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Li X. Application of PBL-CBL and Mini-CEX methods in the standardized training of residents in nephrology department: A prospective study. Pak J Med Sci 2024; 40:2046-2051. [PMID: 39416615 PMCID: PMC11476161 DOI: 10.12669/pjms.40.9.9434] [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: 01/08/2024] [Revised: 06/04/2024] [Accepted: 06/29/2024] [Indexed: 10/19/2024] Open
Abstract
Objective This study explores the application and feasibility of problem based learning (PBL), integrating case based learning (CBL), and the mini clinical evaluation exercise (Mini-CEX) into the standardized training of residents in nephrology department, in order to assess their clinical skills in a comprehensive manner. Methods This prospective study enrolled 60, three years residents majoring in clinical medicine, from June 2022 to December 2023 in Nephrology Department of Baoding No.1 Central Hospital. These participants were randomly allocated into either the combined PBL-CBL and Mini-CEX teaching group (experimental group) or the traditional lecture-based teaching group (control group). Two groups were evaluated with Mini-CEX assessments and test scores upon exit the department, followed by a questionnaire survey to measure satisfaction levels for the teachers. Results There was no statistically significant difference in age, sex, year of graduate school, specialty and student source between the two groups of residents upon the entering the department (P>0.05). Upon the completion, the experimental group, which received PBL-CBL and Mini-CEX teaching methods, demonstrated significantly higher scores in all aspects compared to the control group, with a statistically significant difference (P<0.01). Furthermore, compared the control group, most residents in the experimental group agreed that the PBL-CBL and Mini-CEX teaching methods improve curiosity and enthusiasm for learning (73.3%), communication and expression abilities (73.3%), self-learning abilities (80%), understanding of diseases (76.7%), and like this teaching method (86.7%). Conclusions PBL-CBL and Mini-CEX may be an effective method for improving medical residents' performance and enhancing their clinical skills, which is worthy of promotion in the standardized training of the residents.
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Affiliation(s)
- Xiaodong Li
- Xiaodong Li, Department of Nephrology, Baoding No.1 Central Hospital of Hebei Medical University, Baoding 071000, Hebei, China
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Gopalan C, Halpin PA, Selvam AAA, Hung WC. Exploring educational transformations through the Innovative Flipped Learning Instruction Project Symposium. ADVANCES IN PHYSIOLOGY EDUCATION 2024; 48:505-511. [PMID: 38634124 PMCID: PMC11427018 DOI: 10.1152/advan.00027.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/03/2024] [Accepted: 04/15/2024] [Indexed: 04/19/2024]
Abstract
The flipped classroom is an innovative pedagogy that shifts content delivery outside the classroom, utilizing in-class time for interactive learning. The preclass and in-class activities in this framework encourage individualized learning and collaborative problem-solving among students, fostering engagement. The Innovative Flipped Learning Instruction Project (IFLIP) conducted faculty development workshops over 4 years, guiding science, technology, engineering, and mathematics (STEM) faculty in integrating flipped teaching (FT) into their courses. The research aimed to assess its impact on pedagogical practices, explore its effectiveness, and provide a framework to implement FT across multiple institutions. It sought to evaluate the experiences of these educators throughout the transitional period of instructional change. In the fourth year of this project, a symposium was organized for IFLIP participants to share their experiences and findings concerning FT. This symposium helped promote collaboration among IFLIP participants and faculty interested in FT to disseminate participants' knowledge and experiences in implementing FT strategies. A survey conducted at the end of the symposium indicated that faculty participants with FT experience continued to embrace this pedagogy, and the new adopters expressed intentions to incorporate it into their courses. The survey revealed positive responses: 93% of respondents plan to integrate FT methods in future classes, 90% gained new information from the symposium and intend to implement it, and 91% are likely to recommend FT to colleagues. Ultimately, the symposium underscored the transformative impact of FT in empowering educators to deepen students' conceptual understanding, emphasizing the significance of this pedagogical approach in advancing the quality of education.NEW & NOTEWORTHY Flipped pedagogy shifts content delivery outside the classroom, emphasizing interactive learning during in-class time. The Innovative Flipped Learning Instruction Project (IFLIP) guided science, technology, engineering, and mathematics (STEM) faculty in integrating flipped teaching (FT), tracked experiences during this transition, and provided a framework for FT implementation. A fourth-year symposium fostered collaboration, revealing sustained enthusiasm for FT. The symposium underscored its transformative impact on deepening students' understanding, highlighting its significance in enhancing education quality.
