Effectiveness of problem-based learning methodology in undergraduate medical education: a scoping review

Antimicrobial stewardship for nurse practitioners and physician assistants: enhancing patient safety through education

Background

As nurse practitioners and physician assistants (APPs) become more prevalent in delivering pediatric care, their involvement in antimicrobial stewardship efforts increases in importance. This project aimed to create and assess the efficacy of a problem-based learning (PBL) approach to teaching APPs antimicrobial stewardship principles.

Methods

A PBL education initiative was developed after communication with local APP leadership and focus group feedback. It was offered to all APPs associated with Lurie Children's Hospital of Chicago. Participants completed a survey which assessed opinions on antimicrobial stewardship and included knowledge-based questions focused on antimicrobial stewardship. Prescriptions for skin and soft tissue infections associated with APPs were recorded via chart review before and after the education campaign.

Results

Eighty APPs participated in the initial survey and teaching initiative with 44 filling out the 2-week follow-up and 29 filling out the 6-month follow-up. Subjective opinions of antimicrobial stewardship and comfort with basic principles of AS increased from pre-intervention. Correct responses to knowledge-based assessments increased from baseline after 2-week follow-up (p < 0.01) and were maintained at the 6-month follow-up (p = 0.03). Simple skin and soft tissue infection prescriptions for clindamycin went from 44.4% pre-intervention to 26.5% (p = 0.2) post-intervention.

Conclusions

A PBL approach for APP education on antimicrobial stewardship can be effective in increasing knowledge and comfort with principles of antimicrobial stewardship. These changes are maintained in long-term follow-up. Changes in prescribing habits showed a strong trend towards recommended empiric therapy choice. Institutions should develop similar education campaigns for APPs.

Equivalent Performance of Exam Items Associated with Case-Based Learning, Flipped Classroom, and Lecture in a Pre-clerkship Medical Curriculum

The purpose of our study was to determine if knowledge acquisition, as measured by exam item performance, differed for active or passive learning activities in our medical curriculum. Additionally, we looked for differences in exam item performance in one second-year course that varies the method of an active learning activity, case-based collaborative learning (CBCL). Finally, we assessed whether item performance was impacted when small group activities were conducted online due to the COVID-19 pandemic. Exam item difficulty values were collected for several years of lectures, flipped classroom, and CBCL. Statistical analysis and modeling of data were performed to identify differences in difficulty of exam items that assess content delivered by different learning activities. Our analysis revealed no differences in difficulty of exam items that assess content delivered by different learning activities. Similarly, we determined that varying the execution of CBCL in one course did not impact exam item performance. Finally, moving CBCL small group sessions online did not impact exam item difficulty. However, we did detect a minor reduction in overall exam scores for the period of online instruction. Our results indicate that knowledge acquisition, as assessed by our multiple-choice summative exams, was equivalent regardless of learning activity modality.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01842-8.

"No PBL is better than online PBL": Qualitative exploration regarding the perceived impact of online problem-based learning on nursing and medical students' learning during COVID-19 lockdown

The COVID-19 pandemic and its restrictions increased the adoption of online learning even in low-income countries. The adoption of online teaching methods may have affected teaching and learning, particularly in settings where it was used for the first time. This study was conducted to explore the perceptions of medical and nursing students regarding the impact of online delivery of problem-based learning (PBL) on students learning and academic performance during COVID-19 imposed restrictions.

Methods and materials

This was a qualitative study among fourth and fifth-year nursing and medical undergraduate students at Busitema University Faculty of Health Sciences. Four focused group discussions were conducted and the interviews focused on students' perceptions, experiences, and attitudes toward the PBL process conducted online and its likely impact on their learning. Braun and Clarke's thematic analysis was used for qualitative data analysis.

