This is the first study of ICU delirium assessment to measure the effect of an educational intervention encompassing both didactic and clinical-reasoning-based teaching methods [ 29].
Within didactic instruction, low reasoners had higher reasoning gains within heterogeneous groups (n = 5, Mhomogeneous = 2.20; n = 12, Mheterogeneous = 6.00; F = 3.39, p = 0.08; note: differences were almost significant).
However, the inquiry sections significantly outperformed the didactic sections on the reasoning transfer items (n = 73, Minquiry = 2.89; n = 71, Mdidactic = 2.52; F = 6.42, p = 0.01; see Table 3; reasoning transfer items were calculated based on a six-point scale).
No significant differences were found between the inquiry and didactic sections for overall reasoning gains (n = 73, Minquiry = 1.97; n = 71, Mdidactic = 2.07; F = 0.01, p = NS; reasoning gains were calculated by subtracting initial reasoning scores from final reasoning scores; a maximum of 24 points was possible).
The combination of a didactic lecture and clinical-reasoning-based case scenarios improved the delirium assessment performance in our cohort.
Use of the combination of a didactic lecture and clinical-reasoning-based case scenarios for delirium education rapidly improves the capacity for ICU nurses to perform delirium assessment in a standardized fashion without detrimental effect on accuracy.
These results are not surprising because research shows that inquiry instruction improves reasoning abilities over didactic instruction in college introductory biology classes (Lawson and Johnson [2002], Jensen and Lawson [2011]).
In contrast, low-reasoning students within the didactic sections did not experience such benefits, and in fact had the lowest scores in the study when placed in homogeneous groups.
Although this method seems to be transferable to engineers for common practice, further work is necessary in order to provide a simple, didactic description of the Bayesian line of reasoning, with minimal use of mathematical formalisms, appropriate for communicating this approach to practitioners.
If the goals of teaching are to arouse and keep students' interest, give facts and details, to make students think critically about the subject, and to prepare for independent studies by demonstration of problem solving and professional reasoning, then only two of these purposes are suited to didactic lectures.
