Student perceptions of the use of presentations as a method of learning endocrine and gastrointestinal pathophysiology

Game-based learning enhances students' understanding of endocrine physiology in veterinary medicine

Endocrine physiology is a complex subject for students. Game-based learning (GBL) and case-based learning (CBL) are active methodologies that are widely used because of their potential for motivation and greater proximity to the reality of modern students. We evaluated the effectiveness of GBL and CBL among veterinary medicine students compared with a control group using peer tutoring. Students (n = 106) from two institutions volunteered to participate in this study. The participants were submitted to a pretest questionnaire and subsequently were divided into three paired groups by their performance on the pretest exam: 1) traditional class + peer tutoring, 2) traditional class + GBL, and 3) traditional class + CBL. After the students completed the activities, their performance was once again evaluated by applying a new test with the same initial 10 questions and another set of 10 different questions. The students' perceptions and satisfaction with the methodologies and learning strategies were assessed. Anxiety was assessed with the State-Trait Anxiety Inventory before and after the conventional class and after the active methodologies. The GBL group significantly improved their correct answers compared with the baseline (P < 0.05), with no significant difference from CBL and peer tutoring. Anxiety levels did not differ regardless of the time of evaluation or the teaching methodology applied. GBL promoted a greater perception of the stimulus for self-study and problem-solving ability and contributed to the development of group dynamics compared with the group who received CBL (P < 0.05). In conclusion, GBL showed better results than peer tutoring and CBL.NEW & NOTEWORTHY We compared the supplementary use of game-based learning, case-based learning, and peer tutoring in the study of endocrine physiology by veterinary students and observed a slight advantage for game-based learning over the other two methodologies. The game was developed by the authors and is an unprecedented tool that can prove useful to improve knowledge acquisition in students of veterinary medicine. Thus, game-based learning is an effective supplementary teaching strategy.

Peer-reviewed presentation exchange in an undergraduate classroom

Reading, presenting, and discussing peer-reviewed scientific reports, case studies, and reviews are essential to modern biology education. These exercises model crucial aspects of students' future professional activities and introduce the students to the current scientific concepts and methodology, data analysis, and presentation. A common format for working with primary literature is a journal club: presenting and discussing research literature in front of peers, which has many merits. However, in large modern classrooms, this format is very time-consuming and stressful, especially since presenting is not a commonly taught skill. We argue that student groups for whom the current educational and professional paradigms present a challenge due to a historical lack of representation or wellness issues are deprived of a key educational opportunity. To solve this problem, we formulated an approach called Peer-Reviewed Presentation Exchange (PRPE), which focuses on collaborative analysis, presentation, and review of research literature that includes (i) voice-narrated research presentations by students, (ii) checklists generated by the instructor to establish expectations for an informative presentation or review, and (iii) presentation assignment and peer review process. We tested this approach in an undergraduate cell biology class over 3 years. Pre- and post-assessments show significant gains in self-efficacy and knowledge not only by students who presented but also by the students who reviewed the presentations; therefore, peer-reviewed presentations are an effective tool for learning. Exit surveys show that the approach is seen as beneficial by most students. Our approach allows every student to speak and ask questions in a low-stress creative environment. It is an excellent customizable, trackable, and scalable low-stakes assessment tool.

Online Physiology Practice with Team-Based Learning During the COVID-19 Pandemic

Background

The spread of the coronavirus disease (COVID-19) has significantly affected medical education. In particular, conducting practical training in a face-to-face format has become difficult.

Purpose

To address this problem, online physiology practice combined with team-based learning (TBL) for deep learning of renal physiology was conducted among second-year medical students.

Participants and Methods

The experiment was performed by a group of students, while other students watched online. After the experiment, all students were grouped using breakout rooms. Following a discussion of the data, a clinical case study related to the experiment was conducted using TBL. To examine the effect of online practice in a case study under TBL, the participants completed an anonymous, open-ended, web-based questionnaire after the program, enabling us to compare their expectations and satisfaction. The questionnaire consisted of questions examining students' opinions on the appropriateness of online practice, degree of understanding, ease of asking questions, time efficiency, and the usefulness of case studies using TBL.

Results

There was no change in the number of students who participated in the online practice before and after class. After class, more students considered the level of understanding easier and displayed better on-time efficiency than with regular face-to-face training. However, these questions are difficult to answer.

Conclusion

Online-based physiology practice combined with clinical case studies under TBL helped maintain students' expectations and satisfaction with the training.

