Background

The most common teaching method used in China is lecturing, but recently, efforts have been widely undertaken to promote the transition from teacher-centered to student-centered education. The patient-oriented problem-solving (POPS) system is an innovative teaching-learning method that permits students to work in small groups to solve clinical problems, promotes self-learning, encourages clinical reasoning and develops long-lasting memory. To our best knowledge, however, POPS has never been applied in teaching immunology in China. The aim of this study was to develop POPS in teaching immunology and assess students’ and teachers’ perception to POPS.

Methods

321 second-year medical students were divided into two groups: I and II. Group I, comprising 110 students, was taught by POPS, and 16 immunology teachers witnessed the whole teaching process. Group II including the remaining 211 students was taught through traditional lectures. The results of the pre- and post-test of both groups were compared. Group I students and teachers then completed a self-structured feedback questionnaire for analysis before a discussion meeting attended only by the teachers was held.

Results

Significant improvement in the mean difference between the pre- and post-test scores of those in Groups I and II was seen, demonstrating the effectiveness of POPS teaching. Most students responded that POPS facilitates self-learning, helps them to understand topics and creates interest, and 88.12% of students favored POPS over simple lectures. Moreover, while they responded that POPS facilitated student learning better than lectures, teachers pointed out that limited teaching resources would make it difficult for wide POPS application in China.

Conclusions

While POPS can break up the monotony of dialectic lectures and serve as a better teaching method, it may not be feasible for the current educational environment in China. The main reason for this is the relative shortage of teaching resources such as space, library facilities and well-trained teachers.

Background

Cardiology is one of the most popular of the hospital medical specialties in the UK. It is also a highly competitive specialty in respect of the availability of higher specialty training posts. Our aims are to describe doctors’ early intentions about seeking careers in cardiology, to report on when decisions about seeking a career in cardiology are made, to compare differences between men and women doctors in the choice of cardiology, and to compare early career choices with later specialty destinations.

Methods

Questionnaire surveys were sent to all UK medical graduates in selected qualification years from 1974–2009, at 1, 3, 5, 7 and 10 years after graduation.

Results

One year after graduation, the percentage of doctors specifying cardiology as their first choice of long-term career rose from the mid-1990s from 2.4% (1993 cohort) to 4.2% (2005 cohort) but then fell back to 2.7% (2009 cohort). Men were more likely to give cardiology as their first choice than women (eg 4.1% of men and 1.9% of women in the 2009 cohort). The percentage of doctors who gave cardiology as their first choice of career declined between years one and five after qualification: the fall was more marked for women. 34% of respondents who specified cardiology as their sole first choice of career one year post-graduation were later working in cardiology. 24% of doctors practising as cardiologists several years after qualification had given cardiology as their sole first choice in year one. The doctors’ ‘domestic circumstances’ were a relatively unimportant influence on specialty choice for aspiring cardiologists, while ‘enthusiasm/commitment’, ‘financial prospects’, ‘experiences of the job so far’ and ‘a particular teacher/department’ were important.

Conclusions

Cardiology grew as a first preference one year after graduation to 2005 but is now falling. It consistently attracts a higher percentage of men than women doctors. The correspondence between early choice and later destination was not particularly strong for cardiology, and was less strong than that for several other specialties.

Background

There are an increasing number of studies reporting the efficacy of educational strategies to facilitate the development of knowledge and skills underpinning evidence based practice (EBP). To date there is no standardised guideline for describing the teaching, evaluation, context or content of EBP educational strategies. The heterogeneity in the reporting of EBP educational interventions makes comparisons between studies difficult. The aim of this program of research is to develop the Guideline for Reporting EBP Educational interventions and Teaching (GREET) statement and an accompanying explanation and elaboration (E&E) paper.

Methods/design

Three stages are planned for the development process. Stage one will comprise a systematic review to identify features commonly reported in descriptions of EBP educational interventions. In stage two, corresponding authors of articles included in the systematic review and the editors of the journals in which these studies were published will be invited to participate in a Delphi process to reach consensus on items to be considered when reporting EBP educational interventions. The final stage of the project will include the development and pilot testing of the GREET statement and E&E paper.

Outcome

The final outcome will be the creation of a Guideline for Reporting EBP Educational interventions and Teaching (GREET) statement and E&E paper.

Discussion

The reporting of health research including EBP educational research interventions, have been criticised for a lack of transparency and completeness. The development of the GREET statement will enable the standardised reporting of EBP educational research. This will provide a guide for researchers, reviewers and publishers for reporting EBP educational interventions.

