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Kebaetse MB, Griffiths D, Mokone GG, Mogodi MS, Conteh BG, Nkomazana O, Wright J, Falama R, Kebaetse M. Sociocultural factors affecting first-year medical students' adjustment to a PBL program at an African medical school. BMC MEDICAL EDUCATION 2024; 24:277. [PMID: 38481223 PMCID: PMC10938797 DOI: 10.1186/s12909-024-05229-0] [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: 05/25/2023] [Accepted: 02/26/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Besides regulatory learning skills, learning also requires students to relate to their social context and negotiate it as they transition and adjust to medical training. As such, there is a need to consider and explore the role of social and cultural aspects in student learning, particularly in problem-based learning, where the learning paradigm differs from what most students have previously experienced. In this article, we report on the findings of a study exploring first-year medical students' experiences during the first semester of an undergraduate problem-based learning medical program at an African medical school. METHOD We employed a qualitative case study approach using in-depth interviews with 23 first-year medical students. Participants ranged in age from 18 to 25 years. All students were bi/multilingual (some spoke three to five languages), with English as the learning language. We conducted an inductive thematic analysis to systematically identify and analyze patterns in the data using the Braun and Clarke framework. RESULTS Before medical school, students worked hard to compete for admission to medical school, were primarily taught using a teacher-centered approach, and preferred working alone. At the beginning of medical school, students found it challenging to understand the problem-based learning process, the role of the case, speaking and working effectively in a group, managing a heavy workload, and taking increased responsibility for their learning. By the end of the first semester, most students were handling the workload better, were more comfortable with their peers and facilitators, and appreciated the value of the problem-based learning approach. CONCLUSIONS Our study highlights the importance of interrogating contextual sociocultural factors that could cause tension when implementing problem-based learning in non-western medical schools. Adjustment to problem-based learning requires a conceptual and pedagogic shift towards learner-centered practice, particularly concerning self-direction, the role of the case, and collaborative learning. As such, there is a need to develop and implement research-informed learning development programs that enable students to reflect on their sociocultural beliefs and practices, and enhance their regulatory learning competence to optimize meaningful and early engagement with the problem-based learning process.
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Affiliation(s)
- Masego B Kebaetse
- Department of Medical Education, University of Botswana, Gaborone, Botswana.
| | - Dominic Griffiths
- Wits School of Education, University of the Witwatersrand, Witwatersrand, South Africa
| | - Gaonyadiwe G Mokone
- Department of Biomedical Sciences, University of Botswana, Gaborone, Botswana
| | - Mpho S Mogodi
- Department of Medical Education, University of Botswana, Gaborone, Botswana
| | - Brigid G Conteh
- Communication and Study Skill Unit, University of Botswana, Gaborone, Botswana
| | | | - John Wright
- Department of Biomedical Sciences, University of Botswana, Gaborone, Botswana
| | - Rosemary Falama
- Department of Medical Education, University of Botswana, Gaborone, Botswana
| | - Maikutlo Kebaetse
- Department of Biomedical Sciences, University of Botswana, Gaborone, Botswana
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Zhou F, Sang A, Zhou Q, Wang QQ, Fan Y, Ma S. The impact of an integrated PBL curriculum on clinical thinking in undergraduate medical students prior to clinical practice. BMC MEDICAL EDUCATION 2023; 23:460. [PMID: 37340355 DOI: 10.1186/s12909-023-04450-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 06/14/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Problem-based learning (PBL) is a widely adopted educational approach in medical education that aims to promote critical thinking and problem-solving in authentic learning situations. However, the impact of PBL educational mode on undergraduate medical students' clinical thinking ability has been limitedly investigated. This study aimed to assess the influence of an integrated PBL curriculum on clinical thinking ability of medical students prior to clinical practice. METHODS Two hundred and sixty-seven third-year undergraduate medical students at Nantong University were recruited in this study and were