Development of students' teaching skills is increasingly recognised as an important component of UK undergraduate medical curricula and, in consequence, there is renewed interest in the potential benefits of cross-year peer tutoring. Whilst several studies have described the use of cross-year peer tutoring in undergraduate medical courses, its use in the clinical setting is less well reported, particularly the effects of peer tutoring on volunteer tutors' views of teachers and teaching. This study explored the effects of participation in a cross-year peer tutoring programme in clinical examination skills ('OSCE tutor') on volunteer tutors' own skills and on their attitudes towards teachers and teaching.
Volunteer tutors were final year MBChB students who took part in the programme as part of a Student Selected Component (SSC). Tutees were year 3 MBChB students preparing for their end of year 'OSCE' examination. Pre and post participation questionnaires, including both Likert-type and open response questions, were used. Paired data was compared using the Wilcoxon signed-rank test. All tests were two-tailed with 5% significance level.
Tutors reflected their cohort in terms of gender but were drawn from among the more academically successful final year students. Most had previous teaching experience. They were influenced to participate in 'OSCE tutor' by a desire to improve their own teaching and associated generic skills and by contextual factors relating to the organisation or previous experience of the OSCE tutor programme. Issues relating to longer term career aspirations were less important. After the event, tutors felt that participation had enhanced their skills in various areas, including practical teaching skills, confidence in speaking to groups and communication skills; and that as a result of taking part, they were now more likely to undertake further teacher training and to make teaching a major part of their career. However, whilst a number of students reported that their views of teachers and teaching had changed as a result of participation, this did not translate into significant changes in responses to questions that explored their views of the roles and qualities required of a good clinical teacher.
Findings affirm the benefits to volunteer tutors of cross-year peer tutoring, particularly in terms of skills enhancement and reinforcement of positive attitudes towards future teaching responsibilities, and have implications for the design and organisation of such programmes.
Tutors in a Problem-Based Learning (PBL) curriculum are thought to play active roles in guiding students to develop frameworks for use in the construction of knowledge. This implies that both subject-matter expertise and the ability of tutors to facilitate the learning process must be important in helping students learn. This study examines the behavioural effects of tutors in terms of subject-matter expertise, social congruence and cognitive congruence on students’ learning process and on their final achievement. The extent of students’ learning at each PBL phase was estimated by tracking the number of relevant concepts recalled at the end of each learning phase, while student achievement was based on students’ ability to describe and elaborate upon the relationship between relevant concepts learned. By using Analysis of Covariance, social congruence of the tutor was found to have a significant influence on learning in each PBL phase while all of the tutor-related behaviours had a significant impact on student achievement. The results suggest that the ability of tutors to communicate informally with students and hence create a less threatening learning environment that promotes a free flow exchange of ideas, has a greater impact on learning at each of the PBL phases as compared to tutors’ subject-matter expertise and their ability to explain concepts in a way that is easily understood by students. The data presented indicates that these tutor-related behaviours are determinants of learning in a PBL curriculum, with social congruence having a greater influence on learning in the different PBL phases.
Problem-based learning; Social congruence; Cognitive congruence; Subject-matter expertise; Tutor behaviour
The aim of this study was to research the feasibility of training mental health consumers as tutors for 4th year medical students in psychiatry.
A partnership between a consumer network and an academic unit in Psychological Medicine was formed to jointly develop a training package for consumer tutors and a curriculum in interviewing skills for medical students. Student attitudes to mental health consumers were measured pre and post the program. All tutorial evaluation data was analysed using univariate statistics. Both tutors and students evaluated the teaching program using a 4 point rating scale. The mean scores for teaching and content for both students and tutors were compared using an independent samples t-test.
Consumer tutors were successfully trained and accredited as tutors and able to sustain delivery of tutorials over a 4 year period. The study found that whilst the medical students started with positive attitudes towards consumers prior to the program, there was a general trend towards improved attitude across all measures. Other outcomes for tutors and students (both positive and negative) are described.
Consumer tutors along with professional tutors have a place in the education of medical students, are an untapped resource and deliver largely positive outcomes for students and themselves. Further possible developments are described.
