A flipped classroom, same-level peer-assisted learning approach to clinical skill teaching for medical students

Come Roll with Me: An Interprofessional Experience to Promote Disability Awareness

Problem: One in four American adults have a disability, which makes people with disabilities the largest minority group in the United States (U.S.). Chronic diseases are prevalent within this population, which faces myriad barriers that limit access to healthcare and create significant health care disparities. Yet, disability awareness programs are limited in U.S. medical schools and graduates report a sense of unpreparedness to care for this population. Intervention: Come Roll with Me (CRWM) was implemented as an interprofessional, preclinical experience to provide medical and Doctor of Physical Therapy (DPT) students an opportunity to engage with wheelchair users and one another. Students rotated through four stations with a licensed physical therapist and wheelchair user facilitator. Stations included (1) manual wheelchair self-propulsion, (2) accessible parking, (3) transfers, and (4) open dialog on barriers to healthcare led by the wheelchair user. Context: This study sought to assess the impact of CRWM on students' understanding of the barriers and health disparities faced by individuals with disabilities. Assessment was conducted using course evaluations, thematic analysis of student reflection essays and a focus group with the wheelchair user facilitators to determine if CRWM met pre-implementation program goals and objectives, including the Interprofessional Educational Collaborative (IPEC) core competencies. Impact: Student reflections from both disciplines indicated that learners were able to identify a variety of barriers faced by people with disabilities and prioritize methods to mitigate these factors. Approximately 91% of medical students agreed or strongly agreed that CRWM was effective in their learning on course evaluations. Wheelchair user facilitators noted three important outcomes of CRWM: educating, teaming, and impact on students. Lesson Learned: Come Roll with Me is a robust educational activity, as evidenced by the program meeting all goals and objectives as well as (IPEC) core competencies. It provides students a unique opportunity to learn about disability from another profession and wheelchair users. People with disabilities and DPT students are a unique and underutilized pool of educators in undergraduate medical education.

Evaluation of the effectiveness of using flipped classroom in puncture skills teaching

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.

Integrating New Learning Methods into Equine Nutrition Classrooms: The Importance of Students' Perceptions

Despite greater efforts made over recent years to teach animal nutrition to veterinary students, more needs to be done to develop teaching methods and improve education on equine nutrition. The flipped classroom and peer-assisted learning (FC/PAL) approach is a teaching technique suggested to support learning; however, research into FC/PAL in veterinary education is scarce and little is known about students' views on this approach. This study examined the results of a questionnaire administered to assess veterinary students' perceptions of/views about the suitability of FC/PAL applied in an equine nutrition course. Correlation analysis of students' responses to questionnaire items and principal component analysis (PCA) was performed to analyze the variability in student perceptions. The results showed that although half the students reported to be uninterested in equine nutrition, most expressed positive attitudes towards FC/PAL. Comparing the perceptions/views towards FC/PAL among low and high achievers, a significant difference was found for the item considering the duration of FC/PAL (P = .002). Correlation analysis between questionnaire items showed a predominance of positive moderate correlations among high achievers and weak correlations among low achievers. PCA revealed three important findings. First, student interest towards equine nutrition explains the response variability among low achievers. Second, there was significant agreement among almost all high achievers regarding the duration of the FC/PAL. Third, in the item evaluating the usefulness of collaborating with peers, disagreement was only found among low achievers. In summary, a flipped classroom combined with the same level peer-assisted learning appears to encourage student interaction and collaboration in the classroom.

The Role of Collaborative Observational Practice and Feedback-Discourse to Promote Remote Acquisition of Technical Surgical Skills

INTRODUCTION

Acquisition of technical skills remotely in a decentralized model requires an efficacious way of providing feedback. The primary objective was to test the efficacy of various forms of feedback on the acquisition of surgical skills by medical students.

METHODS

Forty volunteers were randomized to four experimental groups, differing from the nature of feedback (free text versus structured) and who provided the feedback (expert versus peer learners). They had to perform sutures and upload attempts on a learning management system to receive interactive feedback. The pretest and retention test performances were assessed.

RESULTS

All groups significantly improved from pretests to retention tests; however, participants using checklist showed statistically lower improvements than the other groups, which did not differ from each other.

CONCLUSIONS

Remote learners can acquire surgical skills, and most importantly, peers who provide feedback, are as effective as experts if they use open-ended comments and not checklists.

Flipping the classroom in neurological bedside teaching: a prospective controlled study

BACKGROUND

Bedside teaching is essential to foster core clinical competences in medical education, especially in Neurology. However, bedside skills are declining and new concepts to enhance the effectiveness of bedside teaching are needed, also in view of limited in-person teaching possibilities in the ongoing pandemic situation. If theoretical knowledge is taught prior to in-person sessions this might allow to better focus on practical application aspects during bedside teaching. We thus aimed to answer the question to what extent such an approach can enhance the effectiveness of neurological bedside teaching.

METHODS

In this prospective controlled study, neurological bedside courses following a traditional and a flipped classroom (FC) approach were compared with regards to their effects on theoretical knowledge and practical skills of medical students. Evaluations were obtained from 161 students and their lecturers participating in a neurological bedside teaching course at a German university hospital between October 2020 and July 2021. Students were randomly assigned to course dates. However, the 74 students assigned to course dates from May to July 2021 completed a mandatory online preparation course prior to the bedside teaching. These students served as the interventional group (IG) and the remaining 87 students formed the control group (CG). Ratings of knowledge and skills provided by the students and their lecturers on numerical rating scales served as primary outcome measures. Moreover, the time needed to recapitulate theoretical contents during the in-person teaching session was assessed as a secondary outcome measure. Group comparisons were performed using t-statistics.

RESULTS

Theoretical knowledge upon entering the course was rated significantly higher in the IG by the students (p < 0.001) and lecturers (p = 0.003). Lecturers also rated the practical skills of students in the IG significantly higher (p < 0.001). Furthermore, significantly less time was needed to recapitulate theoretical contents during the in-person session in the IG (p = 0.03).

CONCLUSIONS

Using a FC approach enhances the effectiveness of in-person neurological bedside teaching. Thus, these concepts are particularly valuable in the ongoing pandemic situation. Moreover, they might allow to reuse e-learning contents developed during the pandemic and to develop future bedside teaching concepts.