Implementation of modified team-based learning within a problem based learning medical curriculum: a focus group study

Collaborative Assessment in the Gross Anatomy Lab

Purpose

In 2018, the Michigan State University College of Human Medicine incorporated two-stage examinations into the gross anatomy curriculum. Multiple studies have investigated two-stage examinations and have largely reported positive findings. Here, we used a mixed-methods approach to further investigate the feasibility and student perceptions of the two-stage examination in the context of a medical school curriculum that emphasizes longitudinal group-based learning and formative assessments.

Methods

Three student cohorts were assessed with a formative two-stage examination at the end of their first-year anatomy experience. Data for the quantitative analysis included examination scores from the individual and group portions of the two-stage examination. For the qualitative stage of this project, we utilized a constructivist grounded theory methodology in which data, including both post-examination survey results and one-on-one semi-structured student interviews, were transcribed (interviews), coded, inductively and iteratively reviewed, and thematically interpreted.

Results

Survey and interview results revealed an overwhelmingly positive perception of the collaborative assessment experience. Student comments demonstrated educational value in the immediate feedback provided by this examination format and suggested that collaboration during the examination transformed the assessment into a learning experience.

Conclusions

While two-stage examinations have the potential to positively transform an assessment into a learning experience, we also identified complex relationships between content knowledge and anxiety that may affect student perceptions. In addition, examination logistics (e.g., curricular timing) have the potential to negatively affect student perceptions, indicating that faculty should consider these factors when implementing collaborative assessments into their curriculum.

Implementation of Team-Based Learning for a Clinical Module of the Ethiopian Undergraduate Anesthesia Curriculum and Students' Perspectives: A Pilot Cross-Sectional Study

Introduction

Team-based learning (TBL) is an active learning strategy that gives students the opportunity to apply conceptual information through a series of tasks that incorporate individual effort, team collaboration, and immediate feedback. This study aimed to report baseline TBL implementation in a clinical module of a fourth-year competency-based undergraduate anesthesia curriculum and explore the perspectives of students.

Methods

In April 2023, 18 students participated in two TBL sessions over two weeks, and readiness assurance test results and post-TBL evaluations were analyzed. Week one TBL implementation scores were compared with week two, establishing a longitudinal analysis over two points in time. Students also participated in an online survey to assess their views on the advantages and design of TBL, their perceptions of its best and worst features, and their suggestions for its implementation.

Results

Of 18 students, 16 (89%) responded to the survey. Most students believed that TBL was an effective educational strategy but expressed concern about the amount of time required for TBL preparation and the need for student readiness. The individual readiness assurance test scores did not differ significantly between weeks 1 and 2 (mean difference [MD] = 0.39, P= 0.519, 95% CI: -0.824 to 1.60). However, the students' median [IQR] team readiness assurance test scores increased significantly from week one to week two, from 8 [2] to 10 [1] (p = 0.004). Peer evaluation scores also showed a significant increase in week 2 (MD = 2.4, P = 0.001, 95% CI: -3.760 to -0.996).

Conclusion

TBL was successfully implemented for a clinical module at Dilla University-Ethiopia for the first time. Students perceived it positively, but some criticized its preparation time, workload, and minimal facilitator engagement. We suggest convenient and flexible scheduling personalized for each student's needs when TBL is applied for clinical modules.

An Interuniversity Competition for Medical Students to Learn Radiology in the Second Life Metaverse

PURPOSE

The aim of this study was to evaluate an interuniversity competition online to learn radiology held in a 3-D virtual world, the Second Life metaverse, by analyzing the results of the game and students' perceptions.

METHODS

Medical students voluntarily participated in teams of four, for 6 weeks, successively covering radiologic anatomy and radiologic semiology of the chest, abdomen, and musculoskeletal. Each week, participants had 4.5 days to study self-learning presentations and 2.5 days to complete an individual multiple-choice test and a team task, the results of which determined the game's ranking. Participants were asked to complete a cognitive-load test, a perception questionnaire, and a postexposure knowledge test.

RESULTS

The competition was repeated for 2 years (editions), in 2020 and 2021. Seventy-five of 102 teams (73.5%) registered completed the game; 76% of them included third-year students. The average percentage of correct answers in the individual tests and team tasks was 74.2 ± 15.1 and 71.6 ± 14.7 respectively, without significant differences between both competitions. In general, the experience was valued positively (scores >8 on a 10-point scale). A lower perception score was found in 2021 among students from universities other than the organizing university, showing a positive correlation with the in-game score.

CONCLUSIONS

An interuniversity competition in the Second Life metaverse for undergraduate learning radiology is feasible and reproducible. Participating medical students considered it interesting and useful and also identified this activity during the 2 years of the coronavirus disease 2019 pandemic as a playful learning and social interaction experience.

Learning Collaborative Clinical Reasoning in Healthcare Education: An Integrative Review

BACKGROUND

Collaborative clinical reasoning (CCR) occurs when two or more healthcare professionals reflect and negotiate an issue regarding patient's situation or care. This represents a crucial learning goal that needs to be achieved during healthcare education.

PURPOSE

To describe the characteristics of and the pre-conditions for learning collaborative clinical reasoning in healthcare education.