Background

The Objective Structured Clinical Examination (OSCE) has been widely applied as a high-stakes examination for assessing physicians’ clinical competency. In 1992, OSCE was first introduced in Taiwan, and the authorities announced that passing the OSCE would be a prerequisite for step-2 medical licensure examination in 2013. This study aimed to investigate the impacts of the announced national OSCE policy on implementation of OSCE at the institutional level. Further, the readiness and the recognition of barriers toward a high-stakes examination were explored.

Methods

In 2007 and 2010, the year before and after the announcement of high-stakes OSCE policy in 2008, respectively, questionnaires on the status of OSCE implementation were distributed to all hospitals with active OSCE programs in Taiwan. Information on OSCE facilities, equipment, station length, number of administrations per year, and the recognition of barriers to the success of implementing an OSCE were collected. The missing data were completed by telephone interviews. The OSCE format, administration, and facilities before and after the announcement of the nationwide OSCE policy were compared.

Results

The data were collected from 17 hospitals in 2007 and 21 in 2010. Comparing the OSCE formats between 2007 and 2010, the number of stations increased and the station length decreased. The designated space and the equipment for OSCE were also found to have been improved. As for the awareness of OSCE implementation barriers, the hospital representatives concerned mostly about the availability and quality of standardized patients in 2007, as well as space and facilities in 2010.

Conclusions

The results of this study underscored an overall increase in the number of OSCE hospitals and changes in facilities and formats. While recruitment and training of standardized patients were the major concerns before the official disclosure of the policy, space and facilities became the focus of attention after the announcement. The study results highlighted the influence of government policy on different aspects of OSCE implementation in Taiwanese training institutes that showed high level of support as reflected in the improved hardware and the change in OSCE format to serve the summative purpose.

Background

The amount of information needed by doctors has exploded. The nature of knowledge (explicit and tacit) and processes of knowledge acquisition and participation are complex. Aiming to assist workplace learning, Wales Deanery funded “iDoc”, a project offering trainee doctors a Smartphone library of medical textbooks.

Methods

Data on trainee doctors’ (Foundation Year 2) workplace information seeking practice was collected by questionnaire in 2011 (n = 260). iDoc baseline questionnaires (n = 193) collected data on Smartphone usage alongside other workplace information sources. Case reports (n = 117) detail specific instances of Smartphone use.

Results

Most frequently (daily) used information sources in the workplace: senior medical staff (80% F2 survey; 79% iDoc baseline); peers (70%; 58%); and other medical/nursing team staff (53% both datasets). Smartphones were used more frequently by males (p < 0.01). Foundation Year 1 (newly qualified) was judged the most useful time to have a Smartphone library because of increased responsibility and lack of knowledge/experience.

Preferred information source varied by question type: hard copy texts for information-based questions; varied resources for skills queries; and seniors for more complex problems. Case reports showed mobile technology used for simple (information-based), complex (problem-based) clinical questions and clinical procedures (skills-based scenarios). From thematic analysis, the Smartphone library assisted: teaching and learning from observation; transition from medical student to new doctor; trainee doctors’ discussions with seniors; independent practice; patient care; and this ‘just-in-time’ access to reliable information supported confident and efficient decision-making.

Conclusion

A variety of information sources are used regularly in the workplace. Colleagues are used daily but seniors are not always available. During transitions, constant access to the electronic library was valued. It helped prepare trainee doctors for discussions with their seniors, assisting the interchange between explicit and tacit knowledge.

By supporting accurate prescribing and treatment planning, the electronic library contributed to enhanced patient care. Trainees were more rapidly able to medicate patients to reduce pain and more quickly call for specific assessments. However, clinical decision-making often requires dialogue: what Smartphone technology can do is augment, not replace, discussion with their colleagues in the community of practice.

Background

In Kuwait, 21 residency training programs were offered in the year 2011; however, no data is available regarding the criteria of selecting residents for these programs. This study aims to provide information about the importance of these criteria.

Methods

A self-administered questionnaire was used to collect data from members (e.g. chairmen, directors, assistants …etc.) of residency programs in Kuwait. A total of 108 members were invited to participate. They were asked to rate the importance level (scale from 1 to 5) of criteria that may affect the acceptance of an applicant to their residency programs. Average scores were calculated for each criterion.

Results

Of the 108 members invited to participate, only 12 (11.1%) declined to participate. Interview performance was ranked as the most important criteria for selecting residents (average score: 4.63/5.00), followed by grade point average (average score: 3.78/5.00) and honors during medical school (average score: 3.67/5.00). On the other hand, receiving disciplinary action during medical school and failure in a required clerkship were considered as the most concerning among other criteria used to reject applicants (average scores: 3.83/5.00 and 3.54/5.00 respectively). Minor differences regarding the importance level of each criterion were noted across different programs.

