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Hu X, Li J, Wang X, Guo K, Liu H, Yu Q, Kuang G, Zhang S, Liu L, Lin Z, Huang Y, Xiong N. Medical education challenges in Mainland China: An analysis of the application of problem-based learning. MEDICAL TEACHER 2024:1-16. [PMID: 39073879 DOI: 10.1080/0142159x.2024.2369238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 06/13/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND The medical education system in mainland China faces numerous challenges and the lack of learner-centered approaches may contribute to passive learning and reduced student engagement. While problem-based learning (PBL) is common in Western medical schools, its feasibility in China is questioned due to cultural differences. This systematic review aims to summarize the application of PBL in medical education in mainland China based on existing literature, as well as to identify the challenges and opportunities encountered in its implementation. METHODS A systematic literature review was conducted using electronic databases, including MEDLINE, Cochrane Library, EMBASE, Web of Science, Wan fang and CNKI databases. Grey literature sources were explored using Google Scholar. The search was limited to articles that include at least one English abstract up to May 1st, 2023. The inclusion criteria were studies that reported the use of PBL in medical education in mainland China. RESULTS A total of 21 articles were included in the final analysis. The findings indicate that PBL is a well-adopted and effective learning method in most medical education, especially for developing critical thinking, problem-solving, and teamwork skills. However, the application of PBL in mainland China is limited due to various challenges, including faculty resistance, inadequate resources and cultural barriers. To effectively address these challenges, it is essential to provide faculty training, develop appropriate assessment methods to evaluate student progress within the PBL framework and create conducive spaces and resources that support collaborative learning and critical thinking. CONCLUSION The utilization of PBL in mainland China holds potential for enhancing medical education. However, its successful implementation requires significant efforts to address the identified challenges. It is crucial to engage stakeholders in a collaborative effort to promote the application of PBL and ultimately improve the quality of medical education in mainland China.
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Affiliation(s)
- Xinyu Hu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China
| | - Jingwen Li
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China
| | - Xinyi Wang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China
| | - Kexin Guo
- Department of Ophtalmology, The First Affliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hanshu Liu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China
| | - Qinwei Yu
- Department of Cardiology, Wuhan Red Cross Hospital, Hubei, China
| | - Guiying Kuang
- Department of Neurology, Wuhan Red Cross Hospital, Hubei, China
| | - Shurui Zhang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China
| | - Long Liu
- Department of Neurology, Wuhan Red Cross Hospital, Hubei, China
| | - Zhicheng Lin
- Laboratory of Psychiatric Neurogenomics, McLean Hospital, Harvard Medical School Belmont, USA
| | - Yaling Huang
- Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China
| | - Nian Xiong
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China
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Yang W, Zhang X, Chen X, Lu J, Tian F. Based case based learning and flipped classroom as a means to improve international students' active learning and critical thinking ability. BMC MEDICAL EDUCATION 2024; 24:759. [PMID: 39010040 PMCID: PMC11247815 DOI: 10.1186/s12909-024-05758-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 07/09/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND International student education has become an important part of higher education and an important symbol to measure the level of higher education. To change the traditional teaching model, here we introduced a combination of Case-Based Learning (CBL)and Flipped Classroom (FC) into the pathophysiology course for international students. This study aimed to explore whether the active learning ability and critical thinking ability of international students can be improved, based on this new teaching model, improving the innovation ability of teachers' team and students' attitude to the reform. METHODS The two chapters of Cardiac Insufficiency and Apoptosis in Pathophysiology are designed as a CBL + FC teaching method. Distribute the Self-assessment Scale on Active Learning and Critical Thinking (SSACT) and satisfaction questionnaire to international students to evaluate teaching reform based on CBL + FC. RESULTS Compared with the traditional classroom, the online flipped classroom based on CBL has significantly improved the learning enthusiasm, as these students are required to independently complete literature review, actively participate in classroom teaching, learn to use multiple learning strategies, and collaborate with other students to complete PowerPoint (PPT)production. At the same time, the students' ability to raise problems and solve problems has been greatly improved by analyzing clinical cases; By consulting the literature, the theoretical knowledge learned can be better applied to clinical analysis. The results of the satisfaction survey also show that international students are more likely to accept the flipped classroom teaching mode. CONCLUSIONS This teaching mode will stimulate the learning motivation of international students, enhance teaching attraction and increase teaching interaction; At the same time, the CBL + FC teaching method can strengthen the evaluation of international students' in and out of class and online learning, enhance students' active learning ability and critical thinking ability, promote the development of personalized learning, and integrate with international medical education.
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Affiliation(s)
- Wanjing Yang
- Department of Pathophysiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Xiaoyan Zhang
- Department of Pathophysiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Xinhuan Chen
- Department of Pathophysiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Jing Lu
- Department of Pathophysiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Fang Tian
- Department of Pathophysiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, China.
- Department of Pathology and Forensic Medicine, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, China.
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Leigh L, Mok ZH. The effect of different patient-based learning models on student perceptions of empathy, engagement, knowledge, and learning experience. MEDICAL TEACHER 2024:1-8. [PMID: 38608671 DOI: 10.1080/0142159x.2024.2337254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/26/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Problem-based learning is used widely in pharmacy and medical programmes, incorporating realistic patient scenarios into regular teaching as a way of linking theory to practice. Routine case-based learning lessons ranges from real patient involvement, scripted patient scenarios, digital simulations (avatars) as well as through media such as Zoom. The existing literature has explored the extensive benefits of using patients in clinical education, but fewer studies have directly compared the efficacy of each model as learning tools. AIM To compare student perceptions of patient-based learning models to elicit student empathy, increase engagement, improve knowledge, and enrich learning experience. METHODS A questionnaire was distributed to second-year pharmacy students in Swansea University to gather their perceptions on the nine different patient-based learning models in their routine teaching (SUMS RESC 2023-0011). Students were asked to rank their experience of the models explicitly against each other, based on the four pillars of (1) eliciting student empathy, (2) increasing engagement, (3) improving knowledge and (4) enriching the learning experience. Students were also asked to rate the significance of realism (i.e. knowing the patient demographics/having a visual representation of the patient) to their experience. RESULTS Altogether, 31 student rankings of the nine learning models were weighted (9 = highest rank; 1 = lowest ranked). The data showed clear preferences for real-patient involvement over fictional cases, especially for eliciting empathy. Interestingly, scripted scenarios were rated highly for both engagement and learning experience only when avatars were involved, which suggests a role of animated visual representation of the patient in facilitating these outcomes. CONCLUSION Whilst it is useful to have multiple patient-based learning models, this study serves as a guide for educators in preparing case-based learning sessions for achieving the desired outcomes of any of the four pillars above.
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Affiliation(s)
- Luke Leigh
- Swansea University Medical School, Swansea, UK
| | - Zi Hong Mok
- Swansea University Medical School, Swansea, UK
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Kim DH, Yang HK, Baek C, Seo J, Hwang JM. Efficacy of 3D-printed eye model to enhance retinoscopy skills. Sci Rep 2024; 14:4207. [PMID: 38378728 PMCID: PMC10879193 DOI: 10.1038/s41598-024-53321-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/30/2024] [Indexed: 02/22/2024] Open
Abstract
We conducted a prospective study to evaluate the efficacy of simulation-based education using a three-dimensional (3D)-printed schematic eye model in improving the retinoscopy refraction skills of medical students. A schematic eye model was printed using a fused deposition modeling-based 3D printer. Twenty medical students randomized into 3D (n = 10) and control (n = 10) groups received a 1-h lecture on the principles and methods of manifest refraction and were shown how to use the retinoscope and sciascope bars. The 3D group additionally attended a tutorial on the schematic eye. Both groups performed refractive examinations on four eyes of volunteer patients, and the results were recorded as a baseline. Instructor feedback and refraction practice was provided with the 3D group or with control group. To account for subject fatigue, patients spent no more than 8 min on the examination. After a 1-h break to allow for fatigue and familiarity, refraction tests were repeated on four randomly selected eyes of patients. Students' refraction readings were compared with the autorefractor values using a spherical equivalent value and blur strength. All participants measured the time required to complete the refraction test and reported their subjective confidence in the results of each refraction test. Refractive errors before and after training did not differ between the control and 3D groups, with a significant improvement in errors observed in both groups (p = 0.005 and 0.008, respectively). The time to complete refraction before and after training did not differ between the two groups, both of which showed a significant reduction in time (p = 0.005 and 0.028, respectively). Pre- and post-training confidence scores for the accuracy of each refraction on a 10-point Likert scale were not significantly different. However, when comparing score changes between pre- and post-training, only the control group showed a significant increase in confidence (p = 0.005). Tests for the non-inferiority of refractive errors after training indicated that the 3D group was non-inferior to the control group. In conclusion, training in retinoscopy refraction skills using a 3D-printed eye model resulted in significant improvement in accuracy and speed compared to practice with real patients. Except for better confidence in the control group, schematic eye model training was not inferior to practice with real patients.
