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Janzing P, Nourkami-Tutdibi N, Tutdibi E, Freundt P, von Ostrowski T, Langer M, Zemlin M, Steinhard J. Controlled prospective study on ultrasound simulation training in fetal echocardiography: FESIM II. Arch Gynecol Obstet 2024; 309:2505-2513. [PMID: 37454353 PMCID: PMC11147821 DOI: 10.1007/s00404-023-07133-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/27/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE To analyze the learning curves of ultrasound novices in fetal echocardiography during structured simulation-based ultrasound training (SIM-UT) including a virtual, randomly moving fetus. METHODS 11 medical students with minimal (< 10 h) prior obstetric ultrasound experience underwent 12 h of structured fetal echocardiography SIM-UT in individual hands-on sessions during a 6-week training program. Their learning progress was assessed with standardized tests after 2, 4, and 6 weeks of SIM-UT. Participants were asked to obtain 11 fetal echocardiography standard planes (in accordance with ISUOG and AHA guidelines) as quickly as possible. All tests were carried out under real life, examination-like conditions on a healthy, randomly moving fetus. Subsequently, we analyzed the rate of correctly obtained images and the total time to completion (TTC). As reference groups, 10 Ob/Gyn physicians (median of 750 previously performed Ob/Gyn scans) and 10 fetal echocardiography experts (median of 15,000 previously performed Ob/Gyn scans) were examined with the same standardized tests. RESULTS The students showed a consistent and steady improvement of their ultrasound performance during the training program. After 2 weeks, they were able to obtain > 95% of the standard planes correctly. After 6 weeks, they were significantly faster than the physician group (p < 0.001) and no longer significantly slower than the expert group (p = 0.944). CONCLUSION SIM-UT is highly effective to learn fetal echocardiography. Regarding the acquisition of the AHA/ISUOG fetal echocardiography standard planes, the students were able to reach the same skill level as the expert group within 6 weeks.
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Affiliation(s)
- Paul Janzing
- Hospital for General Pediatrics and Neonatology, Saarland University Medical Center, 66421, Homburg/Saar, Germany.
| | - Nasenien Nourkami-Tutdibi
- Hospital for General Pediatrics and Neonatology, Saarland University Medical Center, 66421, Homburg/Saar, Germany
| | - Erol Tutdibi
- Hospital for General Pediatrics and Neonatology, Saarland University Medical Center, 66421, Homburg/Saar, Germany
| | - Paula Freundt
- Hospital for General Pediatrics and Neonatology, Saarland University Medical Center, 66421, Homburg/Saar, Germany
| | | | - Martin Langer
- LARA-Praxis für Frauengesundheit, Bocholt, NRW, Germany
| | - Michael Zemlin
- Hospital for General Pediatrics and Neonatology, Saarland University Medical Center, 66421, Homburg/Saar, Germany
| | - Johannes Steinhard
- Fetal Cardiology, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany
- Prenatal Medicine Center Münster, Münster, NRW, Germany
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Korteland RJ, Kok E, Hulshof C, van Gog T. Teaching through their eyes: effects on optometry teachers' adaptivity and students' learning when teachers see students' gaze. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024:10.1007/s10459-024-10325-3. [PMID: 38598135 DOI: 10.1007/s10459-024-10325-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/17/2024] [Indexed: 04/11/2024]
Abstract
Adaptive teacher support fosters effective learning in one-to-one teaching sessions, which are a common way of learning complex visual tasks in the health sciences. Adaptive support is tailored to student needs, and this is difficult in complex visual tasks as visual problem-solving processes are covert and thus cannot be directly observed by the teacher. Eye-tracking apparatus can measure covert processes and make them visible in gaze displays: visualizations of where a student looks while executing a task. We investigate whether live dynamic gaze displays help teachers in being more adaptive to students' needs when teaching optical coherence tomography interpretation in one-to-one teaching sessions and whether this fosters learning. Forty-nine students and 10 teachers participated in a one-to-one teaching session in clinical optometry. In the control condition, teachers saw the learning task of the student and could discuss it with them, whereas in the gaze-display condition, teachers could additionally see where the student looked. After the 15-minute teaching session, a test was administered to examine achievement. Furthermore, students filled in the 'questionnaire on teacher support adaptivity', and teachers rated how adaptive their support was. Bayesian analyses provide some initial evidence that students did not experience support to be more adaptive in the gaze-display condition versus the control condition, nor were their post-test scores higher. Teachers rated their provided support as being more adaptive in the gaze-display versus the control condition. Further research could investigate if live dynamic gaze displays impact adaptive teaching when used over longer periods or with more teacher training.
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Affiliation(s)
- Robert-Jan Korteland
- Department of Education, Utrecht University, P.O. Box 80140, Utrecht, 3508 CS, Netherlands
| | - Ellen Kok
- Department of Education, Utrecht University, P.O. Box 80140, Utrecht, 3508 CS, Netherlands.
| | - Casper Hulshof
- Department of Education, Utrecht University, P.O. Box 80140, Utrecht, 3508 CS, Netherlands
| | - Tamara van Gog
- Department of Education, Utrecht University, P.O. Box 80140, Utrecht, 3508 CS, Netherlands
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Kumar C, Miller A, Marshall AM, Thompson AR, Lowrie DJ, Weber DE, Kelleher M, Malosh L, Martin C, Christensen HR. Dynamic Opportunities for Medical Students to Assume the Roles of "Medical Teacher". MEDICAL SCIENCE EDUCATOR 2024; 34:445-454. [PMID: 38686166 PMCID: PMC11055825 DOI: 10.1007/s40670-023-01969-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 05/02/2024]
Abstract
The traditional undergraduate medical education curriculum focuses on bolstering knowledge for practice and building clinical skills. However, as future clinicians, medical students will be tasked with teaching throughout their careers, first as residents and then as attendings. Here, we describe teaching opportunities for students that foster their development as future teachers and potential clinician educators. These offerings are diverse in their focus and duration and are offered across various levels of the curriculum - including course-based learning, longitudinal electives, and extra-curricular opportunities for medical students who have a passion for teaching.