Results

Four themes were identified that represented perceptions of online PBL on learning: transition to online learning; perceived benefits of online learning; limited learning and poor performance; and lost soft and practical skills. During the initial stages of introduction to online PBL learning, students transitioning to online had to adapt and familiarize themselves with online learning following the introduction of online learning. Students perceived that learning was less online compared to face-to-face sessions because of reduced learner engagement, concentration, motivation, peer-to-peer learning, and limited opportunities for practical sessions. Online learning was thought to increase students' workload in the form of a number of assessments which was thought to reduce learning. Online tutorials were perceived to reduce the acquisition of soft skills like confidence, communication, leadership, and practical or clinical skills. While learning was thought to be less during online teaching, it was noted to allow continued learning during the lockdown, to be flexible, enhance self-drive and opportunity for work, solve infrastructure problems, and protect them from COVID-19 infection.

Conclusion

Generally, online learning enabled continuity and flexibility of learning. However, online PBL learning was perceived to be less engaging compared to traditional classroom-based PBL. Online PBL was seen to deter students from acquiring critical generic and clinical skills inherently found in traditional PBL. Innovative pedagogical measures should be adopted to avoid reduced learning noted in the online teaching methods to ensure the successful adoption of online teaching and learning in the post-COVID-19 era.

Factors That Enhance and Hinder the Retention and Transfer of Online Pre-Clinical Skills Training to Facilitate Blended Learning

Purpose

During the SARS-CoV-2 pandemic, various online instructional strategies in clinical skills training were piloted. The sudden transition to the remote platform circumvented the rigorous planning associated with curriculum reform. This study aimed to explore students' and tutors' perceptions of factors that promoted or hindered successful learning transfer and to propose a blended conceptual model to guide affective, cognitive, and psychomotor clinical skills training in the pre-clinical phase of medical education.

Methods

A mixed-method quasi-experimental study assessed third-year students' transfer of clinical skills and knowledge following online learning in 2021. Students and their tutors completed online surveys that included open and closed-ended questions regarding factors influencing their experience of the adapted teaching methods. Descriptive statistical analysis was used for the quantitative data. Qualitative responses were thematically analyzed.

Results

One hundred fourteen students (48%) and seven tutors (100%) responded to the surveys. The questionnaires' internal consistency and construct validity were determined using Cronbach's α-Coefficient. There was an overall positive response (86%) to the acceptability of the online platform in clinical skills training. Using online simulations with targeted onsite practice was reported as effective in clinical skills training. Tutors perceived students as well-prepared for the skills laboratory. Five emergent themes, qualified by a linear model of asynchronous and synchronous online and onsite teaching with the evaluation of the instructional design and institutional support, informed the proposed blended learning guide for clinical skills training in the pre-clinical phase.

Conclusion

Blended clinical skills learning that included the flipped classroom concept was well-accepted. Virtual patients proved a convenient cognitive preparation tool for skills training and potentially optimized teaching delivery. The study found that the adapted teaching frameworks incorporating an online clinical skills component into a modified onsite curriculum augmented learners' ability to transfer knowledge to the clinical skills laboratory. An integrated five-step blended model is proposed for future interventions.

Training doctoral students in critical thinking and experimental design using problem-based learning

BACKGROUND

Traditionally, doctoral student education in the biomedical sciences relies on didactic coursework to build a foundation of scientific knowledge and an apprenticeship model of training in the laboratory of an established investigator. Recent recommendations for revision of graduate training include the utilization of graduate student competencies to assess progress and the introduction of novel curricula focused on development of skills, rather than accumulation of facts. Evidence demonstrates that active learning approaches are effective. Several facets of active learning are components of problem-based learning (PBL), which is a teaching modality where student learning is self-directed toward solving problems in a relevant context. These concepts were combined and incorporated in creating a new introductory graduate course designed to develop scientific skills (student competencies) in matriculating doctoral students using a PBL format.

METHODS

Evaluation of course effectiveness was measured using the principals of the Kirkpatrick Four Level Model of Evaluation. At the end of each course offering, students completed evaluation surveys on the course and instructors to assess their perceptions of training effectiveness. Pre- and post-tests assessing students' proficiency in experimental design were used to measure student learning.

