A comparative study: do "clickers" increase student engagement in multidisciplinary clinical microbiology teaching?

Below average ChatGPT performance in medical microbiology exam compared to university students

Background

The transformative potential of artificial intelligence (AI) in higher education is evident, with conversational models like ChatGPT poised to reshape teaching and assessment methods. The rapid evolution of AI models requires a continuous evaluation. AI-based models can offer personalized learning experiences but raises accuracy concerns. MCQs are widely used for competency assessment. The aim of this study was to evaluate ChatGPT performance in medical microbiology MCQs compared to the students’ performance.

Methods

The study employed an 80-MCQ dataset from a 2021 medical microbiology exam at the University of Jordan Doctor of Dental Surgery (DDS) Medical Microbiology 2 course. The exam contained 40 midterm and 40 final MCQs, authored by a single instructor without copyright issues. The MCQs were categorized based on the revised Bloom’s Taxonomy into four categories: Remember, Understand, Analyze, or Evaluate. Metrics, including facility index and discriminative efficiency, were derived from 153 midterm and 154 final exam DDS student performances. ChatGPT 3.5 was used to answer questions, and responses were assessed for correctness and clarity by two independent raters.

Results

ChatGPT 3.5 correctly answered 64 out of 80 medical microbiology MCQs (80%) but scored below the student average (80.5/100 vs. 86.21/100). Incorrect ChatGPT responses were more common in MCQs with longer choices (p = 0.025). ChatGPT 3.5 performance varied across cognitive domains: Remember (88.5% correct), Understand (82.4% correct), Analyze (75% correct), Evaluate (72% correct), with no statistically significant differences (p = 0.492). Correct ChatGPT responses received statistically significant higher average clarity and correctness scores compared to incorrect responses.

Conclusion

The study findings emphasized the need for ongoing refinement and evaluation of ChatGPT performance. ChatGPT 3.5 showed the potential to correctly and clearly answer medical microbiology MCQs; nevertheless, its performance was below-bar compared to the students. Variability in ChatGPT performance in different cognitive domains should be considered in future studies. The study insights could contribute to the ongoing evaluation of the AI-based models’ role in educational assessment and to augment the traditional methods in higher education.

Facilitating Active Collaborative Learning in Medical Education; a Literature Review of Peer Instruction Method

The call for educational reform by the Carnegie Foundation for the Advancement of Teaching marked a pivotal juncture in the trajectory of medical education in the United States. The call underscored the imperative for educational restructuring to equip forthcoming physicians with the requisite skills to engage in lifelong learning. Among the several active teaching methods is the Peer Instruction (PI), a brainchild of Eric Mazur, empowering students to steer their own education and wield knowledge adeptly into real-world scenarios. In this review paper, we delve into the core elements of PI which involves the combination of four dynamic pedagogical approaches which are: Just-in-Time Teaching, ConcepTest, Audience Response System, and Think-Pair-Share technique. PIs effectiveness notwithstanding, it is not exempt from limitations such as its flexible implementation, lengthy time, the level of expertise required for instructional design, among others. While Peer Instruction has become increasingly popular among educators across other disciplines, with proven educational benefits with positive outcomes, PIs footprint in gradate and postgraduate medical education remains inchoate, evidenced by a paucity of scholarly references. This underscores a crucial gap - despite its proven potency in fueling engagement and learning, PI still lacks formal recognition and acknowledgement as a distinct instructional method in medical education. Within these boundaries, the promise of heightened education and amplified engagement beckons further exploration of PI as a medical educational model, warranting more consideration and research.

Effectiveness of the use of clickers versus group discussion in learning by undergraduate medical students

BACKGROUND

The evolution of Medical learning shows the incorporation of modern technology in teaching, learning, assessment, and medical practice. Clickers are easy to use, and provide instantaneous feedback on the student's comprehension of the information given. The aim of the study was to assess the effectiveness of clickers in undergraduate medical students' learning by comparing clickers' scores with group discussion scores.

MATERIALS AND METHODS

A cross-sectional comparative study with cross-over design was conducted for 6 months on 80 students of Phase III Part I MBBS. After an interactive lecture on diarrhea with a community medicine perspective, the students were divided into two groups, A and B, each consisting of 40 students. Group B students were further divided into five subgroups of eight students each. Group A students were assessed with clickers, Group B with group discussion and the cross-over done after 2 weeks. A questionnaire was used to assess the perceptions of the students on the use of clickers. Academic performance scores of the students were compared within the groups at different times (i.e. immediately after the interactive lecture and after 1st week and 2nd weeks) and between the two main groups. Data analysis was performed using SPSS. Mean and standard deviations were calculated for quantitative variables, whereas categorical data was presented as frequencies and proportions. Qualitative data was analyzed using content analysis technique.

