Doughnut rounds
What are they?
For ‘doughnut rounds’ (Fleiszer et al., 1997), students select a weekly piece of reading and then test their peers on its content in round of questions in a game show format. The doughnut aspect does not relate to any structural organisation of the groupwork, but instead to the attending academic bringing doughnuts, who acts as a moderator.
How do they work?
Fleiszer et al. (1997), who introduced this method, describe how they implemented it in medical critical care rounds; the sessions are scheduled for one hour per week with 5-6 students, and students choose the readings/materials that the questions will be based on. All students engage with the same reading/preparation and formulate 12 questions each to allow for potential duplication.
The authors describe two types of questions – ‘quick snappers’ (yes/no, true/false or single sentence) to keep the quick pace of the exercise, and ‘mind-benders’ designed to test synthesis and application of knowledge to a clinical scenario.
Students are given a mark of up to 2 points on answering correctly (though Sohrabi et al., 2021 report up to 3 points), and the scores are recorded on a whiteboard or flipchart by the moderator (thus there is an element of gamification). The student who answers correctly will ask another student who has not yet been asked a question, and this repeats for each round; there may be 3-4 rounds in an hour.
Do they work?
Fleizner et al.’s (1997) study reported students’ enthusiasm in the sessions; a follow-up questionnaire highlighted that having to formulate questions motivated students to read and helped them better understand and retain the information, and that the sessions were fun. Most students found the competition to be healthy although the study reported one student out of 25 who disliked the competitive element. Glessmer et al. (2024), who has implemented the method in oceanography, reported anecdotal differences in student attitudes in different geographical contexts (North America vs. Scandinavia). Another study in clinical anatomy, albeit with a small number of students (17) revealed that most perceived they improved their knowledge of anatomy, and confidence/communication skills, as a result of the doughnut rounds which they considered more enjoyable than traditional methods (Zhang et al., 2017).
Another study in medicine (Bulstrode et al., 2003), a randomised-controlled trial (RCT) of 106 students’ performance in multiple choice questions after lectures versus doughnut rounds, revealed a statistically significant advantage of doughnut rounds over lectures for weaker performing students only. Another RCT study of 70 nursing students revealed a significant difference between pre-and post-test scores with virtual doughnut rounds, compared to no significant difference for online lectures, whilst students expressed significantly greater satisfaction with the doughnut rounds (Sohrabi et al., 2024).
What do I need?
The method is considered to be low-preparation, requiring the facilitator to bring doughnuts and moderate the discussion (Fleiszer et al., 1997). Flipchart paper or a whiteboard and pens are required to log the student scores. Glessmer et al. (2024), who adapted the format into ReADi (Read-Ask-Discuss), outline alternative implementation methods; for example, reducing or eliminating the competitive gamification element. The facilitator could alternatively be a senior student, enabling peer-assisted learning (Zhang et al., 2017).
References and further reading
Bulstrode, C., Gallagher, F. A., Pilling, E. L., Furniss, D., & Proctor, R. D. (2003). A randomised controlled trial comparing two methods of teaching medical students trauma and orthopaedics: traditional lectures versus the “donut round”. The Surgeon, 1(2), 76-80. https://doi.org/https://doi.org/10.1016/S1479-666X(03)80119-1
Fleiszer, D., Fleiszer, T., & Russell, R. (1997). Doughnut Rounds: A self-directed learning approach to teaching critical care in surgery. Medical Teacher, 19(3), 190-193. https://doi.org/10.3109/01421599709019380
Glessmer, M. S. (2024). Adapting a teaching method to fit purpose and context. Oceanography. https://doi.org/https://doi.org/10.5670/oceanog.2024.603
Satyajit, S., & Hironmoy, R. (2019). Students' perception on 'Doughnut rounds' in self directed learning of anatomy. International Journal of Scientific Research, 8, 12.
Sohrabi, Z., Rasouli, D., Nouri Khaneghah, Z., Ramezanpour, E., Nosrati, S., & Zhianifard, A. (2024). Comparing the Effect of Virtual Doughnut Educational Rounds and Online Lecture Methods on the Learning and Satisfaction of Operating Room Nursing Students; A Self-Directed Learning Method. Health Education and Health Promotion, 12(1), 85-89. https://doi.org/10.58209/hehp.12.1.85
Zhang, Y., Zerafa Simler, M. A., & Stabile, I. (2017). Supported self-directed learning of clinical anatomy: a pilot study of doughnut rounds. European Journal of Anatomy, 21(4), 319-324.