Edgar Dale's Pyramid of Learning in medical education: Further expansion of the myth

Team-based learning in the internal medicine clerkship didactics

BACKGROUND

Active-learning approaches, such as team-based learning, are infrequently used in internal medicine clerkship didactics even though there is increasing evidence to suggest medical students prefer it over traditional lecture-based learning. In this study, five team-based learning sessions were incorporated into three blocks of a 12-week internal medicine clerkship.

METHODS

The goal of this quasi-experimental study was to compare learner engagement, satisfaction and preference between team-based learning and lecture-based learning in the internal medicine clerkship didactics. Outcomes were compared using the Classroom Engagement Survey, a satisfaction questionnaire and the Team-Based Learning Student Assessment Instrument (TBL-SAI).

FINDINGS

There was a statistically significant difference in the classroom engagement scores between team- and lecture-based learning (P < 0.0001) with a median of 39.0 and 33.0 in the team-based learning and lecture-based learning groups. For learning preference, the median TBL-SAI score was substantially above neutral. Across all team-based learning sessions, 100% of students were satisfied or strongly satisfied with the learning style as a valuable experience and as a way to learn course material, and only one student was not satisfied or strongly satisfied with team-based learning to improve problem solving skills.

DISCUSSION

The classroom engagement and learning style preference findings were consistent with previously published data in other clerkship settings. Student satisfaction was more consistent with team-based learning than with the lecture-based learning, which may be because of the consistent format whereas lecture-based learning style was faculty dependent.

CONCLUSION

Students preferred team-based learning and had improved engagement and satisfaction when compared to lecture-based learning. This study provides evidence in favour of team-based learning as a strategy to incorporate active learning in clerkship didactics.

What Happens to the Principles of Evidence-Based Practice When Clinicians Become Educators? A Case Study of the Learning Styles Neuromyth

Introduction

The approach of matching teaching practice to individual student "Learning Styles" has been repeatedly shown to be ineffective, even harmful. Yet, it appears a majority of educators believe it to be an effective approach. The status of Learning Styles theory in health professions education is unclear.

Method

We surveyed health professions educators to determine whether they believed that Learning Styles theory is effective and whether this belief translates to action. We also test knowledge of Learning Styles theory.

Results

87.4% of participants are familiar with Learning Styles, but knowledge about specific models varies. 69.9% of participants believed that Learning Styles theory is effective, but only one-third of them were actually using it.

Discussion

More effort is required to emphasise the importance of evidence-based educational awareness and practice in the healthcare community. As is the case with clinical practice, a culture of promoting pedagogy validated by the scientific method should be the norm.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01849-1.

Application of PBL combined with traditional teaching in the Immunochemistry course

BACKGROUND

The problem-based learning (PBL) model has been widely carried out in many fields of medical colleges and universities. Immunochemistry as a cross-disciplinary science plays a vital role in preventing the occurrence of diseases and bridging the development of Life Science and Medicine. But now the Immunochemistry course still lacks the teaching practice in PBL. To explore the significance of PBL applied in the Immunochemistry course, the effect of the PBL model on the learning of undergraduates majoring in Chemicobiology was systematically evaluated.

METHODS

The teaching objects were the undergraduates majoring in Chemicobiology from Guizhou Medical University. The PBL model was applied in the Immunochemistry course. 62 undergraduates in Grade 2018 were set as the control group and adopted the traditional expository model. 93 undergraduates in Grades 2019-2020 were separately set as the experimental groups, which adopted the PBL model based on traditional lecture-based learning. In the PBL model, six cases related to course contents were designed for the students to complete. The final exams of the undergraduates in Grades 2018-2020 were analyzed by the score ranges (< 60 points, 60-69 points, 70-79 points, and ≥ 80 points) and nonparametric test. Finally, the questionnaire survey about the teaching evaluation was performed in Grades 2019-2020.