RESULTS

The mean age of students was 20.4 (SD=0.6) years. The mean scores for the students using clickers were significantly higher than the mean scores for the students using group discussion. Most of the students (78.8%) either agreed or strongly agreed that the "clickers were easy to use."

CONCLUSION

The study concluded that the academic performance of medical undergraduate students using clickers was better than the performance of the students using group discussions.

The effect of reinforcement using the Gimkit game on learning the subject in nursing students

AIM

This study was conducted to evaluate the effect of reinforcement using the Gimkit game and question-and-answer method on the achievement test scores of nursing students.

BACKGROUND

Advances in information and communication technology are one of the most important factors affecting change in health systems. The rapid pace of technological evolution has also significantly affected the nursing education curricula. As the nursing profession continues to change and grow, updating learning strategies in nursing education has become a necessity to prepare nursing students for today's health problems.

DESIGN

The study was conducted as a quasi-experimental model using the pretest-posttest control group model in non-randomized groups.

METHODS

The population of the research consisted of first-year students of the nursing faculty of a state university. The sample of the research consisted of first-year students of the nursing faculty who met the research criteria and accepted to participate in the research. The students participating in the research were divided into experimental and control groups using the simple random method. An achievement test, that is, a pre-test, was administered to both groups before the subject was presented. Afterwards, the same subject was presented to all groups by the same instructor during a 4-h training session. A reinforcement strategy using the Gimkit game was implemented with the students in the experimental group, while the traditional question-and-answer method was used as the reinforcement strategy in the control group. After the reinforcements, the achievement test, that is, the post-test, was administered to both groups again.

RESULTS

In the study, it was determined that there was no statistically significant difference between the pre-tests of the experimental group where the Gimkit game was used and the control group where the question-answer method was used (p = 0.223). In addition, a statistically significant difference was found between the post-test scores of the experimental group where the Gimkit game was used and the control group where the question-and-answer method was used (p = 0.009).

CONCLUSION

In the study, it was determined that the use of the Gimkit game was more effective on learning the subject than the traditional question-and-answer method.

Students’ perception to an interactive web-based response system in oral and maxillofacial pathology teaching

This study evaluated dental students' perceptions and adherence to an interactive web-based response system in the teaching of Oral and Maxillofacial Pathology. Between 2018 and 2019, students from a single Brazilian dental school used the Poll Everywhere® app to answer questions on subjects taught during an Oral and Maxillofacial Pathology course. At the end of the academic semester, the students completed a questionnaire containing 10 questions regarding the app's use. The study included 123 students. Regarding the devices used to answer the questions on the app, 117 (95.1%) students used a smartphone and 3 (2.4%) used a laptop. Almost all students (121; 98.4%) agreed that this interactive web-based response system provided the teacher with a better overview of students' understanding and improved their self-assessment of the acquired knowledge of the subjects. Most students (118; 95.9%) preferred classes using this technology and 122 (99.2%) stated that using the app made them feel more engaged in classes. In addition, all students agreed that the app improved student-teacher interactions. Most students (119; 96.7%) considered the digital interactive method more attractive than the conventional teaching approach, and 99 (80.5%) did not have any negative comments regarding the app. In conclusion, the Poll Everywhere® app provides a more dynamic and attractive educational environment for Oral and Maxillofacial Pathology teaching.

Perception of online and face to face microbiology laboratory sessions among medical students and faculty at Arabian Gulf University: a mixed method study

BACKGROUND

The COVID-19 pandemic has impacted all spheres of society including medical education and healthcare systems. In response to the pandemic, there has been a transition in medical education practice from traditional forms of teaching to online instruction delivery and virtual learning. Effective clinical microbiology education involves a combination of 'hands-on' practical learning and instructional delivery of scientific knowledge. Microbiology practical laboratories are critical learning environments offering 'hands-on' learning experiences that cannot be replicated through online learning. We conducted a mixed-methods study to understand the perception of online and face-to-face microbiology laboratory sessions among the medical students and microbiology faculty at Arabian Gulf University (AGU).

METHODS

The study participants were third and fourth-year undergraduate medical students and faculty involved in delivering microbiology labs at AGU. The questionnaire consisted of questions ranging from perceived learning style to attitude towards online delivery of microbiology curriculum. After the questionnaire administration (google form), focus group discussion (FGD) was conducted for students and microbiology faculty separately.

RESULTS

Among 168 students, 50.6% preferred face-to-face lab sessions as compared to 30.4% who preferred online labs, and 51.8% considered online labs to be an essential addition to face-to-face labs. Among the faculty, 85.7% preferred the face-to-face mode of teaching. All the faculty (100%) disagreed that all the microbiology labs teaching should be online. 57.2% considered online labs to be an essential addition to traditional face-to-face labs. Both faculty and students hold that a blended mode of instructional delivery is vital and indispensable for the transfer of skills and knowledge for microbiology students.

