Does changing from a teacher-centered to a learner-centered context promote self-regulated learning: a qualitative study in a Japanese undergraduate setting

BACKGROUND

Previous studies indicate that a teacher-centered context could hinder undergraduates from self-regulated learning (SRL), whereas a learner-centered context could promote SRL. However, SRL development between a teacher-centered and a learner-centered context has not directly compared in undergraduate settings. Also, it is still unclear how a contextual change toward learner-centered learning could influence SRL in students, who are strongly accustomed to teacher-centered learning.

METHODS

We conducted three focus groups that examined 13 Japanese medical students who left a traditional curriculum composed of didactic lectures and frequent summative tests and entered a seven-month elective course (Free Course Student Doctor or FCSD). The FCSD emphasizes student-designed individualized learning with support and formative feedback from mentors chosen by students' preference. We also conducted two focus groups that examined 7 students who remained in the teacher-centered curriculum during the same period. Students were asked to discuss their 1) motivation, 2) learning strategies, and 3) self-reflection on self-study before and during the period. Data were analyzed using thematic analysis and code comparison between the two cohorts.

RESULTS

The non-FCSD participants described their motivational status as being one among a crowd set by the teacher's yardstick. Their reflection focused on minimizing the gap between themselves and the teacher-set yardstick with strategies considered monotonous and homogeneous (e.g. memorization). FCSD participants described losing the teacher-set yardstick and constructing their future self-image as an alternative yardstick. They compared gaps between their present status and future self-image by self-reflection. To fill these gaps, they actively employed learning strategies used by doctors or mentors, leading to diversification of their learning strategies.

CONCLUSIONS

A contextual change toward learner-centered learning could promote SRL even in students strongly accustomed to teacher-centered learning. In the learner-centered context, students began to construct their self-image, conduct self-reflection, and seek diverse learning strategies by referring to future 'self' models.

Introduction of a student tutor-based basic obstetrical ultrasound screening in undergraduate medical education

BACKGROUND

While there is an increasing interest in incorporating ultrasound in undergraduate medical education and the use of student tutors in conveying this medical skill to assist faculty members, little is known about undergraduate ultrasound teaching in obstetrics and gynecology.

METHODS

After a 3 week training of the student tutors, the student tutors joined an undergraduate ultrasound educational program to teach practical round students. After being certified, the student tutors organized a pre-test, gave a presentation about ultrasound, and then supervised the hands on ultrasound course under faculty staff supervision for round students. Finally, the practical round students had to answer a post-test with image recognition. The practical round students had to evaluate the course using a Likert scale.

RESULTS

111 students joined this ultrasound course. The objective theoretical and practical multiple-choice questions' (MCQ) test showed a statistically significant improvement (50 vs. 90%, p < 0.05). The practical round students expressed a high acceptance (Likert 1.7) and subjective medical skill learning (Likert 1.8). The students also positively graded the student tutors (Likert 1.3).

CONCLUSION

Student tutor-based undergraduate obstetrical and gynecological ultrasound course is a useful method to teach a medical skill and is well accepted by students.

Promoting and strengthening public health through undergraduate education

There are widely divergent views as to what constitutes "public health" and "public health research". But regardless of these views, readers of this journal would likely agree that public health matters; we assert that so does the educational programming that prepares its workforce. Our voiced perspectives as authors are influenced by our respective training, occupations, and academic locales, and we believe that undergraduate public and population health education (UGPPHE) across many disciplines is crucial to strengthening public health in Canada. Existing literature and discourse related to UGPPHE in Canada tends to be concentrated around its ancillary positioning within clinical health disciplines such as medicine, nursing, and dentistry, rather than on the evolution of undergraduate degree programs. While UGPPHE programming has the important function of preparing undergraduates to enter into practice as public health professionals, it has added virtue in its capacity to improve public health literacy and produce a more robust body of informed and engaged citizens. The intent of this commentary is to draw increased attention towards the other disciplines less well known for bringing awareness to UGPPHE in Canada and to commence what will hopefully be a cascade of dialogue from stakeholders across the nation.

