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Sankey C, Riquelme PA, Windish DM. Internal Medicine Residents' Confidence and Preferences in Hospital Medicine Competencies: A Multi-Site Study. J Gen Intern Med 2024:10.1007/s11606-024-09111-z. [PMID: 39384690 DOI: 10.1007/s11606-024-09111-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 09/30/2024] [Indexed: 10/11/2024]
Abstract
BACKGROUND Hospital medicine (HM) is an important career option for internal medicine (IM) residency graduates. Limited data exist regarding preferences and educational gaps in HM competencies among IM residents. OBJECTIVE To assess resident confidence and desire for additional instruction in HM competencies across a broad spectrum of residents. DESIGN A multi-center survey-based assessment of IM resident confidence and desire for additional instruction in published HM competencies. PARTICIPANTS PGY-1 through PGY-4 residents from eight US IM residency programs, including academic medical center (AMC) and community-based programs (CBPs). MAIN MEASURES Resident confidence and desire for more teaching in HM competency domains including procedures, point-of-care ultrasound (POCUS), system-level competencies, clinical skills, patient-level competencies, palliative care, and care transitions. KEY RESULTS We received survey responses from 272 of 594 (46%) residents. More than half of respondents envisioned a future HM position. Results demonstrated lower than expected confidence for all HM competencies surveyed. Confidence was lowest (30-36% confident) for procedures, POCUS, and system-level competencies, and highest (65-78%) in care transitions, patient-level competencies, and palliative care. Desire for more instruction was highest in the same competency domains rated with the lowest confidence. Junior residents (PGY-1 and PGY-2) reported significantly lower confidence levels than senior residents (PGY-3 and PGY-4) across all domains except patient-level competencies. Junior residents expressed a significantly higher desire than senior residents for more teaching in all domains. There were no significant differences in confidence or desire for more instruction between trainees who envision a future HM position versus those who do not. Residents from AMCs expressed significantly higher confidence than those from CBPs in POCUS, clinical skill, patient-level, palliative care, and care transitions, while residents from CBPs reported significantly higher confidence in procedures. CONCLUSIONS Our data can inform targeted inpatient competencies and educational curricula for IM residents in the USA.
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Affiliation(s)
- Christopher Sankey
- Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
| | - Patricio A Riquelme
- Division of Hospital Medicine, Oregon Health & Science University School of Medicine, Portland, OR, USA
| | - Donna M Windish
- Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
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Tzamaras H, Sinz E, Yang M, Ng P, Moore J, Miller S. Competence over confidence: uncovering lower self-efficacy for women residents during central venous catheterization training. BMC MEDICAL EDUCATION 2024; 24:923. [PMID: 39187825 PMCID: PMC11348568 DOI: 10.1186/s12909-024-05747-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 07/04/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND While women make up over 50% of students enrolled in medical school, disparities in self-efficacy of medical skills between men and women have been observed throughout medical education. This difference is significant because low self-efficacy can impact learning, achievement, and performance, and thus create gender-confidence gaps. Simulation-based training (SBT) employs assessments of self-efficacy, however, the Dunning-Kruger effect in self-assessment posits that trainees often struggle to recognize their skill level. Additionally, the impact of gender on self-efficacy during SBT has not been as widely studied. The objective of this study was to identify if the gender-confidence gap and the Dunning-Kruger effect exist in SBT for central venous catheterization (CVC) on the dynamic haptic robotic trainer (DHRT) utilizing comparisons of self-efficacy and performance. METHODS 173 surgical residents (Nwomen=61, Nmen=112) underwent training on the DHRT system over two years. Before and after using the DHRT, residents completed a 14-item Central Line Self-Efficacy survey (CLSE). During training on the DHRT, CVC performance metrics of the number of insertion attempts, backwall puncture, and successful venipuncture were also collected. The pre- and post-CLSE, DHRT performance and their relationship were compared between men and women. RESULTS General estimating equation results indicated that women residents were significantly more likely to report lower self-efficacy for 9 of the 14 CLSE items (p < .0035). Mann-Whitney U and Fisher's exact tests showed there were no performance differences between men and women for successfully accessing the vein on the DHRT. Regression models relating performance and self-efficacy found no correlation for either gender. CONCLUSIONS These results indicate that despite receiving the same SBT and performing at the same level, the gender-confidence gap exists in CVC SBT, and the Dunning-Kruger effect may also be evident.
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Affiliation(s)
- Haroula Tzamaras
- Penn State, Department of Industrial Engineering, State College, 307 Engineering Design and Innovation Building, University Park, PA, 16801, USA
| | - Elizabeth Sinz
- WVU Critical Care and Trauma Institute, Morgantown, WV, USA
| | - Michael Yang
- General Internal Medicine Cedars-Sinai, Los Angeles, CA, USA
| | - Phillip Ng
- General Internal Medicine Cedars-Sinai, Los Angeles, CA, USA
| | - Jason Moore
- Penn State Department of Mechanical Engineering, State College, University Park, PA, USA
| | - Scarlett Miller
- Penn State, Department of Industrial Engineering, State College, 307 Engineering Design and Innovation Building, University Park, PA, 16801, USA.
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O' Sullivan S, Hageh CA, Dimassi Z, Alsoud LO, Presley D, Ibrahim H. Exploring challenges in learning and study skills among first-year medical students: a case study. BMC MEDICAL EDUCATION 2024; 24:869. [PMID: 39135001 PMCID: PMC11318319 DOI: 10.1186/s12909-024-05850-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 08/01/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Despite being high-achieving students, many medical students face academic challenges, particularly during their first year of study. Research indicates that self-regulated learning, involving metacognitive processes and adaptive strategies, can positively influence academic achievement. This study aimed to assess the early learning and study skills of first-year medical students in an international medical school with the goal of developing a learner-centered educational intervention to promote self-regulated learning. METHODS We conducted a retrospective analysis of the Learning and Study Skills Inventory (LASSI) questionnaire that was administered annually each August to first-year medical students from 2019 to 2022. The distribution of students across different percentile ranges for each selected variable was determined for each year and all years collectively. Students were counted within distinct percentile brackets (50th and below, between 51st and 75th, and above 75th ) for each variable. RESULTS A total of 147 students completed the LASSI questionnaire over the 4-year time period. Using academic resources was the greatest concern, with 67% of students in the 50th or below percentile, followed by selecting the main idea (56%), motivation (51%), and concentration (50%). Attitude scored highest across all cohorts, scoring between 21.55 ± 0.73 and 26.49 ± 0.34. In comparing mean scores of LASSI variables across all cohorts, attitude, motivation, test-taking strategies, time management, and the use of academic resources differed significantly (p < 0.05). CONCLUSION LASSI data can provide an early picture of students' support needs. We posit that early identification of student learning and study skills and areas of struggle can inform personalized educational interventions and programs to support first-year medical students.
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Affiliation(s)
- Siobhán O' Sullivan
- Department of Biological Sciences, Khalifa University College of Medicine and Health Sciences, PO Box 127788, Abu Dhabi, United Arab Emirates.
| | - Cynthia Al Hageh
- Department of Medical Sciences, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Zakia Dimassi
- Department of Medical Sciences, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Leen Oyoun Alsoud
- Department of Medical Sciences, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Diane Presley
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Halah Ibrahim
- Department of Medical Sciences, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
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Liang L, Nagasawa M, Ha V, Lin AJ, Akiba Y, Akiba N, Yamakami SA, Uoshima K, Ohyama H. Association between gender and self-assessment skills amongst Japanese dental students. J Dent Sci 2024; 19:1533-1539. [PMID: 39035302 PMCID: PMC11259621 DOI: 10.1016/j.jds.2023.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/27/2023] [Indexed: 07/23/2024] Open
Abstract
Background/purpose Self-assessment in dental education is considered a fundamental skill for proficient oral healthcare providers. While previous studies looked at self-assessment in education, few have done so at Japanese institutions. This study aimed to assess potential associations between gender and self-assessment skills in Japanese dental students. Materials and methods Dental students from Niigata University (n = 301) completed preclinical prosthodontic exercises and self-assessed their practical exam performance. Three calibrated faculty evaluated students' work using the same rubric. The difference between student self-assessment score and mean faculty grade was defined as the student-faculty (S-F) gap, indicating how accurately students evaluated their work. The gap scores were stratified by quartiles by faculty grade and by gender. Regression analysis was used to investigate potential associations. Results Students mean S-F gap was 2.9 ± 10.5 % with a significant negative association to faculty grades (coefficient, -0.32; P < 0.001). There was no significant difference between male and female students for faculty grades, self-assessment scores, and S-F gaps. When stratified by quartile, mean S-F gaps of bottom quartile students (5.7 ± 11.9 %) were significantly higher than the rest of the class (1.9 ± 9.8 %; P = 0.01), while the mean S-F gaps of students in the top quartile (-0.8 ± 10.2 %) were significantly lower than the rest of the class (4.2 ± 10.3 %; P < 0.001). Conclusion Niigata University students generally overestimated their performance. Students with higher faculty grades self-assessed themselves more accurately than students with lower faculty grades. Gender did not influence S-F gaps, despite dentistry in Japan shifting toward a female-dominated field.
