Beyond knowledge and skills: the use of a Delphi study to develop a technology-mediated teaching strategy

Simulation in a blended learning curriculum for neonatology

Blended learning is a learner-centered educational method that combines online and traditional face-to-face educational strategies. Simulation is a commonly utilized platform for experiential learning and an ideal component of a blended learning curriculum. This section describes blended learning, including its strengths and limitations, educational frameworks, uses within health professions education, best practices, and challenges. Also included is a brief introduction to simulation-based education, along with theoretical and real-world examples of how simulation may be integrated into a blended learning curriculum. Examples of blended learning in Neonatal-Perinatal Medicine, specifically within the Neonatal Resuscitation Program, procedural skills training, and the National Neonatology Curriculum, are reviewed.

The impact of the transition from flipped classroom to online lectures on learning outcomes and student satisfaction in a rehabilitation medicine clerkship during the COVID-19 pandemic

BACKGROUND

The flipped classroom (FC) is a well-known active learning module that activates the prior knowledge of students and promotes their cognitive skills during in-class activities. However, most on-site teaching during the COVID-19 pandemic had to be conducted online. The FC in our rehabilitation medicine clerkship curriculum was also shifted to online asynchronous lectures (OLs), without real-time interactions. There is no previous comparison of effectiveness between these two methods. Therefore, this study aimed to compare learning outcomes and student satisfaction in both FC and OL models.

METHODS

The study design was a historically controlled study. A physical modality was chosen for the content. The FC group (n = 233), in the academic years 2018 and 2019, was assigned to perform a pre-class activity consisting of reading study materials. Thereafter, the in-class activity comprised a small-group case-based discussion. The OL group (n = 240) in the academic years 2020 and 2021 followed an online model during the COVID-19 lockdown. They were also asked to read the online materials and then watch a self-paced recorded lecture video on Learning Management Systems. The learning outcomes, including their multiple-choice questions (MCQs) scores, final exam scores, grade points, and letter grades, were evaluated. Their overall course satisfaction ratings were also collected.

RESULTS

The OL group had an overall higher MCQ score for the physical modality portion than the FC group (p = 0.047). The median (lower quartile, upper quartile) of the total 50-MCQ scores were 34 (31, 37) in the OL group and 33 (29, 36) in the FC group (p = 0.007). The median final exam scores of the OL and FC groups were 69.5 and 68.3, respectively (p = 0.026). The median grade points and the letter grades were not significantly different between the groups. The proportions of satisfaction were significantly higher in the FC group than in the OL group.

CONCLUSIONS

The OL group revealed significantly higher learning outcomes than the FC group. However, the FC group showed more satisfaction with interactivity than the OL group. The authors are of the view that a combination of both FC and OL methods will likely result in better outcomes.

Determining electrocardiography training priorities for medical students using a modified Delphi method

BACKGROUND

Although electrocardiography is considered a core learning outcome for medical students, there is currently little curricular guidance for undergraduate ECG training. Owing to the absence of expert consensus on undergraduate ECG teaching, curricular content is subject to individual opinion. The aim of this modified Delphi study was to establish expert consensus amongst content and context experts on an ECG curriculum for medical students.

METHODS

The Delphi technique, an established method of obtaining consensus, was used to develop an undergraduate ECG curriculum. Specialists involved in ECG teaching were invited to complete three rounds of online surveys. An undergraduate ECG curriculum was formulated from the topics of ECG instruction for which consensus (i.e. ≥75% agreement) was achieved.

RESULTS

The panellists (n = 131) had a wide range of expertise (42.8% Internal Medicine, 22.9% Cardiology, 16% Family Medicine, 13.7% Emergency Medicine and 4.6% Health Professions Education). Topics that reached consensus to be included in the undergraduate ECG curriculum were classified under technical aspects of performing ECGs, basic ECG analysis, recognition of the normal ECG and abnormal rhythms and waveforms and using electrocardiography as part of a clinical diagnosis. This study emphasises that ECG teaching should be framed within the clinical context. Course conveners should not overload students with complex and voluminous content, but rather focus on commonly encountered and life-threatening conditions, where accurate diagnosis impacts on patient outcome. A list of 23 "must know" ECG diagnoses is therefore proposed.