independently assigned to either the PBL or control group. The Chinese version of the Clinical Thinking Ability Evaluation Scale was used to assess clinical thinking ability, and the students' performance in the PBL tutorials was assessed by tutors. All participants in both groups were required to complete the pre-test and post-test questionnaires to self-report their clinical thinking ability. A paired sample t-test, independent sample t-test and one-way analysis of variance test (ANOVA) were used to compare the difference in clinical thinking scores among different groups. Multiple linear regression was conducted to analyze the influencing factors correlated with clinical thinking ability. RESULTS The clinical thinking ability of most third-year undergraduate medical students at Nantong University was at a high level. The PBL group had a higher proportion of students with high-level clinical thinking ability in the post-test compared to the control group. The pre-test scores of clinical thinking ability were similar between the PBL and control groups, but the post-test scores of clinical thinking ability in the PBL group were significantly higher than those in the control group. Additionally, there was a significant difference in clinical thinking ability between the pre-test and post-test in the PBL group. The post-test scores of sub-scales of critical thinking ability were significantly higher than the pre-test in the PBL group. Furthermore, the frequency of reading literature, time of PBL self-directed learning, and PBL performance score ranking were influencing factors on the clinical thinking ability of medical students in the PBL group. Moreover, there was a positive correlation between clinical thinking ability and the frequency of reading literature, as well as the scores of the PBL performance. CONCLUSIONS The integrated PBL curriculum model has an active impact on improving undergraduate medical students' clinical thinking ability. This improvement in clinical thinking ability may be correlated with the frequency of reading literature, as well as the performance of the PBL curriculum.
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Affiliation(s)
- Feng Zhou
- Practice and Training Educational Office, School of Medicine, Nantong University, Nantong, 226000, China
| | - Aiming Sang
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Qing Zhou
- Education and Training Department, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Qing Qing Wang
- Department of Thyroid and Breast Surgery, PBL Medical Integrated Education Research Office, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Yao Fan
- Teaching Management Office, School of Medicine, Nantong University, Nantong, 226000, China
| | - Songhua Ma
- Department of Physiology, PBL Medical Integrated Education Research Office, School of Medicine, Nantong University, Nantong, 226000, China.
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Beauchamp NJ, Bryan RN, Bui MM, Krestin GP, McGinty GB, Meltzer CC, Neumaier M. Integrative diagnostics: the time is now-a report from the International Society for Strategic Studies in Radiology. Insights Imaging 2023; 14:54. [PMID: 36995467 PMCID: PMC10063732 DOI: 10.1186/s13244-023-01379-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 03/31/2023] Open
Abstract
Enormous recent progress in diagnostic testing can enable more accurate diagnosis and improved clinical outcomes. Yet these tests are increasingly challenging and frustrating; the volume and diversity of results may overwhelm the diagnostic acumen of even the most dedicated and experienced clinician. Because they are gathered and processed within the "silo" of each diagnostic discipline, diagnostic data are fragmented, and the electronic health record does little to synthesize new and existing data into usable information. Therefore, despite great promise, diagnoses may still be incorrect, delayed, or never made. Integrative diagnostics represents a vision for the future, wherein diagnostic data, together with clinical data from the electronic health record, are aggregated and contextualized by informatics tools to direct clinical action. Integrative diagnostics has the potential to identify correct therapies more quickly, modify treatment when appropriate, and terminate treatment when not effective, ultimately decreasing morbidity, improving outcomes, and avoiding unnecessary costs. Radiology, laboratory medicine, and pathology already play major roles in medical diagnostics. Our specialties can increase the value of our examinations by taking a holistic approach to their selection, interpretation, and application to the patient's care pathway. We have the means and rationale to incorporate integrative diagnostics into our specialties and guide its implementation in clinical practice.
