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Kruppa C, Rudzki M, Baron DJ, Dudda M, Schildhauer TA, Herbstreit S. [Success factors and obstacles in the implementation of competence-oriented teaching in surgery]. CHIRURGIE (HEIDELBERG, GERMANY) 2024:10.1007/s00104-024-02107-9. [PMID: 38829547 DOI: 10.1007/s00104-024-02107-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/03/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND AND OBJECTIVES For successful competence-oriented teaching at the medical faculties it is important to identify the factors that influence its implementation in order to benefit from the strengths and balance out weaknesses. The present study examined the success factors and obstacles of the implementation of competence-oriented teaching in the surgical discipline from the point of view of students and lecturers. METHODS After implementation of competence-oriented teaching based on the teaching goals of the NKLM, in clinical examination courses (bedside teaching and block internship, BP) at two hospitals, a qualitative content analysis and quantification of the answers were performed using focus group interviews and questionnaires with students (S) and lecturers (D). RESULTS During the summer semester 2022 a total of 31 students and 14 lecturers were interviewed in focus groups and 143 questionnaires (123 S, 20 D) were analyzed. For the students the presence of concrete competences/teaching goals, guidelines for the lesson, transparent goals and ability to demand teaching goals as well as structured lessons and mentoring were the main success factors. Lecturers on the other hand reported the presence of concrete goals, assistance for the lesson preparation and the activity of the students as success factors. The results of the questionnaires showed that the majority (88% S, 75% D) were informed about the teaching goals and considered them to be followed (84%S, 95% D). Obstacles were the factors "time", "mentoring" and "information". Factors that were between negative and positive (indifferent factors) were "uncertainty about competence-orientation" and "uncertainty how to examine the teaching success". DISCUSSION Transparent structure and teaching goals as well as a mentoring system are the success factors for the implementation of competence-oriented lessons and should be used as strengths. Indifferent factors represent weaknesses and need to be addressed by training and instruction. Restricted time and personnel resources are the immanent problems that hamper the implementation and require fulminant structural changes.
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Affiliation(s)
- C Kruppa
- Chirurgische Universitätsklinik und Poliklinik, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Ruhr-Universität Bochum, Bochum, Deutschland.
| | - M Rudzki
- Chirurgische Universitätsklinik und Poliklinik, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Ruhr-Universität Bochum, Bochum, Deutschland
| | - D J Baron
- Chirurgische Universitätsklinik und Poliklinik, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Ruhr-Universität Bochum, Bochum, Deutschland
| | - M Dudda
- Zentrum für Muskuloskelettale Chirurgie, Universitätsmedizin Essen, Universität Duisburg-Essen, Essen, Deutschland
- Klinik für Orthopädie und Unfallchirurgie, BG-Klinikum Duisburg, Universität Duisburg-Essen, Duisburg, Deutschland
| | - T A Schildhauer
- Chirurgische Universitätsklinik und Poliklinik, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Ruhr-Universität Bochum, Bochum, Deutschland
| | - S Herbstreit
- Zentrum für Muskuloskelettale Chirurgie, Universitätsmedizin Essen, Universität Duisburg-Essen, Essen, Deutschland
- Klinik für Orthopädie und Unfallchirurgie, BG-Klinikum Duisburg, Universität Duisburg-Essen, Duisburg, Deutschland
- Institut für Didaktik in der Medizin, Medizinische Fakultät, Universität Duisburg-Essen, Essen, Deutschland
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Ordak M. Enhancing biostatistics education for medical students in Poland: factors influencing perception and educational recommendations. BMC MEDICAL EDUCATION 2024; 24:428. [PMID: 38649993 PMCID: PMC11034022 DOI: 10.1186/s12909-024-05389-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND A number of recommendations for the teaching of biostatistics have been published to date, however, student opinion on them has not yet been studied. For this reason, the aim of the manuscript was to find out the opinions of medical students at universities in Poland on two forms of teaching biostatistics, namely traditional and practical, as well as to indicate, on the basis of the results obtained, the related educational recommendations. METHODS The study involved a group of 527 students studying at seven medical faculties in Poland, who were asked to imagine two different courses. The traditional form of teaching biostatistics was based on the standard teaching scheme of running a test from memory in a statistical package, while the practical one involved reading an article in which a particular test was applied and then applying it based on the instruction provided. Other aspects related to the teaching of the subject were assessed. RESULTS According to the students of each course, the practical form of teaching biostatistics reduces the stress level associated with teaching and the student exam (p < 0.001), as well as contributing to an increased level of elevated knowledge (p < 0.001), while the degree of satisfaction after passing the exam is higher (p < 0.001). A greater proportion of students (p < 0.001) believe that credit for the course could be given by doing a statistical review of an article or conducting a survey, followed by the tests learned in class. More than 95% also said that the delivery of the courses should be based on the field of study they were taking, during which time they would also like to have the opportunity to take part in optional activities and hear lectures from experts. CONCLUSION It is recommended that more emphasis be placed on practical teaching the subject of biostatistics.
