The transition to self-regulated learning for first-year dental students: threshold concepts

Early practice makes histology masters: The use of a formative assessment quiz to prepare histology learners for a high-stakes final examination

Assessment of learners in the anatomical sciences is a complex task as it not only tests students' fact knowledge, but also the analysis of visual information. Sometimes, novice histology learners must acquire image recognition skills of microscopic structures in a short time frame. This paper describes a strategy of offering first year dental students at the University of Michigan a short, non-grade contributing, formative assessment quiz in order to better prepare them for a high-stakes, final summative histology examination. Data collected over 7 years indicate that students, who made use of this formative assessment opportunity, performed significantly better in their summative examination than students, who did not. Especially early practice quiz users profited most. Students, who used the practice quiz until they achieved a perfect score, also had statistically higher final examination scores. Students, who did not use the practice quiz, had a significantly lower cumulative D1-year Grade Point Average (D1-GPA) than students, who did, indicating that academically weaker students often underuse supporting learning resources. In general, scores from the Dental Admission Test (DAT) were weak predictors of learning success in the DENT 510 histology course. In contrast, the D1-GPA values had a medium strength positive correlation with final histology examination scores. The major problem that was encountered with this practice quiz strategy was that many students waited until close to the day of the final examination before taking advantage of this feedback opportunity, thereby reducing its potential benefit for improving their overall learning strategy for histology.

The Role of Chatbot GPT Technology in Undergraduate Dental Education

This comprehensive article explores the transformative role of Chatbot GPT, based on the GPT-3 architecture, in revolutionizing dental education. The focus is on its impact across various facets, including personalized learning pathways, integration into virtual patient simulation scenarios, 24/7 accessibility, multilingual support, interactive dental dictionary functionality, evidence-based learning, and assessment and evaluation of dental students. The objective is to showcase how Chatbot GPT enhances educational experiences, promotes inclusivity, and aligns with contemporary pedagogical principles. Chatbot GPT emerges as a powerful ally in dental education, offering personalized learning experiences, risk-free clinical simulations, continuous accessibility, multilingual support, instant terminology assistance, evidence-based learning resources, and real-time assessment capabilities. Its adaptability caters to diverse learning needs, fostering a learner-centered approach and promoting lifelong learning for both dental students and practitioners. As a versatile tool, Chatbot GPT not only transforms the educational journey but also serves as a valuable asset for continuous professional development in the dynamic landscape of dentistry.

Selected Skill Sets as Building Blocks for High School-to-Medical School Bridge: Longitudinal Study Among Undergraduate Medical Students

BACKGROUND

The high school-to-medical school education transition is a significant milestone in the students' academic journey, which is characterized by multiple stressors. Although this crucial transition has been repetitively explored, the concept of proactively intervening to support this transition is still novel.

OBJECTIVE

In this study, we investigated the efficacy of a web-based multidimensional resilience building intervention in developing selected soft skills that are believed to drive the learner's success in any learning setting. The association between the students' academic performance over time and their proficiency in selected modules addressing skill sets, including Time Management, Memory and Study, Listening and Taking Notes, and College Transition, was also assessed to test the impact of the intervention on the students' learning.

METHODS

A longitudinal study was conducted on 1 cohort of students of a Bachelor of Medicine, Bachelor of Surgery program (MBBS). The medical students were offered a learning intervention around 4 skill sets during the first year of the 6-year program. Quantitative analyses were conducted using deidentified data, relating to the students' proficiency in the 4 skill sets and to the students' academic performance: grade point average (GPA). Descriptive analyses constituted computing an overall score of skill sets' proficiency (of all 4 selected skill sets). The mean and SD (and percentage of the mean) were also calculated for each skill set component, independently, and for the overall score of skill sets' proficiency. Bivariate Pearson correlations were used to assess the extent to which the academic performance of the students can be explained by the corresponding students' level of proficiency in each skill set component and by all 4 sets together.

RESULTS

Out of the 63 admitted students, 28 participated in the offered intervention. The means and SDs of the annual GPA of the students for years 1 and 2 (GPA range 1-4) were 2.83 (SD 0.74) and 2.83 (SD 0.99), respectively. The mean and SD of the cumulative GPA toward the end of year 2 was 2.92 (SD 0.70). Correlation analysis showed that the overall score of skill sets proficiency was significantly associated with the annual GPA of year 1 (r=0.44; P=.02) but was not associated with their annual GPA of year 2. The cumulative GPA (toward the end of year 2) appeared to be significantly associated with the overall score (r=0.438; P=.02).

CONCLUSIONS

Developing purposefully selected skill sets among medical students holds the potential of facilitating the high school-to-medical school education transition and is likely to improve their academic performance. As the medical student progresses, the acquired skills need to be continuously reinforced and effectively built upon.