Application of three-dimensional reconstruction and printing as an elective course for undergraduate medical students: an exploratory trial

BACKGROUND

Medical three-dimensional (3D) digital reconstruction and printing have become common tools in medicine, but few undergraduate medical students understand its whole process and teaching and clinical application. Therefore, we designed an elective course of 3D reconstruction and printing for students and studied its significance and practicability.

METHODS

Thirty undergraduate medical students in their second-year of study volunteered to participate in the course. The course started with three lessons on the theory of 3D digital reconstruction and printing in medicine. The students were then randomly divided into ten groups. Each group randomly selected its own original data set, which could contain a series of 2D images including sectional anatomical images, histological images, CT and MRI. Amira software was used to segment the structures of interest, to 3D reconstruct them and to smooth and simplify the models. These models were 3D printed and post-processed. Finally, the 3D digital and printed models were scored, and the students produced brief reports of their work and knowledge acquisition and filled out an anonymous questionnaire about their study perceptions.

RESULTS

All the students finished this course. The average score of the 30 students was 83.1 ± 2.7. This course stimulated the students' learning interest and satisfied them. It was helpful for undergraduate students to understand anatomical structures and their spatial relationship more deeply. Students understood the whole process of 3D reconstruction and printing and its teaching and clinical applications through this course.

CONCLUSION

It is significant and necessary to develop this course for undergraduate medical students.

Does performance on United States national board of medical examiners reflect student clinical experiences in United Arab Emirates?

This article was migrated. The article was marked as recommended. Background: A number of medical schools around the world use the United States National Board of Medical Examiners Subject Examinations as a clerkship assessment of student performance, yet these exams were blueprinted against the United States national core clerkship curriculum which might not be the same as the local curricula to which they are applied in other parts of the world. In this study, we investigated the correlations between the internal medicine clinical experiences at United Arab Emirates University with student performance on the National Board of Medical Examiners subject of internal medicine (NBME). Methods: One hundred and seven junior clerkship students out of 145 (74%) who finished their Internal Medicine clerkship during academic years 2014-2015 and 2015-2016 participated in this study. The students' clinical experiences were measured by the clinical learning evaluation questionnaire (CLEQ) and by the logged number of meaningful patient contacts during their internal medicine clerkship. Results: Linear regression analysis showed no significant association between performance on the subject test and student clinical experiences measured by the CLEQ or the number of logged patients. NBME scores were weakly correlated with OSCEs scores (ɸ 0.20). Conclusions: The study findings raised uncertainties about the suitability of using NBME in the clerkship assessment program in the United Arab Emirates.

The Effects of Interprofessional Education in Mental Health Practice: Findings from a Systematic Review

OBJECTIVE

The aim of this study was to conduct a systematic review of studies describing the effects of interprofessional education (IPE) on undergraduate healthcare students' educational outcomes, compared with conventional clinical training in mental health.

METHODS

MEDLINE, CINAHL, PsychINFO, and EMBASE were searched for studies published in January 2001-August 2017. All retrieved papers were assessed for methodological quality; Kirkpatrick's model was employed to analyze and synthesize the included studies. The following search terms were used: undergraduate, interprofessional education, and educational outcomes.

RESULTS

The eight studies that met the inclusion criteria were highly diverse regarding the studied IPE interventions, methods, and outcomes. Participants included students receiving clinical training in mental health from the following professions: medicine, nursing, occupational therapy, physiotherapy, psychology, and social work. The results of the studies suggest that students respond well to IPE in terms of more positive attitudes toward other professions and improvement in knowledge and collaborative skills. Limited evidence of changes in behavior, organizational practice, and benefits to patients was found.

CONCLUSION

Based on the eight included studies, IPE interventions appear to have an impact regarding positive attitudes toward other professions and increased knowledge of and skills in collaboration compared to conventional clinical training. However, further study of both the processes and the long-term impacts of undergraduate IPE in mental health is needed. The authors recommend that service users are involved in the implementation and evaluation of IPE interventions in mental health to undergraduate healthcare students.

