Undergraduate medical education: a national survey of consultant radiologists

OBJECTIVE

Rising clinical demand and changes to Radiologists' job plans mean it is becoming ever more difficult for Radiologists to teach medical students.The aim of this study was to assess the current role of Radiologists in undergraduate medical education in Scotland.

METHODS

Consultant Radiologists working across all 14 Scottish Health Boards were invited by email to participate in an anonymous short online survey. The survey ran for 6 weeks from November 2019. One reminder email was sent a week before the survey closed.

RESULTS

102 responses were recorded, representing 34% of the total whole time equivalent Radiologists in Scotland. All agreed Radiology should be taught to medical students. Over 70% (n = 73) taught medical students, most often during supporting professional activity time. 76 percent of Radiologists who did not teach expressed a desire to do so. The most common barrier to teaching was not having enough time in their job plan. Scottish Radiologists delivered a median of 10 h (IQR 0-22) a year of teaching to medical students. Thematic analysis of free comments revealed staffing/time constraints severely limiting ability to teach.

CONCLUSION

This is the first national survey to assess the current role of Radiologists in teaching medical students. While most are teaching or want to teach, there is a large drop-off between current Scottish and previously reported UK median teaching hours. Engagement from Universities, Royal College of Radiologists and Health Boards is urgently needed to reverse this trend.

ADVANCES IN KNOWLEDGE

This is the first national survey into the current role of Radiologists in undergraduate medical education. There is a large drop-off between current Scottish and previously reported UK median teaching hours.

Longitudinal team training programme in a Norwegian surgical ward: a qualitative study of nurses' and physicians' experiences with teamwork skills

OBJECTIVES

Teamwork and interprofessional team training are fundamental to ensuring the continuity of care and high-quality outcomes for patients in a complex clinical environment. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based team training programme intended to facilitate healthcare professionals' teamwork skills. The aim of this study is to describe healthcare professionals' experiences with teamwork in a surgical ward before and during the implementation of a longitudinal interprofessional team training programme.

DESIGN

A qualitative descriptive study based on follow-up focus group interviews.

SETTING

A combined gastrointestinal surgery and urology ward at a hospital division in a Norwegian hospital trust.

PARTICIPANTS

A convenience sample of 11 healthcare professionals divided into three professionally based focus groups comprising physicians (n=4), registered nurses (n=4) and certified nursing assistants (n=3).

INTERVENTIONS

The TeamSTEPPS programme was implemented in the surgical ward from May 2016 to June 2017. The team training programme included the three phases: (1) assessment and planning, (2) training and implementation and (3) sustainment.

RESULTS

Before implementing the team training programme, healthcare professionals were essentially satisfied with the teamwork skills within the ward. During the implementation of the programme, they experienced that team training led to greater awareness and knowledge of their common teamwork skills. Improved teamwork skills were described in relation to a more systematic interprofessional information exchange, consciousness of leadership-balancing activities and resources, the use of situational monitoring tools and a shared understanding of accountability and transparency.

CONCLUSIONS

This study suggests that the team training programme provides healthcare professionals with a set of tools and terminology that promotes a common understanding of teamwork, hence affecting behaviour and communication in their daily clinical practice at the surgical ward.

TRIAL REGISTRATION NUMBER

ISRCTN13997367.

Pharmacy educators' views on graduate attributes and case-based learning in an undergraduate degree

BACKGROUND AND PURPOSE

The nature, form, and process of activating graduate attributes is an expanding research focus within the field of professional education. The focus on graduate capabilities has led to higher education institutions interrogating current curricula practices with a view to exploring innovative ways to transform curricula and pedagogy. This article explores pharmacy educators' views on which graduate attributes are important and investigates the role of case-based learning (CBL) in developing graduate attributes in a single university program.

EDUCATIONAL ACTIVITY AND SETTING

This qualitative study is based on data drawn from reflective interviews with pharmacy educators on graduate attributes and from document analysis. Data were analyzed against a framework of graduate attributes and grouped into three domains encompassing knowledge and action as well as construction of graduates' identities as members of a profession.

FINDINGS

The graduate attributes identified by pharmacy educators resonated with the extant literature, organizational policy documents, and the professional council's accreditation framework. The domains of knowledge (Domain 1) and possessing and displaying (Domain 2) are sufficiently addressed in the curriculum. However, engagement with identity construction and roles and responsibilities (Domain 3) appears to be relatively less-developed through CBL.

