Emergency skills learning on video (ESLOV): A single-blinded randomized control trial of teaching common emergency skills using self-instruction video (SIV) versus traditional face-to-face (FTF) methods

Preparing Medical Students for the Final Examinations During the COVID-19 Crisis: A Bumpy Ride to the Finishing Line

In this viewpoint, we share and reflect on the experiences of final-year students preparing for a high-stakes examination at the Faculty of Medicine, Universiti Kebangsaan Malaysia during the COVID-19 pandemic. We highlight the new challenges faced during web-based remote learning and major differences in the clinical learning environment at our teaching hospital, which was one of the designated COVID-19 centers in Malaysia. We also document how a face-to-face professional examination was conducted for final-year medical students at our institution despite in times of a global health crisis. The lessons learned throughout this process address the importance of resilience and adaptability in unprecedented times. Further, we recommend appropriate measures that could be applied by medical schools across the world to improve the delivery of quality medical education during a crisis in the years to come.

The Effectiveness of Self-Instructional Video vs. Classroom Teaching Method on Focused Assessment With Sonography in Trauma Among House Officers in University Hospital

Background: The aim of this study was to compare the effectiveness of self-instructional-video (SIV) and classroom training method (CTM) in learning Focus-Assessment with Sonography-in-Trauma (FAST) among house officers (HO).

Method: A randomized controlled study involving house officers working in the university hospital in Malaysia was conducted where participants were randomized into SIV group (intervention) and CTM group (control). Each group had to undergo a 4 h hands-on training. The intervention group has undergone self-training using the video material without any facilitation while the control group received lecture and hands-on training with facilitators. Participants' performance was assessed using a validated Objective Structured Clinical Examination checklist for landmark identification and interpretation of images generated. Learning preference and confidence level were also assessed.

Result: A total of 33 HO were enrolled in this study. Marks obtained in image acquisition by the intervention and control were 25.3 (SD = 5.3) and 25.6 (SD = 2.3) p > 0.05, respectively. While in image interpretation, the mean score for the intervention and control group was 10.3 (SD 1.7) and 9.8 (SD = 1.7) p > 0.05, respectively. Overall performance assessment, showed the intervention group obtained 35.6 (SD = 5.9) compared to control 35.3 (SD = 3.4), p > 0.05. Based on pre-specified determinant these scores difference falls within the 10% of non-inferiority margin. The absolute difference between both groups was 0.3 (CI = −3.75 to 3.21, p = 0.871), which proves non-inferiority but not superiority. In terms of learning preference and confidence to perform FAST, most of the participants preferred the control group approach.

Conclusion: The SIV method is as effective as the CTM for learning FAST among the house officers and served as an alternative to classroom teaching. However, this technique needs improvement in promoting their confidence and preference. Perhaps incorporating a feedback session after going through the SIV would improve the confidence.

The Development of an Educational Video on Blood Pressure Measurement for Pharmacy Students

INTRODUCTION

High blood pressure is an important worldwide health issue. Pharmacists can perform multifaceted tasks in hypertension management such as measuring blood pressure. In a time where the use of educational videos in health professions education has increased, an educational video might be an option for teaching blood pressure measurement skills to pharmacy students. This project aimed to develop an educational video tailored to pharmacy students on oscillometric blood pressure measurement in a community pharmacy setting that can be used as a self-instruction video.

METHODS

The video was created with support from the university's multimedia center. The video development was roughly divided into pre-production, production, and post-production. Students' satisfaction with and perception of the video was surveyed.

RESULTS

An 11-minute 33-second self-instruction video in the German language on proper oscillometric blood pressure measurement tailored for pharmacy students was created. Along with descriptive slides, the video delineates the necessary steps of blood pressure measurement in a community pharmacy setting in a role-play, to support students in communication with the patient. Results of a survey on the satisfaction and perception of the video from thirty-seven pharmacy students were included in the analysis and revealed that the video was well accepted by pharmacy students. Moreover, approximately 95% responded that instructional videos should be included in future pharmacy education.

CONCLUSION

We successfully developed an educational video on oscillometric blood pressure measurement for a community pharmacy setting. This work is a valuable form of support for faculty members, who intend to develop educational videos. This might be of interest especially during the coronavirus disease 2019 (COVID-19) pandemic, where distance learning has become highly relevant.

Dissecting the Contemporary Clerkship: Theory-based Educational Trial of Videos Versus Lectures in Medical Student Education

BACKGROUND

Despite increasing use of the flipped classroom (FC) technique in undergraduate medical education, the benefit in learning outcomes over lectures is inconsistent. Best practices in preclass video design principles are rarely used, and it is unclear if videos can replace lectures in contemporary medical education.

METHODS

We conducted a prospective quasi-experimental controlled educational study comparing theory-based videos to traditional lectures in a medical student curriculum. Medical students enrolled in an emergency medicine clerkship were randomly assigned to either a lecture group (LG) or a video group (VG). The slide content was identical, and the videos aligned with cognitive load theory-based multimedia design principles. Students underwent baseline (pretest), week 1 (posttest), and end-of-rotation (retention) written knowledge tests and an observed structured clinical examination (OSCE) assessment. We compared scores between both groups and surveyed student attitudes and satisfaction with respect to the two learning methods.

RESULTS

There were 104 students who participated in OSCE assessments (49 LG, 55 VG) and 101 students who participated in knowledge tests (48 LG, 53 VG). The difference in OSCE scores was statistically significant 1.29 (95% confidence interval = 0.23 to 2.35, t(102) = 2.43, p = 0.017), but the actual score difference was small from an educational standpoint (12.61 for LG, 11.32 for VG). All three knowledge test scores for both groups were not significantly different.