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Affiliation(s)
- Chitra Kumar
- The University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Avery Miller
- The University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Aaron M. Marshall
- The University of Cincinnati College of Medicine, Cincinnati, OH USA
- Department of Medical Education, 231 Albert Sabin Way, Cincinnati, OH 45267 USA
| | - Andrew R. Thompson
- The University of Cincinnati College of Medicine, Cincinnati, OH USA
- Department of Medical Education, 231 Albert Sabin Way, Cincinnati, OH 45267 USA
| | - D. J. Lowrie
- The University of Cincinnati College of Medicine, Cincinnati, OH USA
- Department of Medical Education, 231 Albert Sabin Way, Cincinnati, OH 45267 USA
| | - Danielle E. Weber
- The University of Cincinnati College of Medicine, Cincinnati, OH USA
- Department of Pediatrics, 231 Albert Sabin Way, Cincinnati, OH 45267 USA
- Department of Internal Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267 USA
| | - Matt Kelleher
- The University of Cincinnati College of Medicine, Cincinnati, OH USA
- Department of Pediatrics, 231 Albert Sabin Way, Cincinnati, OH 45267 USA
- Department of Internal Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267 USA
| | - Laura Malosh
- The University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Carrie Martin
- The University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Heather R. Christensen
- The University of Cincinnati College of Medicine, Cincinnati, OH USA
- Department of Medical Education, 231 Albert Sabin Way, Cincinnati, OH 45267 USA
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Aquino M, Santamaria J, Quadri E, Riegsecker B, Li J, Kim J, Nausheen F, Han V. Comparing Peer-Taught Student Tutors to Faculty-Taught Student Tutors in Educating Medical Students on Musculoskeletal Ultrasound. Cureus 2024; 16:e59166. [PMID: 38803718 PMCID: PMC11129614 DOI: 10.7759/cureus.59166] [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] [Accepted: 04/27/2024] [Indexed: 05/29/2024] Open
Abstract
INTRODUCTION In recent years, medical education has witnessed a shift in the integration of ultrasound into the preclinical years of medical school. Given the exponential increase in accessibility to ultrasound technology, students now have the opportunity to create peer learning groups in which ultrasound concepts can be taught from peer to peer, empowering students to work together to integrate ultrasound concepts early in their preclinical education. This project investigates the efficacy of peer-taught student tutors (PTSTs) in imparting the fundamentals of basic ultrasound techniques to first-year medical students in the setting of identifying and labeling upper extremity musculoskeletal (MSK) anatomy. Methods: First-year medical students were instructed to identify volar forearm structures with an ultrasound probe. Students and instructors were given access to an ultrasound probe, ultrasound gel, an iPad, and a standardized patient. Students were taught either by an ultrasound instructor (UI) or PTST. After a hands-on demonstration by a UI or PTST, participating students were told to take screenshots and label their images as accurately as possible, identifying the aforementioned volar structures on a standardized patient without any feedback. The labeled screenshot images of volar structures were graded based on the ability to clearly visualize the intended structures. Results: The results of this study compare the efficacy of PTSTs as educators of basic sonographic identification techniques with that of UI faculty members. A chi-square analysis was performed between the images obtained by the UI and PTST students, and there was no statistically significant difference in identification accuracy between the groups (p = 0.7538, 0.1977, 0.1812, 0.301). When using the Mann-Whitney U rank test, there remained no statistically significant difference between the accuracy of the students taught by STs compared to students taught by UIs (p = 0.7744, 0.09538, 0.07547, 0.1846). Another finding showed that students belonging to both teaching groups were generally not able to infer the pathology of volar wrist structures when given pathology identification questions regarding upper extremity ultrasound. Using chi-square with Yates correction, there is no sufficient evidence to justify an association between the ability to answer pathology-based ultrasound questions and instructor type (p = p = 0.6299, 0.8725). CONCLUSIONS This study supports the interpretation that the capability of first-year medical students to learn novice MSK sonographic identification is independent of whether the educator is a PTST or UI. This interpretation reveals a promising avenue toward the integration of the fundamentals of ultrasound identification early in medical education with little to no concern for the exhaustion of institutional resources. Along with the other well-documented benefits of the utilization of STs in medical school, a peer tutoring system centered on ultrasound skills designed in the way this study describes can be an effective, resource-sparing system that enhances medical students' sonographic capabilities early in their preclinical years.
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Affiliation(s)
- Matthew Aquino
- Emergency Medicine, California University of Science and Medicine, Colton, USA
| | - Jedd Santamaria
- Anesthesiology, California University of Science and Medicine, Colton, USA
| | - Ebraheem Quadri
- Radiology, California University of Science and Medicine, Colton, USA
| | - Benjamin Riegsecker
- Internal Medicine, California University of Science and Medicine, Colton, USA
| | - Jeffrey Li
- Internal Medicine, California University of Science and Medicine, Colton, USA
| | - Jane Kim
- Internal Medicine, California University of Science and Medicine, Colton, USA
| | - Fauzia Nausheen
- Medical Education, California University of Science and Medicine, Colton, USA
| | - Vy Han
- Medical Education, California University of Science and Medicine, Colton, USA
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Bapuji R, Eagles D, Ferreira N, Hecht N, Zhang Y, Woo MY, Cheung WJ, Ly V, Pageau P. Comparison of peer-assisted learning with expert-led learning in medical school ultrasound education: a systematic review and meta-analysis. CAN J EMERG MED 2024; 26:188-197. [PMID: 38363447 DOI: 10.1007/s43678-024-00663-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 01/30/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Teaching point-of-care ultrasonography (PoCUS) to medical students is resource intensive. Peer-assisted learning, where the teacher can be a medical student, may be a feasible alternative to expert-led learning. The objective of this systematic review and meta-analysis was to compare the PoCUS performance assessments of medical students receiving peer-assisted vs expert-led learning. METHODS This study was submitted to PROSPERO (CRD42023383915) and reported with PRISMA guidelines. MEDLINE, Embase, ERIC, Education Source, Scopus, and Web of Science were searched from inception to November 2022. Inclusion criteria were studies comparing peer-assisted vs expert-led PoCUS teaching for undergraduate medical students. The primary outcome was performance assessment of PoCUS skills. Two reviewers independently screened citations and extracted data. The Cochrane risk-of-bias tool for randomized trials was used to assess study quality. Studies were included in the meta-analysis if mean performance assessment scores with standard deviations and sample sizes were available. A random-effects meta-analysis was conducted to estimate the accuracy score of practical knowledge test for each group. A meta-regression evaluated difference in mean scores. RESULTS The search yielded 2890 citations; 1417 unique citations remained after removing duplicates. Nine randomized-controlled studies conducted in Germany, USA, and Israel, with 593 participants, were included in the meta-analysis. The included studies assessed teaching of abdominal, cardiac, thoracic, musculoskeletal, and ocular PoCUS skills. Most studies had some risk-of-bias concerns. The estimate accuracy score after weighting is 0.56 (95% CI [0.47, 0.65]) for peer-assisted learning and 0.59 (95% CI [0.49, 0.69]) for expert-led learning. The regression coefficient estimate is 0.0281 (95% CI [- 0.1121, 0.1683]); P value is 0.69. CONCLUSION This meta-analysis found that peer-assisted learning was a reasonable alternative to expert-led learning for teaching PoCUS skills to medical students.
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Affiliation(s)
- Raj Bapuji
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Debra Eagles
- Department of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Civic Campus, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Nathan Ferreira
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Nathan Hecht
- Department of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Civic Campus, Ottawa, ON, Canada
| | - Yuxin Zhang
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Michael Y Woo
- Department of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Civic Campus, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Warren J Cheung
- Department of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Civic Campus, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
| | | | - Paul Pageau
- Department of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Civic Campus, Ottawa, ON, Canada.