In problem-based learning (PBL), tutors play an essential role in facilitating and efficiently structuring tutorials to enable students to construct individual cognitive networks, and have a significant impact on students' performance in subsequent assessments. The necessity of elaborate training to fulfil this complex role is undeniable. In the plethora of data on PBL however, little attention has been paid to tutor training which promotes competence in the moderation of specific difficult situations commonly encountered in PBL tutorials.
Major interactive obstacles arising in PBL tutorials were identified from prior publications. Potential solutions were defined by an expert group. Video clips were produced addressing the tutor's role and providing exemplary solutions. These clips were embedded in a PBL tutor-training course at our medical faculty combining PBL self-experience with a non-medical case. Trainees provided pre- and post-intervention self-efficacy ratings regarding their PBL-related knowledge, skills, and attitudes, as well as their acceptance and the feasibility of integrating the video clips into PBL tutor-training (all items: 100 = completely agree, 0 = don't agree at all).
An interactive online tool for PBL tutor training was developed comprising 18 video clips highlighting difficult situations in PBL tutorials to encourage trainees to develop and formulate their own intervention strategies. In subsequent sequences, potential interventions are presented for the specific scenario, with a concluding discussion which addresses unresolved issues.
The tool was well accepted and considered worth the time spent on it (81.62 ± 16.91; 62.94 ± 16.76). Tutors considered the videos to prepare them well to respond to specific challenges in future tutorials (75.98 ± 19.46). The entire training, which comprised PBL self-experience and video clips as integral elements, improved tutor's self-efficacy with respect to dealing with problematic situations (pre: 36.47 ± 26.25, post: 66.99 ± 21.01; p < .0001) and significantly increased appreciation of PBL as a method (pre: 61.33 ± 24.84, post: 76.20 ± 20.12; p < .0001).
The interactive tool with instructional video clips is designed to broaden the view of future PBL tutors in terms of recognizing specific obstacles to functional group dynamics and developing individual intervention strategies. We show that this tool is well accepted and can be successfully integrated into PBL tutor-training. Free access is provided to the entire tool at http://www.medizinische-fakultaet-hd.uni-heidelberg.de/fileadmin/PBLTutorTraining/player.swf.
Resuscitation from clinical cardiac arrest is complex and often takes several years to learn. This paper describes an intelligent simulation-based tutor for ACLS which increases students' opportunity to practice before, during and after the ACLS course, thus bridging the gap between studying theory and didactic textbook material and working with patients. Sophisticated reasoning about student performance, compared to an expert model, distinguishes this system from other computerized instruction systems. Intelligence in the tutor allows the system to make the simulation dynamically adaptive to focus on areas where the student's learning needs are greatest. A formative evaluation with two classes of fourth year medical students suggested that the tutor was helpful, realistic and effective. Positive reactions and strong student involvement with the simulation suggest that this simulation-based tutor may improve learning and retention while decreasing anxiety for most students.
To determine whether tutoring might be academically beneficial to the tutor, this study investigated the acquisition of spelling words by three elementary students in a peer tutoring program. The experimental design allowed a simultaneous comparison of each child's gain in performance on comparable word lists on which the child tutored another child, was tutored by another child, or neither gave nor received tutoring. The children's spelling improved nearly an equivalent amount on those words on which they tutored another child as on the words on which they were tutored; no such change was noted on the words on which they neither gave nor received tutoring. These findings, that peer tutoring is profitable for the tutor as well as the tutee, provide a basis for recommending peer tutoring as one method of individualizing education.
academic behavior; individualized instruction; tutoring; group consequences; primary classroom; methodology; experimental design; peers; students
Medical programmes that implement problem-based learning (PBL) face several challenges when introducing this innovative learning method. PBL relies on small group as the foundation of study, and tutors facilitate learning by guiding the process rather than teaching the group. One of the major challenges is the use of strategies to assess students working in small groups. Self-, peer- and tutor-assessment are integral part of PBL tutorials and they're not easy to perform, especially for non experienced students and tutors. The undergraduate PBL medical programme was introduced in 2003, and after two years the curriculum committee decided to evaluate the tutorial assessment in the new program.
A random group of ten students, out of a cohort of sixty, and ten tutors (out of eighteen) were selected for semi-structured interviews. The social representations' theory was used to explore how the students and tutors made sense of "assessment in tutorials". The data were content analyzed using software for qualitative and quantitative processing of text according to lexicological distribution patterns.