[Ultrasound training in emergency and intensive care medicine : Integration already in medical school?]

Ultrasound is an important diagnostic tool especially in emergency and intensive care medicine. It is always available at the bedside and shortens time to diagnosis. Many specialties have integrated ultrasound into diagnostic algorithms as part of the extended physical exam. Numerous differential diagnoses can be easily excluded using point-of-care ultrasound and therefore adequate treatment is initiated faster. Emergency or focused ultrasound is therefore of outstanding relevance to any emergency or critical care physician. Integration into medical school curricula is becoming more common tough no nationwide standards are in place yet.

A Quantitative Analysis of Four Undergraduate Human Anatomy Laboratory Curricula: Approaches, Identified Structures, Concepts, and Thematic Emphases

Human anatomy is a foundational course thatserves diverse pre-professional health care majors. However, limited information is available on the teaching approaches, content, and thematic emphases of this course at the undergraduate level when compared with that of medical and other graduate schools. Herein, we document and quantitatively evaluate the laboratory curriculum of four undergraduate human anatomy courses in the USA. For each course, we assess the total number of structures (terms requiring identification during an exam), concepts (terms requiring an explanation), and clinical applications. To facilitate further assessments, we also compare the content distribution of each course with that recommended by the American Association of Clinical Anatomists (AACA). Two courses followed a regional approach emphasizing the use of human cadavers, while the other two followed a system-based approach and used plastic models and non-human cadaveric materials (e.g., cats and sheep). The total amount of information presented to students differed significantly among curricula. The majority of terms (65-88%) taught to students referred to the identification of anatomical structures whereas clinical applications were rare (< 1.3%). Courses using a regional approach expected students to learn as much as twice the number of terms than those following a system-based approach. Functions, innervations, origins, and insertions of muscles are only included in the curriculum of the courses following a regional approach. The proportion of terms devoted to each anatomical module in all curricula was significantly different from each other, as well as from that of AACA recommendation. We discuss these differences in the curriculum, the challenges and limitations inherent with each teaching approach, as well as in the teaching materials used among the curricula. These quantitative analyses aim to provide insightful information about the structure of the undergraduate human anatomy laboratory curriculum and may prove useful when redesigning a course.

Medical students' attitudes toward interactions with the pharmaceutical industry: a national survey in Japan

BACKGROUND

The relationship between students and the pharmaceutical industry has received substantial attention for decades. However, there have been few reports on this issue from East Asia. We aimed to investigate Japanese medical students' interactions with and attitudes toward the pharmaceutical industry, and to assess the correlation between exposures to a formal curriculum on drug promotion and perceptions of the appropriateness of the physician-industry relationship.

METHOD

We invited all 80 medical schools in Japan to participate. A cross-sectional anonymous survey was administered to medical students and school staff at the 40 schools that participated. The questionnaire for students assessed interactions with and attitudes toward the pharmaceutical industry. The questionnaire for school staff assessed the formal undergraduate curriculum.

RESULTS

Forty of the 80 medical schools in Japan participated. The response rate to the medical student survey was 74.1%, with 6771 evaluable responses. More than 98% of clinical students had previously accepted a small gift of stationery, a brochure, or lunch, and significantly higher percentages of clinical than preclinical students had accepted one or more gifts (P < .001). Among preclinical and clinical students, respectively, 62.7 and 71.9% believed it was appropriate to accept stationery, and 60.5 and 71.0% thought that attending an industry-sponsored lunch did not influence clinical practice. Of the 40 participating schools, 13 (33.0%) had a formal curriculum on drug promotion. A multivariate analysis showed an association between exposure to a formal curriculum and students' perceptions of the appropriateness of the physician-industry relationship only for gifts of stationery, which were perceived as inappropriate (OR: 0.81, 95% CI: 0.69-0.95, P = .02).

CONCLUSIONS

Most Japanese medical students interact with the pharmaceutical industry and believe that gift acceptance is appropriate and not influential. This study demonstrated a limited association between students' perceptions of gift appropriateness and exposure to a formal curriculum.