Conclusions

This study provided general information about the criteria that are used to accept/reject applicants to residency programs in Kuwait. Future studies should be conducted to investigate each criterion individually, and to assess if these criteria are related to residents' success during their training.

Background

Successful cecal intubation (SCI) is not only a quality indicator but also an important marker in a colonoscopy trainee’s progress. We conducted this study to determine factors predicting SCI in colonoscopy trainees, and to compare these factors before and after trainees achieve technical competence.

Methods

Design of this study was a cross-sectional studies of two time series design for one year at a single center. From March 2011 to February 2012, a total 2,050 subjects who underwent colonoscopy by four first-year gastrointestinal fellows were enrolled at Christian hospital, Wonju, Republic of Korea. Four gastrointestinal fellows have filled out the colonoscopic documentation. Main outcome measurement was predictive factors affecting cecal intubation failure and learning curves.

Results

Colonoscopy was successfully completed to the cecum in 1,720 patients (83.9%). Success rates gradually increased as trainees performed more colonoscopies: the rate of SCI was 62% in the first 50 cases, and grew to 93% by the 250th case. Logistic regression analysis of factors affecting cecal intubation failure showed that female gender, low BMI (BMI < 18.5 kg/m2), poor bowel preparation, and past history of stomach surgery were more often associated with cecal intubation failure, particularly before the trainees achieved technical competence.

Conclusion

Several patient characteristics were identified that may predict difficulty of cecal intubation in colonoscopy trainees. Particularly, low BMI, inadequate bowel cleansing, and previous stomach operation were predictors of cecal intubation failure before the trainees have reached technical competency. The results could be informative so that trainees enhance the success rate regarding better colonoscopy training programs.

Background

Burnout and intolerance of uncertainty have been linked to low job satisfaction and lower quality patient care. While resilience is related to these concepts, no study has examined these three concepts in a cohort of doctors. The objective of this study was to measure resilience, burnout, compassion satisfaction, personal meaning in patient care and intolerance of uncertainty in Australian general practice (GP) registrars.

Methods

We conducted a paper-based cross-sectional survey of GP registrars in Australia from June to July 2010, recruited from a newsletter item or registrar education events. Survey measures included the Resilience Scale-14, a single-item scale for burnout, Professional Quality of Life (ProQOL) scale, Personal Meaning in Patient Care scale, Intolerance of Uncertainty-12 scale, and Physician Response to Uncertainty scale.

Results

128 GP registrars responded (response rate 90%). Fourteen percent of registrars were found to be at risk of burnout using the single-item scale for burnout, but none met the criteria for burnout using the ProQOL scale. Secondary traumatic stress, general intolerance of uncertainty, anxiety due to clinical uncertainty and reluctance to disclose uncertainty to patients were associated with being at higher risk of burnout, but sex, age, practice location, training duration, years since graduation, and reluctance to disclose uncertainty to physicians were not.

Only ten percent of registrars had high resilience scores. Resilience was positively associated with compassion satisfaction and personal meaning in patient care. Resilience was negatively associated with burnout, secondary traumatic stress, inhibitory anxiety, general intolerance to uncertainty, concern about bad outcomes and reluctance to disclose uncertainty to patients.

Conclusions

GP registrars in this survey showed a lower level of burnout than in other recent surveys of the broader junior doctor population in both Australia and overseas. Resilience was also lower than might be expected of a satisfied and professionally successful cohort.

Background

By 2013 Palliative Care will become a mandatory examination subject in the medical curriculum in Germany. There is a pressing need for effective and well-designed curricula and assessment methods. Debates are on going as how Undergraduate Palliative Care Education (UPCE) should be taught and how knowledge and skills should be assessed. It is evident by this time that the development process of early curricula in the US and UK has led to a plethora of diverse curricula which seem to be partly ineffective in improving the care for the seriously ill and dying offered by newly qualified doctors, as is demonstrated in controlled evaluations. The goals of this study were to demonstrate an evidence-based approach towards developing UPCE curricula and investigate the change in medical students’ self-perceived readiness to deal with palliative care patients and their families.

Methods

To evaluate the effects of the UPCE curriculum we chose a prospective, controlled, quasi-experimental, pre, retrospective-pre, post study design. A total of n = 37 3rd and 4th –year medical students were assigned to the intervention group (n = 15; 4th -year) and to the control group (n = 22; 3rd-year). Resting on the self-efficacy concept of Bandura the measurement was conducted by a refined test-battery based on two independent measurements (the revised Collet-Lester-Fear-of-Death-Scale and the instrument of the “Program in Palliative Care Education and Practice” at Harvard Medical School) including 68 items altogether in a five-point Likert-scale. These items were designed to test elementary skills in caring for the dying and their relatives as perceived by medical undergraduates. Datasets from both groups were analysed by paired and independent two-sample t-test. The TREND statement for reporting non-randomized evaluations was applied for reporting on this quasi-experimental study.