METHOD

An integrative review was conducted. A systematic search was carried out in May 2020 (updated in August 2022) in four databases (CINAHL, Pubmed/Medline, Scopus and Eric/EBSCO). Thirty-three peer-reviewed research articles met the inclusion criteria and were included into a data quality appraisal and analysis. The data was analysed with inductive content analysis.

RESULTS

The characteristics of learning collaborative clinical reasoning were described using the following categories: 1) the collaborative clinical reasoning learning method 2) the collaborative clinical reasoning learning environment and 3) the collaborative clinical reasoning learners. The pre-conditions for learning collaborative clinical reasoning were described using the following categories: 1) the learning situation when learning collaborative clinical reasoning, 2) interaction when learning collaborative clinical reasoning and 3) clinical context when learning collaborative clinical reasoning. The learning situation includes the pedagogical preparation before the learning of collaborative clinical reasoning. The interaction consists of facilitation, feedback and peer communication during the learning of collaborative clinical reasoning. The clinical context utilized in the learning of collaborative clinical reasoning needs to be realistic and familiar for the students.

CONCLUSIONS

The results indicate that interventions enhancing collaboration and clinical reasoning apply a variety of learning methods, however there are certain characteristics of and pre-conditions for learning collaborative clinical reasoning to be considered.

Interprofessional education in problem-based learning: A frontier form of PBL in medical education

BACKGROUND

Interprofessional education (IPE) aims to educate healthcare students to improve collaboration and the quality of care. The delivery of IPE through a problem-based learning (PBL) setting appears to hold good validity. However, there are few studies that show the value of combining these two teaching modes.

MATERIALS AND METHODS

The research was a longitudinal intervention study. A total of 360 students were randomly divided into three interprofessional PBL (IPBL) groups that mixed nursing, pharmacy, and clinical medical students and three uniprofessional PBL (UPBL) groups that consisted of a single profession. An improved Attitude and Learning Ability Questionnaire (ALAQ) was used to measure the improvement in attitudes toward interprofessional cooperation and learning outcomes. The tutorial session and final examination grades were compared between IPBL and UPBL by Chi-square tests and Cochran-Mantel-Haenszel tests. Cronbach's α analysis was calculated to assess the validity and reliability. Cronbach's alpha coefficient of the questionnaire was 0.887, demonstrating high levels of reliability (95% confidence interval [CI]: 0.842 0.916).

RESULTS

According to Chi-square tests and Cochran-Mantel-Haenszel tests, we observed the student's positive attitudes toward interprofessional collaboration and the student's role awareness in the IPBL students was increased compared with UPBL students. In addition, a great majority of IPBL students felt that they had improved their self-learning ability and maintained a high enthusiasm for learning during the course.

CONCLUSION

Our study found that the IPBL teaching model was more effective than the UPBL teaching model in healthcare student's positive attitudes toward interprofessional collaboration and learning outcomes.

A Phenomenological Exploration of Experiences Related to Learning Styles Among Undergraduate Medical Students in a Barbadian Medical School

Introduction

Learning style (LS) frameworks have been implemented by educators to promote participatory learning in order to strengthen learner engagement and to enhance learning outcomes. Self-efficacy has been shown to have an association with learning style and is a predictor of clinical performance and other qualities in medical students. This study examined the perspectives of second and final year medical students in a Caribbean-based medical school, relative to their learning approaches, teaching exposures and preparation for assessments.

Methods

An interpretivist qualitative approach was used to analyze data from two focus groups, conducted as part of a sequential mixed-methods study (November 2018-February 2019) with medical students in the second and final year of study. Discussions were audio-recorded, transcribed verbatim, and inductively coded with in-depth thematic analysis assisted by NVivo software.

Results

Six Year 2 (Female: Male = 5:1) and seven Year 5 (Female: Male = 5:2) participants, ranging between 18 and 34 years and with a range of LS were recruited into the study. Analysis and data reduction produced three organizing themes: "Dynamics of information delivery and acquisition", "Pivoting", and "LS identification, awareness and mutability", and the global construct "Individual and environmental factors modulate the influence of LS preference in triggering self-efficacy". In managing information received in class, students used textbooks, YouTube videos, and collaborative learning to augment perceived gaps in lectures and their personal notes. Learning style self-awareness is useful for facilitating self-efficacy throughout medical school, especially at points of transition within the programme of study.

Conclusion

LS theory and testing appear to be useful for student and teacher awareness. In practice, honing students' adaptability to varying learning settings may be more relevant in helping students achieve self-efficacy.

Applying TEC-VARIETY to Motivate and Engage Learners for Online Learning Success

ABSTRACT

Learner motivation plays an essential role in overcoming barriers to achieve online learning success. Many health professions educators, however, are not familiar with evidence-based motivational principles and techniques that tap into learners' inner resources to promote online learning success. The TEC-VARIETY (T-Tone; E-Encouragement; C-Curiosity; V-Variety; A-Autonomy; R-Relevance; I-Interactivity; E-Engagement; T-Tension; and Y-Yielding products) framework provides evidence-based principles and techniques that motivate and engage learners. Health professions educators can identify and assemble appropriate activities to motivate and engage online learners. Educators are encouraged to use Design-Based Research to guide their adoption of TEC-VARIETY and evaluation of outcomes.