SUMMARY

While CBL in its current form exhibits limitations with regard to developing Domain 3, it has the potential to develop this through emotionally rich cases, role models, and greater integration of CBL and inter-professional education (IPE) as well as making graduate attributes more explicit within the curriculum.

The Current Landscape of College-Sponsored Postgraduate Teaching and Learning Curriculum Programs

Objective. To describe the landscape of teaching and learning curriculum (TLC) programs sponsored by US schools and colleges of pharmacy and evaluate their adoption of best practice recommendations. Methods. A 28-item electronic survey instrument was developed based on best practice recommendations published by the American Association of Colleges of Pharmacy (AACP), American Society of Health-System Pharmacists (ASHP), and American College of Clinical Pharmacy (ACCP) for the conduct of TLC programs. The survey instrument was electronically distributed to 137 accredited colleges and schools of pharmacy in the United States. Results. Eighty-eight institutions responded, resulting in a response rate of 64%. Sixty-one TLC programs were included in the final analysis. Seventy-five percent of TLC programs reported using best practice recommendations; however, 10% of respondents indicated they were not aware of the published recommendations. Inconsistencies among programs were noted in required teaching experiences, participant evaluation, and ongoing programmatic assessment. Conclusion. Most institutions offering TLC programs are aware of published best practice guidelines and have adopted a majority of the published best practices. However, considerable variability exists across the country. Development of a formal external validation process for TLC programs is necessary to ensure consistent quality.

Woman to Woman: Implementation of a Cervical Cancer Education Training Program for Grenadian Lay Health Advisors

The reduction in cervical cancer (CC) in developed countries, due mainly to Pap testing, has not filtered down to Caribbean countries including Grenada despite accessible screening. This is attributed to a lack of knowledge and low screening. Researchers in low resource settings successfully trained lay health advisors (LHAs), using theory-based, culturally relevant interventions to reverse this trend. The use of LHAs in Grenada was not documented in the literature; therefore, the purpose of this study was to implement and evaluate a culturally relevant curriculum in an effort to educate Grenadian LHAs on CC. Using convenience sampling, 8 Grenadian women were recruited from the parishes with the highest rates of CC. They participated in Woman to Woman (W2W), a 2-day CC, and human papilloma virus (HPV) prevention education program facilitated by local content experts. W2W was adapted from an evidence-based curriculum and tailored for the Grenadian context. Training consisted of modules on CC and HPV. Knowledge of LHAs was measured pre- and post-intervention. Summative evaluation was assessed using a focus group discussion. There was a significant increase in CC knowledge among LHA post-training (p < 0.05) and LHAs had positive opinions about the intervention. They had an enhanced sense of self-efficacy and valued feeling part of a team. The W2W results indicated that an evidence-based and culturally tailored educational intervention has the potential for significant gains in CC and HPV knowledge. Future research will evaluate the LHA-led CC and HPV educational intervention in the community setting.

Teaching motivational interviewing in a blended learning environment

BACKGROUND AND PURPOSE

To describe the implementation of blended learning in teaching motivational interviewing (MI) to third-year pharmacy students and evaluate changes in MI knowledge by assessing students' abilities to recognize and formulate responses using MI skills after the training and, for a subset of students, one year later.

EDUCATIONAL ACTIVITY AND SETTING

The comMIt e-learning program was integrated into a third-year pharmacy communication course. Skills learned in the program were applied and assessed using e-learning quizzes, three in-class practice sessions and a 5-minute final assessment video. In addition, students completed a 22-item pre- and post-survey addressing their abilities to recognize and formulate statements using MI skills. This survey was voluntarily completed again one year later.

FINDINGS

Sixty students completed the training and showed a statistically significant improvement between the pre- and post-surveys. Twenty-seven students voluntarily responded to the survey one year later. While overall performance dropped between the post-survey and the one-year follow-up, students sustained their ability to formulate appropriate MI responses to the open-response questions.

SUMMARY

This study demonstrates that students can successfully learn and retain MI skills using blended learning via the comMIt e-learning program and in-class practice activities.