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Affiliation(s)
- Michal Ordak
- Department of Pharmacotherapy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, 1 Banacha Street, 02-097, Warsaw, Poland.
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Gillam L, Crawshaw B, Booker M, Allsop S. Prompt identification of struggling candidates in near peer-led basic life support training: piloting an online performance scoring system. BMC MEDICAL EDUCATION 2023; 23:303. [PMID: 37131183 PMCID: PMC10152634 DOI: 10.1186/s12909-023-04225-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 04/03/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND Bristol Medical School has adopted a near peer-led teaching approach to deliver Basic Life Support training to first year undergraduate medical students. Challenges arose when trying to identify early in the course which candidates were struggling with their learning, in sessions delivered to large cohorts. We developed and piloted a novel, online performance scoring system to better track and highlight candidate progress. METHODS During this pilot, a 10-point scale was used to evaluate candidate performance at six time-points during their training. The scores were collated and entered on an anonymised secure spreadsheet, which was conditionally formatted to provide a visual representation of the score. A One-Way ANOVA was performed on the scores and trends analysed during each course to review candidate trajectory. Descriptive statistics were assessed. Values are presented as mean scores with standard deviation (x̄±SD). RESULTS A significant linear trend was demonstrated (P < 0.001) for the progression of candidates over the course. The average session score increased from 4.61 ± 1.78 at the start to 7.92 ± 1.22 at the end of the final session. A threshold of less than 1SD below the mean was used to identify struggling candidates at any of the six given timepoints. This threshold enabled efficient highlighting of struggling candidates in real time. CONCLUSIONS Although the system will be subject to further validation, our pilot has shown the use of a simple 10-point scoring system in combination with a visual representation of performance helps to identify struggling candidates earlier across large cohorts of students undertaking skills training such as Basic Life Support. This early identification enables effective and efficient remedial support.