Results

Three constructs showed statistically significant differences comparing the intervention group before and after. Willingness to accompany a dying patient increased from 21.40 to 37.30 (p < .001). Self-estimation of competence in communication with dying patients and their relatives increased from 12.00 to 23.60 (p = .001). Finally, self-estimation of knowledge and skills in Palliative Care increased from 8.30 to 13.20 (p = .001).

Conclusions

This study is a small but systematic step towards rigorous curricular development in palliative care. Our manualised curriculum is available for scrutiny and scientific feedback to support an open and constructive process of best-practice comparison in palliative care.

Background

Improving the quality of medical education is a key goal of government policy in Taiwan. The aim of this study was to reflect the responses of medical education from the perspective of graduating medical students in Taiwan. This is the first survey study of medical education in Taiwan.

Methods

Using the Medical School Graduation Questionnaire from the Association of American Medical Colleges (AAMC), we distributed 406 questionnaires to medical students of four medical schools in their last semester, and received 270 back (response rate, 66.5%). There were 11 medical schools in Taiwan. Most questions were assessed on a 5-point Likert scale.

Results

Students identified genetics, biochemistry, and ethics as the three most important premedical subjects preparing them for medical education and gross anatomy, physiology, and pharmacology as the three most helpful basic science subjects preparing them for clinical clerkships and electives. Most Taiwanese students were satisfied with their learning experience in internal medicine. Only 55.9% of students were confident that they had acquired the clinical skills required to become a resident, and 70.7% were satisfied with the quality of their medical education.

Conclusion

The study offers preliminary results on the views of graduating students on the medical education system in Taiwan. In particular, our government and medical educators need to continuously put more effort into building students’ confidence in their clinical skills.

Background

Web 2.0 sites such as YouTube have become a useful resource for knowledge and are used by medical students as a learning resource. This study aimed at assessing videos covering the nervous system examination on YouTube.

Methods

A research of YouTube was conducted from 2 November to 2 December 2011 using the following key words “nervous system examination”, “nervous system clinical examination”, “cranial nerves examination”, “CNS examination”, “examination of cerebellum”, “balance and coordination examination”. Only relevant videos in the English language were identified and related URL recorded. For each video, the following information was collected: title, author/s, duration, number of viewers, number of posted comments, and total number of days on YouTube. Using criteria comprising content, technical authority and pedagogy parameters, videos were rated independently by three assessors and grouped into educationally useful and non-educationally useful.

Results

A total of 2240 videos were screened; 129 were found to have relevant information to nervous system examination. Analysis revealed that 61 (47%) of the videos provided useful information on the nervous system examination. These videos scored (mean ± SD, 14.9 ± 0.2) and mainly covered examination of the whole nervous system (8 videos, 13%), cranial nerves (42 videos, 69%), upper limbs (6 videos, 10%), lower limbs (3 videos, 5%), balance and co-ordination (2 videos, 3%). The other 68 (53%) videos were not useful educationally; scoring (mean ± SD, 11.1 ± 3.0). The total viewers of all videos was 2,189,434. Useful videos were viewed by 1,050,445 viewers (48% of total viewers). The total viewership per day for useful videos was 1,794.5 and for non-useful videos 1,132.0. The differences between the three assessors were insignificant (less than 0.5 for the mean and 0.3 for the SD).

Conclusions

Currently, YouTube provides an adequate resource for learning nervous system examination, which can be used by medical students. However, there were deficiencies in videos covering examination of the cerebellum and balance system. Useful videos can be used as learning resources to medical students.

Background

Technological advances have enabled the widespread use of video cases via web-streaming and online download as an educational medium. The use of real subjects to demonstrate acute pathology should aid the education of health care professionals. However, the methodology by which this effect may be tested is not clear.

Methods

We undertook a literature review of major databases, found relevant articles relevant to using patient video cases as educational interventions, extracted the methodologies used and assessed these methods for internal and construct validity.

Results

A review of 2532 abstracts revealed 23 studies meeting the inclusion criteria and a final review of 18 of relevance. Medical students were the most commonly studied group (10 articles) with a spread of learner satisfaction, knowledge and behaviour tested. Only two of the studies fulfilled defined criteria on achieving internal and construct validity. The heterogeneity of articles meant it was not possible to perform any meta-analysis.