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Affiliation(s)
- Dong Hyun Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hee Kyung Yang
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Changhoon Baek
- Department of Transdisciplinary Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
| | - Jongmo Seo
- Department of Electrical and Computer Engineering, Seoul National University College of Engineering, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jeong-Min Hwang
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
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Kliesener T, Jandek M, Navarini A, Brandt O, Müller S. Dermatology teaching for undergraduate medical students in clinical routine - a structured four-week curriculum. BMC MEDICAL EDUCATION 2024; 24:116. [PMID: 38321407 PMCID: PMC10848555 DOI: 10.1186/s12909-023-04921-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 11/30/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND Dermatology teaching is fundamental for the promotion of young colleagues in our specialty. However, traditional teaching methods are being scrutinized by students of the 'Generation Y and Z', which can pose new challenges for teaching institutions. We therefore aimed to assess the motivational impact and reception of a newly created four-week curriculum containing modernized teaching methods integrated into clinical routine. METHODS In this single-center study, 67 medical students completed this curriculum composed of weekly learning objectives including knowledge of morphological terms, 10 common dermatoses, communication and presentation skills. The participants provided information on their level of interest in dermatology each week as well as positive and negative aspects of the curriculum. RESULTS During the curriculum a significant median increase in interest in dermatology was reported with no differences between the genders. Low initial interest could be improved, high initial interest maintained. Participants with an interest in scientific work (20.9%) were more motivated during the curriculum. The variety, quality of teaching and structure were the main aspects rated positively. Suggestions for improvement included the need for more teaching by senior doctors, transfer of responsibility, and a working environment updated to the latest technology standards. CONCLUSION The presented curriculum was well received by the participants and allowed to better define learning preferences of new generations which can be helpful to modernize traditional teaching methods. Interest in scientific work could be a factor to identify students with a particularly strong interest in dermatology.
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Affiliation(s)
- Tobias Kliesener
- Dermatologische Klinik, Universitätsspital Basel, Basel, Switzerland.
| | - Madeleine Jandek
- Dermatologische Klinik, Universitätsspital Basel, Basel, Switzerland
| | | | - Oliver Brandt
- Dermatologische Klinik, Universitätsspital Basel, Basel, Switzerland
| | - Simon Müller
- Dermatologische Klinik, Universitätsspital Basel, Basel, Switzerland
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Bai S, Jiang H, Wang T, Yang D, Liu Y, Xu C, Zhang L, Zhang Y. An acceptability study of the introduction of total online or partial online PBL in a large classroom setting in biochemistry. BMC MEDICAL EDUCATION 2023; 23:912. [PMID: 38037047 PMCID: PMC10691088 DOI: 10.1186/s12909-023-04767-3] [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: 06/13/2023] [Accepted: 10/12/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Traditional problem-based learning (PBL) relying on tutored learning in small groups is very resource-intensive. Little is known about the benefits of PBL in a large classroom setting. This paper introduced a PBL case into the traditional didactic biochemistry course and investigated the acceptability of total online or partial online PBL in a large classroom setting introduced during the coronavirus pandemic. METHODS The students were allocated into either total online Group 1, partial online Group 2, or partial online and with poorer academic performance Group 3. A questionnaire comprising of 8 closed-ended questions and 2 open-ended questions and final exam performances were used to evaluate the acceptability of total online or partial online PBL in a large classroom setting. The 8 closed-ended questions were analysed by the Kruskal-Wallis test or chi-square tests. The word cloud analysis of the 2 open-ended questions were conducted by Wenjuanxing. Students' performances in the final examination were analysed by One-way Anova. RESULTS Both total online and partial online PBL were rated highly by the students. Overall, there were no significant differences in the effectiveness evaluation of PBL between Group 2 and Group 3. There were no significant differences in final exam performances between Group 1 and Group 2. However, Group 1 rated the effectiveness of PBL much higher than Group 2 and 3. Word cloud analysis of the 2 open-ended questions showed students' positive perspectives of PBL. In biochemistry teaching, from the perspective of the students, the expected optimal number of useful PBL cases might be 2. CONCLUSIONS Both total online and partial online PBL in a large classroom setting were widely accepted as a beneficial supplement to traditional biochemistry classes.
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Affiliation(s)
- Suyun Bai
- Department of Biochemistry and Molecular Biology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Hanming Jiang
- Department of Biochemistry and Molecular Biology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Tao Wang
- Department of Biochemistry and Molecular Biology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Duxiao Yang
- Department of Biochemistry and Molecular Biology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Yizhi Liu
- Department of Medical Statistics, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Changqin Xu
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Limin Zhang
- Department of Rheumatology and Immunology, Shandong Provincial Hospital, Shandong First Medical University, Jinan, China.
| | - Yuanying Zhang
- Department of Biochemistry and Molecular Biology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.
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Gudadappanavar AM, Hombal P, Benni JM, Patel S, Tubaki BR. Evaluation of Virtual Reality High-Fidelity Adult Mannequin-based Simulation of Real-Life Clinical Scenarios in Teaching Clinical Pharmacology to Medical Students. J Pharmacol Pharmacother 2023. [DOI: 10.1177/0976500x231159456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
Background Presently, competency-based medical (CBME) curriculum challenges the medical educators to provide continuing education with new approaches to make learning more stimulating, motivating, and entertaining, fostering excellence in clinical practice. To address these issues, educators have advocated the use of virtual reality and mannequins to teach clinical pharmacology. Aims and Objectives To study the effect, perception, and feedback of virtual reality high-fidelity adult mannequin-based (VHFM) simulation of real-life clinical scenarios over conventional tutorials in teaching clinical pharmacology to medical students. Material and Methods An interventional study was designed for 2nd year MBBS students for a period of 6 months. The enrolled students were randomly assigned to the test group (VHFM) or control group (tutorials). The CAE Healthcare Ltd. maestro, high-fidelity prehospital mannequin (APOLLO) was used in the test group. Three sessions consisting of six different cases were discussed, and multiple-choice questions (MCQs)-based pre-test, post–test, and retest after a month were conducted in both groups and compared. The perception and feedback of faculty and students were obtained by using a modified and revalidated questionnaire. Results The test group outperformed the control group ( p <.001) in all sessions based on pre-test, post-test, and retest scores, and within-group comparisons revealed significant improvements in both groups. Students’ perceptions and feedback regarding VHFM were more enthusiastic and promising than in the tutorial group. Conclusions VHFM is student-centered, provides an active learning environment, and aids in skill development. We strongly suggest VHFM-based learning as a complement to traditional teaching strategies in pharmacology, especially for teaching clinical reasoning to medical students.
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Affiliation(s)
| | - Prashant Hombal
- Department of General Surgery, KAHER, JNMC, Belagavi, Karnataka, India
| | - Jyoti M. Benni
- Department of Pharmacology, KAHER JGMM Medical College, Hubballi, Karnataka, India
| | - Sachin Patel
- Department of Pharmacology, KAHER J.N. Medical College, Belagavi, Karnataka, India
| | - Basavaraj R. Tubaki
- Department of Kayachikitsa, KLE Ayurveda Mahavidyalaya, Belagavi, Karnataka, India
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Bai S, Zhang L, Ye Z, Yang D, Wang T, Zhang Y. The benefits of using atypical presentations and rare diseases in problem-based learning in undergraduate medical education. BMC MEDICAL EDUCATION 2023; 23:93. [PMID: 36747223 PMCID: PMC9900952 DOI: 10.1186/s12909-023-04079-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The nature of student learning in problem-based learning (PBL) largely depends on the quality of the case scenarios presented to them. The effect of case scenarios with higher challenge degree, especially common disease with atypical symptoms (CDAS)- and rare disease (RD)-based case scenarios, on undergraduate medical students remains unclear. This study compared the impact of all scenarios pertaining to common disease with typical symptoms (CDTS) case scenarios, CDTS interspersed with CDAS case scenarios, and CDTS interspersed with RD case scenarios on perceptions of undergraduate students studying organ/system integration curriculum via PBL. METHODS After finishing four CDTS case scenarios, 294 third-year medical students were randomly allocated into three groups: CDTS, CDAS and RD, studying via CDTS, CDAS and RD case scenarios, respectively. A questionnaire with 15 items was conducted to evaluate the students' perceptions. The students' responses were scored using a 4-point rating scale. The data were analysed using the Kruskal-Wallis test. RESULTS Among the three PBL conditions, the ones with a higher degree of challenge were rated higher by the students, which included the quality of the case scenarios and the overall performances of the students. The CDAS and RD cases were more effective in developing students' self-directed learning skills, stimulating them to acquire more knowledge required for future work. The satisfaction percentage of RD case scenario sessions was higher. CONCLUSIONS Of all the three kinds of case scenarios, both CDTS interspersed with CDAS and RD case scenarios had more positive effects on the self-evaluated performance of students. Increasing the challenge and variety of case scenarios by the inclusion of CDAS and RD especially RD might be an effective stimulus in improving students' performance in PBL sessions.