Medical student education in transfusion medicine: Proposal from the "European and Mediterranean initiative in transfusion medicine"

A large body of observations indicate that there is an inconsistent knowledge of Transfusion Medicine among health care professionals as well as inconsistent knowledge in all aspects of the transfusion process, from blood donation to transfusion on the ward. It is obvious to consider that appropriate education in Transfusion Medicine should be achieved in the education of specialists who will prescribe transfusion on a regular basis (hematologists, critical care specialists, anaethesiologists and others.) However,we also believe that education in Transfusion Medicine should also be delivered to almost all other medical specialists who may prescribe blood components. The variability in education of undergraduates in medical schools is universal most likely due to an absence of a predefined common platform. This paper, therefore, focuses on education at the undergraduate level and advocates coverage of the essential physiology and pathophysiology of blood as applied to blood transfusion as well as the medical and societal aspects of issues related to blood donation. It proposes incremental levels of training in Transfusion Medicine, with what is being therefore referred to as 'A', 'B', 'C' etc. curricula in ascending order of complexity; for example, 'A' and 'B' levels would involve medical, midwifery and nursing students, covering a broad base of the subject: they will be detailed in the present essay; ongoing further curricula will focus on physicians and other professionals working within the area or with responsibility for different aspects of the transfusion chain. It is intended that these courses include aspects of donor care, patient care and the appropriate use, safety and effectiveness of blood products. Next, it is advocated that curricula are addressed not only for high-income countries but also for middle- and low-income ones.

Nursing education in Poland - The past and new development perspectives

Professional nursing education in Poland began in 1911 in Kraków. Since then, the nursing education system has continued to change. From the establishment of the first professional nursing school, Poland experienced partition, war and the German occupation, short-lived independence, the Soviet regime and the regaining of its freedom, as well as the development of democracy processes. All of these events impacted on nurses' education. The current state of nursing training is determined by the requirements of the Council of the European Communities. Today, the challenge for nursing education in Poland is the permanent process of the country's education system's adjustment to the European Higher Education Area to ensure the quality of education and to support the mobility of students and academic teachers. Additionally, new competencies pertaining to nurse prescribing, which have been in force in Poland since 2016, will cause new changes to the under- and postgraduate programmes of nursing education. The aim of this study is to present the development of nursing education in Poland in the context of socio-political changes in the country and from the perspective of current nursing challenges worldwide.

Student learning outcomes, perceptions and beliefs in the context of strengthening research integration into the first year of medical school

Research integrated into undergraduate education is important in order for medical students to understand and value research for later clinical practice. Therefore, attempts are being made to strengthen the integration of research into teaching from the first year onwards. First-year students may interpret attempts made to strengthen research integration differently than intended by teachers. This might be explained by student beliefs about learning and research as well as student perceptions of the learning environment. In general, student perceptions of the learning environment play a pivotal role in fostering student learning outcomes. This study aims to determine whether a curriculum change intended to promote research integration fosters student learning outcomes and student perceptions of research integrated into teaching. To serve this purpose, three subsequent cohorts of first-year students were compared, one before and two after a curriculum change. Learning outcomes of these students were measured using scores on a national progress test of 921 students and assessments of a sample of 100 research reports of a first-year student research project. 746 Students filled out the Student Perceptions of Research Integration Questionnaire. The findings suggest that learning outcomes of these students, that is, scores on research related test items of the progress test and the quality of research reports, were better than those of students before the curriculum change.

Medical students' perceptions of general practice as a career; a phenomenological study using socialisation theory

The ageing population and push to community care has significantly increased the workload of General Practitioners (GPs) in the UK and internationally. In an attempt to tackle this, NHS England has promised 5000 more GPs by 2020/21; however, recruitment is in crisis with GP training posts remaining unfilled. Little research has been carried out to assess the fundamental questions of what medical students' perceptions of General Practice are and what shapes their perceptions at medical school. We aimed to explore medical students' conceptualisations of being a GP and specifically the role of the medical school in shaping their perceptions. Two focus groups of year one and year four medical students were undertaken using an interpretive phenomenological approach. Our study has revealed that medical students perceive General Practice to lack prestige and challenge. These perceptions come, at least in part, from a process of socialisation within medical school, whereby medical students internalise and adopt their role models' perceptions and values, and the values portrayed by the hidden curriculum in their medical school culture. Perceived external pressures to pursue a career in General Practice can have a negative influence and medical schools should be made aware of this.