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Affiliation(s)
| | | | | | - Sarah Allsop
- University of Bristol Medical School, Bristol, UK
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Chen X, Gong MF, Wu S, He J. "LEARN", a novel teaching method for Chinese clinical clerkship: A cross-sectional study. Front Surg 2023; 10:1113267. [PMID: 36860941 PMCID: PMC9968847 DOI: 10.3389/fsurg.2023.1113267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/20/2023] [Indexed: 02/16/2023] Open
Abstract
Background Despite the clerkship being crucial in the training of a future doctor, no widely accepted education model has been proposed. This study devised a new model for clinical clerkship rotations, titled "LEARN" for Lecture, English-video, Advisor, Real-case and Notion, and evaluated whether the LEARN model is appropriate for medical education in China. Methods A cross-sectional study was performed among 101 fourth-year students from the Xiangya School of Medicine during an Orthopaedic Surgery clerkship rotation in the Third Xiangya Hospital. They were divided into seven groups and took clerkship based on the LEARN model. A questionnaire was collected at the conclusion to measure learning outcomes. Results The LEARN model was highly accepted with the acceptance of five sessions being 95.92% (94/98), 93.88% (92/98), 96.98% (97/98), 100% (98/98) and 96.94% (95/98). The outcomes of two genders were comparable, whereas a difference was observed in the test score among groups (group 3 scored 93.93 ± 5.20, higher than others). Quantitative analysis showed that positive correlations existed in participation in the Notion (Notion means students' case discussion) section with leadership (r = 0.84, 95% CI: 0.72-0.94, p < 0.001), participation in the Real-case section with leadership (r = 0.66, 95% CI: 0.50-0.80, p < 0.001), participation in the Real-case section with mastery of inquiring skills (r = 0.57, 95% CI: 0.40-0.71, p < 0.001) and participation in the Notion section with mastery of physical examination skills (r = 0.56, 95% CI: 0.40-0.69, p < 0.001). Further qualitative analysis demonstrated that high-level participation in the English-video section indicated better outcomes in mastery of inquiring (p < 0.01), physical examination (p < 0.001), film reading (p < 0.01) and clinical reasoning (p < 0.01) skills. Conclusion Our results support the LEARN model is a promising method for medical clerkship in China. Further research involving more participants and more meticulous design is planned to test its efficacy. For refinement, educators may try to promote students' participation in the English-video session.
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Affiliation(s)
- Xiangyu Chen
- Department of Orthopaedic Surgery, Central South University Third Xiangya Hospital, Changsha, China,Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Matthew F. Gong
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Song Wu
- Department of Orthopaedic Surgery, Central South University Third Xiangya Hospital, Changsha, China
| | - Jinshen He
- Department of Orthopaedic Surgery, Central South University Third Xiangya Hospital, Changsha, China,Correspondence: Jinshen He
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The use of peer physical examination in undergraduate health professions education: Exploring the perceptions of students and educators in a multicultural, multiracial institution. AFRICAN JOURNAL OF HEALTH PROFESSIONS EDUCATION 2022. [DOI: 10.7196/ajhpe.2022.v14i4.1544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background. Teaching clinical skills is core content of the medical and allied health curricula of the Faculty of Health Sciences (FoHS) at the University of the Free State (UFS) in South Africa. A major pedagogical tool used for this purpose across the faculty is peer physical examination (PPE). Objective. To investigate the lived experience and perceptions of students and educators on the use of PPE in undergraduate health professions education at a multicultural and multiracial institution. Suggestions on guidelines for a PPE policy for the FoHS at the UFS were also obtained from the participants. Methods. This research was designed as a qualitative study that used focus group interviews involving 26 participants (19 students and 7 educators) to obtain verbal statements that described their experience and perceptions of the use of PPE in undergraduate health professions education.
Results. Participants reported that PPE was useful to create a safe learning environment and to prepare students for the clinical aspects of their training. Enhancing students’ empathy, competency and clinical confidence were among the advantages attributed to using PPE; it also encouraged peer- assisted learning. Some of the disadvantages ascribed to PPE were that it made it difficult to maintain classroom discipline, and that it could promote memorisation over understanding. Finally, participants suggested that a guideline for PPE policy should address matters of consent, confidentiality, participation and gender, cultural, religious and racial considerations.
Conclusions. The findings of this study reveal that PPE is an acceptable and useful learning strategy for the majority of students and educators. Issues relating to consent, confidentiality and cultural, religious and racial considerations are some of the potential problems associated with the use of PPE at the UFS. We believe that the suggestions given by the participants of this study will inform the establishment of a PPE policy for the FoHS of the UFS.