Conclusions

Previous studies have not well classified which facet of training or educational outcome the study is aiming to explore and had poor internal and construct validity. Future research should aim to validate a particular outcome measure, preferably by reproducing previous work rather than adopting new methods. In particular cognitive processing enhancement, demonstrated in a number of the medical student studies, should be tested at a postgraduate level.

Background

Observation of the performance of medical students in the clinical environment is a key part of assessment and learning. To date, few authors have examined written comments provided to students and considered what aspects of observed performance they represent. The aim of this study was to examine the quantity and quality of written comments provided to medical students by different assessors using a team-based model of assessment, and to determine the aspects of medical student performance on which different assessors provide comments.

Methods

Medical students on a 7-week General Surgery & Anesthesiology clerkship received written comments on ‘Areas of Excellence’ and ‘Areas for Improvement’ from physicians, residents, nurses, patients, peers and administrators. Mixed-methods were used to analyze the quality and quantity of comments provided and to generate a conceptual framework of observed student performance.

Results

1,068 assessors and 127 peers provided 2,988 written comments for 127 students, a median of 188 words per student divided into 26 “Areas of Excellence” and 5 “Areas for Improvement”. Physicians provided the most comments (918), followed by patients (692) and peers (586); administrators provided the fewest (91). The conceptual framework generated contained four major domains: ‘Student as Physician-in-Training’, ‘Student as Learner’, ‘Student as Team Member’, and ‘Student as Person.’

Conclusions

A wide range of observed medical student performance is recorded in written comments provided by members of the surgical healthcare team. Different groups of assessors provide comments on different aspects of student performance, suggesting that comments provided from a single viewpoint may potentially under-represent or overlook some areas of student performance. We hope that the framework presented here can serve as a basis to better understand what medical students do every day, and how they are perceived by those with whom they work.

Background

10-15% of students struggle at some point in their medicine course. Risk factors include weaker academic qualifications, male gender, mental illness, UK ethnic minority status, and poor study skills. Recent research on an undergraduate medicine course provided a toolkit to aid early identification of students likely to struggle, who can be targeted by established support and study interventions. The present study sought to extend this work by investigating the number and characteristics of strugglers on a graduate-entry medicine (GEM) programme.

Methods

A retrospective study of four GEM entry cohorts (2003–6) was carried out. All students who had demonstrated unsatisfactory progress or left prematurely were included. Any information about academic, administrative, personal, or social difficulties, were extracted from their course progress files into a customised database and examined.

Results

362 students were admitted to the course, and 53 (14.6%) were identified for the study, of whom 15 (4.1%) did not complete the course. Students in the study group differed from the others in having a higher proportion of 2ii first degrees, and scoring less well on GAMSAT, an aptitude test used for admission. Within the study group, it proved possible to categorise students into the same groups previously reported (struggler throughout, pre-clinical struggler, clinical struggler, health-related struggler, borderline struggler) and to identify the majority using a number of flags for early difficulties. These flags included: missed attendance, unsatisfactory attitude or behaviour, health problems, social/family problems, failure to complete immunity status checks, and attendance at academic progress committee.

Conclusions

Problems encountered in a graduate-entry medicine course were comparable to those reported in a corresponding undergraduate programme. A toolkit of academic and non-academic flags of difficulty can be used for early identification of many who will struggle, and could be used to target appropriate support and interventions.

Background

This study aims to determine the correlation between medical education systems, medical college (MC) and medical school (MS), and empathy by investigating the changes in empathy among students with each additional year of medical education.

Methods

The subjects were MC and MS students who had participated in the same study the previous year. All participants completed the same self-report instruments: a questionnaire on sociodemographic characteristics, and the Korean edition of the Student Version of the Jefferson Scale of Empathy (JSE-S-K), Among 334 students, the final analysis was conducted on the data provided by 113 MC and 120 MS students, excluding 101 with incomplete data.

Results

The age and sex did not affect the changes in empathy. Though the JSE-S-K score of MS was significantly higher than that of MC in initial investigation, this study found no difference of empathy between MC and MS.

Conclusion

Empathy increased significantly after one year of medical education. The difference between two education systems, MC and MS, did not affect the changes in empathy.

Background

The objective structure clinical examination (OSCE) has been used since the early 1970s for assessing clinical competence. There are very few studies that have examined the psychometric stability of the stations that are used repeatedly with different samples. The purpose of the present study was to assess the stability of objective structured clinical exams (OSCEs) employing the same stations used over time but with a different sample of candidates, SPs, and examiners.