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Audet CM, Seabi T, Oyekunle T, Hove J, Wagner RG. A individually randomized controlled trial comparing Healer-led vs. clinician- led training to improve personal protective equipment use among traditional healers in South Africa. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002945. [PMID: 38394119 PMCID: PMC10889871 DOI: 10.1371/journal.pgph.0002945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/26/2024] [Indexed: 02/25/2024]
Abstract
Like allopathic healthcare workers, healers are also exposed to patients' blood and body fluids. A widespread practice is the traditional "injection," in which the healer performs subcutaneous incisions to rub herbs directly into the bloodied skin, resulting in 1,500 blood exposures over their lifetime. We tested the impact of healer-led PPE training, staffed by trained traditional healers who reported using PPE during each risky clinical encounter vs. healthcare worker (HCW)-led PPE training sessions. We randomized 136 healers into one of the two study arms (67 in the healer-led group, 69 in the HCW-led group) and assessed the impact of trainer on PPE skills and use over a six-month period. All healers received one in-person day of didactic and practical training followed by three sessions at the healers' home. Participants were largely female (80%), averaged 51 years old, and practiced as a healer for an average of 17 years. Almost 44% either disclosed themselves as HIV+ or received a positive HIV test result at study initiation. Healers in the HCW arm showed equivalent PPE scores as those trained by traditional healers at baseline and at seven months. Healers in both arms self-reported high levels of glove use during"injections," with no statistical difference of use by study arm. When we assessed actual gloves and razor blades disposed of each month, a similar trend emerged. No one seroconverted during the study period. The need for PPE support among traditional healers cannot be ignored. Traditional healers can be trained to effectively disseminate PPE knowledge and skills to other traditional healers. With an estimated 200,000 traditional healers in South Africa, it is imperative that all of them have access to PPE training and supplies to prevent HIV, HCV, or HBV infections. Trial registration: ClinicalTrials.gov, NCT04440813. Registered 17 June 2020, https://clinicaltrials.gov/ct2/show/NCT04440813.
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Affiliation(s)
- Carolyn M. Audet
- Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, United States of America
| | - Tshegofatso Seabi
- MRC/Wits Agincourt Research Unit, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Taofik Oyekunle
- Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, United States of America
| | - Jennifer Hove
- MRC/Wits Agincourt Research Unit, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Ryan G. Wagner
- MRC/Wits Agincourt Research Unit, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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Alt L, Walter R, Harris M, Hari R. Optimal timing of faculty teaching when combined with near-peer teaching: A mixed methods analysis. MEDICAL TEACHER 2024:1-8. [PMID: 38301624 DOI: 10.1080/0142159x.2024.2308788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 01/18/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Near-peer teaching is increasingly used in medical education, supporting or replacing faculty teaching. It has positive aspects for learners and tutors, some of which are explained by higher social and cognitive congruence between learners and near-peer tutors (NPTs). This study investigates the optimal combination of faculty tutors (FTs) and NPTs in an abdominal ultrasound course. METHODS Sixty-four third-year medical students underwent a basic ultrasound course, with 75% of lessons taught by NPTs and 25% by FTs. Each of four groups had a different faculty teaching timing. A mixed methods approach used a survey and semi-structured interviews at the course end to elicit learners' preferences, and end-of-course examination scores to look for differences in outcomes. RESULTS Most learners preferred having faculty teaching in the second half of the course, saying it would be overwhelming to start with FTs. Learners preferred between a quarter and a third of the teaching to be from FTs, with NPTs rated better at teaching basics, and FTs contributing unique, helpful clinical knowledge. There was no significant between-group difference in examination scores. CONCLUSIONS Medical students preferred most of their teaching to be from NPTs, with some faculty input in the second half of the course.
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Affiliation(s)
- Leander Alt
- Dean's Office, Medical Faculty, University of Bern, Bern, Switzerland
| | - Robin Walter
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Michael Harris
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- College of Medicine & Health, University of Exeter Medical School, Exeter, UK
| | - Roman Hari
- Dean's Office, Medical Faculty, University of Bern, Bern, Switzerland
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
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Hari R, Kälin K, Birrenbach T, Tal K, Roumet M, Limacher A, Huwendiek S, Serra A, Walter R. Near-peer compared to faculty teaching of abdominal ultrasound for medical students - A randomized-controlled trial. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2024; 45:77-83. [PMID: 37257839 DOI: 10.1055/a-2103-4787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Medical schools increasingly rely on near-peer tutors for ultrasound teaching. We set out to compare the efficacy of a blended near-peer ultrasound teaching program to that of a faculty course in a randomized controlled trial. METHODS 152 medical students received 21 hours of ultrasound teaching either by near-peer teachers or medical doctors. The near-peer course consisted of blended learning that included spaced repetition. The faculty-led course was the European common course for abdominal sonography. The primary outcome measurement was the students' ultrasound knowledge at month 6, assessed by structured examination (score 0 to 50). Secondary outcomes included scores at month 0 and changes in scores after the course. RESULTS Students in the near-peer group scored 37 points, and students in the faculty group scored 31 points six months after course completion. The difference of 5.99 points (95% CI 4.48;7.49) in favor of the near-peer group was significant (p<0.001). Scores immediately after the course were 3.8 points higher in the near-peer group (2.35; 5.25, p<0.001). Ultrasound skills decreased significantly in the six months after course completion in the faculty group (-2.41 points, [-3.39; -1.42], p<0.001]) but barely decreased in the near-peer group (-0.22 points, [-1.19; 0.75, p=0.66]). CONCLUSION The near-peer course that combined blended learning and spaced repetition outperformed standard faculty teaching in basic ultrasound education. This study encourages medical schools to use peer teaching combined with e-learning and spaced repetition as an effective means to meet the increasing demand for ultrasound training.
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Affiliation(s)
- Roman Hari
- Faculty of Medicine, University of Bern Institute of Primary Health Care, Bern, Switzerland
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University School of Health Professions Education, Maastricht, Netherlands
| | - Kaspar Kälin
- Faculty of Medicine, University of Bern Institute of Primary Health Care, Bern, Switzerland
| | - Tanja Birrenbach
- Emergency Departement, Inselspital University Hospital Bern, Bern, Switzerland
| | - Kali Tal
- Faculty of Medicine, University of Bern Institute of Primary Health Care, Bern, Switzerland
| | - Marie Roumet
- Clinical Trials Unit (CTU), University of Bern, Bern, Switzerland
| | - Andreas Limacher
- Clinical Trials Unit (CTU), University of Bern, Bern, Switzerland
| | - Sören Huwendiek
- Institute for medical education, University of Bern Faculty of Medicine, Bern, Switzerland
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University School of Health Professions Education, Maastricht, Netherlands
| | - Andreas Serra
- Internal Medicine and Nephrology, Hirslanden Klinik Hirslanden, Zurich, Switzerland
| | - Robin Walter
- Faculty of Medicine, University of Bern Institute of Primary Health Care, Bern, Switzerland
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Hari R, Caprez R, Dolmans D, Huwendiek S, Robbiani S, Stalmeijer RE. Describing Ultrasound Skills Teaching by Near-Peer and Faculty Tutors Using Cognitive Apprenticeship. TEACHING AND LEARNING IN MEDICINE 2024; 36:33-42. [PMID: 36322510 DOI: 10.1080/10401334.2022.2140430] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
Phenomenon: Ultrasound skills are becoming increasingly important in clinical practice but are resource-intensive to teach. Near-peer tutors often alleviate faculty teaching burden, but little is known about what teaching methods near-peer and faculty tutors use. Using the lens of cognitive apprenticeship, this study describes how much time faculty and near-peer tutors spend on different teaching methods during abdominal ultrasound skills training. Approach: Sixteen near-peer and 16 faculty tutors were videotaped during one 55-min practical ultrasound lesson with randomly assigned students. Videos were directly coded using Cognitive Apprenticeship teaching methods and activities. Segment durations were summed up and compared quantitatively. Findings: All 32 tutors spent most of the time on observing and helping students (Coaching, Median 29:14 minutes), followed by asking open and stimulating questions (Articulation, 12:04 minutes and demonstrating and giving explanations (Modeling, 04:50 minutes). Overall, distributions of teaching methods used were similar between faculty and near-peer tutors. However, faculty tutors spent more time on helping students manually, whereas near-peer tutors spent more time on exploring students' learning gaps and establishing a safe learning climate. Cognitive Apprenticeship was well suited as observational framework to describe ultrasound skills. Insights: Ultrasound train-the-tutor programs should particularly focus on coaching and articulation. Near-peers' similar use of teaching methods adds to the evidence that supports the use of near-peer teaching in ultrasound skills education.