RESULTS

In Grades 2019 and 2020, the excellent rates (≥ 80 points), pass rates (≥ 60 points), fail rates (< 60 points), and average scores of the undergraduates were separately about 29%, 91.11% and 93.75%, 6.25%, and 8.89%, and 72.55 and 74.45 points. But in Grade 2018, the excellent rate, pass rate, failure rate, and average score of the undergraduates were separately 9.68%, 59.68%, 40.32%, and 62.55 points. By the statistical analysis, it was found that the excellent rates (χ2 = 8.317, P < 0.005) and pass rates (χ2 = 24.52, P < 0.0001) in Grades 2018-2020 were different, of which Grade 2020were the highest (29.17%, 93.75%) and Grade 2018 was the lowest (9.68%, 59.68%). The average score, excellent rate, and pass rate in Grade 2018 had significant differences with Grade 2019 (P < 0.0001, P < 0.0167) and Grade 2020 (P < 0.001, P < 0.0167). The questionnaire survey also showed that the student's learning interests, independent problem-solving ability, knowledge structure system, and scientific thought and teamwork awareness were enhanced. In Grades 2019 and 2020, the ICC (95% CI) of criterion validity and inter-rater reliability were separately 0.42/0.34 and 0.81/0.80 (P < 0.0001).

CONCLUSION

The combination of PBL and traditional expository models played positive roles in the student's learning in the Immunochemistry course.

A Comparison of Dry Period Outcomes after Selective Dry Cow Therapy Carried Out by Farm Staff versus Veterinary Students in a Low-Cell-Count Dairy Herd

(1) Background: Selective dry cow therapy is widely promoted in many countries worldwide, however, concerns have been raised about the consequences of the unhygienic application of preparations by untrained operators, especially if no antimicrobials are being used, risking deteriorating mastitis outcomes. (2) Method: This study follows up on cows being dried off by farm staff and those dried off by final-year veterinary students and first-year graduate interns in a supervised training session. Subsequent mastitis parameters and culling data in a single herd with a low somatic cell count were evaluated. (3) Results: A total of 316 dry periods were enrolled in the study. There was no significant difference in the percentage of cows showing at least one high SCC reading within 90 days of the following lactation or cows with at least one case of clinical mastitis within the same period, neither in the total nor in the subset of cows dried off without an antimicrobial. Dry period cure rates and dry period new infection rates were similar too, as was the percentage of cows surviving in the herd after six months. The risk of culling within twelve months post-drying off was lower in cows dried off by students, the difference in survival manifesting itself from 150 days post-drying off, which is an unexplained finding. (4) Conclusion: Well-supervised practical training sessions on drying off routine can be responsibly implemented on well-managed commercial dairy herds.

Medical Teacher's first ChatGPT's referencing hallucinations: Lessons for editors, reviewers, and teachers

Students' inappropriate use of ChatGPT is a concern. There is also, however, the potential for academics to use ChatGPT inappropriately. After explaining ChatGPT's "hallucinations" regarding citing and referencing, this commentary illustrates the problem by describing the detection of the first known Medical Teacher submission using ChatGPT inappropriately, the lessons that can be drawn from it for journal editors, reviewers, and teachers, and then the wider implications if this problem is left unchecked.

Pyramids in medical education: Their conceptualization and utility summarized

Objectives

To examine the conceptual underpinnings of learning pyramids, their limitations and some proposed modifications, and to describe their utility.

Materials and methods

Starting with a selection of pyramids based on whether graphic design was part of their original design and on their conceptual description, we examined the criticisms they have received and the modifications derived from those observations, and the use given to the pyramids most commonly used in medical education.

Results

Five pyramids were included, namely, George Miller, Edgar Dale, Donald Kirkpatrick, Benjamín Bloom and Abraham Maslow. Pyramids describe different aspects of medical education evaluation, either of individuals or of training programs, including competencies, identity, reliability, learning, behavior, results, cognitive complexity and self-realization.

Conclusions

As theoretical models, the pyramids examined have contributed to support learning processes in health professions. Their practical utility extends to different specialties and education levels given that they can help faculty optimize curricular design, teaching and evaluation processes. It is important to conduct a local assessment of the effects on health science programs built on these theoretical models.