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Affiliation(s)
| | - R Nick Bryan
- University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
| | - Marilyn M Bui
- Moffitt Cancer Center and Research Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Gabriel P Krestin
- Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - Carolyn C Meltzer
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Michael Neumaier
- Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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4
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Ho YR, Chen BY, Li CM. Thinking more wisely: using the Socratic method to develop critical thinking skills amongst healthcare students. BMC MEDICAL EDUCATION 2023; 23:173. [PMID: 36941597 PMCID: PMC10026783 DOI: 10.1186/s12909-023-04134-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 03/02/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND In medicine, critical thinking is required for managing and tolerating medical uncertainty, as well as solving professional problems and treating diseases. However, the core of Confucianism, teacher-centered and exam-oriented settings in middle and high school education may pose challenges to developing critical thinking in Han Chinese or Taiwanese students. Students may be adversely affected by these pedagogies since student-centered settings were more effective in stimulating their critical and reflective thinking, as well as a sense of responsibility, in the ever-changing world. Therefore, guiding students with less stable foundations of critical thinking might require a different approach. A review article highlighted the potential utility of the Socratic method as a tool for teaching critical thinking in the healthcare field. The method involves posing a series of questions to students. More importantly, medical students and residents in clinical teaching are familiar with the method. Almost all healthcare students must complete a biochemistry laboratory course as part of their basic science training. Thus, we aimed to train students to develop critical thinking in the biochemistry laboratory course by using learning sheets and teacher guidance based on the Socratic method and questioning. METHOD We recruited second-year students from a medical school, of whom 32 had medical science and biotechnology majors (MSB), 27 had pharmaceutical science majors (PS), and 85 were medical undergraduate (MU) students. An exercise in critical thinking was conducted during a biochemistry laboratory course, which consisted of five different biochemical experiments, along with learning sheets that contained three or four critical thinking questions. Then, the teacher evaluated the students' ability to think critically based on nine intellectual dimensions (clarity, accuracy, precision, relevance, depth, breadth, logic, fairness, and significance) based on the universal intellectual standards developed by Prof. Linda Elder and Richard Paul. In the following analysis, regression models and multivariate analysis were used to determine how students improved over time, and trajectory analysis were carried out in order to observe the trends in students' critical thinking skills construction. RESULTS Clarity and logic dimensions were identified as the key elements to facilitate the development of critical thinking skills through learning sheets and teacher guidance in students across all three different healthcare majors. The results showed that metacognitive monitoring via Socratic questioning learning sheets have demonstrated potential encourage students to develop critical thinking skills in all dimensions. Another unique contribution of current study was present the heterogeneous learning patterns and progress trajectories of clarity and logic dimensions within classes. CONCLUSION Using the Socratic learning model could effectively develop students' critical thinking skills so they can more effectively care for their patients.
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Affiliation(s)
- Yueh-Ren Ho
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, University Road No.1, East District 701, Tainan City, Taiwan (R.O.C.).
- School of Medicine, College of Medicine, National Cheng Kung University, University Road No.1, East District 701, Tainan City, Taiwan (R.O.C.).
| | - Bao-Yu Chen
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, University Road No.1, East District 701, Tainan City, Taiwan (R.O.C.)
| | - Chien-Ming Li
- School of Medicine, College of Medicine, National Cheng Kung University, University Road No.1, East District 701, Tainan City, Taiwan (R.O.C.)
- Division of Infectious Diseases, Department of Internal Medicine, Chi Mei Medical Center, Zhonghua Raod No.901, Yongkang District 710, Tainan City, Taiwan (R.O.C.)