Methods

At Time 1, 191 candidates and at Time 2 (one year apart), 236 candidates participated in a 10-station OSCE; 6 of the same stations were used in both years. Generalizability analyses (Ep2) were conducted. Employing item response analyses, test characteristic curves (TCC) were derived for each of the 6 stations for a 2-parameter model. The TCCs were compared across the two years, Time 1 and 2.

Results

The Ep2 of the OSCEs exceeded.70. Standardized thetas (θ) and discriminations were equivalent for the same station across the two year period indicating equivalent TCCs for a 2-parameter model.

Conclusion

The 6 OSCE stations used by the AIMG program over two years have adequate internal consistency reliability, stable generalizability (Ep2) and equivalent test characteristics. The process of assessment employed for IMG’s are stable OSCE stations that may be used several times over without compromising psychometric properties.

With careful security, high-stakes OSCEs may use the same stations that have high internal consistency and generalizability repeatedly as the psychometric properties are stable over several years with different samples of candidates.

Background

A strategy for reducing mental illness-related stigma in health-profession students is to include contact-based sessions in their educational curricula. In such sessions students are able to interact socially with a person that has a mental illness. We sought to evaluate the effectiveness of this strategy in a multi-centre study of pharmacy students.

Methods

The study was a randomized controlled trial conducted at three sites. Because it was necessary that all students receive the contact-based sessions, the students were randomized either to an early or late intervention, with the late intervention group not having participated in the contact-based education at the time when the primary outcome was assessed. The primary outcome, stigma, was assessed using an attitudes scale called the Opening Minds Survey for Health Care Providers (OMS-HC).

Results

We initially confirmed that outcomes were homogeneous across study centres, centre by group interaction, p = 0.76. The results were pooled across the three study centres. A significant reduction in stigma was observed in association with the contact-based sessions (mean change 4.3 versus 1.5, t=2.1, p=0.04). The effect size (Cohen’s d) was 0.45. A similar reduction was seen in the control group when they later received the intervention.

Conclusions

Contact-based education is an effective method of reducing stigma during pharmacy education. These results add to a growing literature confirming the effectiveness of contact-based strategies for stigma reduction in health profession trainees.

Background

E-learning is a common and popular mode of educational delivery, but little is known about its effectiveness in teaching practical skills. The aim of this study was to determine whether the Physiotherapy eSkills Training Online resource in addition to usual teaching improved the performance of practical skills in physiotherapy students.

Method

This study was a non-randomised controlled trial. The participants were graduate entry physiotherapy students enrolled in consecutive semesters of a neurological physiotherapy unit of study. The experimental group received the Physiotherapy eSkills Training Online resource as well as usual teaching. The Physiotherapy eSkills Training Online resource is an online resource incorporating (i) video-clips of patient-therapist simulations; (ii) supportive text describing the aim, rationale, equipment, key points, common errors and methods of progression; and (iii) a downloadable PDF document incorporating the online text information and a still image of the video-clip for each practical skill. The control group received usual teaching only. The primary outcomes were the overall performance of practical skills as well as their individual components, measured using a practical examination.

Results

The implementation of the Physiotherapy eSkills Training Online resource resulted in an increase of 1.6 out of 25 (95% CI −0.1 to 3.3) in the experimental group compared with the control group. In addition, the experimental group scored 0.5 points out of 4 (95% CI 0 to 1.1) higher than the control group for ‘effectiveness of the practical skill’ and 0.6 points out of 4 (95% CI 0.1 to 1.1) higher for ‘rationale for the practical skill’.

Conclusion

There was improvement in performance of practical skills in students who had access to the Physiotherapy eSkills Training Online resource in addition to usual teaching. Students considered the resource to be very useful for learning.

Background

In the world of technology, when today's student is approaching the on-line /distance learning in the open universities and doing on-line self-assessment, the classroom learning is vanishing slowly. Globally, teachers are taking efforts to improve the pedagogy by implementing effective methods to retain the classroom teaching and student attendance. The present study aims at shedding some light on the need of changing the adult education strategies (andragogy), which can effectively improve the student attendance for lectures.

Methods

It is an observational study, and the conceptual framework of it is based on beliefs, opinions and personal experiences of the respondents. Triangulation method is used for collecting the data. The data is achieved from three groups of concerned population who could provide valid results to support the study. It is collected by interviewing 10 senior faculty members who are/were the 'education experts' in the universities, while the main concerned groups of present educational stream, i.e. 'institution-teachers' and the 'students', were given questionnaires. 570 teacher respondents and 200 student respondents are the main participants of this study.

Results

As per data, it has been observed that senior faculty (90%) and students (93.25%) feel need of student motivation more than the institutional teachers (52.44%). P-values were obtained using Chi-Square test for testing the significance of difference between agreement and disagreement for a specific question.