Application of PBL combined with traditional teaching in the Immunochemistry course

BACKGROUND

The problem-based learning (PBL) model has been widely carried out in many fields of medical colleges and universities. Immunochemistry as a cross-disciplinary science plays a vital role in preventing the occurrence of diseases and bridging the development of Life Science and Medicine. But now the Immunochemistry course still lacks the teaching practice in PBL. To explore the significance of PBL applied in the Immunochemistry course, the effect of the PBL model on the learning of undergraduates majoring in Chemicobiology was systematically evaluated.

METHODS

The teaching objects were the undergraduates majoring in Chemicobiology from Guizhou Medical University. The PBL model was applied in the Immunochemistry course. 62 undergraduates in Grade 2018 were set as the control group and adopted the traditional expository model. 93 undergraduates in Grades 2019-2020 were separately set as the experimental groups, which adopted the PBL model based on traditional lecture-based learning. In the PBL model, six cases related to course contents were designed for the students to complete. The final exams of the undergraduates in Grades 2018-2020 were analyzed by the score ranges (< 60 points, 60-69 points, 70-79 points, and ≥ 80 points) and nonparametric test. Finally, the questionnaire survey about the teaching evaluation was performed in Grades 2019-2020.

RESULTS

In Grades 2019 and 2020, the excellent rates (≥ 80 points), pass rates (≥ 60 points), fail rates (< 60 points), and average scores of the undergraduates were separately about 29%, 91.11% and 93.75%, 6.25%, and 8.89%, and 72.55 and 74.45 points. But in Grade 2018, the excellent rate, pass rate, failure rate, and average score of the undergraduates were separately 9.68%, 59.68%, 40.32%, and 62.55 points. By the statistical analysis, it was found that the excellent rates (χ2 = 8.317, P < 0.005) and pass rates (χ2 = 24.52, P < 0.0001) in Grades 2018-2020 were different, of which Grade 2020were the highest (29.17%, 93.75%) and Grade 2018 was the lowest (9.68%, 59.68%). The average score, excellent rate, and pass rate in Grade 2018 had significant differences with Grade 2019 (P < 0.0001, P < 0.0167) and Grade 2020 (P < 0.001, P < 0.0167). The questionnaire survey also showed that the student's learning interests, independent problem-solving ability, knowledge structure system, and scientific thought and teamwork awareness were enhanced. In Grades 2019 and 2020, the ICC (95% CI) of criterion validity and inter-rater reliability were separately 0.42/0.34 and 0.81/0.80 (P < 0.0001).

CONCLUSION

The combination of PBL and traditional expository models played positive roles in the student's learning in the Immunochemistry course.

Faculty development strategies to empower university teachers by their educational role: A qualitative study on the faculty members and students' experiences at Iranian universities of medical sciences

BACKGROUND

This study aimed to identify and explain the strategies of faculty development based on their role at Iranian Universities of Medical Sciences.

METHODS

We conducted a qualitative content analysis study in 2021 using purposive, snowball sampling, with a maximum variation in the faculty members' age and experience level. Twenty four participants were enrolled in this study (eighteen faculty members and six medical sciences students); data collection consisted of two phases of semi-structured interviews and a brainstorming group technique. Data were categorized into two themes and six related subthemes, based on their similarities and differences after frequent summarization.

RESULTS

The data analysis yielded two themes and eight categories. The first theme was to explain competencies based on role and task with two sub-themes: Tasks and capabilities and development and excellence of personal qualities. The second theme was the best strategies for empowering the teachers with four sub-themes, including problem-based learning, integration of methods, evaluation-based education, and scholarship in education (PIES), which explains the strategies that can support the development of teachers in medical sciences universities, and all the concepts were interrelated to each other.

CONCLUSION

From the experiences of faculty members, the importance of some strategies in education and empowering the teachers' professional competence dimensions should be emphasized. PIES could explain the practical strategies that can support the development of teachers in medical sciences universities.

Student Engagement Using HoloLens Mixed-Reality Technology in Human Anatomy Laboratories for Osteopathic Medical Students: an Instructional Model

Mixed-reality technology is a powerful tool used in healthcare and medical education to engage students in life-like scenarios. This blend of virtual and augmented reality images incorporates virtual projections with the real environment to allow real-time observation and interaction [1]. While this immersive technology offers advantages over cadaver dissections, it creates new challenges to keeping students engaged [2, 3]. Student engagement improves students' commitment to learning, critical thinking, and motivation and results in successful course outcomes [4, 5]. This paper provides an activity model using the HoloLens mixed-reality technology to deliver human gross anatomy laboratory sessions to first-year osteopathic medical students. The activity was designed using Gagne's model for instructional design and team-based learning to create an active learning model, which targets the behavioral, emotional, and cognitive dimensions of student engagement [6, 7]: behavioral engagement through autonomy and time on task, emotional engagement through providing the guiding exploration and narrative flow to accompany students' visual experience, and cognitive engagement by incorporating team-based learning (TBL) and case-based learning (CBL). The instructional model also answers the call for a new type of virtual reality instructor and pedagogical strategy that addresses the unique challenges and increases student engagement with this new technology. The effectiveness of this classroom activity was assessed by observing students for indicators or behaviors of student engagement, which are discussed. Further studies are required to measure the extent to which these indicators were exhibited and compare student engagement with this mixed-reality to didactic cadaver-based laboratory sessions.