CONCLUSION

The blended mode of delivering microbiology laboratory sessions in medical school is successful and well-received by both students and faculty. Students take the responsibility for furthering their own learning and understanding of concepts. Instructors have also noticed that blending learning strategies also successfully enhances the development of cognitive skills and problem-solving abilities in students. A review of the microbiology lab curriculum is necessary to identify content areas that can be delivered effectively through online, face-to-face lab sessions, or both, supported with appropriate tools and infrastructure.

Using alternative teaching and learning approaches to deliver clinical microbiology during the COVID-19 pandemic

The COVID-19 (coronavirus disease 2019) pandemic has had significant impacts upon higher education teaching. Clinical microbiology teaching is primarily focused on a combination of practical skill development and didactic delivery of content. In the pandemic, the absence of in-person teaching has led to educators adapting in-person content for online platforms and delivery. This commentary covers alternative innovative and engaging teaching approaches to deliver clinical microbiology content during the COVID-19 pandemic.

Educating pharmacy students through a pandemic: Reflecting on our COVID-19 experience

The impact of the COVID-19 pandemic on pharmacy education worldwide has been immense, affecting students, educators and regulatory agencies. Pharmacy programmes have had to rapidly adapt in their delivery of education, maintaining standards while also ensuring the safety of all stakeholders. In this commentary, we describe the challenges, compromises and solutions adopted by our institution throughout the pandemic, the lessons learnt, adaptive measures taken, and strategies to develop and future-proof our curricula.

How do they learn: types and characteristics of medical and healthcare student engagement in a simulation-based learning environment

BACKGROUND

Student engagement can predict successful learning outcomes and academic development. The expansion of simulation-based medical and healthcare education creates challenges for educators, as they must help students engage in a simulation-based learning environment. This research provides a reference for facilitators of simulation teaching and student learning in medical and health-related majors by providing a deep understanding of student engagement in a simulation-based learning environment.

METHODS

We conducted semi-structured interviews with ten medical and healthcare students to explore their learning types and characteristics in a simulation-based learning environment. Thematic analysis was used to analyse the data.

RESULTS

The interviews were thematically analysed to identify three types of student engagement in the simulation-based learning environment: reflective engagement, performance engagement, and interactive engagement. The analysis also identified eight sub-themes: active, persistent, and focused thinking engagement; self-directed-learning thinking engagement with the purpose of problem solving; active "voice" in class; strong emotional experience and disclosure; demonstration of professional leadership; interaction with realistic learning situations; support from teammates; and collegial facilitator-student interaction.

CONCLUSIONS

The student interview and thematic analysis methods can be used to study the richness of student engagement in simulation-based learning environments. This study finds that student engagement in a simulation-based learning environment is different from that in a traditional environment, as it places greater emphasis on performance engagement, which combines both thinking and physical engagement, as well as on interactive engagement as generated through interpersonal interactions. Therefore, we suggest expanding the learning space centring around "inquiry", as it can help strengthen reflective communication and dialogue. It also facilitates imagination, stimulates empathy, and builds an interprofessional learning community. In this way, medical and healthcare students can learn through the two-way transmission of information and cultivate and reshape interpersonal relationships to improve engagement in a simulation-based learning environment.

Phone-based audience response system as an adjunct in orthodontic teaching of undergraduate dental students: a cross-over randomised controlled trial

BACKGROUND

The advent of electronic teaching facilities improves tutor-student communication. This study aims to explore the effectiveness of Phone-Based Audience Response System (PB-ARS), as an adjunctive pedagogy tool to enhance the retention of orthodontic information by dental students; and to explore the students' perception of PB-ARS.

METHODS

This cross-over clustered randomised control trial included 34 males who were in the final year of their undergraduate dental training. Participants were allocated to one of two event groups (G1 and G2) using computer-generated randomisation. Both groups simultaneously attended two different traditional lectures (L 1 and L2) a week apart. During L1, PB-ARS was used as an adjunct to conventional presentation to teach G1 participants, (PB-ARS group) while G2's participants acted as a control group (CG), and were taught using a traditional presentation. In the second week (L2), the interventions were crossed-over. Participants from both groups completed pre- and post-lecture multiple-choice questionnaires (MCQ) to assess their short-term retention of information. Their performance in the final MCQ exam (10 weeks following L2) was tracked to assess the long-term retention of the information. Participants also completed post-lecture questionnaires to evaluate their perceptions.