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Affiliation(s)
- Chaya Gopalan
- Department of Applied Health, School of Education, Health and Human Behavior, Southern Illinois University Edwardsville, Edwardsville, Illinois, United States
- Department of Nurse Anesthesiology, School of Nursing, Southern Illinois University Edwardsville, Edwardsville, Illinois, United States
| | - Patricia A Halpin
- Department of Life Sciences, University of New Hampshire, Manchester, New Hampshire, United States
| | | | - Wei-Chen Hung
- Department of Educational Technology, Research and Assessment, Northern Illinois University, DeKalb, Illinois, United States
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Zhang W, Jiang M, Zhao W, Li S, Li F, Feng F, Wang Y, Li Y, Liu L. Evaluation of the effectiveness of using flipped classroom in puncture skills teaching. BMC MEDICAL EDUCATION 2024; 24:176. [PMID: 38395791 PMCID: PMC10885647 DOI: 10.1186/s12909-024-05132-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/04/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND The effectiveness of flipped classroom (FC) on puncture skills in medical education is still uncertain. This study aimed to assess the role of the FC model in puncture skills and investigate the acceptance and approval of FC among medical students and instructors. METHODS A mixed research approach of quasi-experimental research design and descriptive qualitative research was conducted in September 2022 for one month, using an FC teaching method that combined instructional videos and group learning. The study participants were 71 fifth-year medical students from two classes at a Chinese medical school and four instructors. The medical students were randomly divided into two groups: the traditional classroom (TC) group (Group A) and the FC group (Group B). For teaching, Group B used FC, and Group A used PowerPoint-based TC. The effectiveness of the two teaching models was assessed with Objective Structured Clinical Examination (OSCE), and questionnaires were distributed to the medical students and instructors after the assessment. Two independent sample t-tests were used to analyse the differences in demographic data and the OSCE scores of the two groups of medical students. RESULTS Group B scored higher in puncture skills than Group A, especially regarding abdominal puncture (p = 0.03), thoracentesis (p < 0.001), bone marrow puncture (p < 0.001) and average performance of puncture skills (p < 0.001). For lumbar puncture, no difference in skill scores was observed between groups A and B (p > 0.409). The medical students thought that the FC improved their self-learning ability and helped them acquire knowledge. Regarding the OSCE of their skills, most medical students thought that it was more innovative and objective than traditional examinations and that it was better for assessing their overall abilities. Both the FC and OSCE were supported by the medical students. The instructors were also satisfied with the students' performance in the FC and supported the teaching model, agreeing to continue using it. CONCLUSIONS This study shows that FC teaching that combines instructional videos and group learning is a reliable and well-received teaching method for puncture skills, which supplements and expands existing teaching methods in the medical field.
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Affiliation(s)
- Weihao Zhang
- Department of Gastroenterology, The Second Hospital of Shandong University, Jinan, Shandong, 250033, China
| | - Miao Jiang
- Clinical Skill Training Center, The Second Hospital of Shandong University, Jinan, Shandong, 250033, China
| | - Wei Zhao
- Department of Gastroenterology, The Second Hospital of Shandong University, Jinan, Shandong, 250033, China
| | - Shuai Li
- Department of Gastroenterology, The Second Hospital of Shandong University, Jinan, Shandong, 250033, China
| | - Fan Li
- Department of Neurology, The Second Hospital of Shandong University, Jinan, Shandong, 250033, China
| | - Feifei Feng
- Department of Respiration, The Second Hospital of Shandong University, Jinan, Shandong, 250033, China
| | - Yongjing Wang
- Department of Hematology, The Second Hospital of Shandong University, Jinan, Shandong, 250033, China
| | - Yan Li
- Clinical Skill Training Center, The Second Hospital of Shandong University, Jinan, Shandong, 250033, China
| | - Lan Liu
- Department of Gastroenterology, The Second Hospital of Shandong University, Jinan, Shandong, 250033, China.