Clinical Practicum Assessment for Biomedical Science Program from Graduates' Perspective

The clinical practicum for biomedical science students aims to provide graduates with the knowledge and skills required to work in diagnostic laboratory settings. This study examines graduates' perspectives on content, teachers and clinical training and their satisfaction rates based on the skills gained during training. The study was conducted on females who graduated from Qatar University between 2015 and 2020. We used a previously validated questionnaire called CPAT-QU. Telephonic interviews were conducted and were analyzed using SPSS. The results showed a high satisfaction rate, of 80%, for the content and organization of the clinical training. The participants' main concerns included the evaluation criteria, as 8.7% were not satisfied. The students suggested increasing the length of the training in order to obtain experience that was more practical. The students' satisfaction with the teachers was 70% in terms of their attitude, command of knowledge and ability to convey knowledge. In total, 69.5% of the graduates claimed that their instructors were interested in teaching and 4.4% claimed their instructors conveyed disinterest in teaching. The Qatar University graduates were satisfied with the content of their clinical training. However, they reported some gaps in this training. Identifying these gaps will help in restructuring clinical training to improve student experience.

The Effectiveness of Flipped Classroom during the COVID-19 Pandemic in Higher Pharmaceutical Education

BACKGROUND: Despite the apparent advantages of the flipped classroom model especially during a pandemic or natural or technogenic disasters, its overall effectiveness in higher medical and pharmaceutical education continues to be debated. AIM: The goal of the study was to test the effectiveness and acceptability of using the flipped classroom model during the COVID-19 pandemic in higher pharmaceutical education based on the example of the “Pharmaceutical Marketing” discipline at Sechenov First Moscow State Medical University, Russia. METHODS: The study involved 156 fourth-year pharmacy students. They were divided into three clusters: FC – studying in accordance with the flipped classroom model, FC+TBL – using the flipped classroom technology combined with the team-based method, and CC – studying by the traditional scheme (control). The study used the Unified educational portal of the Sechenov University. Additional elements were developed for the electronic educational and methodical complex for the studied section “Analysis of the marketing environment of a pharmaceutical organization.” The effectiveness of the flipped classroom model was evaluated through test control (entrance, formative, thematic, and final) and control of the development of skills and abilities in solving situational problems (thematic and final). The study participants’ attitude toward the use of the flipped classroom model was assessed through a survey. RESULTS: The study demonstrated that students from the FC and FC+TBL clusters were significantly better prepared for practical lessons and worked more effectively and productively during these classes compared to the CC cluster students. The results of the final control also substantiate the advantages of the flipped classroom technology both in assessing practical skills and abilities and in testing. The opportunities for rational implementation of the complex technology (FC+TBL cluster) are identified. CONCLUSIONS: The analysis of students’ general opinion on the flipped classroom model shows that 90.4% of the FC cluster members and 84.6% of the FC+TBL cluster members are satisfied with the results of using this model and consider it suitable for studying both the “Analysis of the marketing environment of a pharmaceutical organization” section and the entire pharmaceutical marketing course. Students’ positive feedback on the use of the flipped classroom model provides grounds for further implementation of this technology in the “Pharmaceutical Marketing” discipline in its entirety and demonstrates that further research on the use of other blended learning models is quite promising.

The impact of asynchronous online anatomy teaching and smaller learning groups in the anatomy laboratory on medical students' performance during the Covid-19 pandemic

Due to the Covid-19 pandemic, National Taiwan University anatomy teachers adopted asynchronous online video teaching and reduced the size of anatomy laboratory groups in April 2020. The aim of this study was to investigate the impact of these changes on medical students' learning. Before Covid-19, the performance of the 2019-2020 cohort was significantly better than that of the 2018-2019 cohort. However, the implementation of modified teaching strategies significantly lowered the laboratory midterm score of the 2019-2020 cohort in the second semester. Conversely, the final laboratory examination score of the 2019-2020 cohort was significantly higher than that of the 2018-2019 cohort. Through correlation analysis, lecture and laboratory examination scores were highly correlated. Additionally, the difference in lecture and laboratory z-scores between two cohorts, the Likert scale survey and free-text feedback of the 2019-2020 cohort, were conducted to show the impact of modified teaching strategies. There were several important findings in this study. First, the change in teaching strategies may temporarily negatively influence medical students to learn anatomy. Besides, analyzing the performance of laboratory assessments could be a complementary strategy to evaluate online assessments. Applying lecture examination scores to predict laboratory performance was a feasible way to identify students who may have difficulty in learning practical dissection. Finally, reducing group size together with reduced peer discussion may have a negative effect on learning cadaver dissection for students with low academic performance. These findings should be taken into consideration when anatomy teachers apply new teaching strategies in anatomy courses.