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Affiliation(s)
- Suyun Bai
- Department of Molecular Biology and Biochemistry, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Limin Zhang
- Department of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Zhen Ye
- Department of Molecular Biology and Biochemistry, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Duxiao Yang
- Department of Molecular Biology and Biochemistry, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Tao Wang
- Department of Molecular Biology and Biochemistry, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.
| | - Yuanying Zhang
- Department of Molecular Biology and Biochemistry, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.
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Zhang X, Zhang G, Liu J, Song X, Li M, Zhang Y, Hao J, Wang C, Li H. Cross-sectional study of the quality of randomized control trials on problem-based learning in medical education. Clin Anat 2023; 36:151-160. [PMID: 36349397 DOI: 10.1002/ca.23977] [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: 08/19/2022] [Revised: 10/24/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
Problem-based learning (PBL) is increasingly being used in medical education globally, but its effectiveness in teaching remains controversial. A randomized controlled trial (RCT) is the method of choice for evaluating its effectiveness. The quality of an RCT has a significant effect on this evaluation, but to date we have not seen an assessment of the quality of RCTs for PBL. Two researchers searched MEDLINE and EMBASE for RCTs addressing PBL in medical education. The overall quality of each report was measured on a 28-point overall quality score (OQS) based on the 2010 revised Comprehensive Standards for Reporting and Testing (CONSORT) Statement. Furthermore, to study the key factors affecting OQS more effectively, a linear regression model of those factors was established using SPSS. After literature screening, 30 RCTs were eventually included and analyzed. The median OQS was 15 (range, 7-20), which meant that half of the items in the revised 2010 CONSORT statement were poorly reported in at least 40% of the RCTs analyzed. The regression model showed that the year of publication of RCTs and the impact factors of the journals in which they were published were the main factors affecting OQS. The overall quality of reporting of RCTs on PBL teaching in medical education was not satisfactory. Some RCTs were subjectively selective in reporting certain items, leading to heterogeneity in quality. It is expected that statisticians will develop new standards more suitable for evaluating RCTs related to teaching research and that editors and peer reviewers will be required to review the relevant RCTs more strictly.
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Affiliation(s)
- Xiaoli Zhang
- Department of Histology & Embryology, School of Basic Medical Sciences, Key Laboratory for Experimental Teratology of Ministry of Education, Shandong University, Jinan, China
| | - Guanran Zhang
- Department of Histology & Embryology, School of Basic Medical Sciences, Key Laboratory for Experimental Teratology of Ministry of Education, Shandong University, Jinan, China
| | - Jing Liu
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Xinyi Song
- Department of Histology & Embryology, School of Basic Medical Sciences, Key Laboratory for Experimental Teratology of Ministry of Education, Shandong University, Jinan, China
| | - Manyu Li
- Department of Histology & Embryology, School of Basic Medical Sciences, Key Laboratory for Experimental Teratology of Ministry of Education, Shandong University, Jinan, China
| | - Yuhua Zhang
- Information-based Teaching Research Center, School of Basic Medical Sciences, Shandong University, Jinan, China
| | - Jing Hao
- Department of Histology & Embryology, School of Basic Medical Sciences, Key Laboratory for Experimental Teratology of Ministry of Education, Shandong University, Jinan, China
| | - Chuanzheng Wang
- Department of Histology & Embryology, School of Basic Medical Sciences, Key Laboratory for Experimental Teratology of Ministry of Education, Shandong University, Jinan, China
| | - Han Li
- Department of Histology & Embryology, School of Basic Medical Sciences, Key Laboratory for Experimental Teratology of Ministry of Education, Shandong University, Jinan, China
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Bernges F, Zielbauer S, Weberschock T, Ochsendorf F. Dermatologische Lehre im Medizinstudium: ein Scoping Review publizierter Interventionsstudien: Teaching dermatology to medical students: a Scoping Review of published interventional studies. J Dtsch Dermatol Ges 2022; 20:1077-1087. [PMID: 35971583 DOI: 10.1111/ddg.14805_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/29/2022] [Indexed: 12/11/2022]
Affiliation(s)
- Felix Bernges
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt, Frankfurt am Main
| | - Sebastian Zielbauer
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt, Frankfurt am Main.,Arbeitsgruppe Evidenzbasierte Medizin Frankfurt, Institut für Allgemeinmedizin, Goethe-Universität Frankfurt, Frankfurt am Main
| | - Tobias Weberschock
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt, Frankfurt am Main.,Arbeitsgruppe Evidenzbasierte Medizin Frankfurt, Institut für Allgemeinmedizin, Goethe-Universität Frankfurt, Frankfurt am Main
| | - Falk Ochsendorf
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt, Frankfurt am Main
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Bernges F, Zielbauer S, Weberschock T, Ochsendorf F. Teaching dermatology to medical students: a Scoping Review of published interventional studies. J Dtsch Dermatol Ges 2022; 20:1077-1087. [PMID: 35908803 DOI: 10.1111/ddg.14805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/29/2022] [Indexed: 11/29/2022]
Abstract
It is unclear how dermatology should be optimally taught to medical students. Therefore, this scoping review was conducted aiming to identify and structure all published interventional studies that investigated dermatological teaching approaches with medical students. The methodology of this scoping review followed the PRISMA Extension for Scoping Reviews. The databases Medline and Embase were searched without restriction until 30.06.2020. A categorization and a descriptive analysis of the studies published as full articles were performed. The database search yielded 36,627 hits. 114 studies met all inclusion criteria. These came from 19 countries, were mainly published since 2010 and were distributed across 64 different journals. 32 randomized controlled trials were identified. A wide variety of teaching approaches was found, including both E-learning and conventional teaching formats. The results of the studies are presented in structured tables. This scoping review documents a large number of studies published worldwide on teaching dermatology to medical students. The teaching of dermatology appears to be successful with numerous teaching approaches, whereby interventions that incorporate didactic principles were verifiably more successful. This literature review can serve as an aid for evidence-based teaching design in dermatology as well as a basis for future research approaches.
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Affiliation(s)
- Felix Bernges
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Sebastian Zielbauer
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany.,Working Group Evidence Based Medicine, Institute of General Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Tobias Weberschock
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany.,Working Group Evidence Based Medicine, Institute of General Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Falk Ochsendorf
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany
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VNursLab 3D Simulator: A Web-Based Nursing Skills Simulation of Knowledge of Nursing Skill, Satisfaction, and Self-Confidence among Nursing Students. SUSTAINABILITY 2022. [DOI: 10.3390/su14094882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The use of technology-based learning methods in nursing education is necessary in the era of digitalization, but these methods are limited, especially in developing countries, including Indonesia. We aimed to evaluate the effectiveness of the Virtual Nursing Skills Simulation Lab (VNursLab), a web-based nursing skills simulation using 3D technology, to improve the knowledge of nursing skills for intravenous catheterization, satisfaction, and self-confidence of nursing students in Indonesia. A quasi-experimental design was used. A total of 139 nursing students participated and were divided into intervention and control groups (69 and 70 participants, respectively). The intervention group had access to the VNursLab 3D simulator for three weeks and had three meetings. The control group had traditional learning (lecture and three meetings). The data were analyzed using the paired t-test, Wilcoxon test, and Mann–Whitney U test. The means and standard deviations of the post-test values in the two groups for the three parameters were 12.26 + 4.11 vs. 9.67 + 3.13 for nursing skill knowledge, 23.00 + 2.32 vs. 21.70 + 2.68 for satisfaction, and 36.25 + 3.48 vs. 34.96 + 3.39 for self-confidence. We found significant differences between the intervention and control groups regarding knowledge of nursing skills (p < 0.001), satisfaction (p < 0.001), and self-confidence (p = 0.014). The VNursLab 3D simulator could be an alternative learning medium to improve nursing students’ understanding of nursing skills, satisfaction, and self-confidence. However, this medium cannot replace direct practical experience. A combination of the two learning methods, virtual-based learning and hands-on practical learning, is beneficial in helping nursing students achieve nursing competencies.
