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Johnsen DC, Roushdy S, Floriani F, Shi W. Conceptualizing patient interactions eliciting empathy, compassion, reflection, and social projection: A model with analysis. J Dent Educ 2024. [PMID: 38764166 DOI: 10.1002/jdd.13585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/30/2024] [Accepted: 05/04/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVES Conceptualizing the next patient interaction is logical, essential, and largely done intuitively with limited literature. The first objective is to elicit student thought experiences to four questions. The secondary objective is to classify responses for respective questions and to review faculty assessments. METHODS Forty-two students completed the exercise in the first clinical prosthodontics experience after a simulation course, in the fall of 2023. Four open-ended questions were 1) differentiation from the ideal, 2) desired outcome(s), 3) self-capabilities, and 4) consequences/prognosis. Nine different faculty assessed the exercise. RESULTS 100% of students responded to all four questions and 83% of responses were judged by faculty to grasp the concept in the question. The authors categorized responses into natural categories for each question. Authors separately assigned responses to categories. The agreement rate was 90%. Little to no overlap in responses was observed among the four questions. The sequence of questions led students to thought experiences from empathy in Question #1, to compassion in Question #2, and to self-reflection in Question #3 to social projection in Question #4. CONCLUSIONS The main objective was met by engaging students in thought-provoking responses to questions the experienced clinician asks of every patient encounter. The exercise elicited different kinds of thought experiences on four topics. The format was succinct with acceptance by students and faculty. The project has progressed from a concept some years ago to a recent pilot to full implementation with the current project. The next steps will be refinement and follow-up in some years. The project follows an emulation model for critical thinking.
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Affiliation(s)
- David C Johnsen
- Professor of Pediatric Dentistry and Dean Emeritus, Iowa Oral Health Research Institute, Iowa City, Iowa, USA
- Clinical Assistant Professor of Prosthodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Sally Roushdy
- Professor of Pediatric Dentistry and Dean Emeritus, Iowa Oral Health Research Institute, Iowa City, Iowa, USA
- Clinical Assistant Professor of Prosthodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Franciele Floriani
- Professor of Pediatric Dentistry and Dean Emeritus, Iowa Oral Health Research Institute, Iowa City, Iowa, USA
- Clinical Assistant Professor of Prosthodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Wei Shi
- Professor of Pediatric Dentistry and Dean Emeritus, Iowa Oral Health Research Institute, Iowa City, Iowa, USA
- Clinical Assistant Professor of Prosthodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
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Brendan Young L, Johnsen DC, Shi W. Student empathy in standardized patient experiences: Applying concepts from a critical thinking emulation model. J Dent Educ 2023; 87:1682-1691. [PMID: 37574703 DOI: 10.1002/jdd.13352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 06/20/2023] [Accepted: 07/27/2023] [Indexed: 08/15/2023]
Abstract
INTRODUCTION Clinician empathy can improve patient outcomes, but the literature is scant on patient-based, student-led experiences to demonstrate the projection of empathy in patient interactions. PURPOSE/OBJECTIVES (1) Develop a learning guide for observable behaviors communicating emotional and cognitive empathy and (2) determine whether the learning guide can be used as a rubric for assessing empathy in a standardized patient experience. METHODS Eleven standardized patients assessed 80 D3 students using a 4-point interval scale on 19 behavioral criteria in four domains: Initiation (four criteria); Health History and Caries Risk (four criteria); Treatment Planning (six criteria); and Communication Skills (five criteria). Standardized patients also provided qualitative feedback. RESULTS Standardized patients completed all 1520 interval scales on the rubric and 94% of 320 open-ended entries. Students performed well. Of the 1520 criterion interval scales, 1242 (81.7%) were rated "excellent." Wilcoxon signed-rank tests revealed Initiation scores (Mean [M] = 3.82, Standard deviation [SD] = 0.28) and Treatment Planning scores (M = 3.82, SD = 0.36) were significantly higher than Health History Scores (M = 3.75, SD = 0.34; p < 0.05). Qualitative feedback also was overwhelmingly positive for Treatment Planning and more equivocal for Health History. CONCLUSIONS The emulation model for students to demonstrate observable aspects of empathy is viable as both a learning guide and evaluation rubric in a standardized patient format. The next steps include the development of a succinct skillset for reinforcement in the patient setting and continued discussion on what best captures core observable aspects of empathy.