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Seifert LB, Coppola A, Diers JWA, Kohl C, Britz V, Sterz J, Rüsseler M, Sader R. Implementation and evaluation of a Tele-OSCE in oral and maxillofacial surgery - a pilot report. GMS JOURNAL FOR MEDICAL EDUCATION 2022; 39:Doc50. [PMID: 36540562 PMCID: PMC9733482 DOI: 10.3205/zma001571] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/23/2022] [Accepted: 08/04/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The ongoing changes in learning and education towards digitalisation have been rapidly accelerated by the COVID-19 pandemic. Especially in dental education where contact to the oral cavity is an integral part of training the chosen digital examination methods and training formats must undergo high requirements to full fill the goal of a real alternative to face-to-face exams. Therefore, this study compared student performance in a newly developed Tele-OSCE with a prior OSCE examinations in presence within an oral- and maxillofacial surgery curriculum. METHODS Study participants were fourth-year (in a five year curriculum) dental students and board certified maxillofacial surgeons (examiners) that took part in a newly developed Tele-OSCE that comprised three five-minute stations (structured facial examination, management mandibular fracture and squamous cell carcinoma) using the zoom® software. Student performance was measured using validated OSCE-Checklists and compared to a previous OSCE examination from the winter term 2019 with the same OSCE stations that was conducted in presence. Significant differences were tested using the Mann-Whitney U test. Furthermore, the new Tele-OSCE was evaluated by students and examiners using previously developed questionnaires. RESULTS Sixty-six dental students (study group: n=34, summer term 2021, control group: n=32 winter term 2019) and nine examiners participated in the study. Compared to previous non-pandemic OSCEs, there were no significant (p=0.53) differences in overall student performance. Evaluation of the Tele-OSCE showed that the demonstration and rating of practical skills was limited due to missing standard patients or phantoms, however, students did not fear to be misjudged. The demonstration and rating of anamnestic and consultation competencies was seen as unproblematic by students and examiners. DISCUSSION This pilot-study showed the feasibility of a Tele-OSCE as a formative examination in dental education. However, both students and examiners felt that the demonstration and assessment of practical skills was limited due the new examination format. Nevertheless, Tele-OSCEs might offer an alternative to enable students to complete their dental training.
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Affiliation(s)
- Lukas Benedikt Seifert
- University Hospital Frankfurt, Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Frankfurt, Germany
| | - Alawia Coppola
- University Hospital Frankfurt, Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Frankfurt, Germany
| | - Julian Wilhelm Amadeus Diers
- University Hospital Frankfurt, Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Frankfurt, Germany
| | - Christoph Kohl
- University Hospital Frankfurt, Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Frankfurt, Germany
| | - Vanessa Britz
- Goethe University, Medical Faculty, Frankfurt Interdisciplinary Simulation Center (FIneST), Frankfurt, Germany
| | - Jasmina Sterz
- Goethe University, Medical Faculty, Frankfurt Interdisciplinary Simulation Center (FIneST), Frankfurt, Germany
- University Hospital Frankfurt, Department for Trauma, Hand and Reconstructive Surgery, Frankfurt, Germany
| | - Miriam Rüsseler
- University Hospital Frankfurt, Department for Trauma, Hand and Reconstructive Surgery, Frankfurt, Germany
| | - Robert Sader
- University Hospital Frankfurt, Department for Trauma, Hand and Reconstructive Surgery, Frankfurt, Germany
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Gripay B, André T, De Laval M, Peneau B, Secourgeon A, Lerolle N, Annweiler C, Justeau G, Connan L, Martin L, Bière L. Benefits of semiology taught using near-peer tutoring are sustainable. BMC MEDICAL EDUCATION 2022; 22:26. [PMID: 35012540 PMCID: PMC8744339 DOI: 10.1186/s12909-021-03086-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 12/06/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Near-peer tutoring appears to be an efficient approach for teaching clinical skills. However, the clinical experience gained in the form of student medical internships may offset any interest in such tutoring programme. We then investigated the long-term benefits of this programme. METHODS This study was conducted in a medical school that experimented in near-peer tutoring for semiology intended for undergraduate medical students. Objective Structured Clinical Examinations and a written semiology test were used to assess students' clinical skills immediately on its conclusion and repeated one and 2 years after the tutoring was completed. RESULTS 116 students were evaluated initially (80 tutored and 36 untutored), 38 at 1 year (16 tutored and 22 untutored), 42 at 2 years (21 tutored and 21 untutored). In the global score for Objective Structured Clinical Examinations: at 1 year, the tutored group scored 14.0 ± 1.05 and the untutored group scored 11.3 ± 2.3 (p < 0.001), at 2 years, the tutored group scored 15.1 ± 1.5 and the untutored group scored 12.4 ± 2.2 (p < 0.001). We found a similar but smaller difference for the written semiology test. The difference for Objective Structured Clinical Examinations between tutored and untutored students vanished over time for cross-cutting skills. CONCLUSIONS Near-peer tutoring in semiology for undergraduate medical students led to better results that remained with the passing of time. Though internships do allow an improvement in the clinical skills of untutored students, they did not reach the level of tutored students.