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Affiliation(s)
- Lang Liang
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Masako Nagasawa
- Division of Bio-Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Vivian Ha
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Amy J. Lin
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Yosuke Akiba
- Division of Bio-Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Nami Akiba
- Division of Bio-Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Shelyn A. Yamakami
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Boston, MA, USA
| | - Katsumi Uoshima
- Division of Bio-Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hiroe Ohyama
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Boston, MA, USA
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Gholami H, Arshad M, Kharazifard MJ, Ghazanfari R. Self-assessment skills of undergraduate dental students in the preclinical course of complete removable prosthodontics at Tehran University of Medical Sciences. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024; 28:1-8. [PMID: 37145242 DOI: 10.1111/eje.12909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/21/2023] [Accepted: 04/16/2023] [Indexed: 05/06/2023]
Abstract
INTRODUCTION This study evaluated the self-assessment skills of third-year dental students regarding their performance in complete removable prosthodontics (CRP) preclinical course. METHODS AND MATERIALS This cross-sectional study was conducted on all third-year dental students attending the International Dental College of Tehran University of Medical Sciences. The students were requested to self-assess their performance in primary impression making, custom tray fabrication, border moulding, final impression making, master cast fabrication, record-base fabrication and tooth arrangement in CRP preclinical course. The performance of dental students in each step was scored by themselves and their mentors. Data were analysed by the Mann-Whitney U, Pearson's correlation and t-tests (α = 0.05). RESULTS Totally 25 male (55.6%) and 20 female (44.4%) dental students were evaluated. Significant differences were noted between male and female dental students in self-assessment scores regarding adequate extension of the custom tray (p = .027), the correct position of tray handle (p = .020), visibility of vestibular width and depth on the cast (p = .011), the coincidence of upper and lower midlines (p = .005) and correct orientation of maxillary and mandibular planes in the articulator (p = .036). The mean self-assessment score of female students was significantly higher than that of male students (p = .01). The scores given by the mentors were not significantly different for male and female students (p = .975). The difference between the self-assessment score of students and the mentor score was not significant (p = .067) either in males or in females (p > .05). CONCLUSION Undergraduate dental students favourably self-assessed their performance in all steps of the preclinical course of CRP, comparable with their mentor assessment.
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Affiliation(s)
- Hooriyeh Gholami
- Dental Implant Research Center, Dental Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Arshad
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Kharazifard
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Dental School, Tehran University of Medical Sciences, Tehran, Iran
| | - Rezvaneh Ghazanfari
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Lavallard V, Cerutti B, Audétat-Voirol MC, Broers B, Sader J, Galetto-Lacour A, Hausmann S, Savoldelli GL, Nendaz M, Escher M. Formative assessments during COVID-19 pandemic: an observational study on performance and experiences of medical students. MEDEDPUBLISH 2023; 13:7. [PMID: 37942501 PMCID: PMC10628360 DOI: 10.12688/mep.19428.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023] Open
Abstract
Background: Because of COVID-19, the 2020 written medical examinations were replaced by mandatory formative online assessments. This study aimed to determine students' performance, self-assessment of performance, and perception about the switch from a summative to a formative approach. Methods: Medical students from year 2 to 5 (n=648) were included. They could repeat each test once or twice. They rated their performance after each attempt and were then given their score. Detailed feedback was given at the end of the session. An online survey determined medical students' perception about the reorganization of education. Two items concerned the switch from summative to formative assessments Results: Formative assessments involved 2385 examinees totaling 3197 attempts. Among examinees, 30.8% made at least 2 attempts. Scores increased significantly at the second attempt (median 9.4, IQR 10.8), and duration decreased (median -31.0, IQR 48.0). More than half of examinees (54.6%) underestimated their score, female students more often than male. Low performers overestimated, while high performers underestimated their scores. Students approved of the switch to formative assessments. Stress was lessened but motivation for learning decreased. Conclusions: Medical students' better scores at a second attempt support a benefit of detailed feedback, learning time and re-test opportunity on performance. Decreased learning motivation and a minority of students repeating the formative assessments point to the positive influence of summative assessment on learning.
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Affiliation(s)
| | - Bernard Cerutti
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Marie-Claude Audétat-Voirol
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Barbara Broers
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Julia Sader
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Annick Galetto-Lacour
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | | | - Georges L. Savoldelli
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Anesthesia, Pharmacology and Intensive Care, Geneva University Hospitals, Geneva, Switzerland
| | - Mathieu Nendaz
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Monica Escher
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Palliative Medicine, Geneva University Hospitals, Geneva, Switzerland
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Flanagan OL, Cummings KM. Standardized Patients in Medical Education: A Review of the Literature. Cureus 2023; 15:e42027. [PMID: 37593270 PMCID: PMC10431693 DOI: 10.7759/cureus.42027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2023] [Indexed: 08/19/2023] Open
Abstract
The concept of standardized patients (SPs) was first introduced in the 1960s by Dr. Howard Barrows of the University of Southern California and has been applied in medical school education since that time. This practice has allowed medical students to practice skills on live persons who are teachers rather than on real patients, who may be endangered by their emerging skills. Previous studies supported the use of SPs but did not measure whether they improved clinical competence or students' confidence in their skills. This literature review evaluated whether current medical education literature supports or refutes the use of SPs compared to other modalities such as simulated patients (SiPs) and virtual reality (VR) in the improvement of student confidence, clinical performance, and interpersonal communication skills. The research questions posed for this review were as follows: do medical students in their first two years of education who have practiced skills using SPs have more self-confidence in their ability to perform skills on real patients than those students who did not use SPs, do medical students in their third and fourth years of medical school have higher clinical competency with sensitive patient examinations after using SPs in their first two years of medical education than those students who did not use SPs, and do medical students who have used SPs for discussing sensitive issues have better interpersonal skills when they encounter real patients in the clinical setting than those who have not used SPs? The methodology for this descriptive, systematic review of the literature was organized using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart to describe how articles were collected and synthesized to evaluate the variables under study. The results of this study revealed that students learned the most when SPs were used because they were able to teach students the skills that they needed in a safe learning environment. Medical students performing sensitive patient examinations with SPs learned not only how to perform the examinations but also how to improve their communication with patients. Students and residents reported increased confidence and clinical competence when performing new skills with SPs rather than with peer practice, virtual reality, or real patients in a clinical setting. Although the utilization of SPs has been studied in multiple ways and found to be a powerful tool in the education of undergraduate medical students and interns, there is still much study to be done to address the human needs of real patients. Gaps in this literature included small sample sizes, a lack of standardized assessment tools, and the need to include a multidisciplinary approach that addresses cultural awareness and appreciation. The authors found limited studies analyzing the effect the coronavirus disease 2019 (COVID-19) pandemic had on the use of SPs in medical school education. Continued scientific inquiry in post-pandemic medical education is an essential component for dissemination as most schools have reintroduced the use of SPs, which strengthens the concept that their use is superior to the other simulation methods used when SPs were not available.
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Affiliation(s)
- Octavia L Flanagan
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine (LECOM), Elmira, USA
| | - Kristina M Cummings
- Department of Family Medicine, Lake Erie College of Osteopathic Medicine (LECOM), Elmira, USA
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Lavallard V, Cerutti B, Audétat-Voirol MC, Broers B, Sader J, Galetto-Lacour A, Hausmann S, Savoldelli GL, Nendaz M, Escher M. Formative assessments during COVID-19 pandemic: an observational study on performance and experiences of medical students. MEDEDPUBLISH 2023. [DOI: 10.12688/mep.19428.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background: Because of COVID-19, the 2020 written medical examinations were replaced by mandatory formative online assessments. This study aimed to determine students’ performance, self-assessment of performance, and perception about the switch from a summative to a formative approach. Methods: Medical students from year 2 to 5 (n=648) were included. They could repeat each test once or twice. They rated their performance after each attempt and were then given their score. Detailed feedback was given at the end of the session. An online survey determined medical students’ perception about the reorganization of education. Two items concerned the switch from summative to formative assessments Results: Formative assessments involved 2385 examinees totaling 3197 attempts. Among examinees, 30.8% made at least 2 attempts. Scores increased significantly at the second attempt (median 9.4, IQR 10.8), and duration decreased (median -31.0, IQR 48.0). More than half of examinees (54.6%) underestimated their score, female students more often than male. Low performers overestimated, while high performers underestimated their scores. Students approved of the switch to formative assessments. Stress was lessened but motivation for learning decreased. Conclusions: Medical students’ better scores at a second attempt support a benefit of detailed feedback, learning time and re-test opportunity on performance. Decreased learning motivation and a minority of students repeating the formative assessments point to the positive influence of summative assessment on learning.