Building Capacity for Caregiver Education in Yap, Micronesia

The US Affiliated Pacific Islands have an urgent need for family caregiver education to prevent caregiver burnout and strengthen the existing culture where seniors are cared for at home by their families. The Pacific Islands Geriatric Education Center conducted a 32-hour family caregiver train-thetrainer workshop in partnership with the Yap Department of Health Services and the Yap Area Health Education Center (AHEC) from October 16 - 20, 2017. Twenty-seven participants including community health workers, peer educators, health assistants, nurses, and physicians were trained as instructors. Confidence in caregiving increased following the training and feedback was extremely positive. Competence in geriatric syndromes was improved after attending the workshop (P < .001). Lessons from the field revealed an immense value of adding home visits to the training practicum as well as the need to translate caregiving handouts into the outer island languages. Yap AHEC is committed to offering this course as part of caregiver education at the hospital and in the community.

National Survey on Canadian Undergraduate Medical Programs: The Decline of the Anatomical Sciences in Canadian Medical Education

The anatomical sciences have always been regarded as an essential component of medical education. In Canada, the methodology and time dedicated to anatomy teaching are currently unknown. Two surveys were administered to course directors and discipline leaders to gain a comprehensive view of anatomical education in Canadian medical schools. Participants were queried about contact hours (classroom and laboratory), content delivery and assessment methods for gross anatomy, histology, and embryology. Twelve schools responded to both surveys, for an overall response rate of 64%. Overall, Canadian medical students spend 92.8 (± 45.4) hours (mean ± SD) studying gross anatomy, 25.2 (± 21.0) hours for histology, and 7.4 (± 4.3) hours for embryology. Gross anatomy contact hours statistically significantly exceeded those for histology and embryology. Results show that most content is delivered in the first year of medical school, as anatomy is a foundational building block for upper-year courses. Laboratory contact time for gross anatomy was 56.8 (± 30.7) hours, histology was 11.4 (± 16.2) hours, and embryology was 0.25 (± 0.6) hours. Additionally, 42% of programs predominantly used instructor/technician-made prosections, another 33% used a mix of dissection and prosections and 25% have their students complete cadaveric dissections. Teaching is either completely or partially integrated into all Canadian medical curricula. This integration trend in Canada parallels those of other medical schools around the world where programs have begun to decrease contact time in anatomy and increase integration of the anatomical sciences into other courses. Compared to published American data, Canadian schools offer less contact time. The reason for this gap is unknown. Further investigation is required to determine if the amount of anatomical science education within medical school affects students' performance in clerkship, residency and beyond.

Survey of Gross Anatomy Education in China: The Past and the Present

Medical education in mainland China has undergone massive expansion and reforms in the past decades. A nation-wide survey of the five-year clinical medicine programs aimed to examine the course hours, pedagogies, learning resources and teaching staff of anatomy both at present and over the past three decades (1990-1999, 2000-2009, and 2010-2018). The directors or senior teachers from 90 out of the 130 five-year clinical medicine programs were invited to fill out a factual questionnaire by email. Ultimately, sixty-five completed questionnaires were received from 65 different schools. It was found that the total number of gross anatomy course hours has decreased by 11% in the past 30 years and that systematic and regional anatomy have been increasingly taught separately among the surveyed medical schools. Problem-based learning has been adopted in thirty-five (54%) of the surveyed schools, and team-based learning is used in ten (15%) of the surveyed schools. The surveyed schools reported receiving more donated cadavers in recent years, with the average number increasing from 20.67 ± 20.29 in 2000-2009 to 36.10 ± 47.26 in 2010-2018. However, this has not resulted in a decrease in the number of students who needed to share one cadaver (11.85 ± 5.03 in 1990-1999 to 14.22 ± 5.0 in 2010-2018). A decreasing trend regarding the teacher-student ratio (1:25.5 in 2000-2009 to 1:33.2 in 2010-2018) was also reported. The survey demonstrated the historical changes in gross anatomy education in China over the past thirty years.