Threshold concepts in health professions education research: a scoping review

Threshold concepts (TCs) are increasingly used in health professions education (HPE) research. TCs are claimed to be conceptual gateways which are often traversed with substantial difficulty. In this paper, we report on a scoping review investigating the following research question: What is the scope and nature of the currently available research on threshold concepts in health professions education literature? We employed Arksey and O'Malley's model for scoping reviews. A search for literature on TCs in HPE research between 2003 and 2020 yielded 999 records of which 59 were included in the review. The data set was subject to quantitative descriptive analysis of article characteristics as well as qualitative thematic analysis of the scope of research on TCs. Among the 59 articles selected for review, there were 30 empirical, 26 conceptual and three reviews. A majority were published in 2015 or later. Almost half of the included articles attempted to identify possible TCs within HPE. Others investigated how TCs can be traversed or suggested how TCs could influence curriculum design. Some critically appraised the framework of TC. Although TCs are increasingly utilised in HPE, the present review identified how researchers came across methodological challenges related to identifying possible TCs and definitional challenges around identifying the essential characteristics of TCs. Before embracing TCs as the next go-to theory for learning in HPE, we acknowledge the need for methodological stringeny and rigour as well as more data to support TCs. Until then, any implementation of TCs in HPE curricula should be done cautiously.

Do We Need to Close the Door on Threshold Concepts?

ISSUE

Threshold Concepts are increasingly used and researched within health professions education. First proposed by Meyer and Land in 2003, they can be defined as ways of knowing central to the mastery of a subject. They are framed as profoundly transformative, impacting the identity of those who encounter them through irreversible shifts in an individual's outlook. Although Threshold Concepts have been identified in a multitude of educational settings across the continuum of health professions education, there has been little critique of Threshold Concepts as a theory of health professions education. Within adjacent fields critical discourse is also underdeveloped, perhaps given the educational resonance of the theory, or the way in which the theory encourages subject specialists to discuss their area of interest in depth. This commentary critically examines how Threshold Concepts have been used and researched within health professions education, applying critiques from other educational fields, to assist scholars in thinking critically regarding their application.

EVIDENCE

Three significant critiques are outlined: 1) 'The floating signifier problem'; 2) 'The body of knowledge problem'; and 3) 'The professional identity problem.' Critique 1, the floating signifier problem, outlines how Threshold Concept theory lacks articulation and has been inconsistently operationalized. Critique 2, the body of knowledge problem, outlines the issues associated with attempting to identify a singular body of knowledge, particularly in regard to the reinforcement of entrenched power dynamics. Critique 3, the professional identity problem, argues that the way in which Threshold Concepts conceptualize identity formation is problematic, inadequately grounded in wider academic debate, and at odds with increasingly constructionist conceptualizations of identity within health professions education.

IMPLICATIONS

These critiques have implications for both educators and researchers. Educators using Threshold Concepts theory must think carefully about the tacit messages their use communicates, consider how the use of Threshold Concepts could reinforce entrenched power dynamics, and reflect on how their use may make material less accessible to some learners. Further, given that Threshold Concept theory lacks articulation, using the theory to structure curricula or educational sessions is problematic. Threshold Concepts are not synonymous with course learning outcomes and so, While considering Threshold Concepts may enable pedagogical discussion, the theory cannot help educators decide which concepts it applies to; this requires careful planning which extends beyond the bounds of this theory. For researchers, there are issues too with power and inconsistent theoretical operationalization, but also with the way in which Threshold Concepts theory conceptualizes identity formation, which cast doubt on its use as a theory of identity development. On balance, we believe Threshold Concept theory suffers a number of fundamental flaws that necessitate a shift from the positioning of Threshold Concepts as a theory, toward the use of Threshold Concepts as a less prescriptive reflective prompt to stimulate pedagogical discussion.

Preclinical to clinical transition experiences of dental students at an Australian Regional University

INTRODUCTION

Clinical experience is a crucial component of dental education as it prepares students for real-world practice. Our study aimed to investigate the transition from preclinical to clinical training experiences of dental students at a regional Australian dental school.

MATERIALS AND METHODS

A mixed-methods study was conducted using a survey and focus groups. Participants were dental students who recently transitioned into clinical training. Survey data were analysed quantitatively using descriptive statistics, whilst the qualitative data were thematically analysed using the conceptual framework of organisational socialisation theory (OST).

RESULTS

Forty-eight of the 69 students in the cohort completed the survey and 10 participated in the focus groups. The quantitative findings revealed that the transition was perceived to be abrupt and associated with a heavy workload. However, orientation sessions and engaging in chairside teaching made transitioning into clinical studies easier. The qualitative findings revealed that the transition process occurred in three phases. In phase 1, participants navigated the educational and social challenges using developmental characteristics such as resilience and positivity. Lessons learnt in phase 1 were used to make necessary learning adjustments in phase 2 and this subsequently enhanced developmental growth in the final phase, which helped ease the transition.