Engaging Biomedical Engineering in Health Disparities Challenges

Health Disparities (HD) are community-based, biomedical challenges in need of innovative contributions from Science, Technology, Engineering and Math (STEM) fields. Surprisingly, STEM professionals demonstrate a persistent lack of HD awareness and/or engagement in both research and educational activities. This project introduced Health Disparities (HD) as technical challenges to incoming undergraduates in order to elevate engineering awareness of HD. The objective was to advance STEM-based, HD literacy and outreach to young cohorts of engineers. Engineering students were introduced to HD challenges in technical and societal contexts as part of Engineering 101 courses. Findings demonstrate that student comprehension of HD challenges increased via joint study of rising health care costs, engineering ethics and growth of biomedical-related engineering areas.

Perspective of Spanish medical students regarding undergraduate education in infectious diseases, bacterial resistance and antibiotic use

INTRODUCTION

One of the main tools to optimize antibiotics use is education of prescribers. The aim of this article is to study undergraduate education in the field of infectious diseases, antimicrobial resistance and antibiotic stewardship from the perspective of Spanish medical students.

MATERIAL AND METHODS

An anonymous online questionnaire was distributed among sixth grade students using different channels in Europe, within the ESGAP Student-Prepare survey. The questionnaire included 45 questions about knowledge, attitudes and perceptions about diagnosis, bacterial resistance, use of antibiotics and undergraduate training in infectious diseases. We present here the Spanish results.

RESULTS

A total of 441 surveys were received from 21 medical schools. A total of 374 responses (84.8%) were obtained from the 8 most represented faculties, with a response rate of 28.9%. Most students felt adequately prepared to identify clinical signs of infection (418; 94.8%) and to accurately interpret laboratory tests (382; 86.6%). A total of 178 (40.4%) acknowledged being able to choose an antibiotic with confidence without consulting books or guidelines. Only 107 (24.3%) students considered that they had received sufficient training in judicious use of antibiotics. Regarding learning methods, the discussion of clinical cases, infectious diseases units rotatories and small group workshops were considered the most useful, being evaluated favorably in 76.9%, 76% and 68.8% of the cases.

CONCLUSION

Medical students feel more confident in the diagnosis of infectious diseases than in antibiotic treatment. They also feel the need to receive more training in antibiotics and judicious antibiotic use.

Impact of a 2-Week Oncology Placement on Medical Students' Perception of Cancer

Statistics show that more than one in two people born after 1960 in the UK will develop cancer during their lifetime. However, a 2013 study found that only 36 % of UK medical schools offer dedicated clinical teaching in oncology. The aim of this study was to assess the views of medical students on five domains of oncology before and after their first clinical placement, to assess the impact, and to obtain students' views on the oncology curriculum. A 28-item questionnaire was developed to compare responses before and after the students' first 2-week clinical placement, and impact was measured as a positive or negative deviation from a baseline response. Students were asked about their career intentions and to evaluate their received teaching. Thirty-six (80 %) students responded to the questionnaire. The largest areas of change were identified in students' confidence in breaking bad news, recognising red flag symptoms, and awareness of the complications of cancer management. Following their placement, 19 students said they would consider a career in oncology, 14 said they would not, and 2 were undecided. Students stated that Maggie's Centre, a patient support facility, was the most useful learning experience. The evidence demonstrates that all students should experience oncology in a variety of settings to aid their learning. Student feedback and perception can help to guide and shape medical teaching.

The provision of accredited higher education on dementia in six European countries: An exploratory study

BACKGROUND

The World Health Organization has identified developing the knowledge and skills of healthcare professionals who are involved in dementia care as a priority. Most healthcare professionals lack the necessary knowledge, skills and understanding to provide high quality dementia care. While dementia education amongst most UK university health and social care programmes is inconsistent, we know little about the provision of dementia education in European universities.