RESULTS

The analysis of the outcomes of the course suggests the training is effective in improving experimental design. The course was well received by the students as measured by student evaluations (Kirkpatrick Model Level 1). Improved scores on post-tests indicate that the students learned from the experience (Kirkpatrick Model Level 2). A template is provided for the implementation of similar courses at other institutions.

CONCLUSIONS

This problem-based learning course appears effective in training newly matriculated graduate students in the required skills for designing experiments to test specific hypotheses, enhancing student preparation prior to initiation of their dissertation research.

A Cohort Study Assessing the Impact of Anki as a Spaced Repetition Tool on Academic Performance in Medical School

Introduction

Anki is an application that capitalizes upon the techniques of spaced repetition and is increasingly utilized by medical students for examination preparation. This study examines the impact of Anki usage in a medical school curriculum on academic performance. Secondary objectives analyzed individual Anki utilization and a qualitative assessment of Anki use.

Methods

A cohort-control study was conducted at Boonshoft School of Medicine. One hundred thirty first-year medical students were enrolled in an Anki utilization training program from July 2021 to September 2021. Training included educational Anki courses and subsequent survey data collection over Anki usage. Data variables included all course final examinations, the Comprehensive Basic Science Exam (CBSE), individual Anki user statistics, nationally standardized exams scores, and Qualtrics surveys on student perceived ease of use.

Results

Seventy-eight students reported using Anki for at least one of the exams, and 52 students did not use Anki for any exam. Anki users scored significantly higher across all four exams: Course I (6.4%; p < 0.001); Course II (6.2%; p = 0.002); Course III (7.0%; p = 0.002); and CBSE (12.9%; p = 0.003). Students who reported higher dependency on Anki for studying performed significantly better on the Course I, II, and CBSE exams.

Conclusion

Anki usage may be associated with an increase in standardized examination scores. This supports Anki as an evidence-based spaced repetition and active retrieval learning modality for medical school standardized examinations. There was little correlation between its specific statistical markers and examination performance. This is pertinent to physicians and medical students alike as the learning and preservation of biomedical knowledge is required for examinations and effective clinical care.

Enhancing medical education in respiratory diseases: efficacy of a 3D printing, problem-based, and case-based learning approach

OBJECTIVES

The present study aims to investigate the efficacy of utilizing three-dimensional (3D) printing technology in concert with Problem-Based Learning (PBL) and Case-Based Learning (CBL) pedagogical approaches in educating senior undergraduate clinical medical students on respiratory diseases.

METHODS

A cohort of 422 fourth-year clinical medicical students of from Anhui Medical University, pursuing a five-year program, were arbitrarily segregated into two distinct groups. The experimental group was subjected to a combined pedagogical approach, which included 3D printing technology, PBL and CBL (referred to as DPC). Conversely, the control group was exposed to conventional teaching methodologies for respiratory disease education. The effectiveness of the teaching methods was subsequently appraised using both theoretical test scores and custom questionnaires.

RESULTS

Post-quiz scores indicated a statistically significant improvement in the DPC group as compared to the traditional group (P < 0.01). Self-evaluation and satisfaction questionnaires revealed that the DPC group's self-assessment scores outperformed the traditional group in several aspects, including clinical thinking ability, learning initiative, self-study ability, anatomical knowledge mastery, confidence in learning, ability to analyze and solve problems, comprehension of the knowledge, help to clinical thinking and level of satisfaction on the teaching methods (P < 0.01). However, within the unsatisfied DPC sub-group, none of these self-assessment aspects, except for comprehension of the knowledge, impacted the learning efficacy (P > 0.05).

CONCLUSION

The deployment of the DPC pedagogical approach may confer unique experiential learning opportunities for students, potentially enhancing theoretical test scores and promoting self-evaluation and satisfaction in the context of respiratory disease education. Hence, it may be instrumental in augmenting the overall teaching efficacy.

