Who teaches basic procedural skills: Student experience versus faculty opinion

Structure and quality of bedside teaching: A videographic analysis

Bedside teaching (BST) is a core element of medical education. In light of a reported decrease in BST, evidence on how to use BST time most efficiently should be developed. Given that little research into the tangible quality characteristics of good BST has been reported, we investigated the influence of various teacher and structural characteristics on the perceived quality of BST. We filmed and coded 36 BSTs involving 24 lecturers and 259 students. Structural characteristics of interest were: number of students and patients, overall duration, and the proportion of clinical examination. Lecturer questionnaires provided insight into teaching experience and intrinsic motivation, and student evaluations assessed the quality of BSTs in three dimensions. Correlations are reported using the Pearson r and a linear mixed model (LMM). The intrinsic motivation of lecturers was significantly positively correlated with perceived quality, but their experience was only weakly so correlated. In the LMM, a significant association was observed for the quality dimension of clinical teaching with the number of patients and the proportion of time spent on clinical examination. Based on our findings, we recommend including multiple patients in BSTs, and providing substantial opportunities for clinical examination. Regarding lecturers, motivation matters more than experience.

Pre-clerkship procedural training in venipuncture: a prospective cohort study on skills acquisition and durability

BACKGROUND

The effectiveness of simulation-based training for skill acquisition is widely recognized. However, the impact of simulation-based procedural training (SBPT) on pre-clerkship medical students and the retention of procedural skills learned through this modality are rarely investigated.

METHODS

A prospective cohort study was conducted among pre-clerkship medical students. Learners underwent SBPT in venipuncture in the skills laboratory. Assessments were conducted at two main points: 1) immediate assessment following the training and 2) delayed assessment one year after training. Learner self-assessments, independent assessor assessments for procedural competency, and communication skills assessments were conducted in both instances. The students were assessed for their competency in performing venipuncture by an independent assessor immediately following the training in the simulated setting and one-year post-training in the clinical setting, using the Integrated Procedural Protocol Instrument (IPPI). The student's communication skills were assessed by standardized patients (SP) and actual patients in the simulated and clinical settings, respectively, using the Communication Assessment Tool (CAT).

RESULTS

Fifty-five pre-clerkship medical students were recruited for the study. A significant increase was observed in self-confidence [mean: 2.89 SD (Standard Deviation) (0.69)] and self-perceived competency [mean: 2.42 SD (0.57)] in performing venipuncture, which further improved at the delayed assessment conducted in the clinical setting (p < 0.001). Similarly, the IPPI ratings showed an improvement [immediate assessment: mean: 2.25 SD (1.62); delayed assessment: mean: 2.78 SD (0.53); p < 0.01] in venipuncture skills when assessed by an independent assessor blinded to the study design. A significant difference (p < 0.01) was also observed in doctor-patient communication when evaluated by SPs [mean: 2.49 SD (0.57)] and patients [mean: 3.76 SD (0.74)].

CONCLUSION

Simulation-based venipuncture training enabled students to perform the procedure with confidence and technical accuracy. Improved rating scores received at a one-year interval denote the impact of clinical training on skills acquisition. The durability of skills learned via SBPT needs to be further investigated.

Mind the gap: The integration of anatomy course contents with basic procedural skills

Objectives

This study investigated the value of procedural skill acquisition in low-fidelity simulation labs for students entering a clinical setting during the mandatory one-month nursing internship.

Methods

We conducted a course that combined gross anatomy knowledge with the teaching of simple procedural skills. We analysed 299 students' opinions and then compared them with their assessment outcomes.

Results

The survey results showed general satisfaction of students with the simulation-based course. Regarding the role of procedural labs as an adequate enhancement for traditional anatomy labs, students considered the basic procedural skills course as a strong alternative for traditional anatomy lectures and labs. Moreover, a comparison of participants' pre- and post-course answers indicated a significant increase in their anatomy knowledge.

Conclusions

This study thus indicated a positive perception of students about a course that employed innovative educational measures. In this way, the positive impact of teaching anatomical knowledge through basic procedures was noted.

Student’s perspective of Residents as educators following introduction of Accreditation Council for Graduate Medical Education-International (ACGME-I) in SingHealth Residency

Introduction:

Singapore’s postgraduate medical education underwent a transition in 2010, moving away from the House staff model to the American Residency model. Teaching was defined as a core competency for SingHealth Residency programs. This study sought to determine how this transition impacted medical students’ perception of Residents as teachers.

Methods:

A 19-item Likert-type questionnaire comprising three domains—(1) quality, (2) frequency and (3) engagement—was given to all Duke-NUS medical students at the end of each clerkship from the academic year (AY) 2009–10 through 2013–14. The first two academic years were classified as the pre-initiation stage of the Residency, and the latter three, the post-initiation stage. Students rated Residents they encountered in their most recent clerkship.

Results:

Student ratings have gradually improved, with the largest improvement occurring after the initiation of Residency, and after the introduction of Residents as Future Teachers courses. Student ratings in the post-initiation Residency years combined were significantly higher than the pre-initiation of Residency years combined, for all three domains. Analysis of individual items revealed significant improvement in student ratings on all items in all domains, except for the quality of teaching in performing procedural skills.

Conclusion:

Findings from this study indicate a positive shift in the teaching culture with the transition of Singapore’s postgraduate medical education from the House staff model to the Residency program.

Low-fidelity bench models for basic surgical skills training during undergraduate medical education

It is remarkable the reduction in the number of medical students choosing general surgery as a career. In this context, new possibilities in the field of surgical education should be developed to combat this lack of interest. In this study, a program of surgical training based on learning with models of low-fidelity bench is designed as a complementary alternative to the various methodologies in the teaching of basic surgical skills during medical education, and to develop personal interests in career choice.