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Nichat A, Gajbe U, Bankar NJ, Singh BR, Badge AK. Flipped Classrooms in Medical Education: Improving Learning Outcomes and Engaging Students in Critical Thinking Skills. Cureus 2023; 15:e48199. [PMID: 38054140 PMCID: PMC10694389 DOI: 10.7759/cureus.48199] [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: 10/04/2023] [Accepted: 11/03/2023] [Indexed: 12/07/2023] Open
Abstract
The flipped classroom (FC) model involves students independently acquiring knowledge before in-person class sessions, during which they engage in active discussions and problem-solving. Various methods to implement FC are quizzes, e-content, case-based learning, problem-based learning, and reading assignments. The advantages of the FC approach included improved student preparation, active participation, and the promotion of critical thinking skills. Some disadvantages identified are technical problems like internet connection, improper planning and preparation, which increases teacher workload, and lack of self-motivation. This review underscores the potential of the FC approach to improve medical education by promoting independent learning, active participation, and deeper understanding. Consideration of factors such as curriculum design, faculty development, technological infrastructure, and student readiness is vital for successfully implementing the FC model. Balancing self-directed study with meaningful face-to-face interactions remains crucial to harnessing the full benefits of this innovative approach. By leveraging technology and student-centered methods, medical educators can create an enriched learning experience that positively influences future healthcare professionals.
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Affiliation(s)
- Adwait Nichat
- Medical Education, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Nagpur, IND
| | - Ujwal Gajbe
- Anatomy, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Nagpur, IND
| | - Nandkishor J Bankar
- Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Brij Raj Singh
- Anatomy, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Nagpur, IND
| | - Ankit K Badge
- Microbiology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Nagpur, IND
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Chan PP, Lee VWY, Yam JCS, Brelén ME, Chu WK, Wan KH, Chen LJ, Tham CC, Pang CP. Flipped Classroom Case Learning vs Traditional Lecture-Based Learning in Medical School Ophthalmology Education: A Randomized Trial. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:1053-1061. [PMID: 37067959 DOI: 10.1097/acm.0000000000005238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
PURPOSE To address the problem of teaching noncore specialties, for which there is often limited teaching time and low student engagement, a flipped classroom case learning (FCCL) module was designed and implemented in a compulsory 5-day ophthalmology rotation for undergraduate medical students. The module consisted of a flipped classroom, online gamified clinical cases, and case-based learning. METHOD Final-year medical students in a 5-day ophthalmology rotation were randomized to the FCCL or a traditional lecture-based (TLB) module. The outcomes of subjective assessments (student-rated anonymous Likert scale questionnaire, scale 1 to 5, and course and teaching evaluation, scale 1 to 6) and objective assessments (end-of-rotation and post-MBChB multiple-choice questions, scale 0 to 60) were compared between the 2 groups. RESULTS Between May 2021 and June 2022, 216 students (108 in each group) completed the study. Compared with the TLB students, the students in the FCCL group rated various aspects of the course statistically significantly higher, including feeling more enthusiastic and engaged by the course and more encouraged to ask questions and participate in discussions (all P < .001). They also gave higher ratings for the instructional methods, course assignments, course outcomes, and course workload ( P < .001). They gave higher course and teaching evaluation scores to the tutors (5.7 ± 0.6 vs 5.0 ± 1.0, P < .001). The FCCL group scored higher than the TLB group on the end-of-rotation multiple-choice questions (53.6 ± 3.1 vs 51.8 ± 2.8, P < .001). When 32 FCCL students and 36 TLB students were reassessed approximately 20 weeks after the rotation, the FCCL group scored higher (40.3 ± 9.1) than the TLB group (34.3 ± 10.9, P = .018). CONCLUSIONS Applying the FCCL module in ophthalmology teaching enhanced medical students' satisfaction, examination performance, and knowledge retention. A similar model may be suitable for other specialties.
