Outcomes of Irish graduate entry medical student engagement with self-directed learning of clinical skills

Self-directed learning assessment practices in undergraduate health professions education: a systematic review

PURPOSE

The goal of this systematic review was to examine self-directed learning (SDL) assessment practices in undergraduate health professions education.

METHODS

Seven electronic databases were searched (PubMed, Embase, PsycINFO, ERIC, CINAHL, Scopus, and Web of Science) to retrieve English-language articles published between 2015 and July of 2022, investigating assessment of SDL learning outcomes. Extracted data included the sample size, field of study, study design, SDL activity type, SDL assessment method, number of SDL assessments used, study quality, number of SDL components present utilising the framework the authors developed, and SDL activity outcomes. We also assessed relationships between SDL assessment method and number of SDL components, study quality, field of study, and study outcomes.

RESULTS

Of the 141 studies included, the majority of study participants were medical (51.8%) or nursing (34.8%) students. The most common SDL assessment method used was internally-developed perception surveys (49.6%). When evaluating outcomes for SDL activities, most studies reported a positive or mixed/neutral outcome (58.2% and 34.8%, respectively). There was a statistically significant relationship between both number and type of assessments used, and study quality, with knowledge assessments (median-IQR 11.5) being associated with higher study quality (p < 0.001). Less than half (48.9%) of the studies used more than one assessment method to evaluate the effectiveness of SDL activities. Having more than one assessment (mean 9.49) was associated with higher quality study (p < 0.001).

CONCLUSIONS

The results of our systematic review suggest that SDL assessment practices within undergraduate health professions education vary greatly, as different aspects of SDL were leveraged and implemented by diverse groups of learners to meet different learning needs and professional accreditation requirements. Evidence-based best practices for the assessment of SDL across undergraduate healthcare professions education should include the use of multiple assessments, with direct and indirect measures, to more accurately assess student performance.

Influencing factors of self-directed learning abilities of medical students of mainland China: a cross-sectional study

OBJECTIVES

This study aimed to evaluate the level of medical students' self-directed learning (SDL) ability in mainland China and to identify its modifiable influencing factors for medical educators to take measures to improve medical professionals' ability in SDL.

DESIGN

This was a cross-sectional study conducted between January and June 2019.

SETTING

This study involved students from five medical colleges located in the cities of Shenyang, Binzhou, Xuzhou, Shanghai and Guangzhou of mainland China.

PARTICIPANTS

Participants included 365 medical students and residents sampled by the stratified clustered random method from five medical colleges.

METHODS

The t-test, F-test and multiple linear regression analyses were performed to test the association between personal and contextual factors of medical students and SDL.

RESULTS

The mean total SDL score was 76.12 (SD=10.96), implying that Chinese mainland medical students had moderate SDL ability. A univariate analysis found that the personal characteristics of confidence, students' enjoyment of their specialty, utilisation of library resources, learning goals and habits and academic performance as well as the contextual factors of age, gender, learning resources, family income and group discussion were significantly associated with the total SDL score (p<0.05). Multiple linear regression analyses showed that academic performance, learning goals, confidence, learning resources, utilisation of library resources, family income and age were significantly associated with the total SDL score (p<0.05).

CONCLUSION

Our study indicated that the contextual factors of learning resources, family income and age as well as the personal factors of academic performance, learning goals, confidence and utilisation of library resources were associated with medical students' SDL ability in mainland China. It may be advisable to implement appropriate teaching strategies to improve students' confidence and assist them establish learning goals, as well as to amplify school learning resources and encourage students to use them fully.

Online Learning Tools in the Era of m-Learning: Utility and Attitudes in Accounting College Students