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Almohaimede AA. Comparison between students' self-evaluation and faculty members' evaluation in a clinical endodontic course at King Saud University. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2022; 26:569-576. [PMID: 34870874 DOI: 10.1111/eje.12733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 09/28/2021] [Accepted: 11/12/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The objective of this study was to compare faculty member evaluations with student self-evaluations in a clinical endodontic course in the dental school at King Saud University and to evaluate the reliability of the students' self-assessment scores after using a rubric with well-defined criteria. MATERIALS AND METHODS Evaluated and self-evaluated endodontic cases that were clinically treated by the fourth-year undergraduate dental students at the College of Dentistry, Girls University Campus, at King Saud University over 2 years (2017-2018) were included. Cases included anterior teeth, premolars and molars. The evaluation form was divided into six sections with well-defined criteria to cover all aspects of nonsurgical root canal treatment with a maximum grade of 10 points can be scored for each student per case. The students evaluated themselves for each section and then were evaluated by two faculty members. Student and faculty assessment agreement and the reliability of the students' self-assessment scores were measured. A p ≤ .05 was considered significant. RESULTS A total of 363 cases were included: 26.7% anterior teeth, 38.84% premolars and 34.43% molars. The students evaluated themselves with higher grades compared to the evaluators' grading in all steps and in the overall grading in all teeth types. The students' self-assessment scores showed good and moderate reliability in all steps and in the overall grading. CONCLUSION The students tend to overrate their performance, and their assessments have moderate to good reliability, which reflects the reliability of the rubric used as an accurate measurement tool that helps the evaluator and the student objectively assess their performance.
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Affiliation(s)
- Amal A Almohaimede
- Endodontic division, Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
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10
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Hope DL, Grant GD, Rogers GD, King MA. Impact of a gamified simulation on pharmacy students' self-assessed competencies. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:990-997. [PMID: 36055708 DOI: 10.1016/j.cptl.2022.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 05/11/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Competency-based pharmacist education develops robust professional identities and prepares graduates for future practice to ensure optimal patient outcomes. An extended gamified simulation was developed as a capstone activity for a new Australian Bachelor of Pharmacy (BPharm) program. The simulation was designed to consolidate students' knowledge, skills, and behaviors from prior learning. This research aimed to explore whether participation in an extended gamified simulation could influence pharmacy students' perceptions of their professional competencies. METHODS Data were collected over three years to compare a superseded Master of Pharmacy (MPharm) program with an incoming BPharm program. Final year students were invited to self-assess their professional competencies at the start and end of their final semester of study, using a digital self-assessment tool which replicated Australia's National Competency Standards Framework for Pharmacists. Participants rated their own competency against the 26 competency standards across five domains on a five-point Likert scale (not at all competent to very competent). This provided pre- and post-data to compare the simulation (BPharm intervention) and a traditional semester (MPharm comparison), in addition to final course grades. RESULTS From 2016 to 2019, 85 (90.4%) of 94 intervention and 50 (83.3%) of 60 comparison students completed the self-assessment of professional competencies. Participation in the gamified simulation significantly improved students' pharmacotherapeutics grades and pre-post change scores for seven of the 26 competency standards, two of the five domains, and all domains combined of the National Competency Standards. CONCLUSIONS An extended, gamified simulation enhances the development of pharmacy students' self-assessed professional competencies.
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Affiliation(s)
- Denise L Hope
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia.
| | - Gary D Grant
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia.
| | - Gary D Rogers
- School of Medicine, Deakin University, Geelong, VIC, Australia.
| | - Michelle A King
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia.
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Heath JK, Alvarado ME, Clancy CB, Barton TD, Kogan JR, Dine CJ. The Context of "Confidence": Analyzing the Term Confidence in Resident Evaluations. J Gen Intern Med 2022; 37:2187-2193. [PMID: 35710674 PMCID: PMC9296754 DOI: 10.1007/s11606-022-07535-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Despite similar performance metrics, women medical trainees routinely self-assess their own skills lower than men. The phenomenon of a "confidence gap" between genders, where women report lower self-confidence independent of actual ability or competency, may have an important interaction with gender differences in assessment. Identifying whether there are gender-based differences in how confidence is mentioned in written evaluations is a necessary step to understand the interaction between evaluation and the gender-based confidence gap. OBJECTIVE To analyze faculty evaluations of internal medicine (IM) residents for gender-based patterns in the use of iterations of "confidence." DESIGN We performed a retrospective cohort study of all inpatient faculty evaluations of University of Pennsylvania IM residents from 2018 to 2021. We performed n-gram text-mining to identify evaluations containing the terms "confident," "confidence," or "confidently." We performed univariable and multivariable logistic regression to determine the association between resident gender and references to confidence (including comments reflecting too little confidence), adjusting for faculty gender, post-graduate year (PGY), numeric rating, and service. SUBJECTS University of Pennsylvania IM residents from 2018 to 2021. KEY RESULTS There were 5416 evaluations of IM residents (165 women [51%], 156 men [49%]) submitted by 356 faculty members (149 women [51%]), of which 7.1 % (n=356) contained references to confidence. There was a significant positive association between the mention of confidence and women resident gender (OR 1.54, CI 1.23-1.92; p<0.001), which persisted after adjustment for faculty gender, numeric rating, and PGY level. Eighty evaluations of the cohort explicitly mentioned the resident having "too little confidence," which was also associated with women resident gender (OR 1.66, CI 1.05-2.62; p=0.031). CONCLUSION Narrative evaluations of women residents were more likely to contain references to confidence, after adjustment for numerical score, PGY level, and faculty gender, which may perpetuate the gender-based confidence gap, introduce bias, and ultimately impact professional identity development.
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Affiliation(s)
- Janae K Heath
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
| | | | - Caitlin B Clancy
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Todd D Barton
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Jennifer R Kogan
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - C Jessica Dine
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Urgo K, Arguello J. Learning assessments in search-as-learning: A survey of prior work and opportunities for future research. Inf Process Manag 2022. [DOI: 10.1016/j.ipm.2021.102821] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Shrivastava S, Shrivastava P. Understanding the significance of high stakes and low stakes assessments in medical undergraduate training. MEDICAL JOURNAL OF BABYLON 2022. [DOI: 10.4103/mjbl.mjbl_13_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Development, implementation and feedback for an online speciality membership examination in orthodontics during the COVID-19 pandemic. Br Dent J 2021; 231:503-511. [PMID: 34686818 PMCID: PMC8531912 DOI: 10.1038/s41415-021-3535-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/15/2021] [Indexed: 11/08/2022]
Abstract
Introduction The Royal College of Surgeons of England (RCSEng) and the Royal College of Physicians and Surgeons of Glasgow (RCPSG) offer the bi-collegiate Membership in Orthodontics (MOrth) examination, a summative assessment of specialist knowledge, skill and behaviour in orthodontics. The COVID-19 pandemic has had a profound global effect on almost every facet of normal life, including the conduct of face-to-face examinations. We highlight development, implementation and feedback for the bi-collegiate MOrth Part 2 examination delivered remotely to a cohort of candidates in September 2020 by RCSEng/RCPSG.Methods Two anonymised online surveys (Google Forms) were distributed via electronic mail following completion of the examination diet. Forty-two candidates were sent a survey covering four domains and comprising a total of 31 questions. The 20 examiners were sent a survey containing eight questions. In both surveys, free-text responses were also collected. A rating system was used to categorise responses. All survey responses were summarised in an online data collection sheet.Results The response rate was 78.5% (33/42) and 75% (15/20) for candidates and examiners, respectively. Overall, favourable responses in relation to all sections of the assessment were elicited from candidates with the majority (mean 79.8%; 75.8-81.9%) reporting that the online examination format worked well. Equally, favourable responses were reported by examiners. Notably, 80% of examiners felt that the online exam style did not affect the mark a candidate would receive, and 100% were confident that the marks the candidates received were a reflection of their ability and were not affected by the online delivery of the assessment.Conclusions The feedback from both candidates and examiners relating to an online remote assessment of the bi-collegiate MOrth Part 2 was generally positive. Based on the survey responses, this format of a high-stakes examination was acceptable to all stakeholders, and demonstrated a high level of perceived validity and reliability in terms of content.