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Trullàs JC, Blay C, Sarri E, Pujol R. Effectiveness of problem-based learning methodology in undergraduate medical education: a scoping review. BMC MEDICAL EDUCATION 2022; 22:104. [PMID: 35177063 PMCID: PMC8851721 DOI: 10.1186/s12909-022-03154-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 02/02/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND Problem-based learning (PBL) is a pedagogical approach that shifts the role of the teacher to the student (student-centered) and is based on self-directed learning. Although PBL has been adopted in undergraduate and postgraduate medical education, the effectiveness of the method is still under discussion. The author's purpose was to appraise available international evidence concerning to the effectiveness and usefulness of PBL methodology in undergraduate medical teaching programs. METHODS The authors applied the Arksey and O'Malley framework to undertake a scoping review. The search was carried out in February 2021 in PubMed and Web of Science including all publications in English and Spanish with no limits on publication date, study design or country of origin. RESULTS The literature search identified one hundred and twenty-four publications eligible for this review. Despite the fact that this review included many studies, their design was heterogeneous and only a few provided a high scientific evidence methodology (randomized design and/or systematic reviews with meta-analysis). Furthermore, most were single-center experiences with small sample size and there were no large multi-center studies. PBL methodology obtained a high level of satisfaction, especially among students. It was more effective than other more traditional (or lecture-based methods) at improving social and communication skills, problem-solving and self-learning skills. Knowledge retention and academic performance weren't worse (and in many studies were better) than with traditional methods. PBL was not universally widespread, probably because requires greater human resources and continuous training for its implementation. CONCLUSION PBL is an effective and satisfactory methodology for medical education. It is likely that through PBL medical students will not only acquire knowledge but also other competencies that are needed in medical professionalism.
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Affiliation(s)
- Joan Carles Trullàs
- Medical Education Cathedra, School of Medicine, University of Vic-Central University of Catalonia, Vic, Barcelona, Spain
- Internal Medicine Service, Hospital de Olot i Comarcal de La Garrotxa, Olot, Girona, Spain
- The Tissue Repair and Regeneration Laboratory (TR2Lab), University of Vic-Central University of Catalonia, Vic, Barcelona, Spain
| | - Carles Blay
- Medical Education Cathedra, School of Medicine, University of Vic-Central University of Catalonia, Vic, Barcelona, Spain
- Catalan Institute of Health (ICS) - Catalunya Central, Barcelona, Spain
| | - Elisabet Sarri
- The Tissue Repair and Regeneration Laboratory (TR2Lab), University of Vic-Central University of Catalonia, Vic, Barcelona, Spain
| | - Ramon Pujol
- Medical Education Cathedra, School of Medicine, University of Vic-Central University of Catalonia, Vic, Barcelona, Spain
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Swinnen E, Fobelets M, Adriaenssens N, Vandyck E, Goelen G, Moortgat E, Laforge D, Peersman W. Effectiveness of an Interprofessional Education Model to Influence Students' Perceptions on Interdisciplinary Work. J Nurs Educ 2021; 60:494-499. [PMID: 34467810 DOI: 10.3928/01484834-20210708-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND To prepare students adequately for the workplace, training on interprofessional practice should be included in the curricula of future health professionals. This study evaluated the effect of an interprofessional education session on undergraduate students' attitudes toward interprofessional collaboration. METHODS A total of 225 medicine, nursing, physiotherapy, and nutrition and dietetics students were randomized to either an intervention (working together interprofessionally, n = 111) or control group (working together with their own profession, n = 114). Pre- and posttest assessment was performed with an adapted version of the Interdisciplinary Education Perception Scale. RESULTS A statistically significant improvement in attitude for Perception of Competence Own Profession (0.82, p = .008) and Perception of Actual Cooperation (1.10, p = .004) was found for students in the intervention group compared with students in the control group. CONCLUSION Interprofessional education sessions were likely to be effective on undergraduate students' attitudes toward interprofessional collaboration. [J Nurs Educ. 2021;60(9):494-499.].
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Huang CD, Tseng HM, Jenq CC, Ou LS. Active learning of medical students in Taiwan: a realist evaluation. BMC MEDICAL EDUCATION 2020; 20:487. [PMID: 33272263 PMCID: PMC7713042 DOI: 10.1186/s12909-020-02392-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Active learning is defined as any instructional method that engages students in the learning process. Cultural differences in learning patterns can play an important role in engagement with active learning. We aimed to examine process models of active learning to understand what works, for whom and why. METHODS Forty-eight sixth- and seventh-year medical students with experience of active learning methods were purposively selected to participate in ten group interviews. Interactions around active learning were analysed using a realist evaluation framework to unpack the 'context-mechanism-outcome' (CMO) configurations. RESULTS Three core CMO configurations, including cultural, training and individual domains, were identified. In the cultural context of a strong hierarchical culture, the mechanisms of fear prompted students to be silent (outcome) and dare not give their opinions. In the training context of teacher-student familiarity alongside teachers' guidance, the mechanisms of learning motivation, self-regulation and enthusiasm were triggered, prompting positive learning outcomes and competencies (outcome). In the individual context of learning how to learn actively at an early stage within the medical learning environment, the mechanisms of internalisation, professional identity and stress resulted in recognising active learning and advanced preparation (outcomes). CONCLUSIONS We identified three CMO configurations of Taiwanese medical students' active learning. The connections among hierarchical culture, fear, teachers' guidance, motivation, the medical environment and professional identity have been shown to affect the complex interactions of learning outcomes. Fear derived from a hierarchical culture is a concern as it is a significant and specific contextual factor, often sparking fear with negative outcomes.
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Affiliation(s)
- Chien-Da Huang
- Chang Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taipei, Taiwan
- Department of Medical Education, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taipei, Taiwan
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, 199 Tun Hua N. Rd, Taipei, Taiwan
| | - Hsu-Min Tseng
- Department of Health Care Management, Chang Gung University, College of Medicine, Taipei, Taiwan
| | - Chang-Chyi Jenq
- Department of Nephrology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taipei, Taiwan
| | - Liang-Shiou Ou
- Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taipei, Taiwan
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Mikuteit M, Steffens S, Grigull L, Kühnle L, Behrends M, Schmidt R, Mücke U. Rapid development of a digital module during the Covid 19 pandemic in undergraduate medical education of pediatrics by teachers and students. GMS JOURNAL FOR MEDICAL EDUCATION 2020; 37:Doc66. [PMID: 33364345 PMCID: PMC7740020 DOI: 10.3205/zma001359] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/07/2020] [Accepted: 10/23/2020] [Indexed: 05/25/2023]
Abstract
Objective: During the early Covid 19 pandemic, undergraduate medical teaching of pediatric medicine had to be switched to online teaching at the Hanover Medical School (MHH). The aim was to develop an online module together with students. Methodology: In a multi-stage process, a working group consisting of lecturers and students developed the concept and implemented it. Afterwards the online module was evaluated. Results: The conceptualization process and the implementation of the module together with students can be represented as a modified PDCA cycle (Plan-Do-Check-Act). We showed that including students in the development of an online module is helpful in times of limited resources e.g. such as personnel and time. Conclusion: The cooperation between students and lecturers is suitable for developing and implementing an online module in a short time. In the future, in addition to joint conceptualization phases, digital elements (e.g. preparatory webinars) for the module itself in attendance phases should be retained.
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Affiliation(s)
| | | | | | - Lara Kühnle
- Medizinische Hochschule Hannover, Hannover, Germany
| | | | - Ralf Schmidt
- Gamespired - game-inspired thinking for your organization, Uplengen, Germany
| | - Urs Mücke
- Medizinische Hochschule Hannover, Hannover, Germany
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17
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Taurines R, Radtke F, Romanos M, König S. Using real patients in e-learning: case-based online training in child and adolescent psychiatry. GMS JOURNAL FOR MEDICAL EDUCATION 2020; 37:Doc96. [PMID: 33364375 PMCID: PMC7740018 DOI: 10.3205/zma001389] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/22/2020] [Accepted: 10/29/2020] [Indexed: 06/12/2023]
Abstract
Objectives: In undergraduate medical education and in the subject of child and adolescent psychiatry, examining young patients face-to-face is a key element of teaching. With the abrupt shutdown of face-to-face teaching caused by the SARS-CoV-2 pandemic, a case-based online training program integrating audio and video of real patients was developed. Methods: The blended learning platform CaseTrain guides medical students in their final year through real child-psychiatric patient cases, such as anorexia, autism, or attention deficit disorder, through presentation of video and audio of real patients and parents. The teaching format complements lectures on child psychiatric topics, comprising asynchronous elements (self-study using the digital material) as well as synchronous elements (web-conferences with a specialist). Learning objectives for students were set to develop knowledge of the spectra of psychiatric disorders that affect children and to recognize approaches how to assess and manage common psychiatric problems of childhood and adolescence. Results: The feedback from medical students through oral and written evaluation was positive. They appreciated getting to know 'real-world patients' in times of such a pandemic, to learn explorative techniques from role models, and to be in close contact with the supervising specialist. In consequence of critical feedback on the length of some video sequences, these training units will undergo revision. Conclusions: Case-based online training may continue to be a useful option in a post-pandemic future as integral part of medical education, complementing face-to-face lectures and training in (child) psychiatry.