Comparison of two teaching methods for stopping the bleed: a randomized controlled trial

BACKGROUND

The "Stop the Bleed" (STB) campaign has achieved remarkable results since it was launched in 2016, but there is no report on the teaching of an STB course combined with a trauma patient simulator. This study proposes the "problem-, team-, and evidence-based learning" (PTEBL) teaching method combined with Caesar (a trauma patient simulator) based on the STB course and compares its effect to that of the traditional teaching method among outstanding doctoral candidates training in haemostasis skills.

METHOD

Seventy-eight outstanding doctoral candidate program students in five and eight-year programs were selected as the research subjects and were randomly divided into a control group (traditional teaching method, n = 34) and an experimental group (PTEBL teaching method combined with Caesar, n = 44). Their confidence in their haemostasis skills and willingness to rescue injured victims were investigated before and after the course in both groups.

RESULT

Students' self-confidence in their STB skills and the willingness to rescue improved after the class in both groups. Compared with the control group, students in the experimental group were more confident in compressing with bandages and compressing with a tourniquet after a class (compressing with bandages: control group 3.9 ± 0.8 vs. experimental group 4.3 ± 0.7, P = 0.014; compressing with a tourniquet: control group 3.9 ± 0.4 vs. experimental group 4.5 ± 0.8, P = 0.001) More students in the experimental group than the control group thought that the use of Caesar for scenario simulation could improve learning (control group 55.9% vs. experimental group 81.8%, P = 0.024), and using this mannequin led to higher teacher-student interaction (control group 85.3% vs. experimental group 97.7%, P = 0.042). The overall effectiveness of the teaching was better in the experimental group than in the control group (control group 85.3% vs. experimental group 97.7%, P = 0.042). There was a significant positive correlation between teacher-student interactions and the overall effectiveness of teaching (R = 1.000; 95% CI, 1.000-1.000; P < 0.001).

CONCLUSION

The PTEBL teaching method combined with Caesar can effectively improve student mastery of STB skills and overcome the shortcomings of traditional teaching methods, which has some promotional value in the training of outstanding doctoral candidates in STB skills.

Effects of bedside team-based learning on pediatric clinical practice in Chinese medical students

BACKGROUND

Bedside teaching is a primary educational tool to improve the clinical practice of medical students. As a new medical pedagogical approach, team-based learning (TBL) is gradually being integrated into Chinese medical education programmes to promote clinical reasoning, knowledge application, teamwork and collaboration. The aim of this controlled study is to investigate the effects of TBL on pediatric bedside teaching in medical students.

METHODS

Thirty medical students in pediatric clinical practice were randomly assigned to an intervention and a control group. Students in the intervention group exposed bedside teaching activity with TBL while students in the control group received traditional bedside teaching. Teaching for the two groups was conducted biweekly, and the same clinical cases were selected for both groups with the same instructors. After six months of clinical practice, the differences of learning outcomes between the two groups were compared through assessments by computer-based case simulations (CCS) and mini-Clinical Evaluation Exercise (mini-CEX). Student feedback following completion of bedside teaching was collected by questionnaire.

RESULTS

The CCS scores in the intervention group were significantly higher than that in the control group (p < 0.05). The mini-CEX results showed that clinical judgment and counseling skills of the intervention group were higher than those in the control group (p < 0.01). Medical interviewing skills and overall clinical competence in the intervention group were better than those in the control group (p < 0.05). In the questionnaire survey, students in the intervention group believed that bedside teaching activity with TBL could promote active learning ability, improve counseling skills and strengthen teamwork.

CONCLUSIONS

Application of TBL in bedside teaching not only enhanced clinical practice skills among medical students but also improved their clinical reasoning and counseling skills.

Teaching and Curriculum of the Preschool Physical Education Major Direction in Colleges and Universities under Virtual Reality Technology

The present work aims to study the influence of virtual reality (VR) technology on the teaching and curriculum of preschool physical education in colleges and universities and establish a virtual teaching model suitable for the college teaching system. The classroom teaching situation of using VR technology in physical training of preschool education major direction in colleges and universities is investigated using the questionnaire survey and teaching experiment. Firstly, the feasibility of applying VR technology to teaching is proved by analyzing the relevant education theories. Secondly, the experimental research method is designed to verify the application effect of VR technology in teaching behavior. Finally, the collected data is sorted out to judge the method’s feasibility. The experimental results demonstrate that 88.0% of the respondents are curious about the application of VR, and 88.6% of the respondents can accept the application of VR in sports dance teaching. Besides, 89.1% claimed that VR technology could enhance students’ understanding of knowledge, and 93.0% thought that VR applications would not interfere with teachers’ explanations. In addition, 80.0% thought that virtual teaching could stimulate students’ interest in learning, 75.0% said that VR application could attract students’ attention, and 63.0% believed that VR application could improve learning efficiency. The preliminary investigation suggests that introducing VR technology can reduce the work intensity of teachers, and the students participating in the survey are optimistic about the application of VR technology in preschool physical education. The formal test based on a t-test indicates that the average score of the experimental group is 3.18 points higher than that of the control group, and there are significant differences in technology between the control group and the experimental group. VR technology can improve students’ technical level, enhance self-confidence, and improve students’ grades. To sum up, this study provides a reference for developing virtual teaching mode and applying VR technology to physical education.