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5
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Beauchamp NJ, Bryan RN, Bui MM, Krestin GP, McGinty GB, Meltzer CC, Neumaier M. Integrative Diagnostics: The Time Is Now-A Report From the International Society for Strategic Studies in Radiology. J Am Coll Radiol 2022; 20:455-466. [PMID: 36565973 DOI: 10.1016/j.jacr.2022.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/01/2022] [Accepted: 11/04/2022] [Indexed: 12/24/2022]
Abstract
Enormous recent progress in diagnostic testing can enable more accurate diagnosis and improved clinical outcomes. Yet these tests are increasingly challenging and frustrating; the volume and diversity of results may overwhelm the diagnostic acumen of even the most dedicated and experienced clinician. Because they are gathered and processed within the "silo" of each diagnostic discipline, diagnostic data are fragmented, and the electronic health record does little to synthesize new and existing data into usable information. Therefore, despite great promise, diagnoses may still be incorrect, delayed, or never made. Integrative diagnostics represents a vision for the future, wherein diagnostic data, together with clinical data from the electronic health record, are aggregated and contextualized by informatics tools to direct clinical action. Integrative diagnostics has the potential to identify correct therapies more quickly, modify treatment when appropriate, and terminate treatment when not effective, ultimately decreasing morbidity, improving outcomes, and avoiding unnecessary costs. Radiology, laboratory medicine, and pathology already play major roles in medical diagnostics. Our specialties can increase the value of our examinations by taking a holistic approach to their selection, interpretation, and application to the patient's care pathway. We have the means and rationale to incorporate integrative diagnostics into our specialties and guide its implementation in clinical practice.
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Affiliation(s)
- Norman J Beauchamp
- Executive Vice President for Health Sciences, Michigan State University, East Lansing, Michigan
| | - R Nick Bryan
- University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Marilyn M Bui
- Moffitt Cancer Center and Research Institute, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Gabriel P Krestin
- Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Geraldine B McGinty
- Senior Associate Dean for Clinical Affairs, Weill Cornell Medicine, New York, New York
| | - Carolyn C Meltzer
- Dean, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Michael Neumaier
- Chairman of Clinical Chemistry, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Zhong C, Lyu K. Scaffolding Junior Middle School Students' Engagement in Online Project-based Learning During the COVID-19 Pandemic: A Case Study from East China. SAGE OPEN 2022; 12:21582440221131815. [PMID: 36317072 PMCID: PMC9596682 DOI: 10.1177/21582440221131815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
During the COVID-19 pandemic, online learning has experienced increasing utilization and poses new challenges for schoolteachers to engage students. Project-based Learning (PBL) is widely acknowledged as an effective pedagogy for motivating and involving students. However, few studies have examined scaffolds that facilitate student engagement in the context of distance PBL. This mixed-method study was conducted with grade 7 teachers and students in a junior middle school in East China from March 2020 to April 2020. Qualitative analysis was employed in interviews with 2 teachers and 21 students. Quantitative analysis was used to visualize the self-reflection reports of 39 students. The findings suggest that the scaffolds of teacher direction, technology support, peer collaboration, and parental assistance play a significant role. In addition, specific scaffolding within the above categories was revealed. The results highlight the problem-oriented, methodological, and synthesized application of various scaffold(ing)s in engaging students and emphasize that scaffolding students emotionally is the core issue to support engagement for remote learning.
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Affiliation(s)
- Cheng Zhong
- Chinese University of Hong Kong,
Hongkong, China
| | - Keyi Lyu
- Hangzhou Normal University, Hangzhou,
China
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7
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Tsai CL, Chiu YL, Chao CT, Lin MW, Ho CC, Chen HL, Sheu BC, Hsu C, Yang CW. Effectiveness of tutor shadowing on faculty development in problem-based learning. BMC MEDICAL EDUCATION 2022; 22:564. [PMID: 35869547 PMCID: PMC9306026 DOI: 10.1186/s12909-022-03615-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND To enhance tutors' teaching skills, tutor shadowing for novice tutors of problem-based learning (PBL) in addition to conventional faculty development (FD) was applied. This study aimed to develop a tutoring-skill scale (TS-scale) and evaluate the effect of shadowing on PBL tutors. METHODS This study employed a before-and-after study design with three phases. In phase 1, a TS-scale was elaborated. A validity examination was performed in phase 2. Phase 3 was a study of the effectiveness using a TS-scale survey of novice PBL tutors before and after the FD course. The FD course for novice PBL tutors included an FD workshop and PBL shadowing activities. RESULTS A TS-scale with a 32-item questionnaire of self-rated confidence for PBL tutors was identified in phase 1. In phase 2, 7 experienced specialists in medical education were invited to evaluate the content validity of the scale. The item content validity index (I-CVI) ranged from 0.86 to 1, and the scale-CVI (S-CVI) was 0.95. A total of 85 novice PBL tutors completed the TS-scale before the FD course, yielding a Cronbach's alpha of 0.98. An exploratory factor analysis with varimax rotation was performed. The twenty-four items with significant loadings greater than 0.5 were incorporated into a new TS-scale and were grouped into three factors: student contact, medical expertise, and teaching expertise. In phase 3, 76 novice PBL tutors completed the 24-item TS-scale before (pretest) and after (posttest) the FD course. Their self-rated confidence improved significantly across the three factors after the FD course. The pretest and posttest scores did not differ according to the tutors' gender, the grades they taught, or their specialty background. CONCLUSIONS Novice PBL tutors benefit from FD that incorporates tutor shadowing in the 3 key domains of tutoring competencies. The TS-scale developed in this study can be applied in future research on FD design.