Conclusions

In India, Universities have already sensed the need of 'teacher development programmes'. But teachers in dental colleges, demand more efforts to be taken by universities and managements in this regard and expect better educational policies to give them accessibility to prove themselves.

Background

In medical training, statistics is considered a very difficult course to learn and teach. Current studies have found that students’ attitudes toward statistics can influence their learning process. Measuring, evaluating and monitoring the changes of students’ attitudes toward statistics are important. Few studies have focused on the attitudes of postgraduates, especially medical postgraduates. Our purpose was to understand current attitudes regarding statistics held by medical postgraduates and explore their effects on students’ achievement. We also wanted to explore the influencing factors and the sources of these attitudes and monitor their changes after a systematic statistics course.

Methods

A total of 539 medical postgraduates enrolled in a systematic statistics course completed the pre-form of the Survey of Attitudes Toward Statistics −28 scale, and 83 postgraduates were selected randomly from among them to complete the post-form scale after the course.

Results

Most medical postgraduates held positive attitudes toward statistics, but they thought statistics was a very difficult subject. The attitudes mainly came from experiences in a former statistical or mathematical class. Age, level of statistical education, research experience, specialty and mathematics basis may influence postgraduate attitudes toward statistics. There were significant positive correlations between course achievement and attitudes toward statistics. In general, student attitudes showed negative changes after completing a statistics course.

Conclusions

The importance of student attitudes toward statistics must be recognized in medical postgraduate training. To make sure all students have a positive learning environment, statistics teachers should measure their students’ attitudes and monitor their change of status during a course. Some necessary assistance should be offered for those students who develop negative attitudes.

Background

Estimation of pharmacokinetic parameters after intermittent intravenous infusion (III) of antibiotics, such as aminoglycosides or vancomycin, has traditionally been a difficult subject for students in clinical pharmacology or pharmacokinetic courses. Additionally, samples taken at different intervals during repeated dose therapy require manipulation of sampling times before accurate calculation of the patient-specific pharmacokinetic parameters. The main goal of this study was to evaluate the effectiveness of active learning tools and practice opportunities on the ability of students to estimate pharmacokinetic parameters from the plasma samples obtained at different intervals following intermittent intravenous infusion.

Methods

An extensive reading note, with examples, and a problem case, based on a patient’s chart data, were created and made available to students before the class session. Students were required to work through the case before attending the class. The class session was devoted to the discussion of the case requiring active participation of the students using a random participation program. After the class, students were given additional opportunities to practice the calculations, using online modules developed by the instructor, before submitting an online assignment.

Results

The performance of students significantly (P < 0.001) improved from a baseline of 11.3% (pretest) to 60.3% (posttest) after the class discussion. The grades of students further improved (P < 0.001) to 89.3% on the take-home assignment after they had a chance to study on their own and work on the online practices. Finally, students scored 82.6% in a formal mid-term examination, suggesting significant retention of the materials.

Conclusions

Despite being a difficult subject, students achieve mastery of pharmacokinetic calculations for the topic of intermittent intravenous infusion when appropriate active learning strategies and practice opportunities are employed.

Background

Many studies have explored approaches to learning in medical school, mostly in the classroom setting. In the clinical setting, students face different conditions that may affect their learning. Understanding students’ approaches to learning is important to improve learning in the clinical setting. The aim of this study was to evaluate the Study Process Questionnaire (SPQ) as an instrument for measuring clinical learning in medical education and also to show whether learning approaches vary between rotations.

Methods

All students involved in this survey were undergraduates in their clinical phase. The SPQ was adapted to the clinical setting and was distributed in the last week of the clerkship rotation. A longitudinal study was also conducted to explore changes in learning approaches.

Results

Two hundred and nine students participated in this study (response rate 82.0%). The SPQ findings supported a two-factor solution involving deep and surface approaches. These two factors accounted for 45.1% and 22.5%, respectively, of the variance. The relationships between the two scales and their subscales showed the internal consistency and factorial validity of the SPQ to be comparable with previous studies. The clinical students in this study had higher scores for deep learning. The small longitudinal study showed small changes of approaches to learning with different rotation placement but not statistically significant.

Conclusions

The SPQ was found to be a valid instrument for measuring approaches to learning among clinical students. More students used a deep approach than a surface approach. Changes of approach not clearly occurred with different clinical rotations.

Background

Transformation of medical students to become medical professionals is a core competency required for physicians in the 21st century. Role modeling was traditionally the key method of transmitting this skill. Medical schools are developing medical curricula which are explicit in ensuring students develop the professional competency and understand the values and attributes of this role. The purpose of this study was to determine student perception of professionalism at the University of Ottawa and gain insights for improvement in promotion of professionalism in undergraduate medical education.

