A trial of structured debate as a self-learning method for students and young healthcare providers to discuss social issues in general and family medicine: A case report in Japan

Structured debate is broadly played by university students and graduates as a competition. The educational benefits of debates, such as fostering critical thinking, are acknowledged across various disciplines.¹ Hence, we proposed using debates as a self-learning method for medical students and young healthcare providers. Herein, we report a trial where debate serves as a tool for self-learning in Japan.

Our debate adhered to the systematic procedures outlined by the Japan Debate Association.² Time allocation was slightly modified (Table S1). We held debates using Zoom, with approximately 5–10 voluntary participants: medical students and young healthcare providers. A “plan (agenda)” was collaboratively based on participants' daily observations and interests (Table 1). The participants were divided into two sides: the “pro” (Affirmative side) and the “con” (Negative side), enabling the debate. After the debate, a panel of three judges decided the persuasiveness of each side. The roles of “pro” and “con” were blindly assigned by a third party, irrespective of individuals' opinions on the topic. We performed four debates, as shown below (Table 1). Participants' motivation for these topics is also described.

After each debate, time for reflection was provided. Summarizing the participants' feedback, we found three distinctive characteristics of learning through structured debate as follows. First, students and early-career healthcare providers demonstrated their capability of thinking and researching actively (more easily with a single axis) when given the role of agreeing or disagreeing with a topic in which their interest was vague rather than with no axis. Second, developing discussions within a certain structure will foster the ability to think logically. Lastly, the students will be able to have a multifaceted viewpoint through arguments from both sides, rather than from one point of view.

Of note, our structured debate was conducted online. Given the increased attention toward online educational systems in light of the COVID-19 pandemic, this trial could potentially serve as a promising alternative tool in the future.

As a limitation, our debates were performed without the involvement of leadership experts, as we intended to provide a voluntarily investigating platform to explore topics of participants' interest. Consequently, the quality of the debates depended markedly on the participants' motivation. Moreover, given that participants of this trial were sufficiently motivated at least enough to invest their precious time voluntarily, well-organized and appealing instructions should be required to install our method in the usual classroom education. For instance, supervision by senior group mentors, who have already acquired the credit, during participants' preparation stage may be beneficial. Prior discussion and consultation with such mentors could also serve as students' gatekeeping not to miss essential points and maintain their direction. Imposing the report submission could also function as a quality assurance opportunity; nonetheless, burdens for teachers would be high.

Additionally, our assessment of the educational effect of the debate is insufficient, given that we solely gathered narrative feedback. However, it is noteworthy that only a few studies evaluated the educational effect of structured debate in the medical field; these reports included a variety of controversial topics such as medical ethics, healthcare systems, and emergency medicine.^3-5 A more comprehensive evaluation from various viewpoints would reinforce our proposal to utilize structured debates as a medical educational platform for students and early-career medical professionals.

The authors have stated explicitly that there are no conflicts of interest in connection with this article.