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Affiliation(s)
- Chiao-Ling Tsai
- Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Center of Faculty Development and Curriculum Integration, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yen-Lin Chiu
- Graduate Institute of Medical Education and Bioethics, National Taiwan University College of Medicine, No. 1, Sec. 1, Ren'ai Rd., Zhongzheng Dist., 100, Taipei, Taiwan
| | - Chia-Ter Chao
- Center of Faculty Development and Curriculum Integration, National Taiwan University College of Medicine, Taipei, Taiwan
- Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Mong-Wei Lin
- Center of Faculty Development and Curriculum Integration, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Chao-Chi Ho
- Center of Faculty Development and Curriculum Integration, National Taiwan University College of Medicine, Taipei, Taiwan
- Chest Medicine Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Huey-Ling Chen
- Graduate Institute of Medical Education and Bioethics, National Taiwan University College of Medicine, No. 1, Sec. 1, Ren'ai Rd., Zhongzheng Dist., 100, Taipei, Taiwan
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Bor-Ching Sheu
- Center of Faculty Development and Curriculum Integration, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chiun Hsu
- Center of Faculty Development and Curriculum Integration, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Education and Research, Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Chih-Wei Yang
- Graduate Institute of Medical Education and Bioethics, National Taiwan University College of Medicine, No. 1, Sec. 1, Ren'ai Rd., Zhongzheng Dist., 100, Taipei, Taiwan.
- Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan.
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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Seki M, Fujinuma Y, Matsushima M, Joki T, Okonogi H, Miura Y, Ohno I, Hiramoto J. Use of a 2-year continuing professional development programme to change Japanese physicians' attitudes to learning primary care: a qualitative study. BMJ Open 2022; 12:e059925. [PMID: 35820767 PMCID: PMC9277376 DOI: 10.1136/bmjopen-2021-059925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To evaluate changes in the learning attitudes of primary care physicians. DESIGN Qualitative study through one focus group interview with the programme's participants. Analysis of the focus group content using the Steps for Coding and Theorization method. SETTING Japan. PARTICIPANTS Eight primary care physicians who completed a 2-year continuing professional development (CPD) programme using a problem-based learning (PBL) approach, focused on acquiring the skills needed to practise as primary care physicians in the community. RESULTS Participants described positive changes in their attitudes and behaviours as a result of the training programme. These changes were grouped into three main themes: 'changes in learning methods regarding medical practice', 'encounters with diverse perspectives and values, and confidence gained from those encounters', and 'showing one's attitude towards learning and its influence on others'. The experienced practitioners participating in this study reported that the programme helped them apply their skills more broadly; for example, searching the literature for psychosocial aspects of practice and engaging more comfortably with diverse perspectives. They reported the positive impact of their learning on their coworkers. CONCLUSION A 2-year CPD programme using PBL can influence primary care physicians' attitudes and learning-related behaviours. Further research is needed to determine which specific aspects of the programme are the most effective and whether the changes in attitudes and behaviours described affect patient care.