Effectiveness of the use of concept maps and simulated cases as a teaching-learning strategy in enhancing the learning confidence of baccalaureate nursing students: A qualitative approach

BACKGROUND

Didactic lectures and exam-oriented learning can lead to students becoming passive learners who rely on rote memory. This learning style negatively impacts their ability to cultivate the core nursing values and critical thinking.

OBJECTIVES

This study aimed to investigate the impact of a concept mapping teaching-learning strategy on undergraduate nursing students' ability to integrate theoretical biosciences knowledge into care practice and on their skills in critical thinking and teamwork.

METHODS

A qualitative research design was adopted. A course entitled Evaluation and Analysis of Adult Nursing Cases was developed based on a concept mapping strategy involving 24 simulated cases relevant to medical and surgical nursing. The participants were students from the two-year undergraduate nursing programme at a university in Taiwan. Data were collected from September 2020 to February 2021. Qualitative data were collected from semi-structured face-to-face interviews with 20 students and from 100 reflective reports on students' learning journeys. The data were analysed using qualitative content analysis.

RESULTS

Two major themes were identified: (1) changes in learning style and thinking and (2) rewards from learning. The participants reported that their learning style had changed from reliance on rote learning to image memory, and their thinking process from linear (cause-effect) to multifaceted thinking at different levels. The teaching and learning strategies contributed to feelings of ability advancement and psychological safety, which led to learning achievement and confidence.

CONCLUSION

The use of a concept mapping strategy and simulated cases enhanced students' learning by enabling them to integrate theoretical knowledge and improve their thinking abilities. The teaching and learning strategies helped participants in learning about psychological safety and increased their learning confidence.

The effect of a virtual simulation-based educational application on nursing students' belief and self-efficacy in communicating with patients about complementary and alternative medicine

BACKGROUND

Simulation-based learning that focuses on the development and assessment of communication and counseling skills can help nursing students achieve better skill performance and gain self-confidence with decision-making ability. It is unknown whether virtual simulation as an instructional design significantly improves educational outcomes than a traditional lecture with low-fidelity simulation in students.

OBJECTIVES

The aim was to explore the effect of a virtual simulation-based educational smartphone application on nursing students' beliefs and self-efficacy in communicating with patients about complementary and alternative medicine (CAM) use.

DESIGN

A quasi-experimental study with pretest-posttest nonequivalent control group design.

SETTINGS AND PARTICIPANTS

A total of 101 nursing students, who were in their second or third-year nursing program at a Southern Taiwan university volunteered to participate in the academic year 2020-2021. Participants were assigned to an experimental or control group in an elective course.

METHODS

All participants received a 4-hour lecture that included an in-class lecture with low-fidelity simulation (paper-based scenarios) about the risk-benefit assessment of a patient's CAM use. The experimental group received a series of 13 virtual simulation exercises with clinical scenarios by means of a smartphone application. Data from belief and self-efficacy scales were collected at the beginning and end of the course from September 2020 to February 2021. Descriptive and inferential statistics were analyzed using the IBM® SPSS® version 23.0.

RESULTS

Although both groups significantly improved their belief and self-efficacy scale scores, the experimental group had significant differences in overall self-efficacy in communicating with patients about CAM use compared with the control group, specifically the CAM perceptions and self-confidence scores.

CONCLUSIONS

Although both in-class and virtual simulation improved nursing students' belief and self-efficacy, the virtual simulation-based educational app is effective as an adjunct learning tool in significantly increasing nursing students' self-efficacy in communicating with patients about CAM use to help minimize their risks.

Effectiveness of web application as educational media in increasing the caries risk knowledge and decreasing the caries risk score among dental students in Indonesia

Background

This study evaluating the effect of web application media in increasing the caries risk knowledge and decreasing the caries risk scores among dental students.

Methods

A quasi-experimental design along with a purposive sampling technique was used in this study. A total of 361 undergraduate pre-clinical dental students from 15 universities in Indonesia were divided into two groups: intervention (n = 282) and control (n = 79). The students in the intervention group received a web application media with educational materials to independently check their caries risk, whereas those in the control group received the application without any educational materials. The students were instructed to use the web application at least once a week for 21 days and complete the pretest and posttest questionnaires and web application evaluation questionnaires. In addition, they were required to independently examine their initial and final caries risk.