The Use of Blended Teaching in Higher Medical Education during the Pandemic Era

OBJECTIVE

This study aims to compare the effect of blended teaching and traditional teaching in higher medical education during the pandemic era.

METHODS

Taking the teaching of neurology as an example, 293 Yangzhou University Clinical Medicine 2016 undergraduate students were selected as the research subjects, and were randomly divided into 2 groups a blended teaching group (n = 148) and a traditional teaching group (n = 145), and received blended teaching and traditional teaching, respectively. The blended teaching was based on a Massive Open Online Course, problem-based learning, and case-based learning and supplemented by Tencent video conferences, QQ messaging groups, and other auxiliary teaching tools. At the end of the course, the teaching effect and satisfaction rate were evaluated through theory assessment, practical skills assessment, and an anonymous questionnaire survey.

RESULTS

There were significant differences in theoretical achievements (81.83 ± 6.23 vs 76.79 ± 6.87, P < 0.001) and practical skill achievements (84.74 ± 6.50 vs 78.48 ± 6.53, P < 0.001). In addition, significant differences in all aspects of satisfaction rate were observed between the two groups (all P < 0.001).

CONCLUSION

Blended teaching is beneficial to students' learning and stimulates their enthusiasm, cultivates clinical thinking ability, and improves teaching quality. Thus, it has played a positive role in the reform of higher medical teaching during the pandemic era.

Does team-based learning affect test scores of the basic medical sciences students in a modular curriculum?

Objectives

The aim of the study was to determine the effectiveness of team-based learning (TBL) sessions as a learning tool and to assess the satisfaction level of medical students towards TBL in modular curriculum.

Methods

Using the quasi-experimental study design, TBL sessions were conducted, involving students of 1^st and 2^nd year of Bachelor of Medicine and Bachelor of Surgery. The TBL infrastructure comprised of pre-class preparation, in-class individual readiness assurance pre-test and post-test, before and after group discussion, respectively. The responses of the students regarding TBL satisfaction were recorded through a structured questionnaire (5-point Likert-type scale) while Wilcoxon signed rank test was applied to measure the effectiveness of TBL sessions.

Results

Out of 192 students, 85% agreed or strongly agreed that TBL helped them think critically, identify their knowledge gaps, boosted their confidence, and motivated them in group participation. Significantly better post-test scores were found in all modules where TBL was used as a teaching tool (Z range = -5.33 to -11.81, P < 0.00).

Conclusion

TBL increases the post-test score in majority of the students, indicating improved learning process. It not only keeps students engaged throughout the learning process but incites critical thinking, problem solving skills, and confidence. Further studies are required to see long-term benefit of TBL in students' learning.

Outcome-based student assessment enhances academic performance in basic medical laboratory course

Basic medical laboratory courses (BMLCs) play an important role in medical educational courses helping the student acquire three important skills of surgical operating, collaborative learning, and problem solving. The outcome-based student assessment (OBSA) is a learning evaluation method that establishes specific evaluation points based on performance of students in three aspects: surgical operating, collaborative learning, and problem solving in the BMLC curriculum practices. The purpose of the present randomized controlled trial study is to explore the efficiency of OBSA program in BMLCs. The 233 students attending BMLCs were randomly divided into 2 groups, 118 in the OBSA group and 115 in the control group. We conducted multiple-choice examination questions (MCQs) test and two questionnaires with the method of two-sample t test for statistics. The results of MCQs in total eight BMLC blocks showed that the academic performance of the OBSA group was significantly better than that of the control group (P < 0.05). In addition, the average scores of direct observation of procedural skills (DOPS) and mini-experimental evaluation exercise in OBSA group were significantly higher than those in control group (P < 0.05). The majority of the medical students preferred the OBSA and considered OBSA could effectively improve their surgical operating skills (83.9%), collaborative learning skills (92.1%), and problem-solving skills (91.1%). From the above, OBSA is an effective evaluation method for the implementation of the BMLC curriculum.

Modified team-based and blended learning perception: a cohort study among medical students at King Saud University

BACKGROUND & OBJECTIVE

Medical schools have evolved toward competency-based education and active learner-centered strategies. Medical informatics course was introduced in 2011 in the 3rd year at the College of Medicine (CoM), King Saud University (KSU), to enhance future medical graduates with technological and information competencies. Modified team-based learning and blended learning were emphasized using face-to-face lectures, various e-learning technologies, workshop and seminars. The current study's main objective was to assess students' perceptions towards blended and modified team-based learning at the CoM in KSU.

METHODS

A survey was distributed to medical students in three consecutive years: 2017-2019. The survey contains items regarding student perception of various types of blended learning techniques applied in the course. The survey was administered using i-Clicker; an interactive device that enables students to answer survey questions. Descriptive statistics were used to examine the perception of students on these blended learning dimensions investigated.

RESULTS

Seven-hundred and one student responded to the questionnaire (male; 69.5%, female 30.5%). Out of which, 59.1% of students found team interactions positively supported discussions and asked questions freely, and 48.1% expressed that working in groups facilitated their learning process. However, 56.0% of students chose face-to-face lectures as the most preferred class activities followed by discussion 23.8%. More than 78% of participants agree that online quizzes are good experience and enjoyable. Grade center where students can check for marks and attendance also received high perception (66.3%).