Even though students and tutors are aware of the broader purpose of assessment, they felt that they were not enough trained and confident to the tutorial assessment. Assigning numbers to complex behaviors on a regular basis, as in tutorials, is counter productive to cooperative group learning and self assessment. Tutors believe that students are immature and not able to assess themselves and tutors. Students believe that good grades are closely related to good oral presentation skills and also showed a corporative attitude among themselves (protecting each other from poor grades).
Faculty training on PBL tutorials' assessment process and a systematic strategy to evaluate new programs is absolutely necessary to review and correct directions. It is envisaged that planners can make better-informed decisions about curricular implementation, review and reform when information of this nature is made available to them.
The purpose of this study was to investigate the stability of three distinct tutor behaviors (1) use of subject-matter expertise, (2) social congruence and (3) cognitive congruence, in a problem-based learning (PBL) environment. The data comprised the input from 16,047 different students to a survey of 762 tutors administered in three consecutive semesters. Over the three semesters each tutor taught two of the same course and one different course. A generalizability study was conducted to determine whether the tutor behaviors were generalizable across the three measurement occasions. The results indicate that three semesters are sufficient to make generalizations about all three tutor behaviors. In addition the results show that individual differences between tutors account for the greatest differences in levels of expertise, social congruence and cognitive congruence. The study concludes that tutor behaviors are fairly consistent in PBL and somewhat impervious to change. Implications of these findings for tutor training are discussed.
Problem-based learning; Tutor performance; Expertise; Social congruence; Cognitive congruence
Problem-based learning (PBL) was introduced in a large classroom setting. Two generic problem-solving tests were administered at the beginning and end of the term, and a statistically significant 13% increase in the test scores of students exposed to PBL was demonstrated; no change in test scores was observed in the control groups not using PBL.
Problem-based learning (PBL) was originally introduced in medical education programs as a form of small-group learning, but its use has now spread to large undergraduate classrooms in various other disciplines. Introduction of new teaching techniques, including PBL-based methods, needs to be justified by demonstrating the benefits of such techniques over classical teaching styles. Previously, we demonstrated that introduction of tutor-less PBL in a large third-year biochemistry undergraduate class increased student satisfaction and attendance. The current study assessed the generic problem-solving abilities of students from the same class at the beginning and end of the term, and compared student scores with similar data obtained in three classes not using PBL. Two generic problem-solving tests of equal difficulty were administered such that students took different tests at the beginning and the end of the term. Blinded marking showed a statistically significant 13% increase in the test scores of the biochemistry students exposed to PBL, while no trend toward significant change in scores was observed in any of the control groups not using PBL. Our study is among the first to demonstrate that use of tutor-less PBL in a large classroom leads to statistically significant improvement in generic problem-solving skills of students.
The effects of unstructured peer-tutoring procedures on the math performance of fourth- and fifth-grade students were investigated. Students' performances in two daily math sessions, during which they worked problems of the same type and difficulty, were compared. When students tutored each other over the same math problems as they subsequently worked, higher accuracies and rates of performance were associated with the tutored math sessions. The use of consequences for accurate performance seemed to enhance the effects of tutoring on accuracy. The results from an independent-study control condition, which was the same peer-tutoring except that students did not interact with each other, suggested that interactions between students during the tutoring procedure were, in part, responsible for improved accuracy and rate of performance. When students tutored each other over different but related problems to those that they were subsequently asked to solve, accuracies and rates during tutored math sessions were also higher, suggesting the development of generalized skills in solving particular types of math problems.
This study examined the role of contextual factors, such as assignment rationale, on the attitudinal effects of peer tutoring. Fourth-grade children engaged in brief tutoring experiences as either a tutor or tutee. Subjects received four rationales for being selected as tutor or tutee: (a) a competence rationale, (b) a physical characteristic rationale, (c) a chance rationale, or (d) no rationale. As predicted, tutors had more positive attitudes than tutees when they had been given a competence or physical characteristic rationale but not when the tutors were provided a chance rationale or no rationale. Additionally, the tutors’ and tutees’ attitudes were enhanced when no rationale was provided. Results are discussed in terms of their implications for a role-theory analysis of tutoring and their implications for applied programs.
Clinical contact in the early curriculum and workplace learning with active tutorship are important parts of modern medical education. In a previously published study, we found that medical students' tutors experienced a heavier workload, less reasonable demands and less encouragement, than students. The aim of this interview study was to further illuminate physicians' experiences as clinical tutors.