CONCLUSIONS

Videos based on cognitive load theory produced similar results and could replace traditional lectures for medical students. Educators contemplating a FC approach should devote their valuable classroom time to active learning methods.

Effects of three different first-aid training methods on knowledge retention of caregivers and teachers: a randomized and longitudinal cohort study in China

OBJECTIVES

The purpose of this study was to assess the effects of pediatric first-aid training methods on caregivers' and teachers' knowledge retention.

STUDY DESIGN

This was a randomized longitudinal cohort study.

METHODS

A stratified random sampling method was used to select 1282 caregivers and teachers with the help of local education authorities in 18 districts and 1 county of Shanghai, China. The selected caregivers and teachers were randomly allocated into groups that were exposed to 3 models of training, including an interactive training model (group A), lecture-based training model (group B), and video instruction training model (group C), for pediatric first-aid training for caregivers and teachers (PedFACTs). Before and after the training, a descriptive questionnaire composed of demographic information and 37 simple-choice questions about first aid was administered. During the follow-up, 120 caregivers and teachers from each of the three methods were randomized and retested 9 months after their training and 120 caregivers and teachers were randomly reselected in each of the three methods and retested 4 years after their training.

RESULTS

Immediately after training, there was a significant difference in the postassessment results between groups A and B (P = 0.002) as well as between groups A and C (P < 0.001). The average interactive training model score was the highest, followed by the instruction training model and video instruction training model. There was no significant difference among the three groups in the reassessment scores at 9 months and 4 years after training (P = 0.744, P = 0.595). The difference in passing the assessment among the three groups at 9 months or 4 years after training was not maintained at a significant level.

CONCLUSION

The three training methods did not affect knowledge retention of the caregivers and teachers at nine months or four years after training completion. Video instruction may be an effective, convenient, and feasible method to train caregivers and teachers.

Effectiveness of digital resuscitation training in improving knowledge and skills: A systematic review and meta-analysis of randomised controlled trials

AIM

This review aims to evaluate the effectiveness of digital resuscitation training in improving knowledge and skill compared with standard resuscitation training.

METHODS

We searched through the CINAHL, Cochrane Library, EMBASE, ERIC, ProQuest Dissertations and Thesis, PsycINFO, PubMed and Scopus from inception of our review until 5 March 2018. The quality of individual and overall evidence was evaluated according to the risk of bias, Medical Education Research Study Quality Instrument (MERSQI) and Grade of Recommendation, Assessment, Development and Evaluation (GRADE) system, respectively. Meta-analyses were performed with the Review Manger software. Z-statistics were used to evaluate the overall effect of training, and I² test was used to assess heterogeneity. Sensitivity and subgroup analyses were used for additional meta-analyses.

RESULTS

Amongst the 15,528 studies retrieved, 20 randomised controlled trials (RCTs) were selected from 13 countries across different ethnicities. More than half (52%) of the trials had a low risk of bias, and MERSQI scores ranged from 13.5 to 15.5. The overall quality of evidence was very low according to GRADE criteria. Meta-analyses revealed that trainees in digital resuscitation training had better knowledge scores but poorer chest compression rates than that of trainees in standard resuscitation training. Digital resuscitation trainings were non-inferior to standard resuscitation trainings in skill performance scores. Subgroup analyses suggested that digital resuscitation training might consider using blended learning approach with virtual patient, computer-screen based, learning theories and video-recorded assessment, especially for basic life support trainings amongst health professionals.

CONCLUSION

Despite the wide variation in digital resuscitation trainings, evidence suggesting the use of digital resuscitation training for improving knowledge and skills is inadequate. Well-designed non-inferiority RCTs in multiple settings with follow-up data and large sample size are needed to ensure the robustness of the evidence.

Effectiveness of teaching automated external defibrillators use using a traditional classroom instruction versus self-instruction video in non-critical care nurses

Objectives:

To evaluate the effectiveness and retention of learning automated external defibrillator (AED) usage taught through a traditional classroom instruction (TCI) method versus a novel self instructed video (SIV) technique in non-critical care nurses (NCCN).

Methods:

A prospective single-blind randomized study was conducted over 7 months (April-October 2014) at the Universiti Kebangsaan Malaysia Medical Center, Kuala Lampur, Malaysia. Eighty nurses were randomized into either TCI or SIV instructional techniques. We assessed knowledge, skill and confidence level at baseline, immediate and 6-months post-intervention. Knowledge and confidence were assessed via questionnaire; skill was assessed by a calibrated and blinded independent assessor using an objective structured clinical examination (OSCE) method.

Results:

Pre-test mean scores for knowledge in the TCI group was 10.87 ± 2.34, and for the SIV group was 10.37 ± 1.85 (maximum achievable score 20.00); 4.05 ± 2.87 in the TCI and 3.71 ± 2.66 in the SIV (maximum score 11.00) in the OSCE evaluation and 9.54 ± 3.65 in the TCI and 8.56 ± 3.47 in the SIV (maximum score 25.00) in the individual’s personal confidence level. Both methods increased the mean scores significantly during immediate post-intervention (0-month). At 6-months, the TCI group scored lower than the SIV group in all aspects 11.13 ± 2.70 versus 12.95 ± 2.26 (p=0.03) in knowledge, 7.27 ± 1.62 versus 7.68 ± 1.73 (p=0.47) in the OSCE, and 16.40 ± 2.72 versus 18.82 ± 3.40 (p=0.03) in confidence level.

Conclusion:

In NCCN’s, SIV is as good as TCI in providing the knowledge, competency, and confidence in performing AED defibrillation.

Beyond homogenization discourse: Reconsidering the cultural consequences of globalized medical education

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.