CONCLUSION

This study confirms that transitioning into clinical training can be complex. However, the educational and socialisation challenges associated with the transition can provide stimulating developmental learning opportunities that advance students' adjustments to the clinical environment with positive, empowering and motivational outcomes that facilitate a smooth transition.

The self-regulated learner, entry characteristics and academic performance of undergraduate nursing students transitioning to University

BACKGROUND

Although the importance of fostering students self-regulated learning is well known, little is known about the relationship between student entry characteristics, particularly students from disadvantaged backgrounds, self-regulatory strategy use and academic performance. The study aim was to examine undergraduate nursing students' entry characteristics, motivational behaviours and learning strategies, and academic performance after transitioning into the first unit of an undergraduate nursing course.

DESIGN

A cross-sectional survey.

SETTING

A university in Australia.

PARTICIPANTS

First-year undergraduate nursing students.

METHODS

The Motivational Strategies for Learning Questionnaire, including demographic information, was distributed to students in the fourth week of commencing University, consent was obtained for the use of student unit grades.

RESULTS

For the 448 eligible students, n = 282 (62.9%) completed the survey. Students were categorised by age into three groups: 18 years, 19-22 years, and 23+ years. Entry characteristics, motivation and learning strategies scores and academic performance were related to the age category with the greatest difference between 18 and 23+ student groups. 23 years+ had higher scores for 11 MSLQ scales (mean difference 0.78-0.31, p < 0.05) highest grades (F = 4.694, p = 0.010). Students 23+ years had the highest motivational behaviours and learning strategies. The international students' academic grades in this study were lower than the domestic student's grades (t = -2.212, p = 0.028).

CONCLUSION

This study highlights the need to address the tensions that exist between attracting quality students, the requirement to assess their quality efficiently and allowing students from disadvantaged groups the opportunity to enter nursing undergraduate degree courses. This study contributes new knowledge to the impact students' entry characteristics have on motivational behaviours, learning strategy use and academic performance. Knowing this would allow faculty to identify students at risk of failure early in the course and offer instructional support.

Becoming a dentist: faculty perceptions of student experiences with threshold concepts in a Canadian dental program

BACKGROUND

In each discipline, there are moments where students "get stuck" in their education and/or training and are often unable to move forward. These moments may be caused by threshold concepts as they represent a portal that students must cross in order to become successful in their chosen profession. This study investigated the threshold concepts from the instructors' perspective that students must navigate as they transform from learners to dentists within a dental program.

METHODS

Two focus groups with faculty members within the School of Dentistry, University of Alberta were completed in the fall of 2017. Focus groups explored the faculty's perception of the students' transition from learner to dentist, difficult moments in the program, and the students' ability to navigate the program successfully.

RESULTS

A qualitative phenomenographic analysis of the faculty focus group transcripts identified four potential threshold concepts within the dental program: 1) dealing with the whole patient, 2) accountability, 3) that you may not know everything, and 4) problem solving and adapting during practice.

CONCLUSION

This study demonstrates that there are concepts within a dental program that faculty believe students must navigate in order to transition from learner to dentist. These concepts may inform curriculum design as well as other disciplines in the health sciences.

What can dental education gain by understanding student experience of the curriculum?

INTRODUCTION

Within higher education, there is increasing recognition that understanding the ways students experience the educational environment is critical to developing programmes that can educate our future professionals. There is a small body of literature about how students experience the dental educational environment; however, none that adopts a qualitative phenomenographic approach. This study aims to contribute to our understanding by asking what is the variation in the ways dental students experience their curriculum?

METHODS

This study uses a phenomenographic methodology. Phenomenography investigates the variation in the way a group of people experience a situation, and how they ascribe meaning to it. Interviews were conducted with 14 senior dental students at the University of Sydney. Transcripts were analysed using a phenomenographic approach.

RESULTS

Six increasingly sophisticated, qualitatively distinct categories of description were identified from the collective of transcripts: surviving the education system; following a guide or manual, learning how to treat teeth, learning how to meet patient treatment needs, learning how to relate with patients and understanding the complexities of dental practice. The outcome space consists of ways the categories of description are related; considering interactions with teachers, ways of coping with multiple opinions and integration of disciplinary learning.

CONCLUSION

This study provides new insights into the multifaceted and relational ways that dental students experience their educational environment. It could point curriculum designers towards strategies that assist students develop sophisticated understandings about themselves as practitioners, patients and the complexities of dental practice. Suggestions about the practical implications of the findings of this research are given.