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Kornmehl DL, Patel E, Agrawal R, Harris JR, Ba AK, Ohyama H. The effect of gender on student self-assessment skills in operative preclinical dentistry. J Dent Educ 2021; 85:1511-1517. [PMID: 33990132 DOI: 10.1002/jdd.12638] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/06/2021] [Accepted: 04/13/2021] [Indexed: 11/06/2022]
Abstract
PURPOSE/OBJECTIVE Self-assessment is a fundamental skill for dentists and other health care providers. It enables these professionals' ability to critically evaluate the quality of their clinical work and improve through self-directed learning. Researchers have investigated how gender affects self-assessment skills and have shown that male students tend to overestimate their performance while female students tend to underestimate theirs as compared to peer or faculty assessment. The goal of this study was to evaluate how the self-assessment skills of dental students differ by gender in operative preclinical dentistry. METHODS Third-year dental students (N = 208, Class of 2016-2021) self-assessed their work using the same rubrics as faculty on four operative dentistry competency examination procedures: Class II amalgam preparation and restoration and Class III resin-composite preparation and restoration. Two calibrated full-time faculty graded all procedures independently. The Student self-assessment-Faculty grade (S-F) gap scores were calculated and statistically analyzed. RESULTS Overall, both genders overestimated their self-assessment for all four procedures as compared to actual scores given by faculty. Males overestimated more significantly than females for Class II Amalgam preparation, but not for the other three procedures. However, when the S-F gap for all procedures was combined and analyzed together, male students significantly overestimated their self-assessments compared to female students. When female and male students grading scores were stratified into quartiles, there were significantly larger differences between males and females in the lower quartiles, which suggest that difference in self-assessment abilities was more prominent among the lower performing students. CONCLUSION The results of this study demonstrate that gender may affect the accuracy of self-assessment in operative preclinical dentistry.
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Affiliation(s)
| | - Eshani Patel
- VA Loma Linda Healthcare System, Loma Linda, California, USA
| | - Ruchika Agrawal
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | | | - Aisha K Ba
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Hiroe Ohyama
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Anxiety, Suicidal Risk and Personal Characteristics of Medical Students. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.1.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background. The prevalence of anxiety, depression, personality traits and poor quality of life among medical students contributes to the formation of suicidal behaviorAims. To reveal the relationship between the severity of anxiety, hopelessness, personality traits and suicidal risk in students of Irkutsk State Medical University.Material and methods. The study included third-year students of the medical faculty of Irkutsk State Medical University (n = 61), average age – 19.7 ± 2.2 years. We used Spielberger – Khanin and Sheehan scales of self-assessment of the anxiety level, the personality questionnaire of Smisek – Mueller “Accent 2-90”, and Beck’s hopelessness scale.Results. According to the results of testing on the Spielberger – Khanin scale, the severity of reactive anxiety reached moderate values in 57.3 % of students, severe anxiety was found in 32.8 %, the absence of anxiety – in 9.8 %. Personal anxiety on the Spielberger – Khanin scale was characterized by moderate values in 52.5 % of cases, severe anxiety was found in 45.9 %, the absence of anxiety – in 1.6 %. Moderate and high values of reactive and personal anxiety were significantly more common compared to the students with no anxiety. According to the psychometric assessment of students using Sheehan scale, clinically expressed anxiety was observed in 47.5 % of cases, severe anxiety disorder – in 4.9 %, lack of anxiety – in 47.5 %. The personality traits of students with anxiety include hyperthymia, excitability, dysthymia, cyclothymia, introversion and exaltation.Нopelessness in students was detected in 27.9 % of cases (mild – in 16.4 %, moderate – in 9.8 %, severe – in 1.6 %). Тhe criterion of hopelessness was detected with pronounced situational and personal anxiety in comparison with moderately pronounced anxiety using Spielberger – Khanin scale (50 % and 39.3 % respectively); expressed and severe anxiety was detected in 51.7 % and 66.7 % of cases on the Sheehan scale.The personality traits of students with hopelessness included stuckness, pedantry (standard level and level above average); cyclothymia in the form of unstable mood; demonstrativeness; excitability (normative level); dysthymia in the form of attempts to deny difficulties; exaltation (average level); introverted personality direction.Conclusion. Determination of factors of suicidal risk is important in the prevention of suicidal behavior among medical students.
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Iguchi A, Hasegawa Y, Fujii K. Student Potential for Self-assessment in a Clinical Dentistry Practical Training Course on Communication Skills. MEDICAL SCIENCE EDUCATOR 2020; 30:1503-1513. [PMID: 34457818 PMCID: PMC8368263 DOI: 10.1007/s40670-020-01061-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study aimed to investigate student potential for self-assessment in a clinical dentistry practical training course focused on communication skills. Participants were 124 fourth-year students (70 males, 54 females; all Japanese) in 2017 and 2018 at the Nippon Dental University, School of Life Dentistry at Niigata. Participating students belonged to different cohorts in 2017 and 2018. Participants were asked to complete a self-evaluation sheet at the end of each unit of the course. Their self-evaluation scores and the faculty evaluation scores for each student for Units 1-1, 1-2, and 1-3 were statistically analyzed. The results showed that females tended to rate themselves significantly higher than males. Furthermore, there were significant differences in evaluation scores between students and faculty for nine of 11 evaluation items for male students and 10 of 11 items for female students in Unit 1-3. Faculty expectations increased from Unit 1-1 to Unit 1-3, although students were satisfied with their performance and had a sense of achievement. However, students' actual performance was below faculty expectations, suggesting faculty evaluations were stricter than students' self-evaluation. Self-assessment may enhance students' ability for self-directed learning and may also inform how faculty can effectively educate dental students. Dental educators should support students to increase their levels of self-efficacy, which will enhance their self-evaluation skills.
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Affiliation(s)
- Asami Iguchi
- School of Life Dentistry at Niigata, The Nippon Dental University, 1-8, Hamaura-cho, Chuo-ku, Niigata, 951-8580 Japan
| | - Yuh Hasegawa
- The Nippon Dental University College at Niigata, 1-8, Hamaura-cho, Chuo-ku, Niigata, 951-8580 Japan
| | - Kazuyuki Fujii
- School of Life Dentistry at Niigata, The Nippon Dental University, 1-8, Hamaura-cho, Chuo-ku, Niigata, 951-8580 Japan
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Martin RD, Naziruddin Z. Systematic review of student anxiety and performance during objective structured clinical examinations. CURRENTS IN PHARMACY TEACHING & LEARNING 2020; 12:1491-1497. [PMID: 33092780 DOI: 10.1016/j.cptl.2020.07.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 06/02/2020] [Accepted: 07/15/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Test anxiety is well studied in higher education, but studies primarily concern traditional assessments, such as written examinations. As use of objective structured clinical examination (OSCE) in pharmacy education increases, a closer examination of non-cognitive factors such as test anxiety is warranted. The purpose of this review was to determine the association between OSCE-associated test anxiety with OSCE performance in health professional students. METHODS A literature search was conducted to identify peer-reviewed literature concerning test anxiety in health professional students associated with OSCE. Investigators searched for a combination of OSCE-related terms with anxiety-related terms using PubMed. Articles were included if they assessed OSCE-related anxiety by quantitative or qualitative methods. Data extracted from eligible articles included demographic data, type of the anxiety survey, associations between OSCE-related anxiety and performance, and other student-factors associated with OSCE-related anxiety. RESULTS The literature search yielded 339 articles. Nine articles met eligibility criteria and were included in the review. Results included students from medical, pharmacy, dental, and nursing professional programs. Anxiety was assessed via multiple scales. Six out of the eight studies assessing the relationship OSCE-related anxiety and OSCE performance found no association between the two measures. Contrary to literature concerning test anxiety in higher education, female gender was not associated with OSCE-related anxiety. CONCLUSION OSCE-related anxiety appears to have minimal to no influence on student performance. Future studies should utilize standardized anxiety assessments and should seek to understand anxiety's effects on student wellbeing and burnout.
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Affiliation(s)
- Randy D Martin
- Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, Texas, United States; Department of Medical Education, Texas Christian University, Fort Worth, Texas, United States.
| | - Zahra Naziruddin
- University of North Texas System College of Pharmacy, Fort Worth, Texas, United States
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Støve MP. Physiotherapy students' self-assessment of performance-Are there gender differences in self-assessment accuracy? PHYSIOTHERAPY RESEARCH INTERNATIONAL 2020; 26:e1878. [PMID: 32924252 DOI: 10.1002/pri.1878] [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: 02/17/2020] [Revised: 07/16/2020] [Accepted: 08/30/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE The ability to critically appraise one's performance is paramount in physiotherapy and, although there is a paucity of research in this area, factors such as gender have been suggested to moderate the self-assessment accuracy of healthcare students. The purpose of this study was to determine a posteriori self-assessment accuracy of first-year physiotherapy students following a multiple-choice anatomy examination and to determine the specific influence of gender as a potential moderator of self-assessment accuracy. METHOD One-hundred-and-forty-two students (n = 72 female) enrolled in their second semester of a three-and-a-half-year physiotherapy programme participated in the study. A purpose-made self-assessment questionnaire was used to measure the students' self-assessment ability, estimating their performance on 11 different anatomical categories following the examination. This was then compared with a criterion measure matched with the questionnaire. The accuracy of the students' self-assessment was investigated by the relation between self-assessment and objective performance. RESULTS The study showed low-to-moderate self-assessment accuracy (rho ranging from 0.318 to 0.675) with the students underestimating their performance in six out of 11 categories (p < 0.019). Gender did not contribute significantly to differences in accuracy between students' self-assessment and the criterion measure (p = 0.474). CONCLUSION According to the results, the students demonstrated low-to-moderate self-assessment accuracy when compared to their performance. Notably, the results clearly showed that gender did not function as a moderator of self-assessment accuracy among first-year physiotherapy students.