OBJECTIVES

To examine the provision of accredited higher education on dementia in European countries, to illustrate that it is highly variable despite universities being the major provider of education for healthcare professionals internationally.

DESIGN

An exploratory research design was used.

SETTINGS

The providers of higher education undergraduate and postgraduate programmes in the Czech Republic, Portugal, Scotland, Slovenia, Spain, Sweden.

PARTICIPANTS

Higher Education Institutions who provide undergraduate and postgraduate education in the fields of nursing, medicine, psychology, social work, physiotherapy, occupational therapy, and gerontology in six European countries.

METHODS

The data was collected using a structured questionnaire. Researchers in each country conducted an internet-based search using the websites of Higher Education Institutions to identify existing accredited dementia education.

RESULTS

These searches revealed a lack of dementia education in undergraduate health and social care study programmes. Three of the six countries offered postgraduate study programmes on dementia. There was a significant variation amongst the countries in relation to the provision of dementia education at undergraduate, postgraduate and doctoral levels.

CONCLUSIONS

Dementia is a global challenge and educating and upskilling the workforce is a policy imperative. To deliver the best dementia care, investment in interprofessional evidence-based education is required if we are to respond effectively and compassionately to the needs of people living with dementia and their families. Higher Education Institutions have an important role to play in equipping health and social care professionals with the knowledge, skills and understanding to respond to this imperative.

Pursuing an Ethical, Socially Just Classroom: Searching for Community Psychology Pedagogy

Discussions of community psychology (CP) ethics often examine how we might best uphold CP values in community-based practice. However, for many community psychologists in faculty positions, our main domain of practice is the undergraduate classroom. Teaching is essential to the growth and sustainability of our field as prospective students tend to discover CP during their undergraduate studies. University-based work is also a key site of CP practice. Universities are contested spaces where interlocking forms of oppression manifest in many ways, including teaching (e.g., what is taught, how, by whom, to whom). CP values compel us to treat our classrooms as more than just information transmission spaces; just as there is no value-neutral research, there is no value-neutral course content or classroom practice. This first-person narrative explores ethical issues that arise when we put CP values, specifically social justice, respect for diversity, participation, and wellness, in conversation with pedagogical best practices and course content in higher education. It presents interrelated ethical dilemmas and the authors' conflicted responses. We conclude with a four-part call to the field for dedicated scholarly spaces and supports focused on the development and study of undergraduate CP pedagogy.

To embed or not to embed? A longitudinal study exploring the impact of curriculum design on the evidence-based practice profiles of UK pre-registration nursing students

BACKGROUND

The use of Evidence-Based Practice (EBP) is increasingly emphasized within healthcare. However, little research has focused on nurses' pre-registration training; particularly regarding the impact of curriculum-design on learning EBP.

OBJECTIVES

This study compared the impact of embedding EBP throughout the curriculum, with modular-based teaching, on pre-registration nursing students' EBP profiles.

DESIGN

A longitudinal panel study.

SETTINGS AND PARTICIPANTS

A convenience sample of fifty-six pre-registration nursing students (55.4% studying an embedded EBP-curriculum and 44.6% studying a modular EBP-curriculum), were recruited from a UK University between 2011 and 2014.

METHODS

Participants completed the Student Evidence-Based Practice Questionnaire (S-EBPQ) in the first, second and third year of their course. This questionnaire measures four EBP domains: frequency of use, attitude, knowledge and skills in retrieving and reviewing evidence, and knowledge and skills in applying and sharing evidence.

RESULTS

Two-way mixed between-within Analyses of Variance revealed significant improvements across all domains, except attitude (which remained broadly positive across all years), for both curriculum-groups. No significant differences in this improvement were identified between the two curricula overall. However, the direction and rate of change of scores on the retrieving and applying subscales (but not frequency of use) for the two groups differed across time; specifically those on the embedded curriculum showed a dip in scores on these subscales in year 2. This appeared to be related to associated features of the course such as the timing of placements and delivery of theory.

