Impact and educational outcomes of a small group self-directed teaching strategy in a clinical neuroscience curriculum

Integrating basic, clinical, and health system science in a medical neuroscience course of an integrated pre-clerkship curriculum

Basic science, clinical science, and health system science (HSS) have become three pillars of integration upon which modern, post-Flexner, medical education is now based. Because of this new approach to curricular integration in a clinical presentation curruculum, medical training is now placed in the context of healthcare delivery. This study described the design, implementation, and assessment of an integrated teaching strategy, including the effect on students' performance in a medical neuroscience course's summative and formative examinations of an integrated clinical presentation curriculum. The integrated teaching of basic science content, clinical case discussion, and HSS was performed in the first year of an allopathic integrated pre-clerkship curriculum. The two cohorts were from two different years, spring 2018 and 2019. The acceptance of the integrated teaching strategy by medical students was above 80% in all categories that were assessed, including enhancing the integrated experience in learning basic and clinical science materials in the context of HSS; understanding of the learning lessons; facilitation of self-directed learning; provision of a better learning environment; and a holistic understanding of materials including the relevance of HSS issues in the discussion of neurological cases in the medical career of the students. More than 90% of the students scored ≥70% in summative questions mapped to the four learning objectives of the integrated teaching session. The objectives are the correlation of structure to specific functions (94.0 ± 0.21), clinical anatomical features of the nervous system (95.0 ± 0.27), cross-sectional features of the nervous system (96.0 ± 0.31), and the effect of lesions on the structure and functional pathways of the nervous system (97.0 ± 0.34). This result was significantly higher when compared to students' performance in the non-integrated teaching cohort (p < 0.05). Formative assessments (F(7,159) = 92.52, p < 0.001) were significantly different between the two groups. When medical students were evaluated using the same questions for formative assessment, they performed better in the integrated teaching cohort (*p < 0.05) compared to the non-integrated teaching cohort (**p < 0.05).

Combatting Neurophobia: A Proposed Preliminary Educational Model to Promote Neurophilia

When we reflect on medical education as a whole, novelty in structure and content promotes growth and enhances student outcomes. The teaching of neurology is no different and presents a more unique hurdle in its instruction considering the well-described phenomenon of neurophobia. With the burden of neurological diseases on the rise, there is a heightened demand for medical educators to understand the possible causes of this educational misalignment and implement solutions necessary to ensure adequate education of students. In this study, we describe a novel approach to neurology education for second-year medical students to stimulate neurophilia, incorporating evidence-based approaches within the identified areas-Active Learning Pedagogies, Diagnostic and Clinical Reasoning, Use of Technology, Field Exposure and Mentorship, and Innovation. Students demonstrated superior academic performance on the National Board of Medical Examiners (NBME) neurology assessments and generally positive feedback on the use of innovative approaches to teaching and learning. Overall, we propose this method of teaching neurology as a model educational platform that aims to reduce neurophobia and promote neurophilia.

Effective Feedback Strategy for Formative Assessment in an Integrated Medical Neuroscience Course

Purpose

Despite the different benefits of formative assessments in an integrated medical curriculum, the effective strategies to provide feedback to medical students to benefit from the different merits of formative assessment are not fully understood. This study aims to determine the effect of different strategies of formative feedback on students' outcomes in a medical neuroscience course.

Method

We compared medical students' performance in summative examinations in the academic year that formative feedback was provided using in-person discussion and compared such performances with the academic year when the feedback was provided by written rationales or a combination of written rationales and in-person discussion. We also surveyed medical students' preferences for whether written or in-person formative feedback is a better strategy to provide feedback at the end of each course.

Results

ANOVA found a significant difference in summative performance scores for those scoring ≥ 70% when formative feedback was provided by providing a rationale, in-person, and a combination of both ([F (2,80) = 247.60, P < 0.001]. Post hoc analysis revealed a significant and highest performance when feedback was provided using the written rationale approach (***P < 0.05), followed by in-person (**P < 0.05). In contrast, the least performance was recorded when formative feedback was provided using a combination of providing a written rationale for the answers to the questions and in-person discussion of the questions (*P < 0.05). Students' preferred approach for receiving formative feedback for their formative assessment was highest for written rationale (***P < 0.05), followed by in-person or a combination of in-person and written rationale (**P < 0.05).

Conclusion

Our results found that medical students preferred a written formative feedback approach, which was associated with better student performance on the summative examination. This study reveals the importance of developing effective strategies to provide formative feedback to medical students for medical students to fully benefit from the merits of formative assessment in an integrated medical school curriculum.