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Stegers‐Jager KM, Savas M, van der Waal J, van Rossum EFC, Woltman AM. Gender-specific effects of raising Year-1 standards on medical students' academic performance and stress levels. MEDICAL EDUCATION 2020; 54:538-546. [PMID: 31960979 PMCID: PMC7317944 DOI: 10.1111/medu.14068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/08/2020] [Accepted: 01/13/2020] [Indexed: 05/05/2023]
Abstract
CONTEXT Medical schools are challenged to create academic environments that stimulate students to improve their study progress without compromising their well-being. OBJECTIVES This prospective comparative cohort study investigated the effects of raising Year-1 standards on academic performance and on students' chronic psychological and biological stress levels. METHODS In a Dutch medical school, students within the last Bachelor's degree cohort (n = 410) exposed to the 40/60 (67%) credit Year-1 standard (67%-credit cohort) were compared with students within the first cohort (n = 413) exposed to a 60/60 (100%) credit standard (100%-credit cohort). Main outcome measures were Year-1 pass rate (academic performance), mean score on the Perceived Stress Scale (PSS, psychological stress) and hair cortisol concentration (HCC, biological stress). RESULTS Year-1 pass rates were significantly higher in the 100%-credit cohort (odds ratio [OR] 4.65). Interestingly, there was a significant interaction effect (OR 0.46), indicating that raising the standard was more effective for male than for female students. PSS scores (n = 234 [response rate [RR]: 57%] and n = 244 [RR: 59%] in the 67%- and 100%-credit cohorts, respectively) were also significantly higher in the 100%-credit cohort (F(1,474) = 15.08, P < .001). This applied specifically to female students in the 100%-credit cohort. Levels of HCC (n = 181 [RR: 44%] and n = 162 [RR: 39%] respectively) did not differ between cohorts, but were significantly higher in female students (F(1,332) = 7.93, P < .01). In separate models including cohort and gender, both PSS score (OR 0.91) and HCC (OR 0.38) were significantly associated with Year-1 performance. Only students with both high PSS scores and high HCC values were significantly at risk of lower Year-1 pass rates (OR 0.27), particularly male students. CONCLUSIONS Raising the Year-1 performance standard increased academic performance, most notably in male students. However, it also increased levels of perceived stress, especially in female students. In particular, the combination of high levels of perceived stress and biological stress, as measured by long-term cortisol, was related to poor academic performance. The study suggests a relationship between raising performance standards and student well-being, with differential effects in male and female students.
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Affiliation(s)
- Karen M. Stegers‐Jager
- Institute of Medical Education Research RotterdamErasmus MC University Medical Centre RotterdamRotterdamthe Netherlands
| | - Mesut Savas
- Division of EndocrinologyDepartment of Internal MedicineErasmus MC University Medical Centre RotterdamRotterdamthe Netherlands
| | - Jeroen van der Waal
- Department of Public Administration and SociologyErasmus University RotterdamRotterdamthe Netherlands
| | - Elisabeth F. C. van Rossum
- Division of EndocrinologyDepartment of Internal MedicineErasmus MC University Medical Centre RotterdamRotterdamthe Netherlands
| | - Andrea M. Woltman
- Institute of Medical Education Research RotterdamErasmus MC University Medical Centre RotterdamRotterdamthe Netherlands
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Khan R, Chahine S, Macaluso S, Viana R, Cassidy C, Miller T, Bartley D, Payne M. Impressions on Reliability and Students' Perceptions of Learning in a Peer-Based OSCE. MEDICAL SCIENCE EDUCATOR 2020; 30:429-437. [PMID: 34457686 PMCID: PMC8368308 DOI: 10.1007/s40670-020-00923-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Peer assessment of performance in the objective structured clinical examination (OSCE) is emerging as a learning instrument. While peers can provide reliable scores, there may be a trade-off with students' learning. The purpose of this study is to evaluate a peer-based OSCE as a viable assessment instrument and its potential to promote learning and explore the interplay between these two roles. METHODS A total of 334 medical students completed an 11-station OSCE from 2015 to 2016. Each station had 1-2 peer examiners (PE) and one faculty examiner (FE). Examinees were rated on a 7-point scale across 5 dimensions: Look, Feel, Move, Special Tests and Global Impression. Students participated in voluntary focus groups in 2016 to provide qualitative feedback on the OSCE. Authors analysed assessment data and transcripts of focus group discussions. RESULTS Overall, PE awarded higher ratings compared with FE, sources of variance were similar across 2 years with unique variance consistently being the largest source, and reliability (r φ ) was generally low. Focus group analysis revealed four themes: Conferring with Faculty Examiners, Difficulty Rating Peers, Insider Knowledge, and Observing and Scoring. CONCLUSIONS While peer assessment was not reliable for evaluating OSCE performance, PE's perceived that it was beneficial for their learning. Insight gained into exam technique and self-appraisal of skills allows students to understand expectations in clinical situations and plan approaches to self-assessment of competence.
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Affiliation(s)
- Rishad Khan
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street North, London, ON N6A 3K7 Canada
| | - Saad Chahine
- Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street North, London, ON N6A 3K7 Canada
| | - Steven Macaluso
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7 Canada
| | - Ricardo Viana
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7 Canada
| | - Caitlin Cassidy
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7 Canada
| | - Thomas Miller
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7 Canada
| | - Debra Bartley
- Department of Surgery, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street North, London, ON N6A 3K7 Canada
- Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street North, London, ON N6A 3K7 Canada
| | - Michael Payne
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7 Canada
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Spoto-Cannons AC, Isom DM, Feldman M, Zwygart KK, Mhaskar R, Greenberg MR. Differences in medical student self-evaluations of clinical and professional skills. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2019; 10:835-840. [PMID: 31576188 PMCID: PMC6769160 DOI: 10.2147/amep.s222774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 09/02/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The skill of self-assessment is critical to medical students. We sought to determine whether there were differences between student self-assessments and their faculty assessments and if they were modified by gender. Additionally, we sought to determine the differences in these assessments between students in a traditional (core) versus an enhanced (SELECT) medical school curriculum. METHODS In this retrospective study, mid-term and final assessment and feedback forms from the first-year Doctoring 1 course were analyzed from three academic years: 2014-2015 through 2016-2017. Data were abstracted from the forms and de-identified for analysis. Class year, student gender, and class type were also abstracted from this "on the shelf" data from program assessment. The level of agreement between faculty and student assessments was investigated using Wilcoxon signed ranks test. The gender differences (male versus female students) between student assessments and their assessment by their faculty were investigated by using the Kruskal Wallis test. RESULTS Five hundred and thirty-five student self-assessments were analyzed. Fifty-six percent (301/535) were male while 44% (234/535) were female. Faculty assessments (P-value <0.001) were higher than students and this was not modified by student gender. Compared to the domain of "participation" in the core program, there was no difference between the student/faculty ratings based on student gender (P-value: 0.48); there was a difference in the SELECT program cohort (P-value: 0.02). Specifically, the female students appear to rate themselves lower (female student: mean/standard deviation: 2.07/0.52) compared to their faculty (faculty: mean/standard deviation: 2.42/0.55). CONCLUSION Faculty consistently assessed the students at a higher rating than the students rated themselves. The level of difference between student self-assessments and their assessment by their faculty was not modified by student gender. With the minor exception of "participation," there was no difference between students in the two different doctoring class curriculums.