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Affiliation(s)
| | - Thomas André
- Faculty of Health, Univ Angers, 49000, Angers, France
| | | | - Brice Peneau
- Faculty of Health, Univ Angers, 49000, Angers, France
| | | | - Nicolas Lerolle
- Faculty of Health, Univ Angers, 49000, Angers, France
- All'Sims Centre for Simulation in Healthcare, Faculty of Health, University Hospital of Angers, 49000, Angers, France
| | | | - Grégoire Justeau
- Faculty of Health, Univ Angers, 49000, Angers, France
- All'Sims Centre for Simulation in Healthcare, Faculty of Health, University Hospital of Angers, 49000, Angers, France
| | | | - Ludovic Martin
- Faculty of Health, Univ Angers, 49000, Angers, France
- All'Sims Centre for Simulation in Healthcare, Faculty of Health, University Hospital of Angers, 49000, Angers, France
| | - Loïc Bière
- Faculty of Health, Univ Angers, 49000, Angers, France.
- All'Sims Centre for Simulation in Healthcare, Faculty of Health, University Hospital of Angers, 49000, Angers, France.
- School of Medicine, University Hospital of Angers, 28 rue Roger-Amsler, 49045, Angers Cedex 01, France.
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Maniki PT, Khan R, Orchard A, De Rapper S, Padayachee N. Promoting the use of point of care testing in non-communicable disease screening among university students. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Nelskamp A, Schnurr B, Germanyuk A, Sterz J, Lorenz J, Sader R, Rüsseler M, Seifert LB. Comparison of 'Mental training' and physical practice in the mediation of a structured facial examination: a quasi randomized, blinded and controlled study. BMC MEDICAL EDUCATION 2021; 21:178. [PMID: 33757503 PMCID: PMC7986263 DOI: 10.1186/s12909-021-02603-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 03/09/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The correct performance of a structured facial examination presents a fundamental clinical skill to detect facial pathologies. However, many students are not adequately prepared in this basic clinical skill. Many argue that the traditional 'See One, Do One' approach is not sufficient to fully master a clinical skill. 'Mental Training' has successfully been used to train psychomotor and technical skills in sports and other surgical fields, but its use in Oral and Maxillofacial Surgery is not described. We conducted a quasi-experimental to determine if 'Mental Training' was effective in teaching a structured facial examination. METHODS Sixty-seven students were randomly assigned to a 'Mental Training' and 'See One, Do One' group. Both groups received standardized video instruction on how to perform a structured facial examination. The 'See One, Do One' group then received 60 min of guided physical practice while the 'Mental Training' group actively developed a detailed, stepwise sequence of the performance of a structured facial examination and visualized this sequence subvocally before practicing the skill. Student performance was measured shortly after (T1) and five to 10 weeks (T2) after the training by two blinded examiners (E1 and E2) using a validated checklist. RESULTS Groups did not differ in gender, age or in experience. The 'Mental Training' group averaged significantly more points in T1 (pE1 = 0.00012; pE2 = 0.004; dE1 = 0.86; dE2 = 0.66) and T2 (pE1 = 0.04; pE2 = 0.008, dE1 = 0.37; dE2 = 0.64) than the 'See One, Do One' group. The intragroup comparison showed a significant (pE1 = 0.0002; pE2 = 0.06, dE1 = 1.07; dE2 = 0.50) increase in clinical examination skills in the 'See One, Do One' group, while the 'Mental Training' group maintained an already high level of clinical examination skills between T1 and T2. DISCUSSION 'Mental Training' is an efficient tool to teach and maintain basic clinical skills. In this study 'Mental Training' was shown to be superior to the commonly used 'See One, Do One' approach in learning how to perform a structured facial examination and should therefore be considered more often to teach physical examination skills.