Learning in the Era of Mobile means an expansion in the range of learning tools, which are much more accessible thanks to the use of mobile devices. The greater possibilities of applying online tools for learning do not eliminate problems related to distance learning, such as personal factors related to attitude and student’s perception in virtual learning environments. It is necessary to consider whether the mere application of online tools in m-learning is enough or whether the context and the way in which online learning tools are applied are what is really important, even more so when the program is directed towards students using a distance learning system. Seen from this point of view, the utility of online tools is a key factor for successful learning. Furthermore, it is known that the personal attitude can affect the student’s perception about different aspects of learning, such as the perceived utility of the tools online. Considering the above arguments, the objective of this research is to measure the perceived utility of online learning tools by university students in a teaching environment accessible by mobile devices. Likewise, as a complementary objective to the measurement of perceived utility, the explanatory variables that could cause some effect on the perceived utility were analyzed. The analysis of explanatory variables is focused on personal attitudes, such as attitude towards accounting or the perceived role of the teacher. The data were collected through a questionnaire. Scoring indicators were applied to quantify the scores of university students for each variable. The analysis showed that mature students in a distance education program in Accounting assign high value to online tools and give a high score to their own attitude towards Accounting and the teacher’s role in virtual learning. Regression analysis indicates that about 34% of the perceived utility of online tools could be explained by their positive attitude towards Accounting and by the role of the teacher in m-learning. The identification of explanatory variables of perceived utility of online tools could improve the design and adaptation of the virtual environment, according to personal needs of college students.

Self-directed learning and practice of Italian osteopathic students during summer break: a cross-sectional survey

Background

Self-directed learning is a student-centered approach based on the students’ evaluation about their own learning needs. Self-directed practice is a component of the self-directed learning which focus on achieving manual and practical skills. Given the abundance of manual skills that students need to develop in the osteopathic curriculum, self-directed practice has become an attractive methodology. Most of the Italian osteopathic educational institutions recognize two types of educational curriculum: T1, for students without a healthcare background; and T2 for students who are already healthcare professionals. The aim of the present study is to investigate the attitudes of Italian osteopathic students toward self-directed practice during the summer break highlighting the possible differences between T1 and T2 students.

Methods

A web-based closed-ended survey was administered to the students attending one of the Italian osteopathic educational institutions which accepted to participate in the research.

Results

Two hundred sixty-eight students on 2549 participated to the survey. 64.92% of the students reported to have performed self-directed practice during the summer break. The main difficulty encountered by students in approaching self-directed practice was ‘lack of people to exercise with’. Most of the students performed self-directed practice between 1 to 5 h per week. The most common clinical condition encountered was Low Back Pain. The anatomical area most approached was lumbar spine. The most commonly simulated tests were the articular mobility tests. The techniques in which students trained the most were muscle energy techniques. Significant difference was found in self-engagement to the self-directed practice between T1 and T2 students (p = 0.026), and in the reasons to perform self-directed practice (p = 0.027).

Conclusions

The results of this study could be useful to reveal some aspects of students’ academic education and future clinical practice. Therefore this paper can be a useful tool for the institutions to develop strategies to overcome the reported problems students have towards self-directed practice. For example it should be discussed the possibility for the students to observe some senior osteopaths during their practice or to plan to maintain an open tutored didactic environment during the summer break as an extracurricular activity.

Factors associated with nursing students' medication competence at the beginning and end of their education

BACKGROUND

In previous studies, deficiencies in nursing students' medication competence have been highlighted. However, the focus of research has been limited especially to medication calculation competence and factors associated with it. In order to develop undergraduate nursing education and research, an understanding of the individual and learning environmental factors associated with medication competence from a broader approach is warranted. Our aim was therefore to evaluate the theoretical, practical and decision-making competence of nursing students and to identify factors associated with their medication competence at the beginning and end of their education.

METHODS

We used a descriptive, correlational study design with a structured instrument including a set of potential associated factors, knowledge test, medication calculation test and patient vignettes. The participants were nursing students at the beginning (n = 328) and at the end of their education (n = 338). Data were analyzed statistically.

RESULTS

In the evaluation of theoretical medication competence, the students' mean score over the semesters was 72 % correct answers in a knowledge test. In the evaluation of practical medication competence, the mean score was 74 % correct answers in a medication calculation test. In the evaluation of decision-making competence, the mean score was 57 % correct answers on deciding the best action in the situation given in patient vignettes. At the end of their education, students were able to solve patient vignettes significantly better. Individual factors were most evidently associated with medication competence. At the beginning of their education, students' previous academic success had a stronger association with medication competence. However, at the end of the education students' abilities in self-regulated learning and study motivation were more significant factors.

CONCLUSION

The core elements of medication competence are significantly interrelated, highlighting the need to provide integrated and comprehensive medication education throughout the undergraduate education. Students' learning style is associated with medication competence. There is a need for methods to identify and support students having difficulties to self-regulate their learning. To increase the safety of medication care of patients, research focusing on the development of effective teaching methods is needed. This study produced information for future nursing education research in this field, especially for interventional studies.