Differences in medical education before, during, and in the post-peak period of the COVID-19 pandemic-exploring senior medical students' attitudes

BACKGROUND

The burden that COVID-19 has brought to the economy, healthcare systems, and education is unmatched. Public health and social measures were implemented to halt transmission. Thus, social gathering and in-person learning, core aspects of medical education, were interrupted. Studies have documented the detrimental impact students graduating during the pandemic have had on their confidence and skills. However, data comparing pre-pandemic, pandemic, and post-peak students still lack. This study aimed to identify senior medical students' attitudes regarding their education and compare them according to the three previously described periods.

METHODS

In this cross-sectional study, the survey employed was designed based on a previous questionnaire and applied to senior medical students before graduating between January 2018 and June 2022. Answers were collected using a three-point Likert scale and Yes/No questions. Associations between variables were examined using Chi-squared, Fisher's Exact tests, and ANOVA, employing logistic regression to calculate odds ratio (OR) when appropriate.

RESULTS

A total of 679 responses were analyzed. Most students (59%) were women. Up to 383, 241, and 55 senior medical students answered the survey before, during, and in the post-peak period of the COVID-19 pandemic, respectively. There was a staggering decrease in the percentage of students in the post-peak compared to the pre-pandemic period that considered certain factors such as being taught about the doctor-patient relationship (62% vs 75%), practicing teamwork (33% vs 54%), preclinical & clinical subjects (44% vs 63%), and being taught to conduct research (22% vs 32%) as "very useful" to their professional traineeship. There was a significant difference between pre-pandemic, pandemic, and post-peak students when asked if the study curriculum accomplished the goal of training a professional with integrity (89% vs 66% vs 64%, p < 0.001), respectively. In a multivariate analysis graduating during the pandemic (OR 3.92; 95% CI, 2.58-5.94) and in the post-peak period (OR 4.24; 95% CI, 2.23-8.07) were independent factors for the appreciation that the study curriculum did not meet its objective.

CONCLUSIONS

The pandemic has hindered medical education. Students' appreciation of their instruction has deteriorated. Urgent interventions that halt the negative impact on training, ensure readiness for future problems and improve schooling worldwide are needed.

Learning and assessment strategies to develop specific and transversal competencies for a humanized medical education

Introduction: Medical education should promote the development of skills and abilities that can be applied to real-world work performance. The aim of this study is to evaluate technical and methodological knowledge, as well as physician-patient communication skills, as one of the most important transversal competencies that a good physician should acquire; all this in a reliable, accurate and objective way. Methods: We present a rubric specifically designed and implemented for the evaluation of specific and transversal competencies in the physiology practical sessions, during the second year of the medical degree. The assessment consists in two evaluation tests: 1) a theoretical test that consists of multiple-choice questions. Students must demonstrate that they have acquired adequate theoretical knowledge (specific competency "to know"); 2) a practical test, in which students are evaluated by the rubric through the simulation of a medical consultation. Thus, demonstrating their ability to execute/apply what they have learned in class (specific competency "to know how to do"). They are also evaluated on the transversal competencies that we call "communication with the patient" (transversal competency "to know how to be there") and "dealing with the patient" (transversal competency "to know how to be"). Results: We evaluated whether there were differences in the grades obtained by students when the transversal competencies were not assessed (academic years 2017-2018 and 2018-2019; n = 289), and when the transversal competencies were assessed by applying the rubric in the academic years 2019-2020, 2021-2022, and 2022-2023 (n = 526). Furthermore, we present a student perception that supports the use of clinical simulation and our rubric as a good method within the competency learning process. Discussion: The acquisition of these competencies, starting from the first courses of undergraduate education, helps to raise the students' awareness in the development of a more humanized medicine, allowing a better response to the patients' needs. Our rubric, which clearly indicate the performance criteria, have become an excellent method to carry out the assessment of competencies, both for students and teachers, since they allow to obtain clear evidence of the level of acquisition and application of knowledge.

The effect of death education course utilizing constructivist learning theory on first grade undergraduate nursing student attitudes and coping abilities towards death: A mixed study design

Inadequate clinical preparation for palliative care is often reflected in inadequate education about death. Nursing students as nurses of the future, it is necessary to make them aware of death and overcome fear of it so that they can cope with their future careers and provide qualified and warmly care service.