Methods

Survey on student perception of professionalism in general, the curriculum and learning environment at the University of Ottawa, and the perception of student behaviors, was developed by faculty and students and sent electronically to all University of Ottawa medical students. The survey included both quantitative items including an adapted Pritzker list and qualitative responses to eight open ended questions on professionalism at the Faculty of Medicine, University of Ottawa. All analyses were performed using SAS version 9.1 (SAS Institute Inc. Cary, NC, USA). Chi-square and Fischer’s exact test (for cell count less than 5) were used to derive p-values for categorical variables by level of student learning.

Results

The response rate was 45.6% (255 of 559 students) for all four years of the curriculum. 63% of the responses were from students in years 1 and 2 (preclerkship). Students identified role modeling as the single most important aspect of professionalism. The strongest curricular recommendations included faculty-led case scenario sessions, enhancing interprofessional interactions and the creation of special awards to staff and students to “celebrate” professionalism. Current evaluation systems were considered least effective. The importance of role modeling and information on how to report lapses and breaches was highlighted in the answers to the open ended questions.

Conclusions

Students identify the need for strong positive role models in their learning environment, and for effective evaluation of the professionalism of students and teachers. Medical school leaders must facilitate development of these components within the MD education and faculty development programs as well as in clinical milieus where student learning occurs.

Background

The use of anonymous audience response technology (ART) to actively engage students in classroom learning has been evaluated positively across multiple settings. To date, however, there has been no empirical evaluation of the use of individualised ART handsets and formative feedback of ART scores. The present study investigates student perceptions of such a system and the relationship between formative feedback results and exam performance.

Methods

Four successive cohorts of Non-Medical Prescribing students (n=107) had access to the individualised ART system and three of these groups (n=72) completed a questionnaire about their perceptions of using ART. Semi-structured interviews were carried out with a purposive sample of seven students who achieved a range of scores on the formative feedback. Using data from all four cohorts of students, the relationship between mean ART scores and summative pharmacology exam score was examined using a non-parametric correlation.

Results

Questionnaire and interview data suggested that the use of ART enhanced the classroom environment, motivated students and promoted learning. Questionnaire data demonstrated that students found the formative feedback helpful for identifying their learning needs (95.6%), guiding their independent study (86.8%), and as a revision tool (88.3%). Interviewees particularly valued the objectivity of the individualised feedback which helped them to self-manage their learning. Interviewees’ initial anxiety about revealing their level of pharmacology knowledge to the lecturer and to themselves reduced over time as students focused on the learning benefits associated with the feedback.

A significant positive correlation was found between students’ formative feedback scores and their summative pharmacology exam scores (Spearman’s rho = 0.71, N=107, p<.01).

Conclusions

Despite initial anxiety about the use of individualised ART units, students rated the helpfulness of the individualised handsets and personalised formative feedback highly. The significant correlation between ART response scores and student exam scores suggests that formative feedback can provide students with a useful reference point in terms of their level of exam-readiness.

Background

During clinical placements, clinical educators facilitate student learning. Previous research has defined the skills, attitudes and practices that pertain to an ideal clinical educator. However, less attention has been paid to the role of student readiness in terms of foundational knowledge and attitudes at the commencement of practice education. Therefore, the aim of this study was to ascertain clinical educators’ views on the characteristics that they perceive demonstrate that a student is well prepared for clinical learning.

Methods

A two round on-line Delphi study was conducted. The first questionnaire was emailed to a total of 636 expert clinical educators from the disciplines of occupational therapy, physiotherapy and speech pathology. Expert clinical educators were asked to describe the key characteristics that indicate a student is prepared for a clinical placement and ready to learn. Open-ended responses received from the first round were subject to a thematic analysis and resulted in six themes with 62 characteristics. In the second round, participants were asked to rate each characteristic on a 7 point Likert Scale.

Results

A total of 258 (40.56%) responded to the first round of the Delphi survey while 161 clinical educators completed the second (62.40% retention rate). Consensus was reached on 57 characteristics (six themes) using a cut off of greater than 70% positive respondents and an interquartile deviation IQD of equal or less than 1.

Conclusions

This study identified 57 characteristics (six themes) perceived by clinical educators as indicators of a student who is prepared and ready for clinical learning. A list of characteristics relating to behaviours has been compiled and could be provided to students to aid their preparation for clinical learning and to universities to incorporate within curricula. In addition, the list provides a platform for discussions by professional bodies about the role of placement education.