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Affiliation(s)
- Masayasu Seki
- Division of General Medicine, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuki Fujinuma
- Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
- Seikyo-ukima Clinic, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
| | - Masato Matsushima
- Division of Clinical Epidemiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tatsuhiro Joki
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Hideo Okonogi
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuhiko Miura
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Iwao Ohno
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Jun Hiramoto
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
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Problem-Based Learning in der Ethiklehre am Beispiel des Bachelorstudiums Pflege. Ethik Med 2022. [DOI: 10.1007/s00481-022-00691-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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10
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Webster A, Metcalf A, Kelly L, Bisesi A, Marnik-Said M, Colbeck C, Marine R, Vinces M, Campbell A, Allen T. Undergraduates' lived experience of project-/problem-based learning in introductory biology. ADVANCES IN PHYSIOLOGY EDUCATION 2022; 46:162-178. [PMID: 34990300 DOI: 10.1152/advan.00042.2021] [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: 03/29/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
Recommendations for enhancing scientific literacy, inclusivity, and the ecosystem for innovation call for transitioning from teacher-centered to learner-centered science classrooms, particularly at the introductory undergraduate level. Yet little is documented about the challenges that undergraduates perceive in such classrooms and the students' ways of navigating them. Via mixed methods, we studied undergraduates' lived experience in one form of learner-centered teaching, hybrid project-/problem-based learning (PBL), in introductory organismal biology at a baccalaureate institution. Prominent in qualitative analyses of student interviews and written reflections were undergraduates' initial expectation of and longing for an emphasis on facts and transmission of them. The prominence diminished from semester's middle to end, as students came to value developing ideas, solving problems collaboratively, and engaging in deep ways of learning. Collaboration and personal resources such as belief in self emerged as supports for these shifts. Quantitative analyses corroborated that PBL students transformed as learners, moving toward informed views on the nature of science, advancing in multivariable causal reasoning, and more frequently adopting deep approaches for learning than students in lecture-based sections. The qualitative and quantitative findings portray the PBL classroom as an intercultural experience in which culture shock yields over time to acceptance in a way supported by students' internal resources and peer collaboration. The findings have value to those seeking to implement PBL and other complex-learning approaches in a manner responsive to the lived experience of the learner.
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Affiliation(s)
| | | | - Lauren Kelly
- Biology Department, Oberlin College, Oberlin, Ohio
| | - Ave Bisesi
- Center for Learning, Education, and Research in the Sciences, Oberlin College, Oberlin, Ohio
| | | | - Carol Colbeck
- Organizational Change Consultants, Sequim, Washington
| | - Robert Marine
- Organizational Change Consultants, Sequim, Washington
| | - Marcelo Vinces
- Center for Learning, Education, and Research in the Sciences, Oberlin College, Oberlin, Ohio
- Weinberg College Adviser, Northwestern University, Evanston, Illinois
| | - Amy Campbell
- Biology Department, Oberlin College, Oberlin, Ohio
| | - Taylor Allen
- Biology Department, Oberlin College, Oberlin, Ohio
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Shimizu I, Kimura T, Duvivier R, van der Vleuten C. Modeling the effect of social interdependence in interprofessional collaborative learning. J Interprof Care 2022; 36:820-827. [DOI: 10.1080/13561820.2021.2014428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ikuo Shimizu
- Center for Medical Education and Clinical Training, Shinshu University, Matsumoto, Japan
| | - Teiji Kimura
- Department of Fundamental Physical Therapy, Shinshu University, Matsumoto, Japan
| | - Robbert Duvivier
- Center for Educational Development and Research in Health Sciences (CEDAR), University Medical Center Groningen, Groningen, The Netherlands
| | - Cees van der Vleuten
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Effective Veterinary Clinical Teaching in a Variety of Teaching Settings. Vet Sci 2022; 9:vetsci9010017. [PMID: 35051101 PMCID: PMC8779673 DOI: 10.3390/vetsci9010017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/29/2021] [Accepted: 01/03/2022] [Indexed: 12/04/2022] Open
Abstract