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Affiliation(s)
- Poemen P Chan
- P.P. Chan is assistant professor, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Vivian W Y Lee
- V.W.Y. Lee is associate professor, Centre for Learning Enhancement And Research, The Chinese University of Hong Kong, Hong Kong, China
| | - Jason C S Yam
- J.C.S. Yam is associate professor, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Marten E Brelén
- M.E. Brelén is associate professor, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Wai Kit Chu
- W.K. Chu is research assistant professor, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Kelvin H Wan
- K.H. Wan was assistant professor, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China, at the time of writing
| | - Li J Chen
- L.J. Chen is professor, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Clement C Tham
- C.C. Tham is S.H. Ho Professor of Ophthalmology and Visual Sciences and chairman, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi P Pang
- C.P. Pang is S.H. Ho Research Professor of Visual Science, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
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Ohta R, Sano C. Case Report-Driven Medical Education in Rural Family Medicine Education: A Thematic Analysis. Healthcare (Basel) 2023; 11:2270. [PMID: 37628468 PMCID: PMC10454442 DOI: 10.3390/healthcare11162270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/31/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Case-based education (CBE) is a teaching method in which learners work on real-life cases to learn and apply concepts and skills they have been taught. Case report-driven medical education using the CBE framework can effectively facilitate student and resident learning, and entice them to become involved in actual clinical practice. Specific case report-driven medical education methods and learning outcomes are not clarified. This study aimed to clarify the specific learning processes and outcomes of case report-driven medical education in rural community-based medical education. Using a qualitative design based on a thematic analysis approach, data were collected through semi-structured interviews. The study participants were medical students and residents in training at a rural Japanese community hospital. Fifty-one case reports were completed and published in Cureus from April 2021 to March 2023. Participants learned about various difficulties related to volatility, uncertainty, complexity, and ambiguity (VUCA) in the medical care of various older patients, which increased their interest in family medicine. They appreciated the importance of case reports in academic careers and how their responsibilities as researchers increase with collaboration. Case report-driven medical education in community hospitals can drive medical students' and junior residents' learning regarding family medicine in the VUCA world.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, 699-1221 96-1 Iida, Daito-cho, Unnan 699-1221, Japan
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, 89-1 Enya cho, Izumo 693-8501, Japan;
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Zeri F, Eperjesi F, Woods C, Bandlitz S, Kumar Bhootra A, Joshi MR, Nagra M, Schweizer H, Naroo SA. Evidence-based teaching in contact lenses education: Teaching and learning strategies. Cont Lens Anterior Eye 2023; 46:101822. [PMID: 36804937 DOI: 10.1016/j.clae.2023.101822] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023]
Abstract
INTRODUCTION Contact lens (CL) practice is an ever-changing field with clinical knowledge, techniques and equipment continuously evolving. These new developments are backed with clinical trials and research to ensure that practitioners feel confident that there is an evidence base to support these advances. Evidence-based practice is now a crucial part of CL practice, and its importance also filters down to CL education. For example, lectures are one of the most popular tools for an educator but, is standing at the front of a lecture theatre full of students a more effective way of teaching than providing the same material for students to read by themselves? What evidence exists specific to CL education? METHOD An expert panel of educators completed a comprehensive literature review of current evidence of teaching methods in CL training, or if not available then what can be learnt from other health care professional training that could be potentially applicable to CL education. RESULTS Due to the amount of evidence available in the overall subject area relating to healthcare education, the initial plan of compiling evidence into one narrative review paper was discarded in favour of producing two linked papers. Here, the first paper details definitions of terminology, and also teaching methods. The second paper focuses on assessment and specific clinical training required to attain CL practice competency. In this first paper, no direct evidence of the spreading and benefit of new education strategies evidence such as flipped classrooms, spaced learning, test-enhanced learning, group work, CBL, PBL, TBL, and reflective practice in CL education was found. The only technique that was widely used in the CL field was case reports and the group discussion of them. Nevertheless, the authors found a consensus of opinion from other disciplines that are transferable to CL teaching and could help students meet the intended learning outcomes. CONCLUSION There is a small amount of evidence supporting CL education, but most of this seems to be related to the practical element of the training. However, there is a lot of evidence in the field of healthcare education from related disciplines which provides additional but important learning tools that may be effectively implemented in CL education.
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Affiliation(s)
- Fabrizio Zeri
- University of Milano-Bicocca, Department of Materials Science, Milan, Italy; College of Health and Life Sciences, Aston University, UK; International Association of Contact Lens Educators, Canada
| | | | - Craig Woods
- School of Optometry and Vision Science, University of New South Wales, Australia; International Association of Contact Lens Educators, Canada
| | - Stefan Bandlitz
- College of Health and Life Sciences, Aston University, UK; Höhere Fachschule für Augenoptik Köln, Cologne School of Optometry, Cologne, Germany
| | | | - Mahesh R Joshi
- Eye and Vision Research Group, University of Plymouth, UK
| | | | | | - Shehzad A Naroo
- College of Health and Life Sciences, Aston University, UK; International Association of Contact Lens Educators, Canada.