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Affiliation(s)
- Arne Nelskamp
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Benedikt Schnurr
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Alexandra Germanyuk
- Department of Urology, Medical Faculty of Saarland University, Saarbrücken, Germany
| | - Jasmina Sterz
- Department of Trauma, Reconstructive and Hand Surgery, Goethe University, Frankfurt, Germany
| | - Jonas Lorenz
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Robert Sader
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Miriam Rüsseler
- Department of Trauma, Reconstructive and Hand Surgery, Goethe University, Frankfurt, Germany
| | - Lukas B Seifert
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
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Seifert LB, Herrera-Vizcaino C, Herguth P, Sterz J, Sader R. Comparison of different feedback modalities for the training of procedural skills in Oral and maxillofacial surgery: a blinded, randomized and controlled study. BMC MEDICAL EDUCATION 2020; 20:330. [PMID: 32972404 PMCID: PMC7513537 DOI: 10.1186/s12909-020-02222-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 09/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The feedback given to students plays an important role in their efficiency related to learning practical skills. In the present study, diverse feedback modalities have been investigated. Our hypothesis is that individualized and unsupervised video feedback can produce a similar learning experience as performing practical skills in an oral and maxillofacial surgery setting with conventional direct expert feedback (control group). METHODS This prospective, randomized, controlled, and blinded study compared direct expert feedback (DEF), individualized video feedback (IVF) and unsupervised video feedback (UVF). The participants were fourth-year dental students from University Goethe in Frankfurt. The students were assigned to one of the three feedback methods (n = 20 per group) using simple randomization. All participants watched an instruction video for an interdental ('Ernst') ligature and periphery venous catheterization. Next, the students were video recorded performing the tasks by themselves (pre-test). Following this, every student received feedback using one of the above-mentioned feedback modalities. The participants then performed the same task again while being video recorded (post-test) to measure the acquired competence. Six weeks later, the students participated in an objective structured clinical examination (OSCE) to evaluate their long-term knowledge retention. All examiners were blinded regarding the students' instructional approach and their affiliation in terms of the learning group. RESULTS For the interdental ligature, we found significant improvements in performance in each feedback modality group between the pre-test and post-test (p < 0.001). UVF had the strongest effect on performance time. The comparison between each group in the post-test showed no significant differences between the three groups. CONCLUSION This study showed that IVF and UVF can be considered an alternative or adjunct to conventional methods (i.e. DEF) when learning procedural skills in oral and maxillofacial surgery. However, DEF showed to be the most effective method of feedback and therefore preferable in teaching.