Twelve tutors in the Early Professional Contact course were interviewed. In the explorative interviews, they were asked to reflect upon their experiences of working as tutors in this course. Systematic text condensation was used as the analysis method.
In the analysis, five main themes of physicians' experiences as clinical tutors in the medical education emerged: (a) Pleasure and stimulation. Informants appreciated tutorship and meeting both students and fellow tutors, (b) Disappointment and stagnation. Occasionally, tutors were frustrated and expressed negative feelings, (c) Demands and duty. Informants articulated an ambition to give students their best; a desire to provide better medical education but also a duty to meet demands of the course management, (d) Impact of workplace relations. Tutoring was made easier when the clinic's management provided active support and colleagues accepted students at the clinic, and (e) Multitasking difficulties. Combining several duties with those of a tutorship was often reported as difficult.
It is important that tutors' tasks are given adequate time, support and preparation. Accordingly, it appears highly important to avoid multitasking and too heavy a workload among tutors in order to facilitate tutoring. A crucial factor is acceptance and active organizational support from the clinic's management. This implies that tutoring by workplace learning in medical education should play an integrated and accepted role in the healthcare system.
Continuing medical education sessions are often poorly attended by general practitioners. One reason may be that these traditionally consist of lectures by hospital consultants with a strong theoretical bias which may have little relevance to the learning needs of general practitioners. To compare the learning styles of teachers and learners in general practice, learning style questionnaires were administered to 50 hospital clinical tutors, 78 general practitioner trainers, 63 trainees and 47 non-trainer principals. The questionnaire covered four different learning preferences: activist, reflector, theorist and pragmatist. The findings showed that the learning styles of hospital tutors and general practitioner trainers were statistically significantly different to those of non-trainer principals and trainees. The tutors and trainers scored much higher on theorist styles and to a lesser extent on reflector and pragmatist styles. There were no significant differences on activist scores. Since teachers tend to teach in their preferred learning style, which may not match the style of the recipients, these findings have implications for continuing medical education in general practice. These implications are discussed.
Objective: Peer-assisted learning is widely used in medical education. However, little is known about an appropriate didactic preparation for peer tutors. We herein describe the development of a focused didactic training for skills lab tutors in Internal Medicine and report on a retrospective survey about the student tutors’ acceptance and the perceived transferability of attended didactic training modules.
Methods: The course consisted of five training modules:
‘How to present and explain effectively’: the student tutors had to give a short presentation with subsequent video analysis and feedback in order to learn methods of effective presentation. ‘How to explain precisely’: Precise explanation techniques were trained by exercises of exact description of geometric figures and group feedback. ‘How to explain on impulse’: Spontaneous teaching presentations were simulated and feedback was given. ‘Peyton’s 4 Step Approach’: Peyton‘s Method for explanation of practical skills was introduced and trained by the participants. ‘How to deal with critical incidents’: Possibilities to deal with critical teaching situations were worked out in group sessions.
Twenty-three student tutors participated in the retrospective survey by filling out an electronic questionnaire, after at least 6 months of teaching experience.
Results: The exercise ‘How to present and explain effectively’ received the student tutors’ highest rating for their improvement of didactic qualification and was seen to be most easily transferable into the skills lab environment. This module was rated as the most effective module by nearly half of the participants. It was followed by ‘Peyton’s 4 Step Approach’ , though it was also seen to be the most delicate method in regard to its transfer into the skills lab owing to time concerns. However, it was considered to be highly effective. The other modules received lesser votes by the tutors as the most helpful exercise in improving their didactic qualification for skills lab teaching.
Conclusion: We herein present a pilot concept for a focused didactic training of peer tutors and present results of a retrospective survey among our skills lab tutors about the distinct training modules. This report might help other faculties to design didactic courses for skills lab student tutors.
Peer-assisted learning; Skills lab; didactic training; Peyton's Methode
Skills labs provide a sheltered learning environment. As close supervision and individual feedback were proven to be important in ensuring effective skills training, we implemented a cross-year peer tutor system in our skills lab of internal medicine that allowed intense training sessions with small learning groups (3–4 students) taught by one student tutor.
