Does Test-enhanced Learning Improve Success Rates of Ultrasound-guided Peripheral Intravenous Insertion? A Randomized Controlled Trial

The Importance of Sociocultural Factors in Moderating the Applicability of Test-Enhanced Learning to Continuing Professional Development

Many studies have shown that repeated testing promotes learning, an effect known as test-enhanced learning. Although test-enhanced learning has been well-established within health care trainees, there are mixed findings of whether testing facilitates learning within continuing professional development (CPD) contexts. This piece argues that for testing to support learning in CPD, there is need to understand the various social, cultural, and structural factors that influence clinicians' willingness to participate in regular testing activities. The solution to this problem is conceptual in nature, whereby CPD programs must consider how learning cultures shape practicing clinicians' perspectives toward testing.

Test-enhanced learning improves learner attendance during a laparoscopic box trainer simulation program

Background

Laparoscopy is the gold standard approach for many surgical procedures, but it is a complex skill to learn. Laparoscopic simulation training may help, but it is unclear how to best engage trainees in these programs. Test‐enhanced learning (TEL) uses regular, well‐defined assessments of performance throughout the training phase of learning.

Aim

The aim of this study was to assess the effects of TEL on a laparoscopic simulation program involving a cohort of medical student volunteers.

Materials and methods

A prospective cohort study was performed with a convenience sample of 40 medical students. Students were recruited to participate in a ten‐week laparoscopic simulation program. Twenty students participated in a laparoscopic surgical program with TEL (‘TEL group’), and 20 students participated in a standard laparoscopic simulation program (‘control group’).

Results

Attendance in the TEL group was significantly higher than in the standard group (71 vs 51.5%, P = 0.03). There was no difference between groups in mean time scores. Four themes were identified in qualitative data drawn from student surveys – personal traits and motivators, training context, clear goals and feedback enabling understanding of one's own performance.

Conclusion

Testing laparoscopic skills throughout a learning program, in conjunction with individualised feedback and tracking of learning trajectory, increases trainee attendance. Laparoscopic simulation training programs are encouraged to reflect on the pedagogic framework in which their procedural skills training operates.

Education in the placement of ultrasound-guided peripheral venous catheters: a systematic review

BACKGROUND

Placing a peripheral vein catheter can be challenging due to several factors, but using ultrasound as guidance increases the success rate. The purpose of this review is to investigate the knowledge already existing within the field of education in ultrasound-guided peripheral vein catheter placement and explore the efficacy and clinical impact of different types of education.

METHODS

In accordance with PRISMA-guidelines, a systematic search was performed using three databases (PubMed, EMBASE, CINAHL). Two reviewers screened titles and abstracts, subsequently full-text of the relevant articles. The risk of bias was assessed using the Cochrane Collaboration risk of bias assessment tool and the New Ottawa scale.

RESULTS

Of 3409 identified publications, 64 were included. The studies were different in target learners, study design, assessment tools, and outcome measures, which made direct comparison difficult. The studies addressed a possible effect of mastery learning and found e-learning and didactic classroom teaching to be equally effective.

CONCLUSION

Current studies suggest a potential benefit of ultrasound guided USG-PVC training on success rate, procedure time, cannulation attempts, and reducing the need for subsequent CVC or PICC in adult patients. An assessment tool with proven validity of evidence to ensure competence exists and education strategies like mastery learning, e-learning, and the usage of color Doppler show promising results, but an evidence-based USG-PVC-placement training program using these strategies combined is still warranted.

No observed effect from a student-led mock objective structured clinical examination on subsequent performance scores in medical students in Canada

Student-led peer-assisted mock objective structured clinical examinations (MOSCEs) have been used in different settings to help students prepare for subsequent higher-stakes, faculty-run OSCEs. MOSCE participants generally valued feedback from peers and report benefits to learning. Our study investigated whether participation in a peer-assisted MOSCE affects subsequent OSCE performance. To determine whether mean OSCE scores differed depending on whether medical students participated in the MOSCE, we conducted a between-subjects analysis of variance (ANOVA), with cohort (2016 vs. 2017) and MOSCE participation (MOSCE vs. No MOSCE) as independent variables and mean OSCE score as the dependent variable. Participation in the MOSCE had no influence on mean OSCE scores (P=0.19). There was a significant correlation between mean MOSCE scores and mean OSCE scores (Pearson's r = 0.52, P<0.001). Whereas previous studies report self-reported benefits from participation in student-lead MOSCEs, it was not associated with objective benefits in this study.