CONCLUSION

Introducing modified team-based and blended-learning are considered challenging, and therefore, investigating their perceptions can provide useful insights into how these methods could be used more effectively. The blended-learning technique is highly essential in teaching medical informatics to overcome challenges faced due to a large number of students and the need for various exposures to reach the course's learning goals. Moreover, it is noticed that students were engaged in face-to-face and online activities, furthermore, modified team-based learning reported facilitating learning and asking questions without embarrassment.

Nursing students' perception of class immersion facilitators in psychiatric nursing: Team-based learning combined with flipped learning

BACKGROUND

Psychiatric nursing is a complex subject for nursing students due to abstract concepts and required pre-licensure competencies including collaboration and communication. A student-centred educational approach is needed to encourage engagement and immersion in class.

OBJECTIVES

This study aimed to use students' perspectives to explore factors facilitating class immersion in a psychiatric nursing subject using team-based learning combined with flipped learning.

DESIGN

This study used a qualitative approach.

SETTINGS

Team-based learning combined with flipped learning was applied in a 3-credit psychiatric nursing subject over a 15-week semester at a university in Daejeon, South Korea.

PARTICIPANTS

Participants included 12 senior nursing students who had completed a psychiatric nursing subject.

METHODS

Data were collected using individual interviews, and analysed by reflexive thematic analysis. Data analysis was based on constructivist learning theory.

RESULTS

The following four main themes emerged, teacher as a facilitator, inquiry-based learning, collaboration, and reflection. The teacher's role as a facilitator was to guide student's self-directed learning and immersion in enjoyable classes with a non-hierarchical environment. Realistic complex problems allowed students to prepare for future clinical practice and helped students with immersion. Students actively integrated different opinions through collaboration with team members and became immersed in class. Students were able to immerse more in class through critical thinking process and immediate feedback.

CONCLUSIONS

The findings suggest that team-based learning combined with flipped learning based on constructivist learning theory may be an effective instructional approach for increasing class immersion in a psychiatric nursing subject, thereby improving instructor's design for the subject.

Team-based learning: design, facilitation and participation

Team-based learning (TBL) provides an active, structured form of small group learning, that can be applied to large classes. Student accountability is achieved through the specific steps of TBL, including pre-class preparation, readiness assurance testing, problem-solving activities, and immediate feedback. Globally, a growing number of healthcare faculties have adopted TBL in a variety of combinations, across diverse settings and content areas. This paper provides a succinct overview of TBL and guidance for teachers towards successful design and implementation of TBL within health professional education. It also offers guidance for students participating in TBL. The paper is informed by both educational theory, and the extensive, seven year experience of the first and last authors in designing, implementing, facilitating and evaluating TBL at a large medical school.

Toward an Integrative Nursing Curriculum: Combining Team-Based and Problem-Based Learning with Emergency-Care Scenario Simulation

Objective: The study intended to combine team-oriented, problem-based learning (PBL) with emergency-care simulation to investigate whether an integrative intervention could positively impact the core nursing competencies and teacher performance of nursing students. Methods: The study belonged to the domain of action research, which aimed to address the weaknesses of traditional teacher-led, lecture-based learning. An 18-week, single-case experimental design, in which 58 senior nursing students at a medical university in central Taiwan participated, was conducted to test the possible benefits of the intervention. The measures included the Scale of Core Nursing Competencies and the Teacher Performance Evaluation Scale. Results: The research results showed that nursing students who received integrative training that combined team-based PBL with emergency-care scenario simulation had stronger mastery over core nursing competencies. At the same time, they also evaluated both the “Emergency Care” course for which the curriculum was used and the teachers’ performance in that course more highly. Conclusions: The findings suggest that an integrative curriculum combining team-based PBL with scenario simulation is worth pursuing. Compared with traditional teacher-led, lecture-based teaching, this curriculum may be more effective in helping nursing students develop core competencies in their field.

Implementation of structured team-based review enhances knowledge consolidation and academic performance of undergraduate medical students studying neuroscience

Team-based learning (TBL) provides a systematic approach to teaching and learning and promotes critical thinking and enhances medical educational activities and professional development. TBL-based didactic methodology has proven beneficial in enhancing learning and consolidating key educational concepts throughout educational curricula. Such areas of application include neuroscience, which is traditionally considered to be one of the most difficult disciplines to be taught in undergraduate medical courses to the point where the scientific literature reports "neurophobia" among undergraduate medical students. Herein, we report the design and application of a modified version of TBL, which we termed team-based review (TBR) throughout two cohorts of undergraduate medical students undertaking neuroscience. We show that our TBR methodology enhanced student understanding of neuroscience, increasing average marks and grades achieved in final exams, while also increasing the proportion of students obtaining higher grades. Application of TBR also improved marks obtained by students throughout continuous assessment (midterms, TBL, and problem-based learning grades). In surveys taken following final exams, students strongly felt that TBR enhanced their learning experience and aided knowledge acquisition, consolidation, and exam preparation. Collectively, we show that TBR-based methodology was effective in enhancing the student learning experience and performance in neuroscience and could potentially be successfully used to enhance performance and learning in other subjects in the undergraduate medical curriculum.