OBJECTIVES

To determine the effect of death education course using constructivist learning theory on first grade undergraduate nursing student attitudes and coping abilities towards death.

DESIGN

This study was designed using a mixed-methods design.

SETTING

Two campuses of a university school of nursing in China.

PARTICIPANTS

First grade Bachelor of Nursing Science students (n = 191).

METHODS

Data collection includes questionnaires and reflective writing as after class task. Quantitative data were analyzed using descriptive statistics, the Wilcoxon Signed Rank test, and the Mann-Whitney U test. As for reflective writing, content analysis was hired to analysis.

RESULTS

The intervention group's attitude towards death tended to be neutral acceptance. The intervention group's ability to deal with death (Z = -5.354, p < 0.001) and expression of thoughts about death (Z = -3.89 b, p < 0.001) greater than that of the control group. Four themes (Awareness of death before class, Knowledge, The meaning of palliative care, New cognition) were identified from reflecting writing.

CONCLUSION

Compared with the conventional teaching, death education course utilizing constructivist learning theory was found to be a more effective method for developing students' death coping skills and reducing fear of death.

Virtual versus paper-based PBL in a pulmonology course for medical undergraduates

BACKGROUND

Problem-based learning (PBL) remains a valid and effective tool for small-group medical education. Using Virtual patients (VP) case simulation in PBL is a recognizable educational method that has successfully prepared students to focus learning on core information that uses realistic patient-based cases relating to everyday clinical scenarios. Using other modalities as the virtual patient in PBL instead of the paper-based methods remains debatable. This study aimed to evaluate the effectiveness of using VP case simulation mannequin in PBL versus the PBL in paper-based cases in improving the cognitive skills by comparing the grades of a multiple-choice question test and assess its ability to reach students' satisfaction using questionnaire with Likert survey instrument.

METHODS

The study was conducted on 459 fourth-year medical students studying in the pulmonology module of the internal medicine course, Faculty of Medicine, October 6 University. All students were divided into 16 PBL classes and randomly divided into groups A and B by simple manual randomization. The groups were parallel with a controlled cross-over study between paper-based and virtual patient PBL.

RESULTS

The pre-test showed no significant difference between both, while post-test scores were significantly higher in both VP PBL cases 1 discussing COPD (6.25 ± 0.875) and case 2 discussing pneumonia (6.56 ± 1.396) compared to paper-based PBL (5.29 ± 1.166, 5.57 ± SD1.388, respectively) at p < 0.1 When students in Group A experienced PBL using VP in case 2 after paper-based PBL in case 1, their post-test score improved significantly. (from 5.26 to 6.56, p < .01). Meanwhile, there was a significant regression in the post-test score of the students in Group B when they experienced the paper-based PBL session in case 2 after using PBL using VP in case 1, (from 6.26 to 5.57, p < .01). Most of the students recommended using VP in PBL as they found VP was more engaging and inducing concentration in gathering the information needed to characterize the patient's problem than in a classroom- paper-based cases session. They also enjoyed the teaching of the instructor and found it a suitable learning style for them.

CONCLUSION

Implementing virtual patients in PBL increased knowledge acquisition and understanding in medical students and was more motivating for students than paper based PBL to gather the needed information.

Direct and indirect effects of self-directed learning on creativity in healthcare undergraduates: a chain mediation model of openness to challenge and diversity and creative self-efficacy

Background

Creativity and self-directed learning (SDL) are prominent for undergraduate healthcare students to provide quality patient care in an increasingly complex healthcare environment. Research suggested that SDL is linked with creativity, yet the mechanism underlying the relationship between SDL and creativity has not been fully understood.

Objective

This study examined the relationship between SDL and creativity and constructed a chain mediation model to identify the mediating effect of openness to diversity and challenge (ODC) and creative self-efficacy (CSE).