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Affiliation(s)
- Regina Taurines
- University Hospital Würzburg, Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Germany
| | - Franziska Radtke
- University Hospital Würzburg, Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Germany
| | - Marcel Romanos
- University Hospital Würzburg, Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Germany
| | - Sarah König
- University Hospital Würzburg, Institute of Medical Teaching and Medical Education Research, Würzburg, Germany
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18
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Torres G, Villagrán I, Fuentes J, Araya JP, Jouannet C, Fuentes-López E. Interactive virtual scenarios as a technological resource to improve musculoskeletal clinical reasoning skills of undergraduate physiotherapy students. Physiother Theory Pract 2020; 38:1016-1026. [PMID: 32814476 DOI: 10.1080/09593985.2020.1809043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Clinical reasoning is a fundamental competency in the learning process of health professionals. Since learning with traditional methods presents difficulties, teaching with interactive virtual scenarios is a good alternative. OBJECTIVE To describe the impact of a blended training with interactive virtual scenarios for the development of clinical reasoning skills in undergraduate physiotherapy students. METHODS A sample of 92 students solved eight storylines. Assessment error percentage, clinical pattern recognition, satisfaction, and the perception of difficulty were obtained. A proportions test was used to compare baseline and final assessments. To analyze the relationship between the variables, multilevel univariate logistic regression models were built. RESULTS A significant difference was observed in the error percentage between baseline and final assessment (p < .001). Comparing the last storyline to the first one, there were 2.63 times more possibilities to correctly recognize the pattern. The error percentage was associated with the opportunity to recognize the pattern precisely (p < .001). Thus, for each increasing unit in the error percentage, the possibility to correctly recognize the pattern decreased by 11% (OR = 0.89). CONCLUSIONS The use of this innovative blended training with virtual scenarios allowed students to systematically improve their recognition abilities of clinical patterns and decrease mistakes in the decision-making process.
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Affiliation(s)
- Gustavo Torres
- Carrera de Kinesiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ignacio Villagrán
- Carrera de Kinesiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javiera Fuentes
- Carrera de Kinesiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan Pablo Araya
- Carrera de Kinesiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Chantal Jouannet
- Centro de Desarrollo Docente, Vicerrectoría Académica, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo Fuentes-López
- Carrera de Fonoaudiología, Departamento de Ciencias de La Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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19
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Pyle E, Hung W. The role of subject presence type on student motivation in a PBL learning environment. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2019; 24:643-663. [PMID: 31016430 DOI: 10.1007/s10459-019-09889-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 04/16/2019] [Indexed: 06/09/2023]
Abstract
Students have been observed as underprepared or skipping steps during the problem-based learning (PBL) process due to fatigue or low motivation, potentially creating a barrier for effective learning. One way to explore resolving this issue is to consider whether variables of problem scenario design can be altered to optimize motivation. This mixed method study considered the impact of presentation modality of the PBL problem subject (i.e., the key character involved in the problem) on student motivation within the context of Speech and Voice Science curricula for forty-six undergraduate students at a midwestern, US university. The frequency of verbal and non-verbal engagement behaviors was monitored during four consecutive PBL problems. The problems were designed to provide increasing levels of social presence and used varied case presentation modalities (e.g., paper, audio-visual, face to face). Although the frequency of engagement behaviors declined during the study and fatigue appeared to play a role, most students identified problems with combination of higher subject presence (i.e., audio-visual, face-to-face) and challenging content as motivating. Students were able to develop a sense of ownership and responsibility for their problem-solving efforts with a problem designed with direct interaction (i.e., face to face) with the problem subject. This study sheds light on the impact of affective problem features (e.g., emotion, personal psychological connection) on students' motivation in the presence of fatigue, which is often undervalued during the design of PBL modules.
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Affiliation(s)
- Elaine Pyle
- Minnesota State University Moorhead, 1104 7th Ave S. Murray Hall 223A, Moorhead, MN, 56563, USA.
| | - Woei Hung
- University of North Dakota, 231 Centennial Drive, Stop 7189, Grand Forks, ND, 58202, USA
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20
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Kononowicz AA, Woodham LA, Edelbring S, Stathakarou N, Davies D, Saxena N, Tudor Car L, Carlstedt-Duke J, Car J, Zary N. Virtual Patient Simulations in Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration. J Med Internet Res 2019; 21:e14676. [PMID: 31267981 PMCID: PMC6632099 DOI: 10.2196/14676] [Citation(s) in RCA: 154] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/06/2019] [Accepted: 06/08/2019] [Indexed: 12/29/2022] Open
Abstract
Background Virtual patients are interactive digital simulations of clinical scenarios for the purpose of health professions education. There is no current collated evidence on the effectiveness of this form of education. Objective The goal of this study was to evaluate the effectiveness of virtual patients compared with traditional education, blended with traditional education, compared with other types of digital education, and design variants of virtual patients in health professions education. The outcomes of interest were knowledge, skills, attitudes, and satisfaction. Methods We performed a systematic review on the effectiveness of virtual patient simulations in pre- and postregistration health professions education following Cochrane methodology. We searched 7 databases from the year 1990 up to September 2018. No language restrictions were applied. We included randomized controlled trials and cluster randomized trials. We independently selected studies, extracted data, and assessed risk of bias and then compared the information in pairs. We contacted study authors for additional information if necessary. All pooled analyses were based on random-effects models. Results A total of 51 trials involving 4696 participants met our inclusion criteria. Furthermore, 25 studies compared virtual patients with traditional education, 11 studies investigated virtual patients as blended learning, 5 studies compared virtual patients with different forms of digital education, and 10 studies compared different design variants. The pooled analysis of studies comparing the effect of virtual patients to traditional education showed similar results for knowledge (standardized mean difference [SMD]=0.11, 95% CI −0.17 to 0.39, I2=74%, n=927) and favored virtual patients for skills (SMD=0.90, 95% CI 0.49 to 1.32, I2=88%, n=897). Studies measuring attitudes and satisfaction predominantly used surveys with item-by-item comparison. Trials comparing virtual patients with different forms of digital education and design variants were not numerous enough to give clear recommendations. Several methodological limitations in the included studies and heterogeneity contributed to a generally low quality of evidence. Conclusions Low to modest and mixed evidence suggests that when compared with traditional education, virtual patients can more effectively improve skills, and at least as effectively improve knowledge. The skills that improved were clinical reasoning, procedural skills, and a mix of procedural and team skills. We found evidence of effectiveness in both high-income and low- and middle-income countries, demonstrating the global applicability of virtual patients. Further research should explore the utility of different design variants of virtual patients.
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Affiliation(s)
- Andrzej A Kononowicz
- Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Kraków, Poland
| | - Luke A Woodham
- Institute of Medical and Biomedical Education, St George's, University of London, London, United Kingdom.,Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Samuel Edelbring
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Learning and Professional Development Group, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Natalia Stathakarou
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - David Davies
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Nakul Saxena
- Health Services and Outcomes Research, National Healthcare Group, Singapore, Singapore
| | - Lorainne Tudor Car
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Jan Carlstedt-Duke
- President's Office, Nanyang Technological University, Singapore, Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Nabil Zary
- Games for Health Innovations Centre, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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Waller BAM, Liu A, Fleming P, Lansang P. Undergraduate Dermatology Medical Education: Results of a Large-Scale Patient Viewing Program. J Cutan Med Surg 2019; 23:482-487. [DOI: 10.1177/1203475419848350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Delivering quality dermatologic instruction to medical students can be difficult; time constraints, limited clinical teachers, and a lack of standardization pose challenges. The literature suggests that many trainees and primary care physicians could benefit from increased clinical dermatology teaching. Objective: We sought to deliver and analyze the results of a large-scale patient-viewing undergraduate dermatology education program. Methods: A total of 250 third-year medical students participated in a 32-station patient-viewing program. Voluntary pre- and posttest surveys were administered to evaluate knowledge and self-perceived abilities in dermatology. The identical tests were composed of 20 multiple-choice and 5 self-perception questions. Results: The response rate for completion of pre- and posttests was 24% (N = 59). Pre- and postknowledge test score means were 69.0% and 93.20%, respectively. Pre- and post–self-perception test score means were 3.95/10 and 7.25/10, respectively. Positive student feedback was received on the patient-viewing educational experience. Conclusion: Improvements in knowledge scores and self-assessment scores support the potential integration of structured patient-viewing teaching into undergraduate dermatology medical education curricula.