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Affiliation(s)
- Roman Hari
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- School of Health Professions Education, Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Reto Caprez
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Diana Dolmans
- School of Health Professions Education, Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Sören Huwendiek
- Department for Assessment and Evaluation, Institute for Medical Education, University of Bern, Bern, Switzerland
| | - Sara Robbiani
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Renée E Stalmeijer
- School of Health Professions Education, Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Besse M, Signerski-Krieger J, Engelmann H, Fink N, Methfessel I, Belz M. Community-supported teaching on the topic of transgender identity in undergraduate medical education - a pilot project. GMS JOURNAL FOR MEDICAL EDUCATION 2023; 40:Doc58. [PMID: 37881525 PMCID: PMC10594031 DOI: 10.3205/zma001640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/30/2023] [Accepted: 07/18/2023] [Indexed: 10/27/2023]
Abstract
Introduction and objectives Future physicians are insufficiently prepared for the topic of transgender identity during their studies. Relevant courses during undergraduate medical education are heterogeneous and not widely established within the curricula. At our university, we investigated if students' knowledge of transgender identity could be increased through medical specialist teaching and teaching delivered by representatives of the trans* community (community-supported teaching). Methods During summer semester 2021 (SS21), the knowledge level on transgender identity of 134 medical students in their fifth clinical semester was evaluated (phase 1). In addition, knowledge gain on gender incongruence through the module "psychiatry" was retrospectively surveyed across two dimensions: 1. diagnostic criteria, 2. treatment/care. During winter semester 2021/22 (WS 21/22), a 90-minute seminar on transgender identity was held either community-supported or by medical specialists (phase 2). Following the psychiatry exam, a re-evaluation was carried out by 115 students (phase 3). Results The students in SS21 did not feel sufficiently educated in the topic of transgender identity through their studies, but rated the relevance of the topic for their later profession as high. Learning gain improved after the introduction of the seminar in WS21/22 compared to the previous semester (both dimensions p<.001). Community-supported and specialist teaching achieved equivalent results. Conclusion One 90-minutes seminar led to a significant learning gain regarding the topic of transgender identity. Community-supported teaching is a promising way to impart knowledge in a qualified manner: Medical faculties should use this form of teaching to convey established knowledge to students in future curricula.
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Affiliation(s)
- Matthias Besse
- University Medical Center Göttingen, Clinic for Psychiatry and Psychotherapy, Göttingen, Germany
| | - Jörg Signerski-Krieger
- University Medical Center Göttingen, Clinic for Psychiatry and Psychotherapy, Göttingen, Germany
| | - Hannah Engelmann
- Trans*Counseling Göttingen c/o Queer Center Göttingen, Göttingen, Germany
| | - Né Fink
- Trans*Counseling Göttingen c/o Queer Center Göttingen, Göttingen, Germany
| | - Isabel Methfessel
- University Medical Center Göttingen, Clinic for Psychiatry and Psychotherapy, Göttingen, Germany
| | - Michael Belz
- University Medical Center Göttingen, Clinic for Psychiatry and Psychotherapy, Göttingen, Germany
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Rollmann I, Lauter J, Kuner C, Herrmann-Werner A, Bugaj TJ, Friederich HC, Nikendei C. Tutors´ and Students' Agreement on Social and Cognitive Congruence in a Sonography Peer-assisted-learning Scenario. MEDICAL SCIENCE EDUCATOR 2023; 33:903-911. [PMID: 37546194 PMCID: PMC10403448 DOI: 10.1007/s40670-023-01814-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 08/08/2023]
Abstract
Purpose Peer-assisted learning has become an integral part within medical education and has been proven to be effective in teaching medical skills. Cognitive and social congruence are important factors that explain the effectiveness of peer-assisted learning. However, although theory suggests this, there is no study to date that demonstrates that students and tutors agree upon the level of cognitive and social congruence. Thus, we compared tutors' and students' perception of cognitive and social congruence and their agreement on the causes of congruence. Methods 36 students and 9 tutors from 9 courses were asked to answer questionnaires for their perception of cognitive and social congruence in a peer-assisted learning sonography scenario. Results Students and tutors experienced cognitive congruence (t = 0.8277, df = 8, p = .4318, 95% CI = [-0.232; 0.491]) and social congruence (t = 0.962, df = 8, p = .364, 95% CI = [-0.145; 0.354]) similarly. In contrast, students and tutors disagreed on causes of cognitive congruence (agreement = 53.90%) and social congruence (agreement = 58.49%). Tutors rated their empathy and interest toward students as the main cause. Students rated the helpfulness, effectiveness, and approachableness of the tutor as the main cause. Conclusions Our study filled the gap in previous research on cognitive and social congruence. Consistent with theoretical considerations, it was shown that students and tutors do indeed experience cognitive and social congruence similarly. Nevertheless, differences also emerged that may carry more or less weight depending on the research question. Future studies should therefore carefully examine whether the assessment of cognitive and social congruence of students and tutors is necessary.