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Affiliation(s)
| | - Deanna M Isom
- Department of Education, Morsani College of Medicine, University of Florida, Tampa, FL, USA
| | - Max Feldman
- Department of Family Medicine, Morsani College of Medicine, Unibversity of Florida, Tampa, FL, USA
| | - Kira K Zwygart
- Department of Family Medicine, Morsani College of Medicine, Unibversity of Florida, Tampa, FL, USA
| | - Rahul Mhaskar
- Department of Internal Medicine, Morsani College of Medicine, University of Florida, Tampa, FL, USA
| | - Marna Rayl Greenberg
- Department of Emergency and Hospital Medicine, Lehigh Valley Campus, Morsani College of Medicine, University of South Florida, Bethlehem, PA, USA
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Kwankajonwong N, Ongprakobkul C, Qureshi SP, Watanatada P, Thanprasertsuk S, Bongsebandhu-Phubhakdi S. Attitude, but not self-evaluated knowledge, correlates with academic performance in physiology in Thai medical students. ADVANCES IN PHYSIOLOGY EDUCATION 2019; 43:324-331. [PMID: 31305154 DOI: 10.1152/advan.00047.2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Positive attitude and self-evaluation are necessary for medical students and doctors. To explore how best to integrate physiology teaching in our Thai medical curriculum, we investigated relationships between student's academic performance, their attitude, self-evaluated knowledge, and proportion of physiology taught in an organ-system integrated block. We organized 13 physiology laboratory classes, during which students self-rated attitude and knowledge. Academic performance was measured by formative and summative assessments. One hundred thirty-six participants were categorized into most proactive (Most PA), more proactive (More PA), less proactive (Less PA), and least proactive (Least PA) attitude groups by self-preparation questionnaire. Eighty participants were categorized into high (HighE), moderate (ModerateE), and low (LowE) self-evaluation rating groups. Mean formatives score in the Most PA group was significantly higher than in the other PA groups (P = 0.003, P = 0.001, and P < 0.001, respectively). Mean summative score in the Most PA group was significantly higher than the Less PA and the Least PA groups (P = 0.017 and P = 0.015 respectively). There was no significant difference in mean assessment scores among HighE, ModerateE, and LowE groups. Proportion of teaching time dedicated to physiology positively correlated with student attitude (r = 0.84, P = 0.001) and negatively correlated with self-evaluation rating (r = -0.73, P = 0.007). Thai medical students may benefit from a proactive attitude to studying physiology, contrasting with traditional didactic expectations of Thai education. Proportion of teaching time dedicated to physiology does not influence academic performance; therefore, future adjustments to curriculum integration may incorporate classes that facilitate self-directed learning. Future study should explore other influences on learning and assessment performance.
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Affiliation(s)
| | - Chuthamas Ongprakobkul
- Department of Physiology, Faculty of Medicine, Chulalongkorn University , Bangkok , Thailand
| | - Shaun Peter Qureshi
- Edinburgh Medical School, University of Edinburgh , Edinburgh , United Kingdom
| | - Pasakorn Watanatada
- Department of Physiology, Faculty of Medicine, Chulalongkorn University , Bangkok , Thailand
| | - Sekh Thanprasertsuk
- Department of Physiology, Faculty of Medicine, Chulalongkorn University , Bangkok , Thailand
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Nayar SK, Musto L, Fernandes R, Bharathan R. Emotional Intelligence Predicts Accurate Self-Assessment of Surgical Quality: A Pilot Study. J Surg Res 2019; 245:383-389. [PMID: 31425880 DOI: 10.1016/j.jss.2019.07.051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/28/2019] [Accepted: 07/17/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Self-assessment is fundamental in surgical training. Accuracy of self-assessment is superior with greater age, experience, and the use of video playback. Presently, there is scarce evidence in the literature regarding predictors for a surgical trainee's aptitude for self-assessment. The objective of this study was to investigate whether emotional intelligence or visual-spatial aptitude can predict effective self-assessment among novice surgeons performing laparoscopic appendectomy (LA). MATERIALS AND METHODS Eighteen novice trainees performed a simulated LA, and two aptitude measures were evaluated: (1) emotional intelligence questionnaire and (2) visual spatial ability test. Self-assessment of their performance was conducted using the Objective Assessment of Surgical and Technical Skills global rating scale and ranking five subtasks of the procedure in order of quality of performance after watching a playback of their LA. Two blinded experts (senior consultant surgeons, performed >100 LAs) assessed surgical quality using the same scoring system. Candidates were ranked into higher and lower aptitude groups for the two aptitude measures. Spearman's rank correlation coefficient was calculated to identify if either of the two groups demonstrated greater agreement between self and expert assessment in relation to the two aptitude measures. RESULTS Participants with a higher degree of emotional intelligence demonstrated significant agreement with expert assessment (r = 0.73, P = 0.031). CONCLUSIONS Emotional intelligence can predict better self-assessment of surgical quality after performing a simulated LA. This may facilitate early identification of individuals who might require mentoring or guidance with self-assessment as well as contribute to selection criteria.
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Affiliation(s)
- Sandeep K Nayar
- Department of General Surgery, Maidstone and Tunbridge Wells NHS Trust, Maidstone, Kent, United Kingdom.
| | - Liam Musto
- Department of General Surgery, Maidstone and Tunbridge Wells NHS Trust, Maidstone, Kent, United Kingdom
| | - Roland Fernandes
- Department of General Surgery, Maidstone and Tunbridge Wells NHS Trust, Maidstone, Kent, United Kingdom
| | - Rasiah Bharathan
- Department of Gynaecological Oncology, Maidstone and Tunbridge Wells NHS Trust, Maidstone, Kent, United Kingdom
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Burbach BE, Struwe LA, Young L, Cohen MZ. Correlates of Student Performance during Low Stakes Simulation. J Prof Nurs 2019; 35:44-50. [DOI: 10.1016/j.profnurs.2018.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 05/11/2018] [Accepted: 06/01/2018] [Indexed: 11/26/2022]
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Strumann C, Flägel K, Emcke T, Steinhäuser J. Procedures performed by general practitioners and general internal medicine physicians - a comparison based on routine data from Northern Germany. BMC FAMILY PRACTICE 2018; 19:189. [PMID: 30509221 PMCID: PMC6276264 DOI: 10.1186/s12875-018-0878-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/19/2018] [Indexed: 11/21/2022]
Abstract
Background In response to a rising shortage of general practitioners (GPs), physicians in general internal medicine (GIM) have become part of the German primary care physician workforce. Previous studies have shown substantial differences in practice patterns between both specialties. The aim of this study was to analyse and compare the application of procedures by German GPs and GIM physicians based on routine data. Methods The Association of Statutory Health Insurance Physicians in the federal state Schleswig-Holstein (Northern Germany) provided invoicing data of the first quarters of 2013 and 2015. Differences between GPs and GIM physicians in the implementation rate of 46 selected primary care procedures were examined by means of the Pearson χ2-test. The selection of procedures was based on international and own preliminary studies on primary care procedures. Results In the first quarter of 2013/2015 respectively, 1228/1227 GPs and 447/484 GIM physicians provided services in Schleswig-Holstein. Significant differences were found for 20 of the 46 procedures. GPs had higher application rates of procedures concerning health screening (e.g. adolescent health examination, well-child visits) and minor surgery. GIM physicians more often applied technology-oriented procedures, such as ultrasound scans, electrocardiograms (ECG), and 24-h ambulatory blood pressure measurements. The treatment patterns of both specialities did not vary much during the study period. Cardiac stress testing was the only significantly increased GP procedure in that time. Conclusions Our results suggest substantial differences in the application of procedures between GPs and GIM physicians with potential consequences for the overall primary healthcare provision. The findings could foster a discussion about training needs for procedures in primary care to ensure its comprehensiveness. The results reflect scope for changes in vocational training in the future for an effective and efficient re-allocation of primary healthcare.
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Affiliation(s)
- C Strumann
- Institute of Family Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany.
| | - K Flägel
- Institute of Family Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany
| | - T Emcke
- Association of Statutory Health Insurance Physicians of the Federal State of Schleswig-Holstein, Bismarckallee 1-6, 23795, Bad Segeberg, Germany
| | - J Steinhäuser
- Institute of Family Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany
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Madrazo L, Lee CB, McConnell M, Khamisa K. Self-assessment differences between genders in a low-stakes objective structured clinical examination (OSCE). BMC Res Notes 2018; 11:393. [PMID: 29903050 PMCID: PMC6003209 DOI: 10.1186/s13104-018-3494-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 06/06/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Physicians and medical students are generally poor-self assessors. Research suggests that this inaccuracy in self-assessment differs by gender among medical students whereby females underestimate their performance compared to their male counterparts. However, whether this gender difference in self-assessment is observable in low-stakes scenarios remains unclear. Our study's objective was to determine whether self-assessment differed between male and female medical students when compared to peer-assessment in a low-stakes objective structured clinical examination. RESULTS Thirty-three (15 males, 18 females) third-year students participated in a 5-station mock objective structured clinical examination. Trained fourth-year student examiners scored their performance on a 6-point Likert-type global rating scale. Examinees also scored themselves using the same scale. To examine gender differences in medical students' self-assessment abilities, mean self-assessment global rating scores were compared with peer-assessment global rating scores using an independent samples t test. Overall, female students' self-assessment scores were significantly lower compared to peer-assessment (p < 0.001), whereas no significant difference was found between self- and peer-assessment scores for male examinees (p = 0.228). This study provides further evidence that underestimation in self-assessment among females is observable even in a low-stakes formative objective structured clinical examination facilitated by fellow medical students.
