Each round, the participants were given the opportunity to react to collective opinion by changing their response or by presenting arguments in favor or against the item in question. Results: We found that support for NSGR in its present form is high and that particularly strong support exists for 1) case-based rounds, 2) high level of audience interaction, 3) resident participation in case presentation and analysis, 4) formal training for residents in leading case-based presentations, and 5) resident feedback and evaluation. Conclusions: Our results offer centers that use a case-based format for NSGR with guidance to maximize the important learning opportunity that it provides. We provide an organized evaluation of expert opinion on how this important educational exercise should be conducted. The results expose some fresh insights into traditional values in medical education.