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Affiliation(s)
- Ivo Rollmann
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstraße 4, 69115, Heidelberg, Germany
| | - Jan Lauter
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstraße 4, 69115, Heidelberg, Germany
| | - Charlotte Kuner
- Clinical Ultrasound Course at Medical Faculty, University of Heidelberg, Heidelberg, Germany
| | - Anne Herrmann-Werner
- Medical Department VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Medical Faculty Tübingen, Tübingen Institute for Medical Education, Tübingen, Germany
| | - Till J. Bugaj
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstraße 4, 69115, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstraße 4, 69115, Heidelberg, Germany
| | - Christoph Nikendei
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Thibautstraße 4, 69115, Heidelberg, Germany
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Kim JJ, Li JJ, Nguyen Q, Neilson E. The Effectiveness of Student-Led Musculoskeletal and Vascular Ultrasound Workshops at a Single Institution: A Retrospective Survey Analysis. Cureus 2023; 15:e41902. [PMID: 37583741 PMCID: PMC10423848 DOI: 10.7759/cureus.41902] [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] [Accepted: 07/14/2023] [Indexed: 08/17/2023] Open
Abstract
Introduction Point-of-care ultrasound (POCUS) is a rapidly evolving field of diagnostic medicine as its low cost, portability, and versatility have made handheld ultrasound (US) probes an invaluable tool for many modern physicians. Despite US's benefits as a bedside evaluative tool, many medical schools have not integrated POCUS into their pre-clerkship medical education due to a lack of equipment and faculty. The first objective of our study was to determine whether student tutors (STs) would be effective resources to teach musculoskeletal (MSK) and vascular US to preclinical medical students. The second objective of our study was to determine whether students who previously attended ST-run MSK US workshops perform better in vascular US than those who did not. Methods Six POCUS workshops were led by STs after approval from experienced US faculty. These included US workshops on gastrointestinal structures, forearm structures, joint structures, basic echocardiography, and US-guided IV access. We collected data from two of our six workshops. We developed surveys to gauge the confidence and ability of students to perform US after an MSK workshop and US-guided IV access workshop led by STs. We also measured students' US abilities and collected student feedback after our US-guided IV access workshop. We evaluated students' US competency in US-guided IV access via their ability to correctly position the US probe, angle the needle of insertion, move the probe with the needle, and access the vein based on the accuracy of the movements. We divided student results into two groups: students who previously attended the MSK workshop before attending the US-guided IV access workshop and students who did not attend the MSK workshop before attending the US-guided IV access workshop. We used averages, frequencies, and two-tailed t-tests to analyze the survey responses and US-guided IV access skill assessments. Results Fifty percent of first- and second-year surveyed students "agreed," and 32.4% "strongly agreed" that they felt confident using US after an ST-run MSK workshop. About 29.4% of surveyed students "agreed" and 41.2% "strongly agreed" that they felt comfortable explaining basic US concepts, such as proper probe positioning and echogenicity. The group of students who attended the MSK workshop prior to the peripheral IV workshop scored similarly to the students who did not attend the MSK workshop (14.33±1.03 versus 14.20±0.84 points). Both groups of students had an average of over 94% accuracy in technique, positioning, angling, moving the US probe, and achieving US-guided venous access after being taught by STs. Qualitative surveying noted positive student feedback, such as "Teacher was great at guiding us through the procedure." Survey responses also included suggestions on adding and diversifying equipment, such as "[It would be useful to have a] different type of needle to see the difference on ultrasound." Conclusion Based on the high percentages of accuracy and confidence, we found that STs were effective resources to teach MSK and vascular POCUS and that students who attended previous MSK ST-run US workshops had stronger vascular US ability over time compared to those who did not. Our data support the use of STs as US educational resources, especially in institutions without an existing pre-clerkship US curriculum and limited US resources.
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Affiliation(s)
- Jane J Kim
- Education, California University of Science and Medicine, Colton, USA
| | - Jeffrey J Li
- Education, California University of Science and Medicine, Colton, USA
| | - Quang Nguyen
- Education, California University of Science and Medicine, Colton, USA
| | - Eric Neilson
- Family Medicine, California University of Science and Medicine, Colton, USA
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13
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Zhao RT, Deng J, Ghanem G, Steiger A, Tang L, Haase D, Sadeghinejad SE, Shibata J, Chiem AT. Using tele-ultrasound to teach medical students: A randomised control equivalence study. Australas J Ultrasound Med 2023; 26:91-99. [PMID: 37252618 PMCID: PMC10225007 DOI: 10.1002/ajum.12335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Objectives Undergraduate ultrasound education is becoming increasingly important, but its expansion is limited by time, space and the availability of trained faculty. In order to validate an alternative and more accessible teaching model, our aim was to assess whether combining teleguidance and peer-assisted learning to teach ultrasound is as effective as traditional in-person methods. Methods Peer instructors taught 47 second-year medical students ocular ultrasound via either teleguidance or traditional in-person methods. Proficiency was assessed using a multiple-choice knowledge test and objective structured clinical examination (OSCE). Confidence, overall experience, and experience with a peer instructor were measured using a 5-point Likert scale. Two one-sided t-tests were used to measure equivalency between the two groups. The null hypothesis that the two groups were not different was rejected when P < 0.05. Results The teleguidance group performed as well as the traditional in-person group in terms of knowledge change, confidence change, OSCE time and OSCE score (p = 0.011, p = 0.006, p = 0.005 and = 0.004, respectively, indicating the two groups are statistically equivalent). The teleguidance group rated the experience highly overall (4.06/5), but less than the traditional group (4.47/5; P = 0.448, indicating statistical difference). Peer instruction was rated 4.35/5 overall. Conclusion Peer-instructed teleguidance was equivalent to in-person instruction with respect to knowledge change, confidence gain and OSCE performance in basic ocular ultrasound.
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Affiliation(s)
- Renee T. Zhao
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
| | - Jasmine Deng
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
| | - Ghadi Ghanem
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
| | - Athreya Steiger
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
| | - Lara Tang
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
| | - David Haase
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
| | - Sima E. Sadeghinejad
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
| | - Jacqueline Shibata
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
- Department of Emergency MedicineOlive View‐UCLA Medical CenterSylmarCaliforniaUSA
| | - Alan T. Chiem
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
- Department of Emergency MedicineOlive View‐UCLA Medical CenterSylmarCaliforniaUSA
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Weimer J, Rolef P, Müller L, Bellhäuser H, Göbel S, Buggenhagen H, Weimer A, Waezsada E, Kirchhoff F, Weinmann-Menke J. FoCUS cardiac ultrasound training for undergraduates based on current national guidelines: a prospective, controlled, single-center study on transferability. BMC MEDICAL EDUCATION 2023; 23:80. [PMID: 36726093 PMCID: PMC9893662 DOI: 10.1186/s12909-023-04062-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION In emergency and critical-care medicine, focused cardiac ultrasound (FoCUS) is indispensable for assessing a patient's cardiac status. The aim of this study was to establish and validate a peer-to-peer-supported ultrasound course for learning FoCUS-specific skills during undergraduate studies at a German university. METHODS A 1-day, 12 teaching units training course was developed for students in the clinical section of medical college, with content based on the current national guidelines. A total of 217 students participated in the study (97 in the course group and 120 in the control group). The course and the participants' subjective assessment of improved skills were evaluated using a questionnaire (7-point Likert scale; 7 = complete agreement and 1 = no agreement at all). Objective learning gains were assessed by tests before and after the course. These consisted of a test of figural intelligence (eight items) and a test of technical knowledge (13 items). RESULTS The course participants experienced significant improvement (P < 0.001) from before to after the course, with a large effect size of η2part = 0.26. In addition, the course group had significantly better results (P < 0.001) than the control group in the post-test, with a medium to large effect size of η2part = 0.14. No significant differences (P = 0.27) were detected in the test section on figural intelligence. The evaluations showed that the participants had a high degree of satisfaction with the course approach, teaching materials, and tutors. There was also a positive increase in their subjective assessment of their own skills, including areas such as technical knowledge, ultrasound anatomy, and performance of the examination. CONCLUSION The results of both the objective learning assessment and the subjective evaluations suggest that a FoCUS course originally intended for qualified physicians is equally suitable for students. With the development and provision of modern digital teaching media, even more students will be able to benefit from this approach in the future.