Exploration of simulated urine sample biochemistry for the diagnosis of diseases: A laboratory practical exercise

The practical work described here is designed for third-year bachelor students in Life Sciences attending a kidney physiology course. It illustrates how urinary biochemistry can be used for a medical diagnosis. Students have to measure glucose, proteins, and creatinine concentrations in three simulated urine samples. First, they independently elaborate detailed protocols from the biochemical kit's technical sheets. Second, after correction of the protocols by the teacher, they perform the biochemical assays. Finally, students write a report in which they interpret the biochemical data and use them in the context of histological images assigned to each urine sample. With their results, their theoretical background and scientific articles supplied by the teacher, they establish the diagnosis indicating which patients are diseased and from which disease they are suffering (diabetes without nephropathy, diabetic nephropathy or hypertensive nephropathy). The originality of this practical work is to give student autonomy from the start of the project by requiring them to write the protocols, and determine the diagnosis by themselves. Simple and inexpensive, this practical forces students to mobilize their knowledge in renal physiology and pathophysiology as well as those acquired in other disciplines such as biochemistry or cellular biology. A survey conducted on two classes of students confirmed that this type of training helps students to better understand renal physiology, to realize the importance of interdisciplinarity (biochemistry, histology, and physiology) and to develop confidence in their ability to work independently.

The use of photovoice to transform health science students into critical thinkers

BACKGROUND

Students are often inadequately prepared for higher education, particularly concerning independent learning and critical thinking. These attributes are essential, especially in health science students as health care needs are complex. Innovative methods of teaching that promote these attributes are thus required. One such method, which has been included previously in other disciplines is photovoice, a participatory method, in which students become co-creators of knowledge. The aim of the study was to determine whether photovoice would promote critical thinking in students enrolled for a module in Public Health. The study also aimed to analyze the experiences of students using this methodology, as part of their learning.

METHODS

Photovoice was introduced to a class of 56 chiropractic and homeopathy students registered for a module on Epidemiology: Public Health in 2019. Students working in self-selected groups were required to take photographs of environmental factors, involved in causing disease. After engaging in a group dialogue, one photograph was selected for presentation in class, with a discussion of how environmental factors visible in the photograph affect the health of individuals. Presentations were assessed based on the picture, presentation quality and ability to answer questions. Focus group discussions were subsequently held to understand the experience of students with this new teaching method. Data was analyzed using thematic analysis.

RESULTS

Students established that it was a positive experience. They recognized the lived realities, within the community, that cause disease. The assignment demonstrated how learning can occur beyond the lecture room and extend into communities. Students offered realistic solutions to health problems that were confronted by communities. In addition, students participated in unintended community engagement.

CONCLUSIONS

The incorporation of photovoice into undergraduate teaching in the health science module promoted higher order learning such as problem solving and critical-thinking. Students transformed from rote learners to critical thinkers who reflected upon what they were taught and how this related to the lived realities of the community. Student communication improved as they disseminated knowledge to others. Teaching using this alternative pedagogy has the potential to produce graduates who are responsive to the local needs of the community.

Peer-teaching at the University of Rwanda - a qualitative study based on self-determination theory

BACKGROUND

Peer-teaching is an educational format in which one student teaches one, or more, fellow students. Self-determination theory suggests that intrinsic motivation increases with the enhancement of autonomy, competence and relatedness.

AIMS

This qualitative study sought to explore and better understand the lived experiences, attitudes and perceptions of medical students as peer-teachers at the University of Rwanda when participating in a peer-learning intervention in the pediatric department.

METHODS

Students participated in a 3-h peer-taught symposium, supervised by a pediatric specialist or resident. Students worked in small groups to deliver a short didactic presentation related to acute illness in children. The symposium prepared the students for simulation-based teaching activities. In-depth, semi-structured, interviews were then employed to explore the students' experiences of the peer-teaching symposium. We specifically aimed to scaffold the analysis of these experiences on the themes of autonomy, competence and relatedness.

RESULTS

Saturation was achieved after interviews with ten students. Students described developing their own autonomous learning strategies, but despite developing this autonomy had a desire for support in the delivery of the sessions. Competence was developed through enhanced learning of the material, developing teaching skills and confidence in public speaking. Students valued the different aspects of relatedness that developed through preparing and delivering the peer-teaching. Several other themes were identified during the interviews, which are not described here, namely; i. Satisfaction with peer-teaching; ii. Peer-teaching as a concept; iii. Practical issues related to the peer-teaching session, and iv. Teaching style from faculty.