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Affiliation(s)
- Lukas B Seifert
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
| | - Carlos Herrera-Vizcaino
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Philipp Herguth
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Jasmina Sterz
- Department of Trauma, Reconstructive and Hand Surgery, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Robert Sader
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
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Seifert LB, Schnurr B, Stefanescu MC, Sader R, Ruesseler M, Sterz J. Comparing video-based versions of Halsted's 'see one, do one' and Peyton's '4-step approach' for teaching surgical skills: a randomized controlled trial. BMC MEDICAL EDUCATION 2020; 20:194. [PMID: 32552805 PMCID: PMC7298758 DOI: 10.1186/s12909-020-02105-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Teaching complex motor skills at a high level remains a challenge in medical education. Established methods often involve large amounts of teaching time and material. The implementation of standardized videos in those methods might help save resources. In this study, video-based versions of Peyton's '4-step Approach' and Halsted's 'See One, Do One' are compared. We hypothesized that the video-based '4-step Approach' would be more effective in learning procedural skills than the 'See One, Do One Approach'. METHODS One-hundred-two naïve students were trained to perform a structured facial examination and a Bellocq's tamponade with either Halsted's (n = 57) or Peyton's (n = 45) method within a curricular course. Steps 1 (Halsted) and 1-3 (Peyton) were replaced by standardized teaching videos. The performance was measured directly (T1) and 8 weeks (T2) after the intervention by blinded examiners using structured checklists. An item-analysis was also carried out. RESULTS At T1, performance scores significantly differed in favor of the video-based '4-step Approach' (p < 0.01) for both skills. No differences were found at T2 (p < 0.362). The item-analysis revealed that Peyton's method was significantly more effective in the complex subparts of both skills. CONCLUSIONS The modified video-based version of Peyton's '4-step Approach' is the preferred method for teaching especially complex motor skills in a large curricular scale. Furthermore, an effective way to utilize Peyton's method in a group setting could be demonstrated. Further studies have to investigate the long-term learning retention of this method in a formative setting.
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Affiliation(s)
- Lukas B Seifert
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
| | - Benedikt Schnurr
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Maria-Christina Stefanescu
- Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Robert Sader
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Miriam Ruesseler
- Department of Trauma, Reconstructive and Hand Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Jasmina Sterz
- Department of Trauma, Reconstructive and Hand Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
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Zabel J, Sterz J, Hoefer SH, Stefanescu MC, Lehmann M, Sakmen DK, Marzi I, Ruesseler M. The Use of Teaching Associates for Knee and Shoulder Examination: A Comparative Effectiveness Analysis. JOURNAL OF SURGICAL EDUCATION 2019; 76:1440-1449. [PMID: 30956084 DOI: 10.1016/j.jsurg.2019.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 11/08/2018] [Accepted: 03/08/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Musculoskeletal diseases and injuries are the most common cause of long-term pain and physical disability. Thus, every medical graduate should be able to perform a structured examination of the musculoskeletal system. Besides the see-one-do-one principle, other teaching methods have been proposed to be effective. The use of teaching associates offers an established, proven pathway for teaching examination skills in urology and gynecology. During the patient experience method, students are examined first, thus giving them an opportunity to feel the examination before performing it themselves. The objective of this study was to compare the efficiency of 3 distinct teaching methods for both knee and shoulder examination. DESIGN The study took place during obligatory knee and shoulder examination training. Participants received basic training, including a demonstration of the structured examination by a specialist in trauma surgery. Afterward, group 1 examined each other under professional supervision; group 2 students examined the teaching associates, followed by mutual examinations; and group 3 students were each examined by the instructor, followed by mutual examinations. The acquired competence was assessed in 5-minute practical assessments directly after training and again 5 weeks later. SETTING The study was conducted at the medical faculty of Goethe University, Frankfurt, Germany. PARTICIPANTS Study participants were third-year undergraduate medical students completing their obligatory 3-week surgical training. RESULTS One hundred and forty-four students [group 1 (N = 53), group 2 (N = 46), and group 3 (N = 45)] participated in the first measurement, 92 students in the second measurement of the study. Directly after the training, group 2 and group 3 performed significantly better than group 1 regarding overall score (p < 0.001) and all 4 checklist parts (p < 0.001). At the second measurement, group 2 performed significantly better than group 1 regarding shoulder examination (p = 0.003) and significantly better than group 3 (p = 0.025) regarding knee examination. CONCLUSIONS The use of a teaching associate and the patient perspective can increase students' performance in knee and shoulder examinations.