Methods

Through convenience sampling, 575 healthcare undergraduates (average age = 19.28 years, SD = 1.124 years) were surveyed from Shandong Province in China. Creativity, SDL, ODC, and CSE were assessed using corresponding scales. Pearson's correlation analysis, hierarchical multiple linear regression analysis, a serial multiple mediation analysis, and bias-corrected percentile Bootstrap method were conducted by using structural equation modeling by AMOS 26.0.

Results

The direct path between SDL and creativity was significant. SDL can positively predict both ODC and CSE, and the latter two variables can significantly and positively predict creativity. ODC and CSE played a significant partial mediating role in the relationship between SDL and creativity. The mediating effect consists of three indirect effects: SDL → ODC → creativity (the mediating effect value is 0.193, p = 0.012), SDL → CSE → creativity (the mediating effect value is 0.096，p = 0.001), and SDL → ODC → CSE → creativity (the mediating effect value is 0.035, p = 0.031).

Conclusion

SDL can positively predict creativity. ODC and CSE had significant mediating effects between SDL and creativity, including single partial mediating effects of ODC and CSE and chain mediating effects of ODC-CSE.

Are preprofessional undergraduate students ready for authentic clinical case studies? An empirical study of students' perceived relevance and motivation

Increasingly, the curricula of many clinical programs have been restructured to an integrated model in which foundational sciences such as physiology, pathophysiology, and pharmacology are taught side by side with clinical reasoning. Case studies are an excellent pedagogical strategy for enhancing such integration, especially if such cases are authentic, that is, they include a broad range of information that could influence the individualization and optimization of patient care. However, authentic cases may be too advanced and thereby dissuade preclinical students. We offered an optional semester-long authentic pharmacotherapy case study to undergraduate students in an introductory pharmacology class in a liberal arts college in the United States Midwest and sought to know what might motivate students to complete this challenging task. Connection with and relevance of the case study were assessed with an anonymous survey. Open-ended questions were analyzed qualitatively. Exploratory factor analysis and nonmetric multidimensional scaling were employed to investigate underlying commonalities and patterns in the motivations for participating in and relating to the case study. Students were motivated more by the perceived relevance and transferability of knowledge acquired to their future career than by their current clinical technician jobs or their personal lives. Rather than causing an information overload and dissuading students, this complex pharmacotherapy case assignment harnessed preclinical students' experiences from cognate cocurricular activities, created numerous points of relevant engagement with instructional content, and therefore motivated students to deeper learning.NEW & NOTEWORTHY Early introduction to clinical reasoning is widely advocated. Case studies are frequently used to enhance integration of foundational sciences with clinical reasoning. Preclinical students may be overwhelmed by complex cases because of the higher-order cognitive tasks involved. We find that complex cases permit connection with students' own experiences and aspirations. These preclinical students were motivated to engage in such challenging academic work because of the perceived transferability of knowledge to their future careers.

A simple approach of applying blended learning to problem-based learning is feasible, accepted and does not affect evaluation and exam results-a just pre-pandemic randomised controlled mixed-method study

We tested for feasibility, acceptance, and "non-inferiority" of small-group teaching applying blended learning (i.e., the integration of face-to-face and online instruction) to problem-based learning (bPbL) compared to conventional PbL (cPbL). In a just pre-pandemic, randomised controlled trial, 317 students attended either bPbL or cPbL groups. The first meeting of the bPbL groups took place online via written internet chat, while cPbL groups met on site. All groups met on site the second time. All students had the opportunity to attend lectures either on site or as videos on demand. We analysed student evaluation data, results in a final summative exam, attendance of lectures on site and use of lecture videos. Furthermore, we performed a qualitative analysis of student statements made in semi-structured group interviews about pros and cons of the bPbL approach. There was no difference between students of either bPbL or cPbL groups with respect to exam results (score: 14.3 ± 2.8 vs. 13.8 ± 2.7) or course evaluation. However, relatively more bPbL than cPbL students reported having used lecture videos, while the proportion of those attending lectures on-site was higher among cPbL students. Interviews revealed that some of the bPbL students' experiences were unexpected and feared disadvantages seemed to be less severe than expected. Participation in a blended PbL format did not worsen course evaluations or exam results, but seemed to influence lecture attendance. The combination of face-to-face and digital elements could be suitable as a hybrid approach to digital instruction in the post-pandemic era.