CONCLUSION

A multidisciplinary expert panel reached consensus on the ECG training priorities for medical students.

Learning in the Digital Era - Awareness and Usage of Free Open Access Meducation among Emergency Department Doctors

Introduction

Information and communication technology has revolutionized the space of medical education by providing a multitude of up-to-date evidence-based data to healthcare practitioners. Despite the increasing popularity of FOAM - Free Open Access Meducation (Medical Education) globally - data relating to its awareness and usage in Africa is lacking. In this study, we explore the awareness and usage of FOAM among doctors working at select emergency departments in Johannesburg.

Methods

The study comprised a prospective, questionnaire based, cross-sectional survey of medical doctors working at five academically affiliated emergency departments in Johannesburg. Data was described and compared.

Results

One-hundred and four participants completed the survey. Most of the respondents were aged between 31 and 39 years (n = 40, 43.9%). There were no significant differences between the proportion of females and males that used FOAM (p = 0.56). Most participants (n = 91, 87.5%) were aware of FOAM, while 82 (78.8%) used FOAM, 13 (12.5%) were unsure if they used FOAM and nine (8.7%) did not use FOAM. Majority of those that used FOAM, only used it once a week (n = 47, 57.3%). Most participants spent between one and two hours per day on FOAM (n = 29, 35.4%). Smartphones were by far the most commonly used device to access FOAM (n = 91, 87.5%).

Conclusion

The level of awareness of FOAM is high and its usage is prevalent among emergency medicine healthcare professionals in Johannesburg. As technology becomes more prominent, institutions must aim to adapt to the digital era in their teaching methods.

Flipping the classroom to teach Millennial residents medical leadership: a proof of concept

INTRODUCTION

The ongoing changes in health care delivery have resulted in the reform of educational content and methods of training in postgraduate medical leadership education. Health care law and medical errors are domains in medical leadership where medical residents desire training. However, the potential value of the flipped classroom as a pedagogical tool for leadership training within postgraduate medical education has not been fully explored. Therefore, we designed a learning module for this purpose and made use of the flipped classroom model to deliver the training.

EVIDENCE

The flipped classroom model reverses the order of learning: basic concepts are learned individually outside of class so that more time is spent applying knowledge to discussions and practical scenarios during class. Advantages include high levels of interaction, optimal utilization of student and expert time and direct application to the practice setting. Disadvantages include the need for high levels of self-motivation and time constraints within the clinical setting.

DISCUSSION

Educational needs and expectations vary within various generations and call for novel teaching modalities. Hence, the choice of instructional methods should be driven not only by their intrinsic values but also by their alignment with the learners' preference. The flipped classroom model is an educational modality that resonates with Millennial students. It helps them to progress quickly beyond the mere understanding of theory to higher order cognitive skills such as evaluation and application of knowledge in practice. Hence, the successful application of this model would allow the translation of highly theoretical topics to the practice setting within postgraduate medical education.

Evaluation of oral microbiology lab curriculum reform

BACKGROUND

According to the updated concept of oral microbiology, the School of Stomatology, Wuhan University, has carried out oral microbiology teaching reforms during the last 5 years. There was no lab curriculum before 2009 except for a theory course of oral microbiology. The school has implemented an innovative curriculum with oral medicine characteristics to strengthen understanding of knowledge, cultivate students' scientific interest and develop their potential, to cultivate the comprehensive ability of students. This study was designed to evaluate the oral microbiology lab curriculum by analyzing student performance and perceptions regarding the curriculum from 2009 to 2013.

