The relationship between the monitored performance of tutors and students at PBL tutorials and the marked hypotheses generated by students in a hybrid curriculum

Prevalence of Psychological Distress among Undergraduate Medical Students: A Cross-Sectional Study

Background:

Stressful environment in medical school often has a negative effect on students' psychosocial well-being. An in-depth understanding of how medical students experience psychological distress and coping is necessary for the prospective students.

Objectives:

To estimate the prevalence of psychological distress among undergraduate medical students and its association with some demographic factors.

Materials and Methods:

A cross-sectional descriptive study was conducted among 380 medical students in the University of the West Indies, Saint Augustine. The questionnaires used in this study consisted of two components – (i) the demographic information that required participants to provide their gender, age, year of study, and nationality and (ii) Depression, Anxiety, and Stress Scale-21 items to measure the levels of psychological distress among participants.

Results:

Anxiety was the most prevalent psychological distress among medical students, with 63% of them having anxiety symptoms. Depression was found to be the second most common psychological distress, with a prevalence of 51%, while 48% of the students suffered from stress. In further analysis, we found that Trinbagonian students were more depressed than the students from Caribbean Community and other nationality. Higher anxiety score was significantly associated with gender and age of the students. There was a significant association between students from different age groups and level of stress.

Conclusions:

A considerable number of students studying medicine are suffering from psychological distress. Intervention programs to address the mental health problems of such students should be initiated.

Best practices to impart clinical skills during preclinical years of medical curriculum

Globally, health is regarded as a booming industry with greater stress being laid on high quality, accountability, and transparency. Traditional medical curricula rely primarily on clerkships during the clinical period of study to train clinical skills, while the preclinical period is mainly used to teach the basic sciences. In recent years, the early introduction of clinical skills training has received increased attention. This review aims to identify and summarize teaching approaches of clinical skills for medical students during preclinical years, namely, (1) framing objectives (2) learning activities, and (3) evaluation strategies. Although the clinical tutor's role is to ensure that students receive effective preclinical skills through different modes of learning (lectures, presentations, and problem-based learning), the role of advanced technologies, namely, simulation-based learning platforms and gamification are found to be very successful. To improve the communication skills, there is strong evidence in support of role plays, and similarly, for enhancing observation skills, an introduction of fine arts in clinical skills training was found to be very useful. Medical schools worldwide should give high priority to conduct faculty development programs on various aspects of training and teaching modalities, evaluation strategies, and improving the evaluation of various clinical skills. Students should be provided with sufficient learning opportunities including a well-equipped clinical skills laboratory and individual attention, and constructive feedback should be given to students for building their confidence level during their learning process.

Tutor assessment of PBL process: does tutor variability affect objectivity and reliability?

BACKGROUND

Ensuring objectivity and maintaining reliability are necessary in order to consider any form of assessment valid. Evaluation of students in Problem-Based Learning (PBL) tutorials by the tutors has drawn the attention of critiques citing many challenges and limitations. The aim of this study was to determine the extent of tutor variability in assessing the PBL process in the Faculty of Medical Sciences, The University of the West Indies, St Augustine Campus, Trinidad and Tobago.

METHOD

All 181 students of year 3 MBBS were assigned randomly to 14 PBL groups. Out of 18 tutors, 12 had an opportunity to assess three groups: one assessed 2 groups and 4 tutors assessed one group each; at the end each group had been assessed three times by different tutors. The tutors used a PBL assessment rating scale of 12 different criteria on a six-point scale to assess each PBL Group. To test the stated hypotheses, independent t-test, one-way ANOVA followed by post-hoc Bonferroni test, Intra Class Correlation, and Pearson product moment correlations were performed.

RESULT

The analysis revealed significant differences between the highest- and lowest-rated groups (t-ratio = 12.64; p < 0.05) and between the most lenient and most stringent raters (t-ratio = 27.96; p < 0.05). ANOVA and post-hoc analysis for highest and lowest rated groups revealed that lenient- and stringent-raters significantly contribute (p < 0.01) in diluting the score in their respective category. The intra class correlations (ICC) among rating of different tutors for different groups showed low agreement among various ratings except three groups (Groups 6, 8 and 13) (r = 0.40). The correlation between tutors' PBL experiences and their mean ratings was found to be moderately significant (r = 0.52; p > 0.05).

CONCLUSION

Leniency and stringency factors amongst raters affect objectivity and reliability to a great extent as is evident from the present study. Thus, more rigorous training in the areas of principles of assessment for the tutors are recommended. Moreover, putting that knowledge into practice to overcome the leniency and stringency factors is essential.

Medical students' perceptions of small group teaching effectiveness in hybrid curriculum

OBJECTIVES

The objective of this study was designed to investigate medical students' perceptions of small group teaching effectiveness in a hybrid curriculum.

MATERIALS AND METHODS

A cross-sectional, descriptive survey was conducted at the School of Medicine, The University of the West Indies, St. Augustine where we collected the data from 195 undergraduate students. A self-administered questionnaire consisting of 25 items was used to measure students' perception on the effectiveness of problem-based learning (PBL) with regard to learning experience, teamwork, confidence, communication skills, and role of the tutor. Statistical analyses included mean and standard deviation for the description of each item; t-test to compare the mean scores for gender and class year, and one-way analysis of variance between groups for age group comparisons.

RESULTS

The students overall perceptions of small group teaching effectiveness showed that the PBL sessions were beneficial to their learning process (mean: 3.63 ± 0.46). Students have positive perceptions toward small group effectiveness, particularly in learning experience (mean: 3.98 ± 0.63) and teamwork (mean: 3.67 ± 0.58). The mean scores, measuring teamwork, for 2^nd year students was significantly higher than that for 1^st year students (3.76 ± 0.55 and 3.55 ± 0.60 respectively, P = 013). A similar significant trend was observed between 2^nd year and 1^st year students on communication skills (3.48 ± 0.67 and 3.29 ± 0.55, respectively, P = 0.046).

CONCLUSIONS

PBL is an effective small group teaching method for medical students. Faculty development and students' training programs are required before implementing PBL.