Video Didactic Preparation Augments Problem-Based Learning for First Year Medical Students

Problem-based learning (PBL) utilizes a self-directed strategy. This process relies on group participation to succeed. Students without a background in biology or medicine can feel overwhelmed by the complexity of the subject matter and unable to participate in the group learning process. We incorporated curated educational videos in the PBL curriculum to help address this situation. First year medical students participated in this study in the form of a typical PBL session. They were then assessed on basic and clinical science knowledge and their learning experience. Student basic science and clinical knowledge were similar between the student groups. However, the students given a list of suggested videos scored higher in their learning experience, perception of feeling prepared, and participating in the group PBL experience than students who were not given the video list. Results from this study indicate that videos can be utilized to enhance the PBL process.

First-year medical students' perceptions of a self-regulated learning-informed intervention: an exploratory study

BACKGROUND

Students with developed self-regulated learning (SRL) skills demonstrate an ability to set individualized educational goals, select optimal learning strategies for reaching these goals, and reflect on overall progress. The primary aims of this study were to investigate first-year medical students' perceived utility of a self-regulated learning-informed intervention and to assess the impact of its implementation on students' intended use of SRL throughout medical school.

METHODS

A two-part educational intervention focused on SRL skill development was carried out at Harvard Medical School during the start of the 2021 academic year. For the first component of the intervention, 169 first-year medical students engaged in an interactive class session structured around SRL concept videos, a brief lecture, small group discussions and individual reflection. Students completed pre- and post-intervention surveys which inquired about learners' current and anticipated application of SRL skills. During the second component of the intervention, 15 first-year medical students participated in a set of one-on-one academic SRL coaching sessions. All coaching participants completed follow-up semi-structured interviews.

RESULTS

A statistically significant increase was observed between students' use of skills in all domains of self-regulated learning prior to the intervention and their anticipated use of these skills following the intervention. Prior to the intervention, 60.1% (n = 92) of students reported utilizing evidence-based learning strategies, compared to 92.8% (n = 142) of students (p < 0.001) who anticipated applying this SRL skills at the completion of the classroom session. Six core themes emerged from qualitative analysis of the post-intervention survey including learning plan development, accountability and progress tracking, goals for growth, engagement through active learning, routine reflection, and adapting to the curriculum.

CONCLUSIONS

Both classroom-based learning sessions and one-on-one academic coaching programs are feasible approaches for encouraging the use of self-regulated learning techniques in the preclinical setting.

Application of problem-based learning combined with a virtual simulation training platform in clinical biochemistry teaching during the COVID-19 pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has had a great impact on the traditional teaching mode (Lecture-based Learning, LBL) and laboratory teaching. To address this challenge, the researchers conducted online Problem-based learning (PBL) teaching and virtual simulation laboratory teaching through DingTalk, and evaluated the effectiveness of this method in teaching clinical biochemistry.

METHODS

With the method of cluster sampling, the researchers randomly selected 60 students from two classes of the Class 2019 as the experimental group for this prospective experimental study. The theory class was taught online PBL through DingTalk, and experimental lectures were given by virtual simulation. After the experimental teaching, students were assessed for theory and operation. Self-administered questionnaires were administered through DingTalk. 65 students from our 2018 medical laboratory class were randomly selected as the control group, and offline LBL and traditional experimental teaching methods were used. Examination results were obtained through teaching portfolios.