Universal design for learning in anatomy education of healthcare students: A scoping review

There are concerns among healthcare practitioners about poor anatomical knowledge among recent healthcare graduates. Universal Design for Learning (UDL) is a framework developed to enhance students' experience of learning and help students to become motivated learners. This scoping review identified whether UDL has been utilized in third level healthcare education and if so, whether it had been used to enhance student motivation to study anatomy. Seven online databases were searched for studies reporting the use of UDL in the curricula of medical, dental, occupational therapy (OT) or speech and language therapy (SLT) programs. Studies were screened for eligibility with set inclusion criteria. Data were extracted and analyzed. Analysis revealed that UDL was not specifically mentioned in any of the studies thus there are no published studies on UDL being formally applied in healthcare education. However, the authors identified 33 publications that described teaching methods which aligned with UDL in anatomy curricula and a thematic analysis yielded four main themes relating to teaching strategies being employed. Universal design for learning was not mentioned specifically, indicating that educators may not be aware of the educational framework, although they appeared to be utilizing aspects of it in their teaching. The review revealed that there is a lack of research concerning the anatomy education of OT and SLT students. The role of UDL in enhancing motivation to learn anatomy in medical, dental, OT and SLT programs has yet to be explored.

Moving from tangibility toward digitalization: investigating team dynamics and facilitator support among medical students in conventional and digital small-group tutorials

BACKGROUND

Small group tutorials (SGT) promotes self-directed learning and is widely used in medical education. The coronavirus pandemic (COVID-19) has accelerated the trend toward SGT digitalization, with unclear effect. We hypothesize that team dynamics and facilitator support influence SGT satisfaction in digital versus conventional SGT.

METHODS

During the spring semester of year 2021, medical students (the second, third, and fourth year; n = 433) participating in conventional face-to-face and digital SGT curricula were enrolled. Participating students completed the collaborative learning attitude scale (including team dynamics, team acquaintance, and facilitator support dimensions) and teamwork satisfaction scale, previously validated for small-group collaborative learning, and chose preference between conventional or digital SGT in future curricula. Exploratory factor analysis (EFA) was performed to extract the essential structural factors of these scales. Paired t-tests were conducted to compare differences in different dimensions and satisfaction between the conventional and digital SGT settings. Two sets of multiple regression analyses were done; one with team satisfaction scale results and the other with preference for digital SGT as the dependent variable were used to evaluate determinants of these two variables.

RESULTS

The EFA results revealed that the original collaborative learning attitude scale was concentrated on two dimensions: team dynamics and facilitator support. No significant differences were noted between the SGT settings for the two dimensions and teamwork satisfaction. Regression analyses showed that teamwork dynamics was independently correlated with teamwork satisfaction in both conventional and digital SGT. Facilitator support was positively correlated with teamwork satisfaction in conventional, but not digital SGT. Higher teamwork satisfaction was an important determinant of preference for digital SGT among medical students.

CONCLUSIONS

Team dynamics were closely linked to teamwork satisfaction among medical students in both conventional and digital SGT, while the role of facilitator support became less obvious during digital SGT.

Case-based learning: A 'Case' for restructuring anatomy education in Indian nursing curriculum

BACKGROUND

Teaching anatomy in a clinical context can aid students in appreciating how the subject will apply to their future career as nurses as well as in other administrative roles. Anatomy is voluminous, making it difficult to retain the factual information in the long run; therefore, this study primarily focuses on whether case-based learning (CBL) with integrated anatomy learning can help in retention of the information over short as well as long spans of time. It also focuses on how profitable would the students be with this different style of learning, and whether it can facilitate in better understanding of the basic and clinical concepts.

MATERIALS AND METHODS

The current study was conducted in the Nursing College of All India Institute of Medical Sciences, Bhopal, India to integrate CBL and evaluate its effect compared to the highly compartmentalized, didactic lectures among the nursing students. The extent of knowledge retention was analyzed by conducting a series of tests before as well as after CBL intervention. Feedback and suggestions were obtained from the students by using the 5-point Likert scale method.

RESULTS

The post-test scores of the students improved by 21% after the CBL. More than 85% of the students opined that CBL improves critical thinking, team work, self-directed learning, and communication skills.

CONCLUSION

CBL promotes effective short-term retention and facilitates comprehension of key concepts. CBL also plays an important role in improving the professional skills of the students, which otherwise is not taught, and equips them for their future careers.