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Affiliation(s)
- Lorenzo Madrazo
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada
| | - Claire B Lee
- Faculty of Medicine, McGill University, 3605 Mountain St, Montreal, QC, H3G 2M1, Canada
| | - Meghan McConnell
- Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Rm 2156, Ottawa, ON, K1H 8L1, Canada
| | - Karima Khamisa
- Division of Hematology, Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada. .,Ottawa Blood Diseases Centre, The Ottawa Hospital (General Campus), Box 201 A, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
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Krautheim V, Schmitz A, Benze G, Standl T, Schiessl C, Waldeyer W, Hapfelmeier A, Kochs EF, Schneider G, Wagner KJ, Schulz CM. Self-confidence and knowledge of German ICU physicians in palliative care - a multicentre prospective study. BMC Palliat Care 2017; 16:57. [PMID: 29166887 PMCID: PMC5700543 DOI: 10.1186/s12904-017-0244-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 11/14/2017] [Indexed: 11/24/2022] Open
Abstract
Background Little is known about ICU physicians’ self-confidence and knowledge related to palliative care. Our objective was to investigate self-confidence and knowledge of German ICU physicians related to palliative care, and to assess the impact of work experience, gender, specialty and additional certifications in pain or palliative medicine. Methods In a multicentre prospective observational study ICU physicians of ten hospitals were asked to rate their self-confidence and to complete a multiple choice questionnaire for the assessment of knowledge. Beyond descriptive statistics and non-parametric tests for group comparisons, linear regression analysis was used to assess the impact of independent variable on self-confidence and knowledge. Spearman‘s rank test was calculated. Results 55% of answers in the knowledge test were correct and more than half of the participants rated themselves as “rather confident” or “confident”. Linear regression analysis revealed that an additional certificate in either pain or palliative medicine significantly increased both knowledge and self-confidence, but only 15 out of 137 participants had at least one of those certificates. Relation between self-confidence and the results of the knowledge test was weak (r = 0.270 in female) and very weak (r = −0.007 in male). Conclusions Although the questionnaire needs improvement according to the item analysis, it appears that, with respect to palliative care, ICU Physicians’ self-confidence is not related to their knowledge. An additional certificate in either pain or palliative medicine was positively correlated to both self-confidence and knowledge. However, only a minority of the participants were qualified through such a certificate. Electronic supplementary material The online version of this article (10.1186/s12904-017-0244-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Veronika Krautheim
- Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| | - Andrea Schmitz
- Interdisziplinäres Zentrum für Palliativmedizin, Medizinische Fakultät Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany
| | - Gesine Benze
- Klinik für Palliativmedizin, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Thomas Standl
- Klinik für Anaesthesiologie, Operative Intensiv- und Palliativmedizin, Städtisches Klinikum Solingen, Solingen, Germany
| | | | - Wolfgang Waldeyer
- Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| | - Alexander Hapfelmeier
- Institut für Medizinische Statistik und Epidemiologie, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Eberhard F Kochs
- Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| | - Gerhard Schneider
- Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany.,Klinik für Anaesthesiologie, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany
| | - Klaus J Wagner
- Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| | - Christian M Schulz
- Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany.
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Hoseinnejad H, Kohan N, Mirzaee A. Evaluating validity of current criteria for judgment passing ER rotation among internee medical students. Ann Med Surg (Lond) 2017; 20:92-96. [PMID: 28761637 PMCID: PMC5522913 DOI: 10.1016/j.amsu.2017.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 06/13/2017] [Accepted: 06/13/2017] [Indexed: 12/03/2022] Open
Abstract
Background Passing the emergency medicine internship is an essential process for all graduates of medical schools. The main purpose of this study was to evaluate validity of current criteria for judgment passing ER rotation among internee medical students. Methods In this cross-sectional study, a total of 200 students in the emergency departments (ED) of the teaching hospitals at Tehran University of Medical Sciences (TUMS) were included. The data were gathered using by a valid self-assessment questionnaire including demographic information and 12-items about the students' level of confidence with the skills and procedures under study. Statistical analyses were done using SPSS (version 22). Results 200 medical students participated in this study. A Univariate analysis showed a significant correlation between successfuly completions of training in emergency medicine (passing emergency medicine in past rotations) with some items in self-assessment questionnaire same as knowledge of interns in managing emergency situations (p = 0.009). The Spearman test demonstrated a significant correlation between the duration of emergency training (number of months which interns spent on the emergency training) with the some items in self-assessment questionnaire same as importance of emergency medicine training (p = 0.019). Conclusions According to association between successfully completions of training in emergency medicine and self-assessment questionnaire, it seems current criteria for judgment passing emergency medicine rotation is valid as well as we recommended using self-assessment for evaluating validity of such testes. Previous studies have shown that the results of clinical tests in emergency medicine and other clinical education courses do not correlate accurately with a medical student's degree of confidence in performing tasks and their readiness for future career. Validity and authenticity of clinical test in emergency medicine and other clinical education course must be evaluated to ensure that these examinations predict whether the students who pass have greater skills and confidence when compared to the ones who fail the rotation. Self-assessment is an effective tool for evaluating validity of clinical tests.
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Affiliation(s)
- Hooman Hoseinnejad
- Department of Emergency Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Kohan
- Medical Graduates, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Corresponding author. Education Development Center, Medical Education Department, Hojjat-Doost Alley, Naderi St., Keshavarz Blvd., Tehran, Iran.Education Development CenterMedical Education DepartmentHojjat-Doost AlleyNaderi St.Keshavarz Blvd.TehranIran
| | - Akram Mirzaee
- Department of Medical Education, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Schmidt CA, Patterson MA, Ellis AM, Nauta HL. Religious and Spiritual Assessment: A Standardized Patient Curriculum Intervention. Clin Simul Nurs 2017. [DOI: 10.1016/j.ecns.2017.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Klapheke M, Johnson T, Cubero M. Assessing Entrustable Professional Activities During the Psychiatry Clerkship. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2017; 41:345-349. [PMID: 28315194 DOI: 10.1007/s40596-017-0665-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 01/12/2017] [Indexed: 05/13/2023]
Abstract
OBJECTIVE Within 10 years, the Association of American Medical Colleges envisions graduating medical students will be entrusted by their school to perform 13 core entrustable professional activities (EPAs) without direct supervision. The authors focused on eight EPAs that appear most relevant to clinical training during the psychiatry clerkship at their institution to evaluate whether students assess themselves as making progress in EPAs during this clerkship, to see how students' self-assessments compare with the clerkship director's assessments, and to see if weaknesses in the curriculum were found. METHODS An EPA-assessment scale was designed (ratings 1 to 5) to assess progress toward entrustment in each EPA. Medical students completed pre- and post-psychiatry clerkship self-assessments. The clerkship director independently assessed each student's progress in EPAs utilizing assessment methods already present in the curriculum. RESULTS Seventy of 116 students (60.3%) completed both pre- and post-clerkship self-assessments. These ratings increased significantly from pre- to post-clerkship, representing large effect sizes from 0.83 to 1.13. The largest mean rating increase was observed for EPA 2, Prioritize a differential diagnosis following a clinical encounter. Mean post-clerkship self-assessment ratings were significantly higher than mean post-clerkship instructor ratings for seven of the eight EPAs. CONCLUSIONS The results suggest training during the psychiatry clerkship can contribute to the professional development of medical students in the eight EPAs studied but that student self-assessments tend to be higher than those of the clerkship director. Further study is needed of the relative value and role of student self-assessments versus faculty assessments of progress in EPAs.
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Affiliation(s)
- Martin Klapheke
- University of Central Florida College of Medicine, Orlando, FL, USA.
| | - Teresa Johnson
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Morayma Cubero
- University of Central Florida College of Medicine, Orlando, FL, USA
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Hadid S. Factors Influencing Nursing Student Self-Assessment in Relation to Instructor Assessment. J Nurs Educ 2017; 56:70-76. [DOI: 10.3928/01484834-20170123-03] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 09/27/2016] [Indexed: 11/20/2022]
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Hall SR, Stephens JR, Seaby EG, Andrade MG, Lowry AF, Parton WJC, Smith CF, Border S. Can medical students accurately predict their learning? A study comparing perceived and actual performance in neuroanatomy. ANATOMICAL SCIENCES EDUCATION 2016; 9:488-495. [PMID: 27037749 DOI: 10.1002/ase.1601] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 12/11/2015] [Accepted: 01/18/2016] [Indexed: 06/05/2023]
Abstract
It is important that clinicians are able to adequately assess their level of knowledge and competence in order to be safe practitioners of medicine. The medical literature contains numerous examples of poor self-assessment accuracy amongst medical students over a range of subjects however this ability in neuroanatomy has yet to be observed. Second year medical students attending neuroanatomy revision sessions at the University of Southampton and the competitors of the National Undergraduate Neuroanatomy Competition were asked to rate their level of knowledge in neuroanatomy. The responses from the former group were compared to performance on a ten item multiple choice question examination and the latter group were compared to their performance within the competition. In both cohorts, self-assessments of perceived level of knowledge correlated weakly to their performance in their respective objective knowledge assessments (r = 0.30 and r = 0.44). Within the NUNC, this correlation improved when students were instead asked to rate their performance on a specific examination within the competition (spotter, rS = 0.68; MCQ, rS = 0.58). Despite its inherent difficulty, medical student self-assessment accuracy in neuroanatomy is comparable to other subjects within the medical curriculum. Anat Sci Educ 9: 488-495. © 2016 American Association of Anatomists.