RESULTS

The experimental group had significantly better examination scores in theoretical knowledge and experimental operational skills than the control group (87.45 ± 5.91 vs. 83.52 ± 9.94, P = 0.0095; 87.08 ± 12.42 vs. 80.18 ± 14.04, P = 0.0044). The results of the questionnaire survey revealed that the experimental group was more receptive to the DingTalk-PBL teaching method and virtual simulation laboratory teaching. Moreover, this hybrid teaching method was more effective in promoting basic knowledge understanding (95.0%, 57/60), facilitating the mastery of operational skills (93.3, 56/60), cultivating interest in learning (96.7%, 58/60), training clinical thinking (95.0%, 57/60), improving communication skills (95.0%, 57/60), and enhancing self-learning ability (91.7%, 55/60) and was more satisfying than traditional teaching method (all P < 0.05).

CONCLUSION

The DingTalk-based PBL method combined with virtual simulation experiments was an effective and acceptable teaching strategy during the pandemic compared with the traditional teaching method.

An innovation on clinical placement for occupational therapy mental health during the COVID-19: A mixed-methods feasibility study

The COVID-19 pandemic altered the health profession's education. Educational activities were shifted to online, and clinical placements were compromised in certain countries. A mixed-methods study included 17 undergraduates undergoing a mental health placement. The first 3 weeks of clinical placement applied online case-based learning in written and in video format. The last 2 weeks involved hybrid remote and physical onsite clinical placement. SPICES model utilizing various active learning activities, case studies and client attendance, facilitator engagement, discussion and feedback were implemented. A self-administered System Usability Scale (SUS), e-learning preference level, focus group discussion, and reflective writing was conducted at the end of each week and the students' final marks were compared with the past cohort who attended conventional physical clinical placement. Two-way mixed ANOVA indicates no significant interaction was found on the SUS (p = 0.062, ηp2 = 0.062) and preference scores (p = 0.285, ηp2 = 0.079) according to week and practical site. There was no significant difference in the final mark among the online and onsite placement of the current cohort (p = 0.350, d = 0.47). The current cohort reported better marks than the previous cohort who attended conventional placement (p = 0.006, d = 0.99). Qualitative findings show positive responses where online activities have minimal restriction on the learning process. This innovative approach is acceptable for substituting conventional clinical learning during this restricted situation.

Factors Affecting Knowledge and Attitude Towards Hybrid Problem-Based Learning Curriculum Among Academicians of the University of Gondar, Northwest Ethiopia

BACKGROUND

Adapting a tutor role in a hybrid problem-based learning (h-PBL) model is a challenge to novices. Therefore, this study aimed to assess the factors associated with the academicians' knowledge and attitude toward the h-PBL curriculum.

METHODS

An institution-based cross-sectional study was conducted from August 1st to 30th, 2021. A Simple random sampling was employed. Data were entered and analyzed with EpiData 4.6 and SPSS® version 25. Multivariable logistic regression analysis was fitted and adjusted odds ratio at a p-value of ≤0.05 and 95% confidence interval were used to declare significant association.

RESULTS

The study included 415 academicians with a response rate of 97.8%. Four-sixths (66.3%) of them have good knowledge (95% CI = 61.7-70.8). Being age 30-34 (AOR = 2.97; 95% = CI: 1.69-5.23), being age over 34 (AOR = 3.36; 95% CI = 1.6-6.66), currently teaching (AOR=1.84; 95 CI = 1.1-3.07) and having received PBL training (AOR = 1.9; 95% CI = 1.01-2.7) were significantly associated with good knowledge. More than half (51.1%) had a favorable attitude (95% CI = 46.3-55.9). Being age over 34 (AOR = 3.69; 95% CI: 1.98-6.89), having 5-9 (AOR = 2.21; 95% CI: 1.85-2.34) and above 9 years of experience (AOR = 1.53; 95% CI = 1.03-2.11), having received PBL training (AOR = 1.93; 95% CI = 1.17-2.8), ever-constructing PBL cases (AOR = 1.7; 95% CI = 1.08-2.68), and presence of rooms set aside for PBL sessions (AOR = 2.26; 95% CI = 1.2-4.16) were significantly associated with academicians' favorable attitude.

CONCLUSION

Academicians' knowledge and attitude towards the h-PBL curriculum can be improved with training, participation in PBL case construction, and setting rooms aside for PBL sessions.