The expectations, experiences and criticisms of peer tutors regarding the tutor system for undergraduate skills lab training were investigated in the context of a focus group. In addition, tutees' acceptance of this learning model and of their student tutors was evaluated by means of a pre/post web-based survey.
14 voluntary senior students were intensely prepared by consultants for their peer tutor activity. 127 students participated in the project, 66.9% of which responded to the web-based survey (23 topics with help of 6-point Likert scale + free comments). Acceptance was very high (5.69 ± 0.07, mean ± SEM), and self-confidence ratings increased significantly after the intervention for each of the trained skills (average 1.96 ± 0.08, all p < 0.002). Tutors received high global ratings (5.50 ± 0.07) and very positive anonymous individual feedback from participants. 82% of tutees considered the peer teaching model to be sufficient, and a mere 1% expressed the wish for skills training to be provided by faculty staff only. Focus group analyses with tutors revealed 18 different topics, including profit in personal knowledge and personal satisfaction through teaching activities. The ratio of 1:4 tutor/tutees was regarded to be very beneficial for effective feedback, and the personalized online evaluation by tutees to be a strong motivator and helpful for further improvements. The tutors ascribed great importance to the continuous availability of a contact doctor in case of uncertainties.
This study demonstrates that peer teaching in undergraduate technical clinical skills training is feasible and widely accepted among tutees, provided that the tutors receive sufficient training and supervision.
Elementary school students often misinterpret the equal sign (=) as an operational rather than a relational symbol. Such misunderstanding is problematic because solving equations with missing numbers may be important for higher-order mathematics skills including word problems. Research indicates equal-sign instruction can alter how typically-developing students use the equal sign, but no study has examined effects for students with mathematics difficulty (MD) or how equal-sign instruction contributes to word-problem skill for students with or without MD. The present study assessed the efficacy of equal-sign instruction within word-problem tutoring. Third-grade students with MD (n = 80) were assigned to word-problem tutoring, word-problem tutoring plus equal-sign instruction (combined) tutoring, or no-tutoring control. Combined tutoring produced better improvement on equal sign tasks and open equations compared to the other 2 conditions. On certain forms of word problems, combined tutoring but not word-problem tutoring alone produced better improvement than control. When compared at posttest to 3rd-grade students without MD on equal sign tasks and open equations, only combined tutoring students with MD performed comparably.
Background: Peer assisted learning is known as an effective educational strategy in medical teaching. We established a peer assisted teaching program by student tutors with a focus on clinical competencies for students during their practical training on paediatric wards. It was the purpose of this study to investigate the effects of a clinical skills training by tutors, residents and consultants on students evaluations of the teaching quality and the effects of a peer teaching program on self assessed clinical competencies by the students.
Methods: Medical student peers in their 6th year were trained by an intensive instruction program for teaching clinical skills by paediatric consultants, doctors and psychologists. 109 students in their 5th year (study group) participated in a peer assisted teaching program for training clinical skills in paediatrics. The skills training by student peer teachers were supervised by paediatric doctors. 45 students (control group) participated in a conventional paediatric skills training by paediatric doctors and consultants. Students from both groups, which were consecutively investigated, completed a questionnaire with an evaluation of the satisfaction with their practical training and a self assessment of their practical competencies.
Results: The paediatric skills training with student peer teachers received significantly better ratings than the conventional skills training by paediatric doctors concerning both the quality of the practical training and the support by the teaching medical staff. Self assessed learning success in practical skills was higher rated in the peer teaching program than in the conventional training.
Conclusions: The peer assisted teaching program of paediatric skills training was rated higher by the students regarding their satisfaction with the teaching quality and their self assessment of the acquired skills. Clinical skills training by student peer teachers have to be supervised by paediatric doctors. Paediatric doctors seem to be more motivated for their own teaching tasks if they are assisted by student peer teachers. More research is needed to investigate the influence of peer teaching on the motivation of paediatric doctors to teach medical students und the academic performance of the student peers.
Peer assisted learning; clinical skills training in paediatrics; student evaluation; student self assessment
Currently only a few reports exist on how to prepare medical students for skills laboratory training. We investigated how students and tutors perceive a blended learning approach using virtual patients (VPs) as preparation for skills training.