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Affiliation(s)
- Johannes Weimer
- Rudolf-Frey Lernklinik, Department of Medicine, University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
| | - Peter Rolef
- Rudolf-Frey Lernklinik, Department of Medicine, University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, University of Mainz, Mainz, Germany
| | - Henrik Bellhäuser
- Institute of Psychology, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Sebastian Göbel
- Department of Medicine II, Cardiology Center, Department of Medicine, University of Mainz, Mainz, Germany
| | - Holger Buggenhagen
- Rudolf-Frey Lernklinik, Department of Medicine, University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Andreas Weimer
- Center for Orthopedics, Emergency Surgery, and Paraplegics, Department of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Elias Waezsada
- Department of Cardiology, Kerckhoff Hospital, Bad Nauheim, Germany
| | - Friederike Kirchhoff
- Rudolf-Frey Lernklinik, Department of Medicine, University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Julia Weinmann-Menke
- Department of Medicine I, Nephrology Center, Department of Medicine, University of Mainz, Mainz, Germany
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15
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Schiavon R, Casella F, Cogliati C. Moving forward with point-of-care ultrasound: An (early) educational effort can (also) strengthen research. Eur J Intern Med 2022; 106:54-55. [PMID: 36229284 DOI: 10.1016/j.ejim.2022.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 09/29/2022] [Indexed: 11/24/2022]
Affiliation(s)
- R Schiavon
- Internal Medicine, L. Sacco Hospital, ASST FBF-Sacco, Milan, Italy
| | - F Casella
- Internal Medicine, L. Sacco Hospital, ASST FBF-Sacco, Milan, Italy
| | - C Cogliati
- Internal Medicine, L. Sacco Hospital, ASST FBF-Sacco, Milan, Italy; Department of biochemical and clinical sciences, University of Milan, Italy.
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16
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Zhang H, Liao AWX, Goh SH, Wu XV, Yoong SQ. Effectiveness of peer teaching in health professions education: A systematic review and meta-analysis. NURSE EDUCATION TODAY 2022; 118:105499. [PMID: 35961134 DOI: 10.1016/j.nedt.2022.105499] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/26/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The reform in health professions education requires the focus to shift from fact memorization to exploring, analyzing, assimilating, and synthesizing information to promote active and collaborative learning. Peer teaching is one of the educational strategies. AIMS This review aimed to explore and synthesize quantitative evidence to determine the overall effect of peer teaching in enhancing students' theoretical knowledge and practical skills (e.g., procedural skills and resuscitation) in health professions education. METHODS PubMed, ScienceDirect, CINAHL, ERIC, ProQuest, reference lists of relevant studies, and reviews were searched till November 2021. Results were pooled using random-effects meta-analysis or narrative synthesis. RESULTS A total of 44 RCTs were included. This review showed a significant effect of peer teaching on procedural skills improvement and a comparable effect on theoretical knowledge and resuscitation skills acquisition compared to the conventional teaching method. Near-peer teaching seemed to be the most effective method for skill improvement. Subgroup analysis showed no significant differences between peer teaching and conventional teaching groups (e.g., expert/faculty teaching, self-study or lectures). CONCLUSIONS Peer teaching seems to be a promising teaching and learning strategy in health professions education, positively affecting theoretical knowledge and procedural skills. Future research should explore the effect of peer teaching in developing countries to provide a comprehensive picture of peer teaching.
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Affiliation(s)
- Hui Zhang
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | | | - Sam Hongli Goh
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Xi Vivien Wu
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Si Qi Yoong
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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17
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Wong BSH, Shorey S. Nursing students' experiences and perception of peer feedback: A qualitative systematic review. NURSE EDUCATION TODAY 2022; 116:105469. [PMID: 35834865 DOI: 10.1016/j.nedt.2022.105469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/14/2022] [Accepted: 07/03/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Peer feedback is an effective learning tool for students, improving academic performance and learning satisfaction. In nursing education, it has been widely used in the assimilation of clinical skills. However, the effectiveness of peer feedback as an educational intervention needs to be evaluated holistically beyond intervention research, considering students' perception to garner valuable insights to guide the successful implementation of peer feedback. OBJECTIVE This review aimed to consolidate the qualitative evidence exploring perceptions and experiences of nursing students who have used peer feedback as a learning tool. DESIGN Qualitative systematic review. DATA SOURCES Nine databases were searched from their respective inception dates until December 2021. REVIEW METHODS Data were extracted using a modified Joanna Brigg's qualitative data extraction tool, and the Critical Appraisal Skills Programme (CASP) tool was used to appraise the quality of included studies. Meta-synthesis was done using Sandelowski and Barroso's two-step approach. RESULTS The review included 14 studies and the synthesis identified an overarching theme: 'feeling lost to finding ways' and four themes: (1) An uncomfortable learning experience; (2) confronting disagreements; (3) greater engagement with learning; and (4) value added beyond learning. CONCLUSION The present review summed up the wide range of nursing students' experiences, from feeling inadequate and having little confidence in the usefulness of peer feedback to reaping valuable benefits in terms of teamwork and leadership skills. The nursing curriculum could include peer feedback; however peer students adequate training and support. Future research could focus on developing and evaluating preparatory programs to improve the learning experiences of nursing students using peer feedback.
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Affiliation(s)
- Bryan Shi Hong Wong
- Nursing Division, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore.
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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18
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Ganesananthan S, Zahid A, Choudhry A, Vadiveloo TV, Khan N, Yang T, Urrehman H, Mahesh S, Yousef Z. The Utility and Educational Impact of a Virtual Webinar to Deliver an International Undergraduate Cardiovascular Conference. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:993-1002. [PMID: 36072821 PMCID: PMC9441587 DOI: 10.2147/amep.s376114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Conferences are an important avenue for dissemination of knowledge, research and provide networking opportunities for career development. The COVID-19 pandemic has prompted adoption of virtual platforms for delivery of these conferences. The aim of the study was to determine the utility and educational impact of a student-led virtual webinar to deliver an undergraduate cardiovascular conference compared to a traditional in-person conference. METHODS We conducted a two-day virtual conference using the Zoom platform in June 2021. The conference consisted of cardiology subspecialty lectures, and workshops were conducted by a junior doctor, senior cardiology trainees and consultants. The conference also outlaid a virtual poster hall and oral presentation session while networking opportunities were encouraged using breakout rooms and poster hall chat function. A 38-item self-administered online questionnaire was designed and disseminated at the end of the conference to all attending delegates. All data analysis and data visualisation strategies were conducted on R statistical programming. RESULTS Eight-hundred and forty students from 55 countries attended the event. Four hundred and ninety participants (58.5% response rate, 55.9% female) completed the questionnaire. Factors such as weekend conference (84.9%), student-led or organised (84.1%), environmental/sustainable (82.3%), appropriate level for me (81.5%) and comfort to present (80.8%) were deemed to be at least equal to traditional in-person conference. The conference also increased participants' interest, their core cardiology knowledge and improved their critical analysis and basic echocardiography skills [median 4 (IQR 3-5) for all parameters]. Overall, participants also found it easy to use the virtual platform [median 5 (IQR 5-5)] and easier to ask questions compared to in-person conferences [median 5 (IQR 4-5) vs median 4 (IQR 3-5), p < 0.001]. CONCLUSION Our virtual conference provided opportunities to students that the COVID-19 pandemic would have otherwise affected; however, its utility and educational impact will need to be assessed within its individual context of delivery.