CONCLUSIONS

Taking a modular or embedded approach to EBP may have little impact on students' final EBP profiles. However, careful consideration should be given to the timing of related course features which may play a key role in students' perceptions of their knowledge and skills in its application. Further research should explore how curriculum-design might build on students' initial positive attitudes towards EBP and its use in their practice.

A review of simulation-enhanced, team-based cardiopulmonary resuscitation training for undergraduate students

Cardiopulmonary resuscitation training is an essential element of clinical skill development for healthcare providers. The International Liaison Committee on Resuscitation has described issues related to cardiopulmonary resuscitation and emergency cardiovascular care education. Educational interventions have been initiated to try to address these issues using a team-based approach and simulation technologies that offer a controlled, safe learning environment. The aim of the study is to review and synthesize published studies that address the primary question "What are the features and effectiveness of educational interventions related to simulation-enhanced, team-based cardiopulmonary resuscitation training?" We conducted a systematic review focused on educational interventions pertaining to cardiac arrest and emergencies that addressed this main question. The findings are presented together with a discussion of the effectiveness of various educational interventions. In conclusion, student attitudes toward interprofessional learning and simulation experiences were more positive. Research reports emphasized the importance of adherence to established guidelines, adopting a holistic approach to training, and that preliminary training, briefing, deliberate practices, and debriefing should help to overcome deficiencies in cardiopulmonary resuscitation training.

A survey of palliative medicine education in Japan's undergraduate medical curriculum

BACKGROUND

This study aimed to examine the status of undergraduate palliative care education among Japanese medical students using data from a survey conducted in 2015.

METHODS

A questionnaire was originally developed, and the survey forms were sent to universities. The study's objectives, methods, disclosure of results, and anonymity were explained to participating universities in writing. Responses returned by the universities were considered to indicate consent to participate. Descriptive statistical methodology was employed.

RESULTS

The response rate was 82.5% (66 of 80 medical faculties and colleges). Palliative care lectures were implemented in 98.5% of the institutions. Regarding lecture titles, "palliative medicine," "palliative care," and "terminal care" accounted for 42.4, 30.3, and 9.1% of the lectures, respectively. Teachers from the Department of Anesthesia, Palliative Care, and Psychiatry administered 51.5, 47.0, and 28.8% of lectures, respectively. Subjects of lectures included general palliative care (81.8%), pain management (87.9%), and symptom management (63.6%). Clinical clerkship on palliative care was a compulsory and non-compulsory course in 43.9 and 25.8% of the schools, respectively; 30.3% had no clinical clerkship curriculum.

CONCLUSIONS

Undergraduate palliative care education is implemented in many Japanese universities. Clinical clerkship combined with participation in actual medical practice should be further improved by establishing a medical education certification system in compliance with the international standards.

A qualitative study of undergraduate clerkships in the intensive care unit: It's a brand new world

INTRODUCTION

While ICU clerkships are commonplace in undergraduate medical education, little is known about how students learn there. This study aimed to explore students' perceptions of the ICU as a learning environment, the factors influencing their learning and any perceived differences between learning in the ICU and non-ICU settings.

METHODS

We used interpretivist methodology, a social cognitive theoretical framework and a qualitative descriptive strategy. Ten medical students and four graduate doctors participated in four semi-structured focus group discussions. Data were analyzed by six-step thematic data analysis. Peer debriefing, audit trail and a reflexive diary were used.

RESULTS

Social cognitive influences on learning were apparent in the discussions. Numerous differences emerged between ICU and non-ICU clinical clerkships, in particular an unfamiliarity with the environment and the complex illness, and difficulty preparing for the clerkship. A key emergent theme was the concept of three phases of student learning, termed pre-clerkship, early clerkship and learning throughout the clerkship. A social cognitive perspective identified changes in learner agency, self-regulatory activities and reciprocal determinism through these phases. The findings were used to construct a workplace model of undergraduate intensive care learning, providing a chronological perspective on the clerkship experience.

