Independent and mentored video review of OSCEs

Sleep Patterns of Premedical Undergraduate Students: Pilot Study and Protocol Evaluation

BACKGROUND

Poor sleep hygiene persists in college students today, despite its heavy implications on adolescent development and academic performance. Although sleep patterns in undergraduates have been broadly investigated, no study has exclusively assessed the sleep patterns of premedical undergraduate students. A gap also exists in the knowledge of how students perceive their sleep patterns compared to their actual sleep patterns.

OBJECTIVE

This study aims to address 2 research questions: What are the sleep patterns of premedical undergraduate students? Would the proposed study protocol be feasible to examine the perception of sleep quality and promote sleep behavioral changes in premedical undergraduate students?

METHODS

An anonymous survey was conducted with premedical students in the Medical Science Baccalaureate program at an R1: doctoral university in the Midwest United States to investigate their sleep habits and understand their demographics. The survey consisted of both Pittsburg Sleep Quality Index (PSQI) questionnaire items (1-9) and participant demographic questions. To examine the proposed protocol feasibility, we recruited 5 students from the survey pool for addressing the perception of sleep quality and changes. These participants followed a 2-week protocol wearing Fitbit Inspire 2 watches and underwent preassessments, midassessments, and postassessments. Participants completed daily reflections and semistructured interviews along with PSQI questionnaires during assessments.

RESULTS

According to 103 survey responses, premedical students slept an average of 7.1 hours per night. Only a quarter (26/103) of the participants experienced good sleep quality (PSQI<5), although there was no significant difference (P=.11) in the proportions of good (PSQI<5) versus poor sleepers (PSQI≥5) across cohorts. When students perceived no problem at all in their sleep quality, 50% (14/28) of them actually had poor sleep quality. Among the larger proportion of students who perceived sleep quality as only a slight problem, 26% (11/43) of them presented poor sleep quality. High stress levels were associated with poor sleep quality. This study reveals Fitbit as a beneficial tool in raising sleep awareness. Participants highlighted Fitbit elements that aid in comprehension such as being able to visualize their sleep stage breakdown and receive an overview of their sleep pattern by simply looking at their Fitbit sleep scores. In terms of protocol evaluation, participants believed that assessments were conducted within the expected duration, and they did not have a strong opinion about the frequency of survey administration. However, Fitbit was found to provide notable variation daily, leading to missing data. Moreover, the Fitbit app's feature description was vague and could lead to confusion.

CONCLUSIONS

Poor sleep quality experienced by unaware premedical students points to a need for raising sleep awareness and developing effective interventions. Future work should refine our study protocol based on lessons learned and health behavior theories and use Fitbit as an informatics solution to promote healthy sleep behaviors.

Twelve tips for practical clinical skills coaching

Coaching is rapidly evolving in clinical medicine, including for clinical skills (CS) learning. Yet a schema is needed for how to coach students in the many CS that are pivotal to the practice of medicine. These twelve tips aim to provide practical strategies for teachers and educators to coach students for CS learning. The tips cover many important aspects of CS coaching, including establishing a safe space, ways to prepare to coach, setting goals, guiding a coaching relationship, fostering coaching conversations, and in-person or virtual approaches. Together, the tips align as seven key steps of an overall coaching process. The twelve tips apply equally to coaching struggling students and all students seeking to improve CS and offer a guide for coaching at an individual or program level.

Memory, credibility and insight: How video-based feedback promotes deeper reflection and learning in objective structured clinical exams

INTRODUCTION

Providing high-quality feedback from Objective Structured Clinical Exams (OSCEs) is important but challenging. Whilst prior research suggests that video-based feedback (VbF), where students review their own performances alongside usual examiner feedback, may usefully enhance verbal or written feedback, little is known about how students experience or interact with VbF or what mechanisms may underly any such benefits.

METHODS

We used social constructive grounded theory to explore students' interaction with VbF. Within semi-structured interviews, students reviewed their verbal feedback from examiners before watching a video of the same performance, reflecting with the interviewer before and after the video. Transcribed interviews were analysed using grounded theory analysis methods.

RESULT

Videos greatly enhanced students' memories of their performance, which increased their receptivity to and the credibility of examiners' feedback. Reflecting on video performances produced novel insights for students beyond the points described by examiners. Students triangulated these novel insights with their own self-assessment and experiences from practice to reflect deeply on their performance which led to the generation of additional, often patient-orientated, learning objectives.

CONCLUSIONS

The array of beneficial mechanisms evoked by VbF suggests it may be a powerful means to richly support students' learning in both formative and summative contexts.