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Affiliation(s)
- Lance Brendan Young
- Department of Preventive and Community Dentistry, Iowa Oral Health Research Institute, Iowa City, Iowa, USA
| | - David C Johnsen
- Department of Preventive and Community Dentistry, Iowa Oral Health Research Institute, Iowa City, Iowa, USA
| | - Wei Shi
- Department of Preventive and Community Dentistry, Iowa Oral Health Research Institute, Iowa City, Iowa, USA
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Zhang Y, Liu J, Liang J, Lang J, Zhang L, Tang M, Chen X, Xie Y, Zhang J, Su L, Wang X. Online education isn't the best choice: evidence-based medical education in the post-epidemic era-a cross-sectional study. BMC MEDICAL EDUCATION 2023; 23:744. [PMID: 37817252 PMCID: PMC10563228 DOI: 10.1186/s12909-023-04746-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 10/04/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND The COVID-19 pandemic led many educational institutions to shift to online courses, making blended education a significant trend in teaching. We examined the effectiveness of blended learning in an evidence-based medicine course. METHODS We compared the examination scores of a blended learning group, an online only group, and a traditional offline group and conducted a questionnaire survey on students' preferences for different learning modes and the reasons for their preferences. A total of 2100 undergraduate students in clinical medicine were included in this cross-sectional study. Examination results were collected, and questionnaires were administered to the study participants. We compared the mean scores and exam pass rates of the three teaching groups using ANOVA and c2test for multiple comparisons. RESULTS The blended group's exam scores and pass rate were significantly higher than those of the offline and online groups. Furthermore, 71.6% preferred the blended teaching mode. In the survey on " learning effectiveness", the majority of the students believed that blended education could better enhance the initiative of learning, the interest of the course, the pertinence of the learning content, the comprehension of evidence-based medical thinking, and the basic skills of evidence-based practice. Subsequently, in a questionnaire administered to a blended group of students, their foremost reason for liking online instruction was 'flexible in time and space' (99%), followed by 'can be viewed repeatedly, facilitating a better understanding of knowledge points' (98%). Their foremost reason for liking offline teaching was 'helps to create a good learning atmosphere' (97%), followed by 'teachers can control students' learning status in real time' (89%). CONCLUSIONS This study explored the effectiveness of learning in evidence-based medicine courses by comparing the learning outcomes and personal perceptions of three different teaching modes. This is the first cross-sectional study in which three different teaching models are compared and discussed in an evidence-based medicine course. We also elaborate on the specific instructional protocols for each model. This study shows that using a blended education approach in evidence-based medicine courses can improve students' learning motivation, autonomy, and satisfaction. It also enhances instructional efficiency, thereby improving students' understanding of the course content.
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Affiliation(s)
- Yi Zhang
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China.
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China.
| | - Jiarui Liu
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- School of Public Health, Guizhou Medical University, No. 6, Ankang Avenue, Machang Town, Guian New District, Zunyi, Guizhou Province, China
| | - Jun Liang
- School of Chemical Engineering and Light Industry, Guangdong Industry Polytechnic, Guangzhou, Guangdong, 510300, China
| | - Jie Lang
- Enrollment and Employment Office, Zunyi Medical University, Zunyi, Guizhou, 563099, China
| | - Lijia Zhang
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China
| | - Mingwen Tang
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China
| | - Xinyu Chen
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China
| | - Yan Xie
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China
| | - Jianlin Zhang
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China
| | - Liyu Su
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China
| | - Xin Wang
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China.
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, 563003, China.
- Guizhou Provincial Key Laboratory of Medicinal Biotechnology in Colleges and Universities, Zunyi Medical University, Zunyi, Guizhou, 563000, China.
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Phenwan T, Peerawong T, Jarusomboon W, Sittiwantana E, Satian C, Supanichwatana S. Using Zoom and Card Game to Conduct Advance Care Planning Classes: An Innovative Practice. OMEGA-JOURNAL OF DEATH AND DYING 2023; 87:1028-1047. [PMID: 34275389 DOI: 10.1177/00302228211032735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND This article demonstrates the innovative practice of using a card game to teach participants about Advance Care Planning (ACP) and palliative care in Thailand via Zoom during the COVID-19 pandemic. AIMS To assess the feasibility of using online workshops to conduct sensitive topics of palliative care and death and dying. METHODS The interactive online workshops were conducted after imposition of the COVID-19 restriction and national lockdown in Thailand between March and September 2020. The sessions were conducted via Zoom meetings and Facebook secret group. Trained facilitators plus one IT team member hosted each workshop. Participants were given an anonymous post-course evaluation with open-ended written feedback form. Content analysed was used. RESULTS Eleven sessions were conducted. 103 participants joined the online classes. Participants gave an overwhelmingly positive of the workshops, emphasising on: (i) convenient; (ii) social connectedness during the lockdown; (iii) bichronous element of the activities.