Fifth-year medical students (N=617) were invited to voluntarily participate in a paediatric skills laboratory with four specially designed VPs as preparation. The cases focused on procedures in the laboratory using interactive questions, static and interactive images, and video clips. All students were asked to assess the VP design. After participating in the skills laboratory 310 of the 617 students were additionally asked to assess the blended learning approach through established questionnaires. Tutors’ perceptions (N=9) were assessed by semi-structured interviews.
From the 617 students 1,459 VP design questionnaires were returned (59.1%). Of the 310 students 213 chose to participate in the skills laboratory; 179 blended learning questionnaires were returned (84.0%). Students provided high overall acceptance ratings of the VP design and blended learning approach. By using VPs as preparation, skills laboratory time was felt to be used more effectively. Tutors perceived students as being well prepared for the skills laboratory with efficient uses of time.
The overall acceptance of the blended learning approach was high among students and tutors. VPs proved to be a convenient cognitive preparation tool for skills training.
Medical education; Skills laboratory; Virtual patients; Blended learning
Determine effects of computer-based tutoring on diagnostic performance gains, meta-cognition, and acceptance using two different problem representations. Describe impact of tutoring on spectrum of diagnostic skills required for task performance. Identify key features of student-tutor interaction contributing to learning gains.
Prospective, between-subjects study, controlled for participant level of training. Resident physicians in two academic pathology programs spent four hours using one of two interfaces which differed mainly in external problem representation. The case-focused representation provided an open-learning environment in which students were free to explore evidence-hypothesis relationships within a case, but could not visualize the entire diagnostic space. The knowledge-focused representation provided an interactive representation of the entire diagnostic space, which more tightly constrained student actions.
Metrics included results of pretest, post-test and retention-test for multiple choice and case diagnosis tests, ratios of performance to student reported certainty, results of participant survey, learning curves, and interaction behaviors during tutoring.
Students had highly significant learning gains after one tutoring session. Learning was retained at one week. There were no differences between the two interfaces in learning gains on post-test or retention test. Only students in the knowledge-focused interface exhibited significant metacognitive gains from pretest to post-test and pretest to retention test. Students rated the knowledge-focused interface significantly higher than the case-focused interface.
Cognitive tutoring is associated with improved diagnostic performance in a complex medical domain. The effect is retained at one-week post-training. Knowledge-focused external problem representation shows an advantage over case-focused representation for metacognitive effects and user acceptance.
In three experiments, we compared the effects of instructional arrangements that varied in: teacher versus peer mediators, methods used, levels of student academic responding generated, and content taught and tested. Instructional arrangements (i.e., tasks, structure, teacher position, teacher behavior) and students' levels of academic responding were measured by an observation system which served as an index of the independent variables. Students' accuracy on weekly spelling, arithmetic, and vocabulary tests and pre- and post-standardized achievement tests (Experiments 2 and 3 only) were the dependent variables. Results indicated that the classwide peer tutoring, compared to the teacher's procedure, produced more student academic responding and higher weekly test scores, regardless of treatment order or subject matter content (Experiment 1). The four lowest performing students in each class, in particular, benefited from peer tutoring, often performing as well as the other students. These findings were replicated in Experiments 2 and 3 wherein content taught/tested was also manipulated. Standardized test score gains were higher in those areas in which peer tutoring was used longest. Issues related to the functional analysis of instruction and achievement gain are discussed.
Home-based peer tutoring was used to teach math skills to 4 girls with deficits in mathematics and histories of abuse or neglect. Girls living in the same home formed tutoring dyads, and each participant served as both the peer tutor and the tutee during the course of the study. At the initiation of the tutoring intervention, an expert tutor provided multiple 3-min tutoring sessions to the designated peer tutor on three or four mathematics skills. The peer tutor concurrently provided 3-min tutoring sessions on the same skills to the tutee using a multiple baseline design. Results showed that participants improved their performance on all target skills. Additional interventions were implemented for some skills to improve accuracy further. Maintenance tests were also administered after 3 to 5 months of no practice on the skills. Results showed that tutors and tutees maintained their accuracy on 7 of the 12 skills assessed.