Medical students' ratings of the relevance and actual implementation of interprofessional education and preferences for teaching formats: comparison by gender and prior education

Objectives: Interprofessional education is becoming increasingly important for collaboration in patient care. In the national context, there are few empirical studies on the assessment of medical students as important stakeholders in their education. Method: Students (N=2,974) participated in a semester-wide online evaluation of the modular curriculum of medicine at the Charité Berlin. Socio-demographic data (including gender, completion of prior education/studies), assessments of the relevance and extent of interprofessional collaboration and preferences for interprofessional education in various teaching formats were collected. Results: In total, data from 1,019 students were included in the evaluation. The relevance of interprofessional collaboration was considered high by medical students. Female students rated the relevance higher than male students. The completion of pre-education (vocational training or study) had no additional influence. The actual implementation of interprofessional education was rated equally low by female and male students. Medical students rated patient-centred, interactive small group formats as particularly suitable for interprofessional education. There were no gender differences, but the effect was more pronounced among students with vocational training. Conclusion: The assessments of female and male students show a large difference between the perceived relevance and the actual implementation of interprofessional collaboration in the modular curriculum of medicine. This study provides an empirical basis for the actual implementation of interprofessional collaboration and students' views on suitable teaching formats for interprofessional education.

Protecting children across borders - child protection in an international context (Germany/Switzerland) as an interprofessional teaching unit

Introduction: Interprofessional collaboration (IPC) in everyday clinical practice is a prerequisite for good patient care but currently this is not sufficiently anchored in the education of health care professionals. Project description: A course on child protection in the interprofessional and international domain was established at the Medical School, University of Freiburg. In this course, students of medicine, nursing science and social work acquire skills for successful interprofessional cooperation. Its participants learn across professional and national borders, not only with but also from and about each other. In this way, they deepen their insights into international IPC through a key topic that is relevant to many disciplines. The course is run as a one-day campus day. This paper presents the course setup and evaluation results. Methods: The evaluation was carried out online and in writing in a before and after format using the Freiburg Questionnaire for Interprofessional Learning Evaluation (FILE) in addition to oral feedback. Learning objectives for IPC and child protection were formulated and the participants were asked about their subjective achievements. Results: From summer semester (SuSe) 2017 to SuSe 2018, 39 participants took part in the course. It was rated as m=1.5 (using German school grades where 1=very good, 6=unsatisfactory). In 18 of the 26 FILE items, participants report a self-assessed increase in knowledge or skills/abilities. This growth in learning coincides with the learning objectives set. Discussion & conclusion: From the perspective of the participants, the course teaches interprofessional competencies in an international setting and is seen as an informative course offer. The continuation or expansion of such courses as a supplement to purely single-country interprofessional courses is desirable.

Assessment of structured classroom debate to teach an antimicrobial stewardship elective course

BACKGROUND AND PURPOSE

The main aim of this study was to evaluate the effect of a structured classroom debate format on teaching antimicrobial stewardship.

EDUCATIONAL ACTIVITY AND SETTING

An active learning approach using a debate format was implemented to engage students in infectious diseases concepts to further develop critical thinking skills. This was a one-group, pre- and posttest design conducted in third year pharmacy students enrolled at the Philadelphia College of Osteopathic Medicine School of Pharmacy Georgia campus. A ten-item assessment survey was used prior to and after the course to evaluate student knowledge. Student perception of skill development was assessed by a survey using a five-point Likert scale. The skills assessed included critical thinking, communication, public speaking, research/drug information, and teamwork.

FINDINGS

Thirty-three students participated in the six debates over the course of the semester. There was a statistically significant increase in post-knowledge assessment mean score (75%) compared to pre-knowledge assessment mean score (45%). The post-course survey showed improved confidence in perception of skills in all of the areas assessed.

SUMMARY

The structured classroom debate format has a positive association with increasing students' knowledge level and perception of skills assessed.

The Decline in Community Preceptor Teaching Activity: Exploring the Perspectives of Pediatricians Who No Longer Teach Medical Students

PURPOSE

Difficulty in recruiting and retaining community preceptors for medical student education has been described in the literature. Yet little, if any, information is known about community outpatient preceptors who have stopped or decreased teaching time with students. This study aimed to examine these preceptors' perspectives about this phenomenon.

METHOD

Using a phenomenology framework, this multi-institutional qualitative study used semistructured interviews with community pediatric preceptors who had stopped or reduced teaching time with medical students. Interviews were conducted between October 2017 and January 2018 and transcribed verbatim. Interviews explored factors for engaging in teaching, or decreasing or ceasing teaching, that would enable future teaching. An initial code book was developed and refined as data were analyzed to generate themes.

RESULTS

Twenty-seven community pediatricians affiliated with 10 institutions participated. Thirty-seven codes resulted in 4 organizing themes: evolution of health care, personal barriers, educational system, and ideal situations to recruit and retain preceptors, each with subthemes.