METHODS

The lab curriculum adopted modalities for cooperative learning. Students collected dental plaque from each other and isolated the cariogenic bacteria with selective medium plates. Then they purified the enrichment culture medium and identified the cariogenic strains by Gram stain and biochemical tests. Both quantitative and qualitative data for 5 years were analysed in this study. Part One of the current study assessed student performance in the lab from 2009 to 2013. Part Two used qualitative means to assess students' perceptions by an open questionnaire.

RESULTS

The 271 study students' grades on oral microbiology improved during the lab curriculum: "A" grades rose from 60.5 to 81.2 %, and "C" grades fell from 28.4 to 6.3 %. All students considered the lab curriculum to be interesting and helpful. Quantitative and qualitative data converge to suggest that the lab curriculum has strengthened students' grasp of important microbiology-related theory, cultivated their scientific interest, and developed their potential and comprehensive abilities.

CONCLUSION

Our student performance and perception data support the continued use of the innovative teaching system. As an extension and complement of the theory course, the oral microbiology lab curriculum appears to improve the quality of oral medicine education and help to cultivate high-quality innovative medical talents.

Teaching differential diagnosis in primary care using an inverted classroom approach: student satisfaction and gain in skills and knowledge

BACKGROUND

Differential diagnosis is a crucial skill for primary care physicians. General practice plays an increasing important role in undergraduate medical education. Via general practice, students may be presented with an overview of the whole spectrum of differential diagnosis in regard to common symptoms encountered in primary care. This project evaluated the impact of a blended learning program (using the inverted classroom approach) on student satisfaction and development of skills and knowledge.

METHODS

An elective seminar in differential diagnosis in primary care, which utilized an inverted classroom design, was offered to students. Evaluation followed a mixed methods design: participants completed a pre- and post-test, a questionnaire, and a focus group discussion. Interviews were transcribed verbatim and answers were grouped according to different themes. Test results were analysed using the Wilcoxon matched-pairs signed-ranks test.

RESULTS

Participants (n = 17) rated the course concept very positively. Especially the inverted classroom approach was appreciated by all students, as it allowed for more time during the seminar to concentrate on interactive and practice based learning. Students (n = 16) showed a post-test significant overall gain in skills and knowledge of 33%.

CONCLUSIONS

This study showed a positive effect of the inverted classroom approach on students' satisfaction and skills and knowledge. Further research is necessary in order to explore the potentials of this approach, especially the impact on development of clinical skills.

Twelve tips for "flipping" the classroom

The flipped classroom is a pedagogical model in which the typical lecture and homework elements of a course are reversed. The following tips outline the steps involved in making a successful transition to a flipped classroom approach. The tips are based on the available literature alongside the author's experience of using the approach in a medical education setting. Flipping a classroom has a number of potential benefits, for example increased educator-student interaction, but must be planned and implemented carefully to support effective learning.

A validation study of the psychometric properties of the Groningen Reflection Ability Scale

BACKGROUND

Reflection, the ability to examine critically one's own learning and functioning, is considered important for 'the good doctor'. The Groningen Reflection Ability Scale (GRAS) is an instrument measuring student reflection, which has not yet been validated beyond the original Dutch study. The aim of this study was to adapt GRAS for use in a Danish setting and to investigate the psychometric properties of GRAS-DK.

METHODS

We performed a cross-cultural adaptation of GRAS from Dutch to Danish. Next, we collected primary data online, performed a retest, analysed data descriptively, estimated measurement error, performed an exploratory and a confirmatory factor analysis to test the proposed three-factor structure.

RESULTS

361 (69%) of 523 invited students completed GRAS-DK. Their mean score was 88 (SD = 11.42; scale maximum 115). Scores were approximately normally distributed. Measurement error and test-retest score differences were acceptable, apart from a few extreme outliers. However, the confirmatory factor analysis did not replicate the original three-factor model and neither could a one-dimensional structure be confirmed.

CONCLUSIONS

GRAS is already in use, however we advise that use of GRAS-DK for effect measurements and group comparison awaits further review and validation studies. Our negative finding might be explained by a weak conceptualisation of personal reflection.