CONCLUSIONS

This is the first study to assess peer-learning activities in Rwanda. It has used qualitative methods to deeply explore the lived experiences, attitudes and perceptions of medical students. The peer-teaching strategy used here demonstrates the potential to enhance intrinsic motivation while increasing knowledge acquisition and teaching skills. We postulate that students in resource-limited settings, similar to Rwanda, would benefit from peer-teaching activities, and in doing so could enhance their intrinsic motivation.

Peer instruction in a physiology laboratory course in China

Peer instruction has been used extensively in lecture courses; however, there is little evidence of its use in laboratory courses. The purpose of the present study was to describe the implementation of the peer instruction method in a physiology laboratory course in China. Second-year medical students attended a 6-wk physiology laboratory course in the fall semester of the 2016-2017 school year. In the six new physiology laboratory classes, peer instruction strategies were used to substitute for the traditional short, didactic lectures. The effects of peer instruction were measured by in-class quizzes and confidence levels. The students' evaluations of peer instruction were measured by a Likert scale questionnaire. Peer instruction significantly improved the mean score on quizzes (0.53 ± 0.50 vs. 0.68 ± 0.47, P < 0.001) and confidence levels (2.36 ± 0.66 vs. 2.80 ± 0.45, P < 0.001). Furthermore, for individual incorrect answers, 39.07% changed to correct answers after peer instruction, whereas, for correct answers, 6.61% were changed to an incorrect response. Overall, significantly more students changed their answers from incorrect to correct than from correct to incorrect [χ²: 333.11; degrees of freedom (df): 1; P < 0.001]. Therefore, the positive effects of peer instruction were higher than the negative effects (χ²: 244.55; df: 1; P < 0.001). Moreover, student evaluations of peer instruction were highly positive. In conclusion, the implementation of peer instruction to the physiology laboratory course is an effective strategy to enhance students' performance on in-class quizzes and confidence levels. In addition, the attitude of students toward peer instruction was favorable.

Collective and experimental research project for master's students on the pathophysiology of obesity

We describe here a collective and experimental research project-based learning (ERPBL) for master's students that can be used to illustrate some basic concepts on glucose/lipid homeostasis and renal function around a topical issue. The primary objective of this ERPBL was to strengthen students' knowledge and understanding of physiology and pathophysiology. The secondary objectives were to help students to develop technical/practical abilities and acquire transversal skills with real-world connections. Obesity is a worldwide public health problem that increases the risk for developing type 2 diabetes and nephropathies. To study the impact of western dietary habits, students evaluated the effects of a diet enriched with fat and cola [high-fat and cola diet (HFCD)] on metabolism and renal function in mice. Students mainly worked in tandem to prepare and perform experiments, but also collectively to compile, analyze, and discuss data. Students showed that HFCD-fed mice 1) developed obesity; 2) exhibited glucose homeostasis impairments associated to ectopic fat storage; and 3) displayed reduced glomerular filtration. The educational benefit of the program was estimated using three evaluation metrics: a conventional multicriteria assessment by teachers, a pre-/posttest, and a self-evaluation questionnaire. They showed that the current approach successfully strengthened scientific student knowledge and understanding of physiology/pathophysiology. In addition, it helped students develop new skills, such as technical and transversal skills. We concluded that this ERPBL dealing with the pathophysiology of obesity was strongly beneficial for master's students, thereby appearing as an efficient and performing educational tool.

A new approach for laboratory exercise of pathophysiology in China based on student-centered learning

Student-centered learning is generally defined as any instructional method that purportedly engages students in active learning and critical thinking. The student-centered method of teaching moves the focus from teaching to learning, from the teachers' conveying course concepts via lecture to the understanding of concepts by students. The student-centered method has been used extensively in lecture courses in China; however, there is little evidence of its use in laboratory courses. The purpose of the present study was to describe the implementation of a student-centered method in a pathophysiology laboratory course. The use of student-centered learning strategies in an undergraduate laboratory course was well received by both students and teachers. Here, students had to take on responsibility for their own learning and, thus, became more accountable. Moreover, they reported increased active learning, skill development, information collection, and retention. In addition, mean scores for the quiz were significantly higher in the student-centered method compared with the traditional teaching method. The shift from teacher-centered delivery to a student-centered model led to a positive change, in which the learners drove the process and were guided, not directed, by the teacher.