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Affiliation(s)
| | - Annie Liu
- Division of Dermatology, University of Toronto, ON, Canada
| | | | - Perla Lansang
- Division of Dermatology, University of Toronto, ON, Canada
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22
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Yun SY, Choi JY. [A Comparative Study on Learning Outcomes according to the Integration Sequences of S-PBL in Nursing Students: Randomized Crossover Design]. J Korean Acad Nurs 2019; 49:92-103. [PMID: 30837446 DOI: 10.4040/jkan.2019.49.1.92] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 01/14/2019] [Accepted: 01/14/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to compare the effects of simulation integrated with problem based learning (S-PBL) according to the sequences of problem-based learning (PBL) and high fidelity simulation training (HFS) on knowledge, clinical performance, clinical judgment, self-confidence, and satisfaction in fourth-grade nursing students. METHODS In this randomized crossover design study, four S-PBLs on medical-surgical nursing were applied alternatively to two randomly-assigned groups of 26 senior nursing students for 8 weeks. The collected data were analyzed using an independent t-test. RESULTS The method of administering PBL prior to HFS led to significantly higher scores on knowledge (t=2.28, p=.025) as compared to the method of administering HFS prior to PBL. However, the latter method led to significantly higher scores on clinical performance (t=-6.49, p<.001) and clinical judgment (t=-4.71, p<.001) as compared to the method of administering PBL prior to HFS. There were no differences in the effect of the two methods on self-confidence (t=1.53, p=.128) and satisfaction (t=1.28, p=.202). CONCLUSION The integration sequences of S-PBL was associated with different learning outcomes. Therefore, when implementing S-PBL, it is necessary to consider the educational goal to executes an appropriate sequence of integration.
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Affiliation(s)
- So Young Yun
- College of Nursing, Chonnam National University, Gwangju, Korea
| | - Ja Yun Choi
- College of Nursing, Chonnam National University, Gwangju, Korea.
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23
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Tudor Car L, Kyaw BM, Dunleavy G, Smart NA, Semwal M, Rotgans JI, Low-Beer N, Campbell J. Digital Problem-Based Learning in Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration. J Med Internet Res 2019; 21:e12945. [PMID: 30816846 PMCID: PMC6416535 DOI: 10.2196/12945] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/21/2019] [Accepted: 02/04/2019] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The use of digital education in problem-based learning, or digital problem-based learning (DPBL), is increasingly employed in health professions education. DPBL includes purely digitally delivered as well as blended problem-based learning, wherein digital and face-to-face learning are combined. OBJECTIVE The aim of this review is to evaluate the effectiveness of DPBL in improving health professionals' knowledge, skills, attitudes, and satisfaction. METHODS We used the gold-standard Cochrane methods to conduct a systematic review of randomized controlled trials (RCTs). We included studies that compared the effectiveness of DPBL with traditional learning methods or other forms of digital education in improving health professionals' knowledge, skills, attitudes, and satisfaction. Two authors independently screened studies, extracted data, and assessed the risk of bias. We contacted study authors for additional information, if necessary. We used the random-effects model in the meta-analyses. RESULTS Nine RCTs involving 890 preregistration health professionals were included. Digital technology was mostly employed for presentation of problems. In three studies, PBL was delivered fully online. Digital technology modalities spanned online learning, offline learning, virtual reality, and virtual patients. The control groups consisted of traditional PBL and traditional learning. The pooled analysis of seven studies comparing the effect of DPBL and traditional PBL reported little or no difference in postintervention knowledge outcomes (standardized mean difference [SMD] 0.19, 95% CI 0.00-0.38). The pooled analysis of three studies comparing the effect of DPBL to traditional learning on postintervention knowledge outcomes favored DPBL (SMD 0.67, 95% CI 0.14-1.19). For skill development, the pooled analysis of two studies comparing DPBL to traditional PBL favored DPBL (SMD 0.30, 95% CI 0.07-0.54). Findings on attitudes and satisfaction outcomes were mixed. The included studies mostly had an unclear risk of bias. CONCLUSIONS Our findings suggest that DPBL is as effective as traditional PBL and more effective than traditional learning in improving knowledge. DPBL may be more effective than traditional learning or traditional PBL in improving skills. Further studies should evaluate the use of digital technology for the delivery of other PBL components as well as PBL overall.
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Affiliation(s)
- Lorainne Tudor Car
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Bhone Myint Kyaw
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Gerard Dunleavy
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Neil A Smart
- School of Science & Technology, University of New England, Armidale, Australia
| | - Monika Semwal
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Jerome I Rotgans
- Medical Education Research Unit, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Naomi Low-Beer
- Medical Education Research Unit, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - James Campbell
- Health Workforce Department, World Health Organization, Geneva, Switzerland
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Zhao X, Cong L. Effect of problem and scripting-based learning combining wearable technology on orthopedic operating room nurses' learning outcomes. NURSE EDUCATION TODAY 2019; 73:13-16. [PMID: 30472404 DOI: 10.1016/j.nedt.2018.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 10/05/2018] [Accepted: 11/05/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Orthopedic operating room (OR) nurses entail specialized skills and training, which are not part of the regular curricula at most nursing college. Instead, many nursing students' exposure to orthopedic care in the orthopedic range is limited to occasional observational assignments. Additionally, teamwork is an important factor affecting the performance of the orthopedic OR nurses. This results in a knowledge gap in clinical nursing education. Problem and scripting based learning (PSBL) method is a crucial tool of pre-operative prepared improvement. It is easy for surgeon to record surgical video from his own field of vision by wearable technology (WT). Nevertheless, few studies related to combine WT and PSBL been done to investigate features underlying efficiency in training of novice orthopedic OR nurses. OBJECTIVE This study aimed to evaluate the feasibility of combining WT with PSBL in training of novice orthopedic OR nurses. METHODS 20 operating room post-graduate-year-1 nurses from the First Hospital of China Medical University were randomly divided into two groups ("conventional training (CT)" group and "WT combining with PSBL" group). Initially the superior orthopedic operating room nurses who immediately followed each procedure filled out a feedback questionnaire of the novice nurses. After finished procedure, novice nurses had a basic understanding of each training method benefits and then filled out the questionnaires. Statistical analysis of the results was performed. RESULTS Novice nurses of WT&PSBL Group got the better score in most of the preparedness and performance feedback statement. Mean scores of overall total preparedness and performance feedback statement of WT&PSBL Group was higher than CT Group (P ≤ 0.05). Based on summarizing the questionnaires, the novice nurse in WT- PSBL Group also made significantly better total score than "Conventional training" Group (P ≤ 0.05). CONCLUSIONS WT&PSBL method, as a crucial tool for improving pre-operative preparedness and intra-operative performance, can cultivate novice orthopedic operating room nurses' ability to use prior knowledge and cognitive frameworks flexibly to deal with problems during performance. It plays a crucial role in training confident and safe orthopedic operating room nurses. DESIGN Randomized controlled trial (RCT).
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Affiliation(s)
- Xin Zhao
- Department of Operation Room, The First Hospital of China Medical University, No.155, Nanjing Bei Street, Shenyang 110001, PR China
| | - Lin Cong
- Department of Orthopedic Surgery, The First Hospital of China Medical University, No.155, Nanjing Bei Street, Shenyang 110001, PR China.
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Kok EM, van Geel K, van Merriënboer JJG, Robben SGF. What We Do and Do Not Know about Teaching Medical Image Interpretation. Front Psychol 2017; 8:309. [PMID: 28316582 PMCID: PMC5334326 DOI: 10.3389/fpsyg.2017.00309] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 02/20/2017] [Indexed: 11/13/2022] Open
Abstract
Educators in medical image interpretation have difficulty finding scientific evidence as to how they should design their instruction. We review and comment on 81 papers that investigated instructional design in medical image interpretation. We distinguish between studies that evaluated complete offline courses and curricula, studies that evaluated e-learning modules, and studies that evaluated specific educational interventions. Twenty-three percent of all studies evaluated the implementation of complete courses or curricula, and 44% of the studies evaluated the implementation of e-learning modules. We argue that these studies have encouraging results but provide little information for educators: too many differences exist between conditions to unambiguously attribute the learning effects to specific instructional techniques. Moreover, concepts are not uniformly defined and methodological weaknesses further limit the usefulness of evidence provided by these studies. Thirty-two percent of the studies evaluated a specific interventional technique. We discuss three theoretical frameworks that informed these studies: diagnostic reasoning, cognitive schemas and study strategies. Research on diagnostic reasoning suggests teaching students to start with non-analytic reasoning and subsequently applying analytic reasoning, but little is known on how to train non-analytic reasoning. Research on cognitive schemas investigated activities that help the development of appropriate cognitive schemas. Finally, research on study strategies supports the effectiveness of practice testing, but more study strategies could be applicable to learning medical image interpretation. Our commentary highlights the value of evaluating specific instructional techniques, but further evidence is required to optimally inform educators in medical image interpretation.