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Affiliation(s)
- Julian Zabel
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Jasmina Sterz
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Sebastian H Hoefer
- Centre of Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | | | - Marieke Lehmann
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Dennis K Sakmen
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Ingo Marzi
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Miriam Ruesseler
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany.
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Ruesseler M, Tomczak M, Thrun M, Pfau S, Marzi I, Sterz J. The Influence of the Instructional Approach on Acquiring Clinical Skills in Surgery: A Comparative Effectiveness Study. JOURNAL OF SURGICAL EDUCATION 2019; 76:140-149. [PMID: 30122637 DOI: 10.1016/j.jsurg.2018.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/20/2018] [Accepted: 07/08/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The instructional approach used to teach skills and competencies seems to have a critical impact on retaining and performing the learned skills/competencies. However, for most of them, the effect of different instructional approaches as well as evidence for appropriate approaches is unknown. The aim of the present study was to analyze and compare the impact of different instructional approaches in the acquisition of basic skills during undergraduate surgical training. DESIGN Randomized controlled cohort study. For the intervention, four instructional approaches ('See one - Do one', 'Video 4-Step Approach', 'Mental Group Mapping', and 'Control') were compared in six basic skills. Students completed a six-station OSCE (one for each skill) during their skills lab training week after the intervention. SETTING This study was conducted at the medical faculty of the Goethe University, Frankfurt, Germany. PARTICIPANTS Medical students in their fourth year completing their four week of obligatory surgical training. RESULTS A total of 151 students were included. The group 'Mental Group Mapping' scored significantly higher in comparison to 'See one - Do one' in four of the six skills and 'Control' in five skills. The group 'Video 4-Step Approach' scored significantly higher in comparison to 'See one - Do one' (three skills) in comparison to 'Control' (two skills). There were no significant differences between the approaches 'Mental Group Mapping' and 'Video 4-Step Approach' as well as between the approaches 'See one - Do one' and 'Control'. CONCLUSION Activating instructional approaches such as the '4-Step Approach' and 'Mental Group Mapping' have a significant impact on performing the learned skills and competencies.
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Affiliation(s)
- Miriam Ruesseler
- Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
| | - Mairen Tomczak
- Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
| | - Monika Thrun
- Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
| | - Sebastian Pfau
- Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
| | - Ingo Marzi
- Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
| | - Jasmina Sterz
- Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
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A nationwide survey of undergraduate training in oral and maxillofacial surgery. Oral Maxillofac Surg 2018; 22:289-296. [PMID: 29797106 DOI: 10.1007/s10006-018-0703-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/17/2018] [Indexed: 10/16/2022]
Abstract
PURPOSE To investigate the current status of undergraduate training in oral and maxillofacial (OMF) surgery in Germany using a nationwide survey and hence contribute to an educational improvement in the field. METHODS A 39-item questionnaire was sent to all university clinics with an OMF surgery chair in Germany (n = 34). RESULTS Ninety-two percent of OMF clinics are involved in the curricular training in medicine and 100% in dentistry. Eighty-one percent of OMF clinics perform curricular examinations and, respectively, 86% in dentistry. Examinations are mainly performed written with multiple-choice tests (62% medicine, 76% dentistry) and using non-structured oral examinations (57% medicine, 86% dentistry). Objective structured clinical examinations (OSCEs) are only used in 19% of all faculties. CONCLUSION OMF surgery with its involvement both in medical and dental education has a special position as a surgical discipline. Our results show that OMF as a specialty is underrepresented in dental and especially in medical education considering the numerical and health economic importance of OMF consultations. Enhancing curricular integration and developing more structured examination forms is necessary to guarantee a high quality of OMF education.
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