CONCLUSIONS

From the viewpoints of physicians who had decreased or stopped teaching students, this study more deeply explores previously described reasons contributing to the decline of community preceptors, adds newly described barriers, and offers strategies to help counter this phenomenon based on preceptors' perceptions. These findings appear to be manifestations of deeper issues including the professional identify of clinical educators. Understanding the barriers and strategies and how they relate to preceptors themselves should better inform education leaders to more effectively halt the decline of community precepting and enhance the clinical precepting environment for medical students.

Does a novel teaching approach work? A Students' perspective

BACKGROUND

There is always a call for educational reform and further research to improve educational programs. The continuous development of new educational approaches is a work in progress. Educational strategies like team-based learning, flipped classroom, and lottery-based token economy, were used to develop a novel teaching approach.

AIM

This study had two major goals. The first goal was to introduce a novel teaching approach in professional healthcare academies. The second goal was to get an in-depth understanding, from the students' perspective, about the benefits and limitations of this new teaching approach.

METHOD

The study was conducted using a qualitative, phenomenological research design. Third and fourth-year nursing students completed reflective journals to describe their personal experience with the new teaching approach at the end of the semester. The students' responses were analyzed and coded using Kember's four-category coding schema for reflective writing, to extract themes using thematic analysis.

FINDINGS

Seventy-five students completed and returned their reflective journals. The analysis showed various challenges and facilitators/benefits of the students' experiences. The themes that emerged from the analysis were: lack of exposure vs. a sense of achievement; lack of teamwork skills vs. role fulfillment; working with new people vs. conflict resolution; variation vs. collaboration/creativity; time management vs. constructive competition; wasting resources vs. flexibility, and proactivity/active engagement. These themes summarized why the new teaching approach worked and what barriers students faced with the new assembly.

CONCLUSION

Results from the current study demonstrated the great potential of the new teaching approach. Recommendations for future research were also discussed.

Qualitative Analysis of the Impact of Changes to the Student Evaluation of Teaching Process

Objective. To determine how changes to the student evaluation of teaching (SET) survey instrument and process at a college of pharmacy contributed to improved student response rates and to understand how the process could be further refined. Methods. Pharmacy students from the class of 2018 who had participated in both the old and new SET process were recruited to participate in one of four focus group interviews. An inductive approach was used for data collection and analysis. A focus group guide was created based on two major domains: comparing changes between the old and new SET process and survey form, and determining how the new SET process could be further refined. Results. In South Jordan, UT, six students participated in one of the focus groups and seven students participated in the other focus group. In Henderson, NV, seven students participated in each of the two focus groups. Twenty-seven total students participated in the four focus groups across two campuses. Students stated that reducing the number of questions on each SET survey instrument and using a 5-point rather than a 10-point Likert scale were positive changes. The changes also motivated them to complete the surveys, which improved overall response rates. Although students reported that the monetary incentive (contributions toward the cost of the class banquet) that had been added to the new SET process was a strong motivator, the incentive itself would have likely been insufficient without the other changes. Several participants stated that receiving feedback from faculty members on changes made to teaching materials based upon previous student evaluations was also an important motivator for students to continue completing the surveys. Conclusion. Students identified several motivators for SET participation. Improving the process for survey completion is essential to improve response rates to more accurately represent the feedback of the entire student body. Additionally, the evaluation process must ensure that the data gathered are robust, accurate, and insightful, to be of good use of student and faculty time.

Feedback in medical education - a workshop report with practical examples and recommendations

Background: As a teaching method, feedback is an integral part of medical education. However, there is a lack of a uniform theoretical basis or generally recognized guidelines for its specific design. Against this background, the aim of this article is to discuss conceptual considerations and empirical findings regarding feedback using various practical examples. Procedure and conceptual considerations: Building on the results of a workshop of the Committee for Communicative and Social Competences of the Society for Medical Education (GMA), this article first explains central conceptual considerations and empirical results on the topic of feedback. A particular focus is on various variables that influence the effect of feedback. This includes the feedback source, the frequency of feedback, starting points of feedback, the connection between feedback and reflection as well as the motivation and meta-cognitive skills of the feedback recipient. Practical examples: The implementation of feedback in practice is illustrated using eight examples from the field of medical and dental education. They stem from various settings and the focus is on formative oral feedback. It will become evident that the focus is more on the givers of feedback than the recipients of feedback. Instructions for recipients of feedback on how to reflect on it is still the exception. Discussion: Many of the relevant aspects for the effect of feedback described in the literature are already taken into account in the practical examples discussed. In conclusion, seven recommendations are made for implementing feedback in practice.