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Affiliation(s)
- Tharin Phenwan
- School of Health Sciences, University of Dundee, University of Dundee, UK
- School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
| | - Thanarpan Peerawong
- Department of Radiology, Prince of Songkla University, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | | | - Ekkapop Sittiwantana
- Peaceful Death, Bangkok Noi, Bangkok, Thailand
- Contemplative Education Center, Mahidol University, Salaya, Thailand
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Johnsen DC, Mahrous A, Syrbu J, Kallem ML, Comnick CL. Conceptualizing the next patient interaction: A clinical skillset using an emulation model in critical thinking. J Dent Educ 2022; 86:1602-1610. [PMID: 35918297 DOI: 10.1002/jdd.13062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 12/14/2022]
Abstract
CONCEPTUALIZING The next patient interaction is logical, essential, and largely done intuitively. MAIN PURPOSE To design and test a succinct learning guide for student guidance and student-faculty interaction in conceptualizing the next patient interaction. METHODS In 2021 and 2022, faculty scored questions from 1-5: Recognize deviation from the ideal? Articulate how and how much the situation deviated? Gage consequences of the situation? Assess own capabilities? To what extent does the student have a clear grasp of the procedural outcome? Faculty were also given open-ended questions. RESULTS Forty-eight reports were completed, 25 D3 and 23 D4. Three hundred thirty-five faculty entries were made in the questions calling for a 1-5 response out of a possible 336 responses. Statistically significant differences were noted. Students were better able to recognize the situation as different from ideal than to articulate how and how much the situation deviated. Students were better able to grasp how and how much this situation differs from the ideal than to assess own capabilities. D4 students were better able to recognize deviation from the ideal and to articulate how and how much the situation deviated than were D3 students. For open-ended questions, more students were scored as "Prepared" than were scored as "Unsure" and "Missed" combined. CONCLUSIONS The exercise is seen as a succinct and constructive (nonjudgmental) path to guide the student's conceptualization of the next patient encounter before the encounter begins. Next steps will be incremental for wider use in a clinical teaching environment.
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Affiliation(s)
- David C Johnsen
- Department of PedIatric Dentistry, University of Iowa College of Dentistry, Dental Science building, Iowa City, Iowa, USA
| | - Ahmed Mahrous
- Department of Prosthodontics, University of Iowa College of Dentistry, Dental Science Building, Iowa City, Iowa, USA
| | - John Syrbu
- Department of Family Dentistry, University of Iowa College of Dentistry, Dental Science Building, Iowa City, Iowa, USA
| | - Marisa L Kallem
- Division of Biostatistics and Computational Biology, University of Iowa College of Dentistry and Department of Biostatistics, University of Iowa College of Public Health, Public Health Science Building, Iowa City, Iowa, USA
| | - Carissa L Comnick
- Division of Biostatistics and Computational Biology, University of Iowa College of Dentistry and Department of Biostatistics, University of Iowa College of Public Health, Dental Science Building, Iowa City, Iowa, USA
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Kerkstra RL, Rustagi KA, Grimshaw AA, Minges KE. Dental education practices during COVID-19: A scoping review. J Dent Educ 2022; 86:546-573. [PMID: 34978714 PMCID: PMC9015347 DOI: 10.1002/jdd.12849] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/25/2021] [Accepted: 11/20/2021] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Dental education was brought to a halt with the emergence of coronavirus disease (COVID-19). Traditional dental education comprised students working closely with instructors in a clinical laboratory setting; however, public health precautions necessitated a shift to a virtual learning platform. A scoping review of dental education practices since the start of the pandemic will help to understand approaches instructors have taken to provide dental education during this unprecedented time and suggest future applications of virtual learning in dental education. METHODS We performed an exhaustive scoping literature search of primary peer-reviewed intervention articles published between December 2019 and April 2021 using the following databases: Academic Search Premier, Cochrane Library, Embase, ERIC, LitCovid, MedEdPortal, MedRxiv, Medline, Scopus, and Web of Science. The selection process included two independent reviewers through each phase of review. Articles were categorized and analyzed by domain. RESULTS A total of 629 articles were identified; after titles and abstracts were reviewed, 66 articles were selected for full-text review. Following full-text review, 41 articles met eligibility criteria and comprised our study sample. Articles were arranged within domains of assessment, instruction, instructional technology, and software. The advantages to online dental education included improved accessibility, willingness to accept new assessment techniques, and lower anxiety levels. Barriers included problems with technology, classroom time management, lack of student interaction, and absence of hands-on training. CONCLUSION Evidence suggests emerging best practices in dental education during COVID-19, and recommendations for the future of virtual and distance learning in dental education.
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Affiliation(s)
- Robin L Kerkstra
- Department of Allied Health, School of Health Sciences, University of New Haven, West Haven, Connecticut, USA
| | - Khyati A Rustagi
- Department of Health Administration and Policy, School of Health Sciences, University of New Haven, West Haven, Connecticut, USA
| | - Alyssa A Grimshaw
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, West Haven, Connecticut, USA
| | - Karl E Minges
- Department of Health Administration and Policy, School of Health Sciences, University of New Haven, West Haven, Connecticut, USA
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