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Affiliation(s)
- Sashiananthan Ganesananthan
- National Heart and Lung Institute, Imperial College London, London, UK
- Cardiff University School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Abeer Zahid
- Cardiff University School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Anam Choudhry
- Cardiff University School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Thivya V Vadiveloo
- Cardiff University School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Nailah Khan
- Cardiff University School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Ting Yang
- Cardiff University School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Haroon Urrehman
- Cardiff University School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Sahana Mahesh
- Cardiff University School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Zaheer Yousef
- Cardiff University School of Medicine, Cardiff University, Cardiff, Wales, UK
- Department of Cardiology, University Hospital Wales, Cardiff, Wales, UK
- Welsh Heart Research Institute, Cardiff University, Cardiff, Wales, UK
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Kloth C, Schmidt SA, Graeter T, Nikolaou K, Kaufmann S, Beer M, Thaiss WM. Evaluation of an elective ultrasound course for medical students. Clin Anat 2022; 35:354-358. [PMID: 35128729 DOI: 10.1002/ca.23838] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 12/23/2021] [Accepted: 01/21/2022] [Indexed: 01/08/2023]
Abstract
To evaluate the educational benefits of teaching ultrasound in an elective radiological course for medical students. We conducted a single-center retrospective analysis of a one-week elective ultrasound course in which 39 medical students (25 female; median age 25.8 ± 2.8 years, range 21-35, 4th and 5th years of undergraduate medical education) participated as part of their radiological training. The students completed a pre- and post-course questionnaire using a five-point Likert scale for self-assessment of technical knowledge, confidence in the procedure regarding different organs, motivation for performing ultrasound, and the importance of ultrasound in medical education. The students also assessed the value of ultrasound teaching in the context of their general medical degree. Pre-test and post-test scores showed significantly improved radiology knowledge (p ≤ 0.001) concerning all abdominal organs (liver, spleen, gallbladder, kidney, urinary bladder, aorta and retroperitoneum). A significant improvement was registered in performing ultrasound of peripheral arteries and venous structures (each p = 0.001), and also of the thyroid gland (p = 0.006). General surveys at the end of the elective were overwhelmingly positive, with constructive criticism and complimentary comments. Systematic training in ultrasound markedly improved the students' skills. This was especially pronounced for solid organ structures, while students requested more education regarding the retroperitoneum and vascular structures. Teaching ultrasound in an elective hands-on training course improves anatomical understanding and practical skills associated with increased motivation. The results affirm the necessity and clinical relevance of the course during the radiological training of medical students.
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Affiliation(s)
- Christopher Kloth
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Ulm, Germany
| | - Stefan Andreas Schmidt
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Ulm, Germany
| | - Tilmann Graeter
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Ulm, Germany.,Department of Neuroradiology, Vascular and Interventional Radiology, LKH University Clinic, Auenbruggerplatz, 1, 8036 Graz, Austria
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls University, Tübingen, Germany
| | - Sascha Kaufmann
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls University, Tübingen, Germany.,Clinic of Urology, Siloah St. Trudpert Klinikum, Pforzheim, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Ulm, Germany
| | - Wolfgang Maximilian Thaiss
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Ulm, Germany.,Department of Diagnostic and Interventional Radiology, Eberhard-Karls University, Tübingen, Germany.,Department of Nuclear Medicine, Ulm University Medical Center, Ulm, Germany
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20
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Ultrasonography in undergraduate medical education: a comprehensive review and the education program implemented at Jichi Medical University. J Med Ultrason (2001) 2022; 49:217-230. [PMID: 35034230 PMCID: PMC8761092 DOI: 10.1007/s10396-021-01178-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/01/2021] [Indexed: 11/03/2022]
Abstract
The concept of point-of-care ultrasound has been widely accepted owing to the development of portable ultrasound systems and growing body of evidence concerning its extensive utility. Thus, it is reasonable to suggest that training to use this modality be included in undergraduate medical education. Training in ultrasonography helps medical students learn basic subjects such as anatomy and physiology, improve their physical examination skills, and acquire diagnostic and procedural skills. Technological advances such as simulators, affordable handheld devices, and tele-ultrasound systems can facilitate undergraduate ultrasound education. Several reports have indicated that some medical schools have integrated ultrasound training into their undergraduate medical curricula. Jichi Medical University in Japan has been providing medical students with ultrasound education to fulfill part of its mission to provide medical care to rural areas. Vertical integration of ultrasound education into a curriculum seems reasonable to ensure skill retention and improvement. However, several issues have hampered the integration of ultrasound into medical education, including a lack of trained faculty, the need to recruit human models, requisition of ultrasound machines for training, and limited curricular space; proposed solutions include peer teaching, students as trained simulated patients, the development of more affordable handheld devices, and a flipped classroom approach with access to an e-learning platform, respectively. A curriculum should be developed through multidisciplinary and bottom-up student-initiated approaches. Formulating national and international consensuses concerning the milestones and curricula can promote the incorporation of ultrasound training into undergraduate medical education at the national level.
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Miller C, Weindruch L, Gibson J. Near Peer POCUS Education Evaluation. POCUS JOURNAL 2022; 7:166-170. [PMID: 36896277 PMCID: PMC9979912 DOI: 10.24908/pocus.v7i1.15019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: At Texas College of Osteopathic Medicine (TCOM), point of care ultrasound (POCUS) is taught to medical students in conjunction with trained medical student teaching assistants (TAs). The purpose of our study is to evaluate the effectiveness of near peer teaching in the setting of ultrasound education. We hypothesized that this would be the preferred learning technique among TCOM students and TAs. Methods: To evaluate our hypotheses about the value of near peer instruction, we created two comprehensive surveys for students to share their experiences with the ultrasound program. One survey was for general students and the other survey was for students designated as TAs. The surveys were sent via email to second and third-year medical students. Results: General Student Population Survey Results: Of the 63 students who took the survey, 90.4% agreed that ultrasound is an integral part of medical education, 79.4% of students either agreed or strongly agreed that ultrasound improves their understanding of systems-based course material, 53.9% of students prefer near peer techniques over other teaching methods, while only 38.7% of students would prefer faculty-led sessions. 73% of students agreed that their ultrasound skills have improved with peer-led sessions, 71.4% of students agreed that peer-led sessions have made them want to pursue additional ultrasound training, and 96.8% of students report that they are very likely or somewhat likely to use POCUS in their future practice. Ultrasound Teaching Assistant Survey Results: Nineteen TAs responded to the survey, of which 78.9% assisted with more than 4 teaching sessions, 84.2% attended more than 4 TA training sessions, 94.7% reported spending additional time practicing ultrasound outside of TA activities each week, 100% agreed or strongly agreed that being an ultrasound TA has helped their medical education, and 78.9% either agreed or strongly agreed that they feel competent in their ultrasound skills. Among TAs, 78.9% preferred near peer techniques over other teaching methods, 100% agreed or strongly agreed that being a TA has helped develop their ultrasound skills, and 100% were likely or very likely to use POCUS in their future practice. Conclusions: Based on the results of our surveys, we were able to conclude that near peer teaching is the preferred learning method among students at our institution, and TCOM students found ultrasound to be a beneficial adjunct to systems courses in medical school education.