What Makes the "Perfect" Inpatient Consultation? A Qualitative Analysis of Resident and Fellow Perspectives

PURPOSE

To characterize the methods of inpatient consult communication, given new communication modalities; to explore residents' and fellows' perspectives on the ideal consult and how this consult could affect their teaching, learning, and patient safety; and to identify barriers to and strategies for optimizing consultations.

METHOD

Using qualitative grounded theory, the authors conducted semistructured focus groups with pediatric residents and fellows at Lucile Packard Children's Hospital at Stanford University from October 2016 to September 2017, using questions developed by expert consensus to address study objectives. Sessions were audiorecorded and transcribed verbatim. Two authors independently coded the transcripts and reconciled codes to develop categories and themes using constant comparison. The third author validated the codes, categories, and themes. To ensure trustworthiness, participants edited the themes for accuracy.

RESULTS

Twenty-seven residents and 16 fellows participated in 7 focus groups (3 with residents, 4 with fellows). Four themes emerged: (1) Many forms of communication are successfully used for initial inpatient consult recommendations (in person, phone, text messages, notes in electronic medical records); (2) residents and fellows prefer in-person communication for consults, believing it leads to improved teaching, learning, and patient safety; (3) multiple strategies can optimize consults regardless of communication modality; and (4) how residents frame the initial consult affects the interaction and can increase fellow engagement, which leads to more fellow teaching, residents' improved understanding, and better patient care.

CONCLUSIONS

Residents and fellows believe that structured initial consults conducted in person improve teaching, learning, and patient care. Several strategies exist to optimize this process.

Implementing a Wearable Sensor for Lymphedema Garments: A Prospective Study of Training Effectiveness

Lymphedema garments apply therapeutic pressure to maintain minimum leg volume. Practitioners and patients apply these garments and seek to achieve appropriate compression pressure "by feel."

PURPOSE

A study was conducted to assess the feasibility of applying a sensor-feedback device to train staff to accurately apply garments.

METHODS

A convenience sample of wound care and rehabilitation staff volunteered for a prospective, randomized, unblinded, single-center pilot study. Participants were randomized to instruction+feedback (ie, receiving training on compression application and using the device to determine whether they achieved desired pressure) or instruction only groups (n = 6 each). Each volunteer applied hook-and-loop closures on the author's leg pre- and post-training with a target of 35 mm Hg, or |Ppre- 35|= |Ppost- 35|=0. (|P| is absolute value of P). The feedback group used a device to measure the applied compression; the device consists of a capacitive sensor of thin polyurethane foam between conductive fabric layers and a microcomputer/Bluetooth transmitter under a vacuum seal that fits into a fabric pocket of a lymphedema garment at the posterior ankle and pairs with a mobile device. A lymphology-certified therapist coordinated training. Data were collected with a pen/paper tool and analyzed with Student's t test.

RESULTS

The instruction+feedback group was closer to target after training (|Ppre - 35|= 10 ± 12 mm Hg; |Ppost - 35|=5 ± 4 mm Hg; P <.05; paired t test) than the instruction only group (|Ppre- 35|=19 ± 11 mm Hg; |Ppost - 35|=12 ±12 mm Hg; not significant).

CONCLUSION

This wearable mobile pressure sensor device assists practitioners in applying hook-and-loop lymphedema garments closer to target pressure. Larger studies with clinicians and research that involves patient application of compression are warranted.

Medication adherence teaching activity for first year pharmacy students in a Canadian university: Description and evaluation

BACKGROUND AND PURPOSE

Medication non-adherence is a significant health problem in Canada and pharmacists are ideally positioned to help patients adhere to their regimens. There is an urgent need for pharmacy schools to ensure graduates receive training in this area. In this paper, we describe a medication taking simulation activity for first year pharmacy students using a multi-method approach to evaluation.

EDUCATIONAL ACTIVITY AND SETTING

Students were provided with placebo capsules and instructed to take one capsule twice per day for two weeks, complete the Beliefs About Medications Questionnaire (BMQ) before the activity, and provide a pill count and reflection on their experiences afterwards. Quantitative analysis involved calculation of percent adherence from pill counts and establishing beliefs about medications from BMQ scores. Perceptions of the teaching activity were determined using qualitative inductive content analysis of a sub-set of student reflections.