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Affiliation(s)
- Ellen M Kok
- Department of Educational Development and Research, School of Health Professions Education, Maastricht University Maastricht, Netherlands
| | - Koos van Geel
- Department of Educational Development and Research, School of Health Professions Education, Maastricht University Maastricht, Netherlands
| | - Jeroen J G van Merriënboer
- Department of Educational Development and Research, School of Health Professions Education, Maastricht University Maastricht, Netherlands
| | - Simon G F Robben
- Department of Radiology, Maastricht University Medical Centre Maastricht, Netherlands
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Gosselin K, Norris JL, Ho MJ. Beyond homogenization discourse: Reconsidering the cultural consequences of globalized medical education. MEDICAL TEACHER 2016; 38:691-9. [PMID: 26571353 DOI: 10.3109/0142159x.2015.1105941] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Global medical education standards, largely designed in the West, have been promoted across national boundaries with limited regard for cultural differences. This review aims to identify discourses on cultural globalization in medical education literature from non-Western countries. METHODS To explore the diversity of discourses related to globalization and culture in the field of medical education, the authors conducted a critical review of medical education research from non-Western countries published in Academic Medicine, Medical Education and Medical Teacher from 2006 to 2014. Key discourses about globalization and culture emerged from a preliminary analysis of this body of literature. A secondary analysis identified inductive sub-themes. RESULTS Homogenization, polarization and hybridization emerged as key themes in the literature. These findings demonstrate the existence of discourses beyond Western-led homogenization and the co-existence of globalization discourses ranging from homogenization to syncretism to resistance. CONCLUSIONS This review calls attention to the existence of manifold discourses about globalization and culture in non-Western medical education contexts. In refocusing global medical education processes to avoid Western cultural imperialism, it will also be necessary to avoid the pitfalls of other globalization discourses. Moving beyond existing discourses, researchers and educators should work towards equitable, context-sensitive and locally-driven approaches to global medical education.
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Affiliation(s)
- K Gosselin
- a National Taiwan University College of Medicine , Taiwan
| | - J L Norris
- a National Taiwan University College of Medicine , Taiwan
| | - M-J Ho
- a National Taiwan University College of Medicine , Taiwan
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Pennaforte T, Moussa A, Loye N, Charlin B, Audétat MC. Exploring a New Simulation Approach to Improve Clinical Reasoning Teaching and Assessment: Randomized Trial Protocol. JMIR Res Protoc 2016; 5:e26. [PMID: 26888076 PMCID: PMC4776024 DOI: 10.2196/resprot.4938] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 11/04/2015] [Accepted: 11/05/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Helping trainees develop appropriate clinical reasoning abilities is a challenging goal in an environment where clinical situations are marked by high levels of complexity and unpredictability. The benefit of simulation-based education to assess clinical reasoning skills has rarely been reported. More specifically, it is unclear if clinical reasoning is better acquired if the instructor's input occurs entirely after or is integrated during the scenario. Based on educational principles of the dual-process theory of clinical reasoning, a new simulation approach called simulation with iterative discussions (SID) is introduced. The instructor interrupts the flow of the scenario at three key moments of the reasoning process (data gathering, integration, and confirmation). After each stop, the scenario is continued where it was interrupted. Finally, a brief general debriefing ends the session. System-1 process of clinical reasoning is assessed by verbalization during management of the case, and System-2 during the iterative discussions without providing feedback. OBJECTIVE The aim of this study is to evaluate the effectiveness of Simulation with Iterative Discussions versus the classical approach of simulation in developing reasoning skills of General Pediatrics and Neonatal-Perinatal Medicine residents. METHODS This will be a prospective exploratory, randomized study conducted at Sainte-Justine hospital in Montreal, Qc, between January and March 2016. All post-graduate year (PGY) 1 to 6 residents will be invited to complete one SID or classical simulation 30 minutes audio video-recorded complex high-fidelity simulations covering a similar neonatology topic. Pre- and post-simulation questionnaires will be completed and a semistructured interview will be conducted after each simulation. Data analyses will use SPSS and NVivo softwares. RESULTS This study is in its preliminary stages and the results are expected to be made available by April, 2016. CONCLUSIONS This will be the first study to explore a new simulation approach designed to enhance clinical reasoning. By assessing more closely reasoning processes throughout a simulation session, we believe that Simulation with Iterative Discussions will be an interesting and more effective approach for students. The findings of the study will benefit medical educators, education programs, and medical students.
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Affiliation(s)
- Thomas Pennaforte
- Sainte-Justine Hospital, Department of Neonatology, University of Montreal, Montreal, QC, Canada.
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Kilgour JM, Grundy L, Monrouxe LV. A Rapid Review of the Factors Affecting Healthcare Students' Satisfaction with Small-Group, Active Learning Methods. TEACHING AND LEARNING IN MEDICINE 2016; 28:15-25. [PMID: 26787081 DOI: 10.1080/10401334.2015.1107484] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
UNLABELLED PHENOMENON: Problem-based learning (PBL) and other small-group, active learning methodologies have been widely adopted into undergraduate and postgraduate healthcare curricula across the world. Although much research has examined student perceptions of these innovative teaching pedagogies, there are still questions over which factors influence these views. This article aims to identify these key elements that affect healthcare student satisfaction with PBL and other small-group learning methods, including case-based and team-based learning. APPROACH A systematic rapid review method was used to identify high-quality original research papers from the healthcare education literature from between 2009 and 2014. All papers were critically appraised before inclusion in line with published guidelines. Narrative synthesis was achieved using an inductively developed, thematic framework approach. FINDINGS Fifty-four papers were included in the narrative synthesis. The evidence suggests that, despite an initial period of negative emotion and anxiety, the perspectives of healthcare students toward small-group, active learning methods are generally positive. The key factors influencing this satisfaction level include (a) the facilitator role, (b) tutorial structure, (c) individual student factors, (d) case authenticity, (e) increased feedback, (f) group harmony, and (g) resource availability. Insights: Student satisfaction is an important determinant of healthcare education quality, and the findings of this review may be of value in future curriculum design. The evidence described here suggests that an ideal curriculum may be based on an expert-led, hybrid PBL model.
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Affiliation(s)
- James M Kilgour
- a Institute of Medical Education, School of Medicine, Cardiff University , Cardiff , United Kingdom
| | - Lisa Grundy
- a Institute of Medical Education, School of Medicine, Cardiff University , Cardiff , United Kingdom
| | - Lynn V Monrouxe
- a Institute of Medical Education, School of Medicine, Cardiff University , Cardiff , United Kingdom
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Matchim Y, Kongsuwan W. Thai nursing students' experiences when attending real life situations involving cardiac life support: A Phenomenological study. NURSE EDUCATION TODAY 2015; 35:1186-91. [PMID: 26047601 DOI: 10.1016/j.nedt.2015.05.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 05/09/2015] [Accepted: 05/16/2015] [Indexed: 05/25/2023]
Abstract
BACKGROUND During the last few years, manikin simulations have been used for cardiac life support training procedures in medical and nursing education. However, some nursing students have experienced attending real events involving cardiac life support during their clinical practice. OBJECTIVE This study aims to describe the meaning of experience of Thai nursing students when attending real situations of cardiac life support. METHODS A hermeneutic phenomenological study was used. Third and fourth year bachelor of nursing students at a university in the southern region of Thailand who had the experience of attending real situation of cardiac life support were purposely selected as the informants. The data were generated from individual in-depth interviews with eighteen nursing students. Van Manen's approach was used to analyze the data. Trustworthiness was established using the criteria set out by Lincoln and Guba. RESULTS Essential themes situated in the context of the four existential grounds of body, time, space, and relation emerged. These were: being worried and fearful while desiring to participate in cardiac life support procedures; enhancing self value; knowing each moment is meaningful for one's life; having time to understand the reality of life; being in a small corner; appreciating such opportunities and the encouragement given by nurses and the healthcare team; and feeling empathy. CONCLUSIONS Besides learning in classrooms and practicing in labs, experiencing real situations is beneficial for nursing students in learning cardiac life support. This study provides information that can be used for clinical teaching management in the topics relating to cardiac life support.
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Affiliation(s)
- Yaowarat Matchim
- Faculty of Nursing, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand.
| | - Waraporn Kongsuwan
- Faculty of Nursing, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand.