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Chen L, Chen W. TRAINING OPTIMIZATION IN SOCCER PLAYERS WITH SPORTS INJURIES. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012022_0716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
ABSTRACT Introduction: Strengthening the optimization of soccer skills training and strengthening the prevention of sports injuries are important research topics for soccer development in the post-injury rehabilitation phase. Functional training control has been empirically shown to be effective in accelerating rehabilitation. Objective: Investigate the situation of sports injuries in soccer and the effect of optimizing skill training on people with sports injuries in functional training for rehabilitation. Methods: During a 6-week experiment, the experimental group was inserted into the functional training mode, while the control group performed traditional training. The functional training was performed thrice a week for one hour per session. After 6 weeks, physiological and functional data were compared, classified, and analyzed. Results: The total FMS score of the experimental group increased from 13.61 to 17.30, while that of the control group ranged from 14.04 to 15.54. Conclusion: Selecting multiple training methods focused on different sports skills, focusing on balance, strength, and coordination, can optimize the sports skills of soccer players who have sports injuries. The researched protocol was shown to improve the competitive level of athletes and reduce the risk of future sports injuries. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
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Affiliation(s)
- Li Chen
- Guangdong Medical University, China
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Li Y, Gao C, Zhu X, Zhu J, Ding Z, Han Z. Application of SPARK teaching in acute abdomen radiography teaching for undergraduate medical students. BMC MEDICAL EDUCATION 2022; 22:881. [PMID: 36536422 PMCID: PMC9762863 DOI: 10.1186/s12909-022-03957-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Acute abdomen is a series of acute and severe abdominal diseases commonly encountered in clinic. It is important to strengthen the image teaching of acute abdomen for undergraduates. AIM This study aimed to explore the application effect of SPARK[sub-speciality (S), problem-based learning (P), assessment (A), report (R) and reading skill (K)] teaching mode in the experimental teaching of acute abdomen for undergraduate medical students. METHODS We selected a total of 58 third year medical students for observation. The students were divided into experimental group and control group. Among them, 29 students in the experimental group studied in SPARK teaching mode, 29 students in the control group studied in traditional teaching mode. The two groups of students were tested after the theory class, before and after the experimental class, and one week after the experimental class, to compare the application effects of the two teaching modes. After the test one week after the experimental class, the two groups of students jointly adopted SPARK mode to learn, and were tested again one month after the experimental class to compare whether the two groups of students achieved the same results. The total score of all tests was 150. RESULTS The average scores of the experimental group and the control group after theory class were (69.0 ± 26.4) and (72.1 ± 24.1) respectively, with no statistical difference (t = 0.468, P = 0.642). The average scores of the experimental group before, after and one week after the experimental class were higher than those of the control group. The experimental group was (84.5 ± 23.1), (109.7 ± 23.8), (105.5 ± 31.0) respectively, and the control group was (52.8 ± 15.1), (93.8 ± 17.0), (80.0 ± 22.8) respectively. The differences were statistically significant (t = -6.195, P = 0.00; t = -2.919, P = 0.05; t = -3.569, P = 0.01). The average scores of the experimental group and the control group after one month were (99.0 ± 31.0) and (95.5 ± 25.6) respectively, and there was no significant difference between the two groups (t = -0.462, P = 0.646). CONCLUSIONS The SPARK teaching mode was helpful for undergraduate medical students to consolidate image foundation, improve image reading skills.
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Affiliation(s)
- Yangsheng Li
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 310006, Hangzhou, Zhejiang, China
| | - Chengcheng Gao
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 310006, Hangzhou, Zhejiang, China
| | - Xiangwen Zhu
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 310006, Hangzhou, Zhejiang, China
| | - Jiying Zhu
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 310006, Hangzhou, Zhejiang, China
| | - Zhongxiang Ding
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 310006, Hangzhou, Zhejiang, China
| | - Zhijiang Han
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 310006, Hangzhou, Zhejiang, China.
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