Patient-Centered Team-Based Learning in Pre-Clinical Curriculum Supporting the Application of Knowledge to Real-World Clinical Experience

We report an active learning session which effectively supported 1st year medical students applying their learning experience in a clinical setting. A team-based learning (TBL) on familial hypercholesterolemia (FH) with a live patient was given to deliver basic genetics knowledge in a clinically relevant context. Subsequently, two participating students applied their learning experience by presenting a differential diagnosis of homozygous FH in a patient at a medical mission in Central America. We propose that combining active learning with clinically relevant scenarios effectively fosters student's clinical reasoning skills and can bridge the perceived gap between basic science and clinical education.

Using problem-based learning to improve patient safety in the emergency department

Pressures from rising patient numbers and overcrowding in emergency departments (EDs) are putting patients' safety at risk. Beyond improved provision of resources, two elements are essential to patient safety in emergency care - work culture and staff training. In traditional training environments, the teacher dispenses knowledge to nursing students in a classroom setting. However, problem-based learning (PBL) and the related concept of team-based learning (TBL) aim to enhance learners' knowledge and skills in non-technical subjects, such as patient safety, as well as their ability to address challenges they encounter in clinical practice. This article explores the theories that underpin PBL and TBL and discusses how they can be used by nurse educators to motivate staff and improve patient safety in the ED.

Implementation of Team-Based Learning: a Tale of Two New Medical Schools

Team-based learning (TBL) is gaining popularity at medical schools transitioning from lecture-based to active learning curricula. Here, we review challenges and opportunities faced in implementing TBL at 2 new medical schools. We discuss the importance of using meaningful TBL grades as well as the role TBL plays in developing critical reasoning skills and in early identification of struggling students. We also discuss how the concurrent use of learning strategies with different incentive structures such as problem- and case-based learning could foster the development of well-rounded physicians. We hope this monograph helps and even inspires educators implementing TBL at their schools.

Improving burn surgery education for medical students in China

INTRODUCTION

In China, although burn treatment develops rapidly, and ranks in the forefront of the world, there is a relative shortage of burn specialists, which limits the development of burn education. In traditional curriculum of surgery education, burn surgery education accounts for few proportions, which results in the indifference to the burn surgery among medical students. To date, few research reported the application of Clinical pathway- Problem based Learning (CP-PBL) in burn surgery education. The objective of the study is to explore the teaching effect of this novel teaching method in burn surgery education.

METHODS

A pilot study was performed. One hundred and six students were randomly divided into a Lecture based Learning (LBL) only group (control group) and a LBL combined Clinical pathway- Problem based Learning group (observation group). A set of test was designed as evaluation criteria based on questions of burn surgery in National Medical Licensing Examination (NMLE) from 2011 to 2018.

RESULTS

The students with Clinical pathway- Problem based Learning had better academic performances in profession theory. Type A2 and Type A3/A4 scores in the observation group were higher than those in the control group (p < 0.05). The scores of the observation group were higher than those of control group in the domains of understanding and application (p < 0.05). They also have higher favorable impressions of learning experience.

CONCLUSIONS

More active approaches yield more learning and are viewed more favorable, which provides a vital message for the evolution of curriculum in Chinese medical schools.

Implementation of flipped classroom combined with problem-based learning: an approach to promote learning about hyperthyroidism in the endocrinology internship

BACKGROUND

With the development of medicine, new teaching methods, such as flipped classroom and problem-based learning (PBL), have received much attention in medical education. However, the implementation of flipped classroom combined with PBL in endocrinology education has not been well investigated. Considering that both two teaching methods may complement each other, therefore, the aim of this study was to evaluate students' learning effectiveness acceptability of the pedagogy between traditional lecture-based teaching methods and the combination of flipped classrooms with PBL teaching methods in the endocrinology internship.

METHODS

74 fourth-year medical students at the Bengbu Medical College were enrolled in the endocrinology internship. Hyperthyroidism was chosen for the content of this study. The participants were randomly allocated into either the combination group of flipped classroom with PBL (CG) or the traditional lecture-based classroom group (TG). Both a pre-quiz and a post-quiz were conducted before and after the classes, respectively. All questions in the quizzes were classified into two aspects, basic theoretical knowledge and clinical case analyses based on the Bloom's Taxonomy. The scores were compared and students were required to complete the questionnaire to evaluate their perceptions and experience.

RESULTS

The mean post-quiz scores of both the TG and the CG were higher than those of the pre-quiz. Additionally, the post-quiz showed that students in the CG had significantly higher scores in the TG. Further analysis found that after class, only the difference in clinical case analysis between CG and TG was significant. The scores of all items in the questionnaires were higher in the CG than in the TG. More students agreed that the combined teaching method could help to improve their performance, at the same time, it could increase their workload.

CONCLUSIONS

The combination of the flipped classroom and PBL teaching approach could be a better option over the traditional lecture-based classroom in the teaching of hyperthyroidism during endocrinology internship, although it can increase students' workload. To be widely accepted and implemented, further optimizations are required.