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Affiliation(s)
- Samuel R Hall
- Centre for Learning Anatomical Sciences, University of Southampton, Southampton, United Kingdom
- Department of Neurosurgery, University Hospitals Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Jonny R Stephens
- Centre for Learning Anatomical Sciences, University of Southampton, Southampton, United Kingdom
- Department of Orthopedic Surgery, St Mary's Hospital London, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Eleanor G Seaby
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | | | - Andrew F Lowry
- Department of Neurology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trusts, Sheffield, United Kingdom
| | - Will J C Parton
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Claire F Smith
- Department of Anatomy, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Scott Border
- Centre for Learning Anatomical Sciences, University of Southampton, Southampton, United Kingdom
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Waqas A, Rehman A, Malik A, Muhammad U, Khan S, Mahmood N. Association of Ego Defense Mechanisms with Academic Performance, Anxiety and Depression in Medical Students: A Mixed Methods Study. Cureus 2015; 7:e337. [PMID: 26543695 PMCID: PMC4627837 DOI: 10.7759/cureus.337] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 09/30/2015] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Ego defense mechanisms are unconscious psychological processes that help an individual to prevent anxiety when exposed to a stressful situation. These mechanisms are important in psychiatric practice to assess an individual's personality dynamics, psychopathologies, and modes of coping with stressful situations, and hence, to design appropriate individualized treatment. Our study delineates the relationship of ego defense mechanisms with anxiety, depression, and academic performance of Pakistani medical students. METHODS This cross-sectional study was done at CMH Lahore Medical College and Fatima Memorial Hospital Medical and Dental College, both in Lahore, Pakistan, from December 1, 2014 to January 15, 2015. Convenience sampling was used and only students who agreed to take part in this study were included. The questionnaire consisted of three sections: 1) Demographics, documenting demographic data and academic scores on participants' most recent exams; 2) Hospital Anxiety and Depression Scale (HADS); and 3) Defense Style Questionnaire-40 (DSQ-40). The data were analyzed with SPSS v. 20. Mean scores and frequencies were calculated for demographic variables and ego defense mechanisms. Bivariate correlations, one-way ANOVA, and multiple linear regression were used to identify associations between academic scores, demographics, ego defense mechanisms, anxiety, and depression. RESULTS A total of 409 medical students participated, of whom 286 (70%) were females and 123 (30%) were males. Mean percentage score on the most recent exams was 75.6% in medical students. Bivariate correlation revealed a direct association between mature and neurotic ego defense mechanisms and academic performance, and an indirect association between immature mechanisms and academic performance. One-way ANOVA showed that moderate levels of anxiety (P < .05) and low levels of depression (P < .05) were associated with higher academic performance. CONCLUSION There was a significant association between academic performance and ego defense mechanisms, anxiety, and depression levels in our sample of Pakistani medical students.
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Affiliation(s)
- Ahmed Waqas
- Final year MBBS Student, CMH Lahore Medical College and Institute of Dentistry, Shami Road, Lahore Cantt
| | - Abdul Rehman
- Medical Student, Allama Iqbal Medical College, Lahore, Pakistan
| | - Aamenah Malik
- Department of Biochemistry, CMH Lahore Medical College and Institute of Dentistry, Shami Road, Lahore Cantt
| | - Umer Muhammad
- Department of Psychiatry, Combined Military Hospital, Lahore, Pakistan
| | - Sarah Khan
- Department of Biochemistry, CMH Lahore Medical College and Institute of Dentistry, Shami Road, Lahore Cantt
| | - Nadia Mahmood
- Department of Pathology, CMH Lahore Medical College and Institute of Dentistry, Shami Road, Lahore Cantt
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Lyndon MP, Strom JM, Alyami HM, Yu TC, Wilson NC, Singh PP, Lemanu DP, Yielder J, Hill AG. The relationship between academic assessment and psychological distress among medical students: a systematic review. PERSPECTIVES ON MEDICAL EDUCATION 2014; 3:405-418. [PMID: 25428333 PMCID: PMC4263790 DOI: 10.1007/s40037-014-0148-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
A systematic review was conducted to determine the relationship between academic assessment and medical student psychological distress with the aim of informing assessment practices. A systematic literature search of six electronic databases (Medline, Medline IN PROCESS, PubMed, EMBASE, Psychinfo, ERIC) from 1991 to May 2014 was completed. Articles focusing on academic assessment and its relation to stress or anxiety of medical students were included. From 3,986 potential titles, 82 full-text articles were assessed for eligibility, and 23 studies met review inclusion criteria. Studies focused on assessment stress or anxiety, and assessment performance. Consistent among the studies was the finding that assessment invokes stress or anxiety, perhaps more so for female medical students. A relationship may exist between assessment stress or anxiety and impaired performance. Significant risks of bias were common in study methodologies. There is evidence to suggest academic assessment is associated with psychological distress among medical students. However, differences in the types of measures used by researchers limited our ability to draw conclusions about which methods of assessment invoke greater distress. More rigorous study designs and the use of standardized measures are required. Future research should consider differences in students' perceived significance of assessments, the psychological effects of constant exposure to assessment, and the role of assessment in preparing students for clinical practice.
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Affiliation(s)
- Mataroria P Lyndon
- South Auckland Clinical Campus, The University of Auckland, Middlemore Hospital, Private Bag 93311, Auckland, Otahuhu, 1640, New Zealand.
- Ko Awatea, Counties Manukau District Health Board, Auckland, New Zealand.
- Department of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland, New Zealand.
| | - Joanna M Strom
- Counties Manukau District Health Board, Auckland, New Zealand
| | - Hussain M Alyami
- Department of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland, New Zealand
| | - Tzu-Chieh Yu
- Centre for Medical and Health Sciences Education, The University of Auckland, Auckland, New Zealand
| | - Nichola C Wilson
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Primal P Singh
- Department of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland, New Zealand
| | - Daniel P Lemanu
- Department of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland, New Zealand
| | - Jill Yielder
- Medical Program Directorate, The University of Auckland, Auckland, New Zealand
| | - Andrew G Hill
- Department of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland, New Zealand
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Li Y, Li N, Han Q, He S, Bae RS, Liu Z, Lv Y, Shi B. Performance of physical examination skills in medical students during diagnostic medicine course in a University Hospital of Northwest China. PLoS One 2014; 9:e109294. [PMID: 25329685 PMCID: PMC4198092 DOI: 10.1371/journal.pone.0109294] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 09/10/2014] [Indexed: 11/18/2022] Open
Abstract
This study was conducted to evaluate the performance of physical examination (PE) skills during our diagnostic medicine course and analyze the characteristics of the data collected to provide information for practical guidance to improve the quality of teaching. Seventy-two fourth-year medical students were enrolled in the study. All received an assessment of PE skills after receiving a 17-week formal training course and systematic teaching. Their performance was evaluated and recorded in detail using a checklist, which included 5 aspects of PE skills: examination techniques, communication and care skills, content items, appropriateness of examination sequence, and time taken. Error frequency and type were designated as the assessment parameters in the survey. The results showed that the distribution and the percentage in examination errors between male and female students and among the different body parts examined were significantly different (p<0.001). The average error frequency per student in females (0.875) was lower than in males (1.375) although the difference was not statistically significant (p = 0.167). The average error frequency per student in cardiac (1.267) and pulmonary (1.389) examinations was higher than in abdominal (0.867) and head, neck and nervous system examinations (0.917). Female students had a lower average error frequency than males in cardiac examinations (p = 0.041). Additionally, error in examination techniques was the highest type of error among the 5 aspects of PE skills irrespective of participant gender and assessment content (p<0.001). These data suggest that PE skills in cardiac and pulmonary examinations and examination techniques may be included in the main focus of improving the teaching of diagnostics in these medical students.
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Affiliation(s)
- Yan Li
- First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Shaanxi, Xi'an, China
| | - Na Li
- First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Shaanxi, Xi'an, China
| | - Qunying Han
- First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Shaanxi, Xi'an, China
| | - Shuixiang He
- First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Shaanxi, Xi'an, China
| | - Ricard S. Bae
- First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Shaanxi, Xi'an, China
| | - Zhengwen Liu
- First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Shaanxi, Xi'an, China
- * E-mail:
| | - Yi Lv
- First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Shaanxi, Xi'an, China
| | - Bingyin Shi
- First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Shaanxi, Xi'an, China
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