Performance of first-year health sciences students in a large, diverse, multidisciplinary, first-semester, physiology service module

Health Science students at the University of KwaZulu-Natal perform better in their professional modules compared with their physiology modules. The pass rates of physiology service modules have steadily declined over the years. While a system is in place to identify "at-risk" students, it is only activated after the first semester. As a result, it is only from the second semester of their first year studies onward that at-risk students can be formally assisted. The challenge is thus to devise an appropriate strategy to identify struggling students earlier in the semester. Using questionnaires, students were asked about attendance, financing of their studies, and relevance of physiology. After the first class test, failing students were invited to complete a second questionnaire. In addition, demographic data were also collected and analyzed. Correlation analyses were undertaken of performance indicators based on the demographical data collected. The 2011 class comprised mainly sport science students (57%). The pass rate of sport science students was lower than the pass rates of other students (42% vs. 70%, P < 0.001). Most students were positive about physiology and recognized its relevance. Key issues identified were problems understanding concepts and terminology, poor study environment and skills, and lack of matriculation biology. The results of the first class test and final module marks correlated well. It is clear from this study that student performance in the first class test is a valuable tool to identify struggling students and that appropriate testing should be held as early as possible.

Reception learning and self-discovery learning in histology: students' perceptions and their implications for assessing the effectiveness of different learning modalities

Two questionnaires were used to investigate students' perceptions of their motivation to opt for reception learning (RL) or self-discovery learning (SDL) in histology and their choices of complementary learning strategies (CLS). The results demonstrated that the motivation to attend RL sessions was higher than the motivation to attend SDL to gain new knowledge (P < 0.01) and to apply this acquired knowledge to diagnosis (P < 0.01), therapy (P < 0.01), and research (P < 0.05). Students also showed a stronger preference for RL based on motivations related to leadership (P < 0.01) and competition (P < 0.01), although the rates were very low in both cases (≤ 1.9 ± 1.1). Statistically significant differences were found between male and female students for leadership (higher in males), responsibility (higher in females), and acquiring new knowledge (higher in females only in RL). This study's findings for students' preferred CLS strategies suggested a greater need for additional complementary resources after RL than after SDL (P < 0.01). In conclusion, RL was associated with a greater need for complementary training resources such as textbooks, atlases, the internet, audiovisual media, and tutorials, whereas SDL was associated with a greater need to orient teaching and training toward medical practice. These results suggest the need to reorient both types of learning processes to enhance their effectiveness in teaching histology, especially in the case of SDL, which should place more emphasis on clinically oriented knowledge.

Active physiology learning in a diverse class: an analysis of medical student responses in terms of sex, home language, and self-reported test performance

The student body at the Nelson R. Mandela School of Medicine (NRMSM) is very diverse, representing many cultures, religions, and languages. Research has shown that weakness in English can impact student performance. Recent studies have also highlighted sex-based differences in students' learning and listening styles. These factors pose both challenges and opportunities for teachers of physiology. Student presentations were incorporated for a number of years into the traditional didactic second-year medical physiology curriculum at the NRMSM. Feedback obtained about the perceived benefits of these presentations for the learning of gastrointestinal and endocrine physiology included demographic data pertaining to students' sex, home language, and self-reported performance in tests. Analysis of the 50-item questionnaire responses, obtained over a 2-yr period, provided some interesting insights. Student responses to the items differed significantly in 27 of the 50 items in the questionnaire, based on sex alone (22%), sex and home language (7%), home language alone (37%), performance alone (26%), and performance and home language (7%). Our analyses of student perceptions support the findings of other studies and show that factors such as sex, home language, and student performance can play an important role in the way students are motivated to learn. In designing active learning strategies, academics need to take into account the potential influences that might affect student learning in diverse, multicultural, and multilingual classes.

Intergroup peer assessment in problem-based learning tutorials for undergraduate pharmacy students

OBJECTIVE

To develop, implement, and evaluate a process of intergroup peer assessment and feedback using problem-based learning (PBL) tutorials.

METHODS

A peer-assessment process was used in a PBL tutorial setting for an integrated pharmacy practice course in which small groups of students graded each others' PBL case presentations and provided feedback in conjunction with facilitator assessment.

ASSESSMENT

Students' quantitative and qualitative perceptions of the peer assessment process were triangulated with facilitator feedback. Students became more engaged, confident, and motivated, and developed a range of self-directed, life-long learning skills. Students had mixed views regarding the fairness of the process and grade descriptors. Facilitators strongly supported the peer assessment process.

CONCLUSIONS

Peer assessment is an appropriate method to assess PBL skills and is endorsed by students as appropriate and useful.