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Affiliation(s)
| | | | - John Gibson
- Texas College of Osteopathic Medicine Texas USA
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22
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Khapre M, Deol R, Sharma A, Badyal D. Near-Peer Tutor: A Solution For Quality Medical Education in Faculty Constraint Setting. Cureus 2021; 13:e16416. [PMID: 34422460 PMCID: PMC8369978 DOI: 10.7759/cureus.16416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 12/24/2022] Open
Abstract
Near-peer mentoring is a formal relationship in which more qualified students guide immediate junior students. It is an innovative approach to increase students' engagement from varied backgrounds and cultures in the health profession. This systematic review and meta-analysis aimed to investigate and compare the effectiveness of near-peer tutoring and faculty/expert teaching in health science undergraduates on knowledge and skill outcome. The review question considered was "how effective is near-peer tutor compare to faculty/expert teaching for undergraduate health science students?" A comprehensive systematic search was undertaken in PubMed, Embase, Scopus, and Cochrane and screened initially in Rayyan software (Qatar Computing Research Institute, Qatar). Identified articles were screened independently for eligibility by two reviewers and extracted the data. Data were analyzed using standardized mean difference with Review manager version 5.5 (Cochrane Campbell Collaboration). Sixteen studies were analyzed. Heterogeneity (I2) among studies was high in knowledge and skill scores. Heterogeneity was reduced by 30-40% after sensitivity analysis. No difference in knowledge and skill score was found among the near-peer and expert teaching groups. Students had a satisfactory learning experience with near-peer tutors except for some issues related to teaching proficiency in near-peers. Near-peer teaching was found to be as effective as faculty/expert teaching. Students were more comfortable with near-peers. As mentioned by students, some challenges were differences in teaching skills and level of knowledge among near-peers.
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Affiliation(s)
- Meenakshi Khapre
- Social Preventive Medicine, All India Institute of Medical Sciences, Rishikesh, IND
| | - Rupinder Deol
- College of Nursing, All India Institute of Medical Sciences, Rishikesh, IND
| | - Anusha Sharma
- Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, IND
| | - Dinesh Badyal
- Pharmacology, Christian Medical College, Ludhiana, IND
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23
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Audet CM, Shepherd BE, Aliyu MH, Moshabela M, Pettapiece-Phillips MJ, Wagner RG. Healer-led vs. clinician-led training to improve personal protective equipment use among traditional healers in South Africa: a randomized controlled trial protocol. Glob Health Action 2021; 14:1898131. [PMID: 33797347 PMCID: PMC8023590 DOI: 10.1080/16549716.2021.1898131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/01/2021] [Indexed: 11/30/2022] Open
Abstract
There are estimated two million traditional healers in sub-Saharan Africa (SSA), with more than 10% (200,000) working in South Africa. Traditional healers in SSA are frequently exposed to bloodborne pathogens through the widespread practice of traditional 'injections', in which the healers perform dozens of subcutaneous incisions to rub herbs directly into the bloodied tissue with their hands. Healers who report exposure to patient blood have a 2.2-fold higher risk of being HIV-positive than those who do not report exposure. We propose a randomized controlled trial (61 healers in the intervention group and 61 healers in the control group) in Mpumalanga Province. Healers will receive personal protective equipment (PPE) education and training, general HIV prevention education, and three educational outreach visits at the healer's place of practice to provide advice and support for PPE use and disposal. Healers in the control arm will be trained by health care providers, while participants in the intervention arm will receive training and outreach from a team of healers who were early adopters of PPE. We will evaluate intervention implementation using data from surveys, observation, and educational assessments. Implementation outcomes of interest include acceptability and feasibility of PPE use during clinical encounters and fidelity of PPE use during treatments that involve blood exposure. We will test our two intervention strategies to identify an optimal strategy for PPE education in a region with high HIV prevalence.
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Affiliation(s)
- Carolyn M. Audet
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa
| | - Bryan E. Shepherd
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Muktar H. Aliyu
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mosa Moshabela
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | | | - Ryan G. Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa
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24
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Khoury M, Fotsing S, Jalali A, Chagnon N, Malherbe S, Youssef N. Preclerkship Point-of-Care Ultrasound: Image Acquisition and Clinical Transferability. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2020; 7:2382120520943615. [PMID: 32754649 PMCID: PMC7378712 DOI: 10.1177/2382120520943615] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/18/2020] [Indexed: 06/01/2023]
Abstract
INTRODUCTION The integration of point-of-care ultrasound (POCUS) in preclerkship medical education is currently popular and based on the notion that POCUS may improve diagnostic and procedural skills in medical students. However, empirical evidence demonstrating that POCUS can enhance clinical skills in preclerkship students has been lacking. We sought to evaluate anatomical sonographic knowledge and ultrasound generation capabilities associated with the implementation of a 3-h echocardiography training camp led by 2 emergency physicians and using a flipped classroom design. METHODS Preclerkship students from the University of Ottawa (n = 32) were recruited to participate. A flipped classroom model was adopted, providing students with a 3-chaptered peer-designed, expert validated ultrasound manual before the workshop, to maximize scanning times (2 h of reading). A pretest Likert-type design was used to assess student perception of the ultrasound tool. Similarly, a pretest/post-test model was used to assess sonographic anatomical identification. In addition, a subsequent Objective Structured Clinical Examination (OSCE) test was done 3 weeks after the hands-on session, to evaluate image generation (4 cardiac views: parasternal long, parasternal short, subxiphoid, and apical 4 chambers), understanding of knobology and structural labeling. RESULTS For the sonographic anatomy, there was a statistically significant increase (P < .001) between pretest (average = 12.12) and post-test (average = 18.85). The OSCE, which also ascertained knowledge retention, found that 81% of students were able to generate all 4 cardiac views perfectly, 6% were able to obtain 3 views, 10% obtained 2 views and 3% successfully generated a single view. The most challenging scan to generate was the apical 4-chamber view. CONCLUSION The positive outcomes stemming from this study reinforces the notion that formal curricular integration of POCUS at the preclerkship level has tangible benefits for medical students.
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Affiliation(s)
- Michel Khoury
- Faculty of Medicine, University of
Ottawa, Ottawa, ON, Canada
- Affaires Francophones, University of
Ottawa, Ottawa, ON, Canada
| | - Salomon Fotsing
- Affaires Francophones, University of
Ottawa, Ottawa, ON, Canada
| | - Alireza Jalali
- Faculty of Medicine, University of
Ottawa, Ottawa, ON, Canada
| | - Nicolas Chagnon
- Department of Emergency Medicine,
Montfort Hospital, Ottawa, ON, Canada
| | | | - Nermine Youssef
- Faculty of Medicine, University of
Ottawa, Ottawa, ON, Canada
- Affaires Francophones, University of
Ottawa, Ottawa, ON, Canada
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