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Hung CH, Lin CY. Using concept mapping to evaluate knowledge structure in problem-based learning. BMC MEDICAL EDUCATION 2015; 15:212. [PMID: 26614519 PMCID: PMC4662011 DOI: 10.1186/s12909-015-0496-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 11/22/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Many educational programs incorporate problem-based learning (PBL) to promote students' learning; however, the knowledge structure developed in PBL remains unclear. The aim of this study was to use concept mapping to generate an understanding of the use of PBL in the development of knowledge structures. METHODS Using a quasi-experimental study design, we employed concept mapping to illustrate the effects of PBL by examining the patterns of concepts and differences in the knowledge structures of students taught with and without a PBL approach. Fifty-two occupational therapy undergraduates were involved in the study and were randomly divided into PBL and control groups. The PBL group was given two case scenarios for small group discussion, while the control group continued with ordinary teaching and learning. Students were asked to make concept maps after being taught about knowledge structure. A descriptive analysis of the morphology of concept maps was conducted in order to compare the integration of the students' knowledge structures, and statistical analyses were done to understand the differences between groups. RESULTS Three categories of concept maps were identified as follows: isolated, departmental, and integrated. The students in the control group constructed more isolated maps, while the students in the PBL group tended toward integrated mapping. Concept Relationships, Hierarchy Levels, and Cross Linkages in the concept maps were significantly greater in the PBL group; however, examples of concept maps did not differ significantly between the two groups. CONCLUSIONS The data indicated that PBL had a strong effect on the acquisition and integration of knowledge. The important properties of PBL, including situational learning, problem spaces, and small group interactions, can help students to acquire more concepts, achieve an integrated knowledge structure, and enhance clinical reasoning.
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Affiliation(s)
- Chia-Hui Hung
- Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, No. 79-9, Sha-Luen Hu, Xi-Zhou Li, Hou-Loung Town, Miaoli, Taiwan.
| | - Chen-Yung Lin
- Graduate Institute of Science Education, National Taiwan Normal University, No. 88, Ting-Jou Rd., sec. 4, Taipei, Taiwan.
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Zhong X, Wang P, Feng J, Hu W, Huang C. Novel Transparent Urinary Tract Simulator Improves Teaching of Urological Operation Skills at a Single Institution. Urol Int 2015; 95:38-43. [PMID: 25720440 DOI: 10.1159/000375129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 01/09/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This randomized controlled study compared a novel transparent urinary tract simulator with the traditional opaque urinary tract simulator as an aid for efficiently teaching urological surgical procedures. METHODS Senior medical students were tested on their understanding of urological theory before and after lectures concerning urinary system disease. The students received operative training using the transparent urinary tract simulator (experimental group, n = 80) or the J3311 opaque plastic urinary tract simulator (control, n = 80), specifically in catheterization and retrograde double-J stent implantation. The operative training was followed by a skills test and student satisfaction survey. RESULTS The test scores for theory were similar between the two groups, before and after training. Students in the experimental group performed significantly better than those in the control group on the procedural skills test, and also had significantly better self-directed learning skills, analytical skills, and greater motivation to learn. CONCLUSION During the initial step of training, the novel transparent urinary tract simulator significantly improved the efficiency of teaching urological procedural skills compared with the traditional opaque device.
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Affiliation(s)
- Xiao Zhong
- Department of Urology, Second Affiliated Hospital, Third Military Medical University, Chongqing, PR China
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Badiyepeymaie Jahromi Z, Mosalanejad L. Integrated method of teaching in Web Quest activity and its impact on undergraduate students' cognition and learning behaviors: a future trend in medical education. Glob J Health Sci 2015; 7:249-59. [PMID: 25946931 PMCID: PMC4802140 DOI: 10.5539/gjhs.v7n4p249] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 11/23/2014] [Indexed: 11/26/2022] Open
Abstract
Introduction: Web Quest is one of the new ways of teaching and learning that is based on research, and includes the principles of learning and cognitive activities, such as collaborative learning, social and cognitive learning, and active learning, and increases motivation. The aim of this study is to evaluate the Web Quest influence on students’ learning behaviors. Materials and Methods: In this quasi-experimental study, which was performed on undergraduates taking a psychiatric course at Jahrom University of Medical Sciences, simple sampling was used to select the cases to be studied; the students entered the study through census and were trained according toWeb Quest methodology. The procedure was to present the course as a case study and team work. Each topic included discussing concepts and then patient’s treatment and the communicative principles for two weeks. Active participation of the students in response to the scenario and introduced problem was equal to preparing scientific videos about the disease and collecting the latest medical treatment for the disease from the Internet. Three questionnaires, including the self-directed learning Questionnaire, teamwork evaluation Questionnaire (value of team), and Buffard self-regulated Questionnaire, were the data gathering tools. Results: The results showed that the average of self-regulated learning and self-directed learning (SDL) increased after the educational intervention. However, the increase was not significant. On the other hand, problem solving (P=0.001) and the value of teamwork (P=0.002), apart from increasing the average, had significant statistical values. Conclusions: In view of Web Quest’s positive impacts on students’ learning behaviors, problem solving and teamwork, the effective use of active learning and teaching practices and use of technology in medical education are recommended.
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The effect of different levels of realism of context learning on the prescribing competencies of medical students during the clinical clerkship in internal medicine: an exploratory study. Eur J Clin Pharmacol 2014; 71:237-42. [PMID: 25511362 DOI: 10.1007/s00228-014-1790-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 12/02/2014] [Indexed: 12/30/2022]
Abstract
PURPOSE The aim of this study is to evaluate the effect of different levels of realism of context learning on the prescribing competencies of medical students during the clinical clerkship in internal medicine. METHODS Between 2001 and 2007, 164 medical students took part in the prospective explorative study during their clinical clerkship in internal medicine at the VU University Medical Center, Amsterdam, The Netherlands. In a fixed order, each student had to formulate a treatment plan for a real patient in three situations of increasing realism: a minimal level (studying a patient record), medium level (preparing for a therapeutic consultation), and optimal level (preparing for and performing a therapeutic consultation with the patient). RESULTS In comparison to studying a patient record (minimal context level), preparing a therapeutic consultation (medium context) improved four of the six steps of the WHO six-step plan. Preparing and performing a therapeutic consultation with a real patient (optimal context) further improved three essential prescribing competencies, namely checking for contraindications and interactions, prescription writing, and instructions to the patient. CONCLUSION AND RECOMMENDATIONS The results of this first explorative study suggest that enrichment of the learning context (responsibility for patient care) might be an important factor to improve the training of rational prescribing skills of medical students during their clinical clerkship in internal medicine. Clinical (pharmacology) teachers should be aware that seemingly small adaptations in the learning context of prescribing training during clinical clerkships (i.e., with or without involvement with and responsibility for patient care) may have relatively large impact on the development of prescribing competencies of our future doctors.
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Selzer R, Tallentire VR, Foley F. The effects of utilizing a near-patient e-learning tool on medical student learning. MEDICAL TEACHER 2014; 37:558-565. [PMID: 25189190 DOI: 10.3109/0142159x.2014.955842] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
CONTEXT This study aimed to develop a near-patient, e-learning tool and explore student views on how utilization of such a tool influenced their learning. METHODS Third year medical students from Monash University in Melbourne, Australia were invited to trial a novel, near-patient, e-learning tool in two separate pilots within the ward environment. All participating students were invited to contribute to focus groups which were audio-recorded, transcribed verbatim and thematically analyzed. RESULTS Four focus groups were conducted with a total of 17 participants. The emerging themes revealed influences on the students' learning both prior to and during a clinical encounter, as well as following completion of an e-learning module. The unifying concept which linked all six themes and formed the central feature of the experience was patient-centered learning. This occurred through the acquisition of contextualized knowledge and the facilitation of workplace integration. CONCLUSIONS Utilization of a near-patient e-learning tool influences medical student learning in a number of complex, inter-related ways. Clinical e-learning tools are poised to become more commonplace and provide many potential benefits to student learning. However, incorporation of technology into clinical encounters requires specific skills which should form an integral part of primary medical training.
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Braeckman L, 't Kint L, Bekaert M, Cobbaut L, Janssens H. Comparison of two case-based learning conditions with real patients in teaching occupational medicine. MEDICAL TEACHER 2014; 36:340-346. [PMID: 24571645 DOI: 10.3109/0142159x.2014.887833] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To investigate the impact of three different training formats in occupational medicine (OM) on perceptions and performance of undergraduate students. METHODS A comparative study which included all fourth-year medical students was conducted over a three-year period. The year group in 2010 (211 students) received paper case studies followed by one small group session. The format used in 2011 actively engaged 188 students in the learning process by adding collaborative work and group discussions to the written information. In 2012, the approach comprised no longer constructed text cases but 212 students encountered real patients. Students' perceptions were obtained by questionnaire. Their learning performance was assessed through review of written reports and score on oral presentations. Statistical differences in ratings were analyzed using Fisher's exact and Kruskal-Wallis tests. RESULTS All three formats were found to equally achieve the stated learning objectives. The year groups with incorporation of active learning strategies and patient contacts had significant better test performance compared to those receiving only written case studies. Real patient students gave statistically significant higher rates for relevance, authenticity and appropriate difficulty level of the training than did students who discussed written case studies. CONCLUSION Both approaches with augmented interaction in 2011 and 2012, improved performance and satisfaction among students. However, students valued the use of real patients higher than paper-form cases.
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