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1.  A "T-index" for the evaluation of teaching performance of medical university staff? 
Medical Teacher  2013;35(5):425.
PMCID: PMC3984142  PMID: 23464898
Employee Performance Appraisal; methods; Faculty, Medical; Humans; Teaching
2.  Just enough, but not too much interactivity leads to better clinical skills performance after a computer assisted learning module 
Medical teacher  2012;34(10):10.3109/0142159X.2012.706727.
Well-designed computer-assisted instruction (CAI) can potentially transform medical education. Yet little is known about whether specific design features such as direct manipulation of the content yield meaningful gains in clinical learning. We designed three versions of a multimedia module on the abdominal exam incorporating different types of interactivity.
As part of their physical diagnosis course, 162 second-year medical students were randomly assigned (1:1:1) to Watch, Click or Drag versions of the abdominal exam module. First, students’ prior knowledge, spatial ability, and prior experience with abdominal exams were assessed. After using the module, students took a posttest; demonstrated the abdominal exam on a standardized patient; and wrote structured notes of their findings.
Data from143 students were analyzed. Baseline measures showed no differences among groups regarding prior knowledge, experience, or spatial ability. Overall there was no difference in knowledge across groups. However, physical exam scores were significantly higher for students in the Click group.
A mid-range level of behavioral interactivity was associated with small to moderate improvements in performance of clinical skills. These improvements were likely mediated by enhanced engagement with the material, within the bounds of learners’ cognitive capacity. These findings have implications for the design of CAI materials to teach procedural skills.
PMCID: PMC3826788  PMID: 22917265
3.  Optimal learning in a virtual patient simulation of cranial nerve palsies: The interaction between social learning context and student aptitude 
Medical teacher  2012;35(1):e876-e884.
Simulation in medical education provides students with opportunities to practice interviews, examinations, and diagnosis formulation related to complex conditions without risks to patients.
To examine differences between individual and team participation on learning outcomes and student perspectives through use of virtual patients (VPs) for teaching cranial nerve (CN) evaluation.
Fifty-seven medical students were randomly assigned to complete simulation exercises either as individuals or as members of three-person teams. Students interviewed, examined, and diagnosed VPs with possible CN damage in the Neurological Exam Rehearsal Virtual Environment (NERVE). Knowledge of CN abnormalities was assessed pre- and post-simulation. Student perspectives of system usability were evaluated post-simulation.
An aptitude-treatment interaction (ATI) effect was detected; at pre-test scores ≤50%, students in teams scored higher (83%) at post-test than did students as individuals (62%, p = 0.02). Post-simulation, students in teams reported greater confidence in their ability to diagnose CN abnormalities than did students as individuals (p = 0.02; mean rating = 4.0/5.0 and 3.4/5.0, respectively).
The ATI effect allows us to begin defining best practices for the integration of VP simulators into the medical curriculum. We are persuaded to implement future NERVE exercises with small teams of medical students.
PMCID: PMC3770843  PMID: 22938679
4.  Medical education: Changes and perspectives 
Medical Teacher  2013;35(8):621-627.
As medical education undergoes significant internationalization, it is important for the medical education community to understand how different countries structure and provide medical education. This article highlights the current landscape of medical education in China, particularly the changes that have taken place in recent years. It also examines policies and offers suggestions about future strategies for medical education in China. Although many of these changes reflect international trends, Chinese medical education has seen unique transformations that reflect its particular culture and history.
PMCID: PMC3741015  PMID: 23631405
5.  Admission selection criteria as predictors of outcomes in an undergraduate medical course: A prospective study 
Medical Teacher  2011;33(12):997-1004.
In 1998, a new selection process which utilised an aptitude test and an interview in addition to previous academic achievement was introduced into an Australian undergraduate medical course.
To test the outcomes of the selection criteria over an 11-year period.
1174 students who entered the course from secondary school and who enrolled in the MBBS from 1999 through 2009 were studied in relation to specific course outcomes. Regression analyses using entry scores, sex and age as independent variables were tested for their relative value in predicting subsequent academic performance in the 6-year course. The main outcome measures were assessed by weighted average mark for each academic year level; together with results in specific units, defined as either ‘knowledge'-based or ‘clinically’ based.
Previous academic performance and female sex were the major independent positive predictors of performance in the course. The interview score showed positive predictive power during the latter years of the course and in a range of ‘clinically' based units. This relationship was mediated predominantly by the score for communication skills.
Results support combining prior academic achievement with the assessment of communication skills in a structured interview as selection criteria into this undergraduate medical course.
PMCID: PMC3267525  PMID: 21592024
6.  Personality Testing May Improve Resident Selection in Anesthesiology Programs 
Medical teacher  2009;31(12):e551-e554.
Current methods of selecting future residents for anesthesiology training programs do not adequately distinguish those who will succeed from the pool of seemingly well-qualified applicants. Some residents, despite high exam scores, may struggle in the OR in stressful situations.
This study examined whether specific neuropsychological and personality measures can distinguish high competency residents from low competency residents to aid in resident selection.
25 residents enrolled in an anesthesiology program at a major academic institution were identified for participation. 13 were evaluated identified as “high competency” residents and 12 as “low competency ” by the department's clinical competency committee. Groups were evaluated on measures of fine motor dexterity, executive functioning, processing speed, attention, and personality using IPIP-NEO.