FINDINGS

All 224 students participated and complete pill count and BMQ data was obtained from 190 students (85%). Applying a cut-off of 80% to categorize adherence status, 51.8% of students were adherent. BMQ analyses indicated collective student uncertainty in three BMQ sub-scales (specific-necessity, specific-concern, and general-overuse) and a significant difference between adherent and non-adherent students in the specific-necessity sub-scale. Qualitative analyses of a set of student reflections resulted in two major themes: (1) developing empathy and (2) learning about adherence.

SUMMARY

This activity provided opportunities for students to experience the challenges involved in medication-taking from the patient's perspective and to realize the pharmacist's role to facilitate medication adherence.

A multiyear comparison of flipped- vs. lecture-based teaching on student success in a pharmaceutical science class

BACKGROUND AND PURPOSE

To gauge the potential effect of mode of content delivery on overall student success in a pharmaceutical sciences course in a doctor of pharmacy program.

EDUCATIONAL ACTIVITY AND SETTING

Principles of Drug Action I (PDAI) is a first-year pharmaceutical science course typically taught by multiple faculty, and each utilizes their own approach to deliver course content. Over a seven year period, the course naturally separated into blocks. Block-1 was taught using a traditional lecture-based approach while Block-2 varied between either a lecture-based or a flipped-classroom format. Student success was evaluated by exam at the end of each block.

FINDINGS

For the four years in which Block-2 was taught by lecture, the number of exam failures was similar to Block-1. For each of the three years Block-2 was taught via the flipped-classroom format, the number of exam failures was approximately half that of Block-1. While grades for the lecture-based Block-1 trended downward over the seven-year evaluation period, average exam grades overall were similar between Block-1 and Block-2 each year regardless of teaching modality.

SUMMARY

Retrospective analysis of this novel blocked approach within PDAI provided a means of internally evaluating the potential effect of teaching format on overall student performance. The results described here support previous studies that indicate that the flipped-classroom approach can reduce course failures. These findings also show that flipped-classroom teaching may have a greater impact on improving learning in lower-performing students.

Predicting Bullying through Motivation and Teaching Styles in Physical Education

From the theoretical framework offered by the self-determination theory, the objective of the study was to test a predictor model of bullying behaviors based on the physical education teacher’s supportive style, the students’ satisfaction of basic psychological needs, and self-determined motivation. A total of 608 students of both sexes, between 11 and 15 years of age, from primary and secondary schools in the province of Alicante (Spain) voluntarily completed questionnaires to measure each of the variables under study. The design of the study was cross-sectional. The results showed that the autonomy supportive style positively predicted the satisfaction of basic psychological needs, which, in turn, positively predicted self-determined motivation towards physical education. The latter negatively predicted bullying perpetration and bullying victimization. The controlling style presented inverse relationships to those of the autonomy supportive style. These results are in line with the positions of the self-determination theory and underline the potential responsibility of physical education teachers in the struggle against bullying, and how, by supporting autonomy and avoiding a controlling style, they can help reduce bullying perpetration and victimization.

Inclusion by design: Embedding inclusive teaching practice into design and preparation of laboratory classes

INTRODUCTION

Creation of an inclusive learning environment and provision of individual adjustments are duties of higher education providers. However, laboratory practical teaching is not always inclusive beyond general university requirements. Lab classes can present many barriers to disabled learners. Proactive adjustments embedded into the design and preparation of laboratory classes can make lab-based teaching as inclusive and accessible as possible.

PERSPECTIVE

The main challenges, difficulties, and barriers experienced by students with disabilities during laboratory classes were identified and analysed. A review of a large number of sources was conducted, and the best available evidence of inclusive practice in science and medicine laboratories (including those already implemented in the Reading School of Pharmacy and Leicester School of Pharmacy) were retrieved, critically appraised, and summarized. Recommendations on embedding inclusive practices into the design and preparation of laboratory classes were developed, including methods for making the following accessible: (1) printed materials, such as handouts, instructions, notes, etc.; (2) video files; and (3) colours. Additionally, the use of a range of pedagogic techniques and assistive technologies in inclusive teaching is discussed.