CONCLUSIONS

The ICU, a rich, social learning environment, is different in many respects to other hospital settings. Students navigate through three phases of an ICU clerkship, each with its own attendant emotional, educational and social challenges and with different dynamics between learner and environment. This chronological perspective may facilitate undergraduate educational design in the ICU.

Influence of motivation, self-efficacy and situational factors on the teaching quality of clinical educators

BACKGROUND

Being exposed to good teachers has been shown to enhance students' knowledge and their clinical performance, but little is known about the underlying psychological mechanisms that provide the basis for being an excellent medical teacher. Self-Determination Theory (SDT) postulates that more self-regulated types of motivation are associated with higher performance. Social Cognitive Theory (SCT) focuses on self-efficacy that has been shown to be positively associated with performance. To investigate the influences of different types of teaching motivation, teaching self-efficacy, and teachers' perceptions of students' skills, competencies and motivation on teaching quality.

METHODS

Before the winter semester 2014, physicians involved in bedside teaching in internal medicine at the University Medical Center Hamburg-Eppendorf completed a questionnaire with sociodemographic items and instruments measuring different dimensions of teaching motivation as well as teaching self-efficacy. During the semester, physicians rated their perceptions of the participating students who rated the teaching quality after each lesson. We performed a random intercept mixed-effects linear regression with students' ratings of teaching quality as the dependent variable and students' general interest in a subject as covariate. We explored potential associations between teachers' dispositions and their perceptions of students' competencies in a mixed-effects random intercept logistic regression.

RESULTS

94 lessons given by 55 teachers with 500 student ratings were analyzed. Neither teaching motivation nor teaching self-efficacy were directly associated with students' rating of teaching quality. Teachers' perceptions of students' competencies and students' general interest in the lesson's subject were positively associated with students' rating of teaching quality. Physicians' perceptions of their students' competencies were significantly positively predicted by their teaching self-efficacy.

CONCLUSIONS

Teaching quality might profit from teachers who are self-efficacious and able to detect their students' competencies. Students' general interest in a lesson's subject needs to be taken into account when they are asked to evaluate teaching quality.

The impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students

BACKGROUND

The use of standardized patients is not very common in psychiatric nursing education and there has been no study conducted in Turkey.

AIM

This study evaluated the impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students.

DESIGN

This manuscript addressed the quantitative aspect of a doctoral thesis study in which both quantitative and qualitative methods were used. A pre-test and post-test were employed in the quantitative analysis in a randomized and controlled study design.

RESULTS

The motivation scores, and interim and post-test scores for perceived learning were higher in the experimental group compared to pre-test scores and the scores of the control group. The students in the experimental group reported that they felt more competent about practical training in clinical psychiatry, as well as in performing interviews with patients having mental problems, and reported less anxiety about performing an interview when compared to students in the control group.

CONCLUSION

It is considered that the inclusion of standardized patient methodology in the nursing education curriculum in order to improve the knowledge level and skills of students would be beneficial in the training of mental health nurses.

Creating vascular models by postprocessing computed tomography angiography images: a guide for anatomical education

BACKGROUND

A new application of teaching anatomy includes the use of computed tomography angiography (CTA) images to create clinically relevant three-dimensional (3D) printed models. The purpose of this article is to review recent innovations on the process and the application of 3D printed models as a tool for using under and post-graduate medical education.

METHODS

Images of aortic arch pattern received by CTA were converted into 3D images using the Google SketchUp free software and were saved in stereolithography format. Using a 3D printer (Makerbot), a model mode polylactic acid material was printed.

RESULTS

A two-vessel left aortic arch was identified consisting of the brachiocephalic trunk and left subclavian artery. The life-like 3D models were rotated 360° in all axes in hand.

CONCLUSIONS

The early adopters in education and clinical practices have embraced the medical imaging-guided 3D printed anatomical models for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between the anatomical structures. Printed vascular models are used to assist in preoperative planning, develop intraoperative guidance tools, and to teach patients surgical trainees in surgical practice.