There were no significant differences between groups on measures of fine-motor dexterity, executive functioning, processing speed, or attention. High competency residents scored significantly higher than low competency residents on measures of cooperation, self-efficacy, and adventurousness, and lower on measures of neuroticism, anxiety, anger, and vulnerability.
Although measures of fine-motor dexterity, executive functioning, processing speed, and attention do not appear to distinguish between high- and low competency residents in anesthesiology, specific personality characteristics may be associated with future success in an anesthesiology training program.
PMCID: PMC2861414  PMID: 19995155
7.  Twelve tips for teaching diversity and embedding it in the medical curriculum 
Medical teacher  2009;31(11):990-993.
Despite growing recognition of the need to increase cultural diversity undergraduate education in the UK, the US and Canada, there is a lack of cohesion in the development and delivery of cultural diversity teaching in medical schools in these three countries. This article highlights 12 tips for developing cultural diversity education in undergraduate medical programmes by integrating it in institutional policies, curriculum content, faculty development and assessment. These tips can be used to help ensure that students gain needed knowledge, skills and attitudes consistent with a view of patients as complex individuals with unique needs.
PMCID: PMC2967223  PMID: 19909038
8.  Does medical student knowledge of anticoagulation differ by future intended practice? 
Medical teacher  2010;32(10):857-859.
The scope of medical student knowledge may differ by the student’s future intended specialty.
To determine whether medical student knowledge of and confidence with anticoagulation differed by perceived likelihood of managing anticoagulation in future practice.
One hundred twenty-three third and fourth year medical students (41% response rate) participated in a cross-sectional web-based survey. We assessed whether perceived likelihood of managing anticoagulation in future intended practice was associated with anticoagulation knowledge and confidence with managing anticoagulation.
Measurements and Main Results
Out of 24 questions assessing anticoagulation knowledge, the mean percentage correct was 58% (SD 29%). Anticoagulation knowledge did not differ by perceived likelihood of managing anticoagulation as part of their future practice. However, students predicting higher likelihood of managing anticoagulation in their future practice were significantly more confident about their ability to manage anticoagulation (p=0.005).
Using anticoagulation as a model, we did not find evidence that medical student knowledge differed by perceived scope of future practice. Future study will need to confirm whether range and depth of medical knowledge differs by medical students intended future practice and specialties.
PMCID: PMC2946377  PMID: 20854163
9.  The educational impact of assessment: A comparison of DOPS and MCQs 
Medical Teacher  2013;35(11):e1598-e1607.
To evaluate the impact of two different assessment formats on the approaches to learning of final year veterinary students. The relationship between approach to learning and examination performance was also investigated.
An 18-item version of the Study Process Questionnaire (SPQ) was sent to 87 final year students. Each student responded to the questionnaire with regards to DOPS (Direct Observation of Procedural Skills) and a Multiple Choice Examination (MCQ). Semi-structured interviews were conducted with 16 of the respondents to gain a deeper insight into the students’ perception of assessment.
Students’ adopted a deeper approach to learning for DOPS and a more surface approach with MCQs. There was a positive correlation between an achieving approach to learning and examination performance. Analysis of the qualitative data revealed that deep, surface and achieving approaches were reported by the students and seven major influences on their approaches to learning were identified: motivation, purpose, consequence, acceptability, feedback, time pressure and the individual difference of the students.
The format of DOPS has a positive influence on approaches to learning. There is a conflict for students between preparing for final examinations and preparing for clinical practice.
PMCID: PMC3809925  PMID: 23808609
10.  Twelve tips for designing and running longitudinal integrated clerkships 
Medical Teacher  2013;35(12):989-995.
Longitudinal integrated clerkships (LICs) involve learners spending an extended time in a clinical setting (or a variety of interlinked clinical settings) where their clinical learning opportunities are interwoven through continuities of patient contact and care, continuities of assessment and supervision, and continuities of clinical and cultural learning. Our twelve tips are grounded in the lived experiences of designing, implementing, maintaining, and evaluating LICs, and in the extant literature on LICs. We consider: general issues (anticipated benefits and challenges associated with starting and running an LIC); logistical issues (how long each longitudinal experience should last, where it will take place, the number of learners who can be accommodated); and integration issues (how the LIC interfaces with the rest of the program, and the need for evaluation that aligns with the dynamics of the LIC model). Although this paper is primarily aimed at those who are considering setting up an LIC in their own institutions or who are already running an LIC we also offer our recommendations as a reflection on the broader dynamics of medical education and on the priorities and issues we all face in designing and running educational programs.
PMCID: PMC3836395  PMID: 23883396
11.  Developing questionnaires for educational research: AMEE Guide No. 87 
Medical Teacher  2014;36(6):463-474.
In this AMEE Guide, we consider the design and development of self-administered surveys, commonly called questionnaires. Questionnaires are widely employed in medical education research. Unfortunately, the processes used to develop such questionnaires vary in quality and lack consistent, rigorous standards. Consequently, the quality of the questionnaires used in medical education research is highly variable. To address this problem, this AMEE Guide presents a systematic, seven-step process for designing high-quality questionnaires, with particular emphasis on developing survey scales. These seven steps do not address all aspects of survey design, nor do they represent the only way to develop a high-quality questionnaire. Instead, these steps synthesize multiple survey design techniques and organize them into a cohesive process for questionnaire developers of all levels. Addressing each of these steps systematically will improve the probabilities that survey designers will accurately measure what they intend to measure.
PMCID: PMC4059192  PMID: 24661014

Results 1-11 (11)