Results

A significant increase in the level of knowledge was observed in the intervention group, but not in the control group, after the use of the web application. Each group showed a decrease in the caries risk score, but the difference was not statistically significant before and after the use of a web application in both groups.

Conclusion

These findings indicate that health promotion and education about caries risk through web application media can improve the knowledge and reduce the caries risk in dental dentistry students.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-021-01995-1.

Simulation-based assessments of fire emergency preparedness and response in virtual reality

The current study aimed at evaluating the prospects of a three-dimensional gas power plant (GPP) simulation in an immersive virtual reality (IVR) environment for fire emergency preparedness and response (EPR). To achieve this aim, the study assessed the possibility of safety situational awareness, evacuation drills and hazard mitigation exercises during a fire emergency simulation scenario. The study likewise evaluated the safety and ergonomics of the environment while addressing this aim. We employed the virtual reality accident causation model (VR-ACM) for the assessment with 54 participants individually in IVR. Participants were grouped into two according to whether they had work experience in engineering or not. The obtained results suggested that IVR can be realistic and safe, with the potential for presenting hazardous scenarios necessary for fire EPR. Furthermore, the results indicated that there were no statistically significant differences in the perceptions of both groups regarding the prospects of IVR towards EPR.

Simulation-Based Learning Versus Didactic Lecture in Teaching Bronchial Asthma for Undergraduate Medical Students: a Step Toward Improvement of Clinical Competencies

BACKGROUND

Simulation-based learning (SBL), an effective teaching strategy, is still questionable on whether it can be an alternative to didactic lectures in medical education. Our study aimed to evaluate the effectiveness of SBL versus traditional lectures in retention of knowledge.

METHODS

A randomized controlled trial was conducted among medical students who were divided in two groups (36 students each). Each group received the same information about diagnosis and management of bronchial asthma, but with a different teaching method: didactic lecture or simulation. Knowledge level was tested before, immediately after the teaching sessions and 3 months later using multiple-choice questions. Student's satisfaction was evaluated using feedback questionnaire.

RESULTS

The simulation group scored higher than the lecture group in the post-test and the late test. However, these differences were not significant. Additionally, students' satisfaction scores were significantly higher in the simulation group than in the lecture group (p < 0.01). Students ranked simulation significantly better regarding motivation (71.9%), comfort (59.4%), understanding (59.4%), and effective communication (59.4%) (p < 0.01).

CONCLUSION

Simulation is as effective as lecture in retention of medical knowledge. Nonetheless, students agree that it is more satisfactory and interesting. SBL integration in medical programs is recommended to overcome obstacles in clinical training.

Ethics in medical education digital scholarship: AMEE Guide No. 134

Ethics has long been a concern in medicine, education and scholarship. In the digital age, new complexities have arisen, and many medical education researchers are unprepared for the pitfalls ahead, often negotiating these in the absence of guidelines, and unaware of the many tools that can be used to assist them. This Guide takes the medical education scholar through a journey in which issues of ethics are discussed in all stages of digital scholarship: research preparation, research subject monitoring and data gathering, securing one's data (and balancing security against accessibility), anonymising textual and non-textual data, third party identifiability in digital data, writing one's own work (including plagiarism and paper mills), copyright (including issues of Creative Commons and royalty-free), accessing inaccessible reference material, ethically citing electronic material, and manuscript submission (including issues of selecting journals, open access and data sharing). The Guide ends with a brief look to the future. This Guide aims to be a useful tool to alert the readers to some of the most important ethical issues that need to be considered, and some practical solutions to ethical problems faced, when engaging in medical education digital scholarship.

Debunking myths in medical education: The science of refutation

de Bruin argues that efforts to eradicate erroneous assumptions students and teachers hold about learning requires refutation, a process that combines both correct scientific knowledge and rejection of misconceptions.