IMPLICATIONS

We have developed general accessibility guides and provided laboratory teaching staff with examples of good inclusive teaching practice. Active implementation of the inclusive-by-design approach, in contrast to inclusive-on-request, can be beneficial for both learners and teaching staff since inclusion-by-design helps to establish a lasting inclusive culture in teaching laboratories.

Impact of a community-based intervention on Latino grandparents' knowledge about and self-efficacy in supporting grandchildren's physical activities

INTRODUCTION

Latino grandparents are often involved in rearing grandchildren, but their roles in promoting children's physical activity (PA) have been largely overlooked. This study examined the impact of a community-based intervention called Nietos Activos y Saludables (Active and Healthy Grandchildren) on Latino grandparents' knowledge about and self-efficacy in supporting grandchildren's (aged 2-12 years) PA.

METHOD

The Spanish language intervention, consisting of 4 weekly sessions, was delivered to 12 Latino grandparents (primarily female, aged > 60 years) in Los Angeles County from October to November 2017. Pre- and posttest surveys and postintervention focus groups assessed the intervention impact.

RESULTS

Participants indicated that the intervention provided useful information. After intervention sessions, participants achieved a higher score in test on PA requirements for children. They also reported greater knowledge about children's PA, local resources for children's PA, and modifying children's behavior. Additionally, participants reported greater confidence in motivating children in PA and collaborating with parents in promoting children's PA. Results of focus groups generally confirmed the quantitative findings.

DISCUSSION

Nietos Activos y Saludables intervention has the promise to increase Latino grandparents' knowledge about and self-efficacy in supporting grandchildren's PA. Future studies should test the impact of the intervention on grandparents' behavior and grandchildren's health outcomes using a randomized controlled trial. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Flipped classroom versus a didactic method with active learning in a modified team-based learning self-care pharmacotherapy course

BACKGROUND AND PURPOSE

To examine the educational outcomes comparing flipped classroom method versus a didactic method with active learning in two semesters of a modified team-based learning (TBL) self-care pharmacotherapy course and explore student-identified preferences for teaching modality.

EDUCATIONAL ACTIVITY AND SETTING

Grade performance on readiness assurance processes, both individual (iRAP) and team (tRAP), and exam questions were compared in two semester-long course offerings. Additionally, students were surveyed pre- and post-course.

FINDINGS

The mean iRAP scores were 81.9% for the didactic method and 80.7% for the flipped method (p = .092). The mean tRAP scores were 93.6% for both didactic and flipped methods (p = .979). Mean exam performance for content taught using didactic and flipped methods were 83.3% and 83.5%, respectively (p = .730). Pre-course respondents indicated the following preferences: didactic (27.7%), flipped (9%), combination (58.2%), no preference (5.1%). Post-course, 46.8% preferred didactic, 5.7% preferred flipped, and 47.5% preferred a combination. Respondents perceived the didactic method helped develop deeper understanding, stimulated greater interest, and improved retention; however, they felt the flipped method improved critical thinking and application.

SUMMARY

There were no statistically significant differences in student outcomes comparing teaching methods while student preference for the flipped classroom decreased.

Strategic elements of residency training in China: transactional leadership, self-efficacy, and employee-orientation culture

BACKGROUND

The standardized training of resident physicians in China is significant and robust. During the training, clinical teachers act as leaders. The training taking place in public hospitals requires a transactional leadership style (TLS), but existing research studies seldom analyze how to promote residents' performance from this perspective.

METHODS

Two hundred and ninety six new residents undertaking standardized training were recruited from five tertiary hospitals in two provinces of China. Hierarchical moderated and mediated regression analyses were used to test the hypotheses. The hypotheses include that TLS is positively related to the training performance; mediating effect of self-efficacy and moderating effect of employee-orientation organizational culture (EOC) are significant.

RESULTS

(1) Two kinds of teachers' TLS, punishment and reward, have significant positive influence on residents' performance. (2) Self-efficacy of residents partly mediates the positive relationship. (3) EOC moderates the relationship between the punitive behavior of clinical teachers with TLS and the self-efficacy of the residents.

CONCLUSIONS

Empirical evidence has shown the positive relationship between teachers' TLS and residents' performance outcomes in China. Teachers can enhance training performance by promoting self-efficacy of residents. This study also advances our understanding of EOC by examining the demonstrated moderating effects of cultural background in the relationship between teachers' TLS and the self-efficacy of residents.