RESULTS

Twenty-nine and 31 participants from the CG and PB-ARS group completed this trial, respectively. Although 87.5% of students in the PB-ARS group showed an improvement in their immediate post-lecture scores compared with 79.3% for the CG, it was statistically insignificant (p = 0.465). Similarly, the intervention showed an insignificant effect on the long-term retention of the knowledge (p = 0.560). There was a mildly but favourable attitude of students towards the use of PB-ARS. However, the difference in the overall level of satisfaction between both groups was statistically insignificant (p = 0.183).

CONCLUSION

PB-ARS has a minimal and insignificant effect on the short- and long-term retention of orthodontic knowledge by male undergraduate dental students. PB-ARS was the preferred adjunct tool to conventional classroom teaching. Due to the limitations of this trial, a long-term randomised controlled trial with a larger sample size is recommended.

Pharmacology through Play: using Lego® to revise core concepts for undergraduates

This article was migrated. The article was marked as recommended. Background: Pharmacology, while critical knowledge for healthcare professionals, is often viewed by students as dry and difficult to understand. We sought to examine the student acceptability of a Lego®-based learning session, in an attempt to improve pharmacology learning. Methods: In line with constructivist theories, students were facilitated to build, in small groups, their own Lego® shape to represent an area of core pharmacology and to use this to explain the concept to other students (e.g. agonist-receptor interactions). The validated Course Experience Questionnaire (CEQ) was used to gauge students' ideas on the session. Multiple choice questions were used before and after the session to evaluate knowledge. Results: Most students were positive regarding the session, finding it enjoyable, relevant for their learning and even recommending it be used to explore more complex areas of pharmacology. In addition, there was a significant increase in the MCQ scores following the session. Conclusions: This study used constructivist theory to develop a novel teaching intervention to create a more student-centred, active learning environment. This effective low-cost method could be applied to other teaching programmes to enhance student learning.

Can e-learning improve the performance of undergraduate medical students in Clinical Microbiology examinations?

BACKGROUND

Clinical Microbiology is a core subject in medical undergraduate curricula. However, students struggle to cover the content and clinically contextualise basic microbiology. Our aim was to evaluate student engagement with new e-learning material and to investigate the impact it had on examination performance in a Clinical Microbiology module.

METHODS

An online resource was designed to support didactic teaching in a Fundamentals of Clinical Microbiology module. One cohort of students had access to the online material (2017/2018 class) and the other did not (2016/2017 class). Each cohort sat the same multiple-choice question (MCQ) and short-note question (SNQ) examination papers and the impact of engagement with the online resource and examination performance was analysed.

RESULTS

Both groups were of the same academic standard prior to beginning the module. In the 2017/2018 cohort, 227/309 (73.5%) students had ≥80% engagement with the content. Students engaged most with the index of pathogens and pathogen focused clinical cases related to diverse genera and families of clinically important microorganisms. A statistically higher difference in the mean percentage grade in both the MCQ and SNQ examinations was seen for 2017/2018 compared to 2016/2017 cohort. For the MCQ examination, the 2017/2018 cohort were on average 5.57% (95% confidence interval (CI): 3.92 to 7.24%; P < 0.001) higher, and for the SNQ examination the 2017/2018 cohort were on average 2.08% (95% CI: 0.74 to 3.41%; P = 0.02) higher. When the results were adjusted for previous examination performance, for every percentage increase in online engagement the grade in the SNQ examination only increased by 0.05% (95% CI: 0.02 to 0.08) on average.

CONCLUSIONS

These findings suggest students engage with e-learning when studying and that such activities may help students perform better in assessments.

Systematic review of the implementation of audience response systems and their impact on participation and engagement in the education of healthcare professionals

Background

Audience response system provides a mechanism to engage larger groups as active participants in teaching sessions. However, they are traditionally based on 'fixed' closed loop system, which limits their functionality to a single geographical location, thus has the effect of confining their use to universities and other larger institutions, with a primary focus on education. Conversely, in the healthcare education context, the majority of formal education is undertaken through postgraduate training programmes, largely conducted in smaller cohorts in clinical settings.

Objective

The purpose of this review is to evaluate audience response systems in terms of feasibility of implementation and the impact on participation within the field of education of healthcare professionals, in comparison to the non-healthcare education.

Study selection

Therefore, systematic structured searches of PubMed and Medline databases for healthcare education were conducted, and Scopus, Education Resources Information Center, British Education Index, Education Abstracts, Education Administration Abstracts and PsycINFO databases for non-healthcare education databases.

Findings and conclusions

Consistent and fundamental differences were found in the studies evaluating healthcare education compared with other fields, with more difficulties encountered in implementation and a less significant impact on engagement seen. Here we discuss the consequences of these findings on the use of audience response systems and beyond.