maltreated youth; mathematics; peer tutoring
ReportTutor is an extension to our work on Intelligent Tutoring Systems
for visual diagnosis. ReportTutor combines a virtual microscope and a
natural language interface to allow students to visually inspect a virtual
slide as they type a diagnostic report on the case. The system monitors
both actions in the virtual microscope interface as well as text
created by the student in the reporting interface. It provides feedback
about the correctness, completeness, and style of the report. ReportTutor
uses MMTx with a custom data-source created with the NCI Metathesaurus. A
separate ontology of cancer specific concepts is used to
structure the domain knowledge needed for evaluation of the student’s
input including co-reference resolution. As part of the early
evaluation of the system, we collected data from 4 pathology residents
who typed in their reports without the tutoring aspects of the system, and
compared responses to an expert dermatopathologist. We analyzed
the resulting reports to (1) identify the error rates and distribution
among student reports, (2) determine the performance of the system in
identifying features within student reports, and (3) measure the accuracy
of the system in distinguishing between correct and incorrect report
Effective teaching requires an understanding of both what (content knowledge) and how (process knowledge) to teach. While previous studies involving medical students have compared preceptors with greater or lesser content knowledge, it is unclear whether process expertise can compensate for deficient content expertise. Therefore, the objective of our study was to compare the effect of preceptors with process expertise to those with content expertise on medical students' learning outcomes in a structured small group environment.
One hundred and fifty-one first year medical students were randomized to 11 groups for the small group component of the Cardiovascular-Respiratory course at the University of Calgary. Each group was then block randomized to one of three streams for the entire course: tutoring exclusively by physicians with content expertise (n = 5), tutoring exclusively by physicians with process expertise (n = 3), and tutoring by content experts for 11 sessions and process experts for 10 sessions (n = 3). After each of the 21 small group sessions, students evaluated their preceptors' teaching with a standardized instrument. Students' knowledge acquisition was assessed by an end-of-course multiple choice (EOC-MCQ) examination.
Students rated the process experts significantly higher on each of the instrument's 15 items, including the overall rating. Students' mean score (±SD) on the EOC-MCQ exam was 76.1% (8.1) for groups taught by content experts, 78.2% (7.8) for the combination group and 79.5% (9.2) for process expert groups (p = 0.11). By linear regression student performance was higher if they had been taught by process experts (regression coefficient 2.7 [0.1, 5.4], p < .05), but not content experts (p = .09).
When preceptors are physicians, content expertise is not a prerequisite to teach first year medical students within a structured small group environment; preceptors with process expertise result in at least equivalent, if not superior, student outcomes in this setting.
Since the beginning of the year 2000 medical students of the University of Ulm are working in their curriculum with the web-based and case-oriented tutoring system "Docs 'n Drugs - The Virtual Polyclinic". The system consists of different subsystems and services. One subsystem is the Training System. It is based on three models: the Tutoring Process Model, the Case Knowledge Model and the Medical Knowledge Model. They describe the tutoring process as a series of nodes and steps, depict the structure of the medical cases, and provide the medical knowledge respectively. Case knowledge and medical knowledge form the expert knowledge of the medical domain. Together with the tutoring process, they build the basis for automatic intelligent tutoring. After giving a deeper insight into the system architecture and the training case structure, an informal evaluation shows a first feedback of the learners.
Respiratory disease is a major cause of morbidity and mortality not only in the United Kingdom, but globally. A good understanding of respiratory disease and its treatment is essential for all medical graduates. As a result of changes in clinical practice, patients with some common respiratory illnesses are less often admitted to hospital, restricting the experience available to undergraduate students. Combined with a potential shortage of clinical teachers, this means that new methods of teaching need to be developed and appraised. The aim of this study was to establish whether a web-based package on the diagnosis of respiratory disease would be as effective and as acceptable to final year medical students as tutor-led methods of teaching the same material.
137 out of 315 final year undergraduate students in a single medical school volunteered to take part. Each received up to two hours of tutor-lead interactive, tutor-lead didactic or electronic, Web-based teaching on the accurate diagnosis and management of respiratory disease. Post teaching performance was assessed by multiple true/false questions and data interpretation exercises, whilst students' teaching preferences were assessed by questionnaire.
Despite a high knowledge baseline before the study, there was a small, but statistically significant increase in knowledge score after all forms of teaching. Similarly, data interpretation skills improved in all groups, irrespective of teaching format, Although paradoxically most students expressed a preference for interactive tutor-lead teaching, spirometry interpretation in those receiving web-based teaching improved significantly more [p = 0.041] than in those in the interactive group.
Web-based teaching is at least as good as other teaching formats, but we need to overcome students' reluctance to engage with this teaching method.