This review explores different modalities for clinical teaching of veterinary learners globally. Effective clinical teaching aims to prepare graduates for a successful career in clinical practice. Unfortunately, there is scant literature concerning clinical teaching in veterinary medicine. Our intent for this review is to stimulate and/or facilitate discussion and/or research in this important area. We discuss the different forms that veterinary clinical teaching can take, depending on their setting, which can be university-based clinical activities, work-based in commercial clinical practices, or in a traditional academic setting with little to no real-time exposure to clients and patients. We suggest that each of these modalities has a place in clinical teaching of veterinary learners at any point in the curriculum but that a mix of these approaches will likely provide an improved experience for the learner. Further, we discuss strategies to improve clinical teaching in these different settings. Potential strategies related to the teaching skills of clinical instructors could include training in delivery of clinical teaching in a variety of learning settings, and instructors’ official recognition, including opportunities for career progression. Potential strategies to improve clinical teaching in different teaching settings would vary with the learning settings. For example, in traditional academic settings, case-based learning with incorporation of simulation models is one proposed strategy. The involvement of learners in ‘teach-others’ is a strategy for both traditional academic and clinical settings. Finally, clearly addressing Day One competencies is required in any clinical teaching setting.
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Lundegren N, Jönsson A, Lindberg P. An upgrade of the Malmö model by implementing case-based teaching and learning, in an undergraduate dental education. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2021; 25:649-656. [PMID: 33314476 PMCID: PMC8597100 DOI: 10.1111/eje.12642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/25/2020] [Accepted: 12/06/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND At our dental education, the examination failure rate amongst students has increased, resulting in subsequent involuntary dropouts. One of the main problems seems to be that the students struggle with taking the necessary responsibility for their learning, as required by the problem-based learning (PBL) methodology. AIM To describe the background to, and the transition process from, pure PBL to case-based teaching and learning (CBT) with flipped classroom seminars at the dental programme at [anonymised for peer review]. METHODS In this position paper, we describe our observed problems with the PBL methodology, as implemented at this faculty, and the potential benefits of a change towards CBT. The current implementation of CBT is presented, along with educational research supporting the choice of activities. RESULTS Tentative findings are that the flipped classroom seminars and the clearer instructions appear to be successful with higher levels of activity, engagement and attendance amongst the students, and the students have evaluated the seminars as very good learning activities. CONCLUSION Tentative findings suggest that the current implementation of CBT may be a fruitful way of teaching in dental education today. Most of the teaching staff have been reawakened to teaching, and as a result, the content of the courses are being reviewed and improved. The students appreciate that what is expected of them has been made clearer and that there is a variety of learning activities.
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Affiliation(s)
- Nina Lundegren
- Oral DiagnosticsSection 4Faculty of OdontologyMalmö UniversityMalmöSweden
| | - Anders Jönsson
- Faculty of EducationUniversity of KristianstadKristianstadSweden
| | - Pia Lindberg
- Oral PathologySection 1Faculty of OdontologyMalmö UniversityMalmöSweden
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Abrandt Dahlgren M, Valeskog K, Johansson K, Edelbring S. Understanding clinical reasoning: A phenomenographic study with entry-level physiotherapy students. Physiother Theory Pract 2021; 38:2817-2826. [PMID: 34544323 DOI: 10.1080/09593985.2021.1976332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Entry-level students' conceptualizations of clinical reasoning can provide a starting point for program planning related to clinical reasoning development with a focus on patient-centered care. OBJECTIVE The aim of the study is to explore how physiotherapy students understand clinical reasoning midway through their education. Nine physiotherapy students were interviewed at the end of their third semester. METHODS Semi-structured individual interviews were conducted, recorded and transcribed verbatim. A phenomenographic approach to qualitative data analysis, seeking to explore variations in students' conceptions was applied. RESULTS The students' ways of understanding clinical reasoning could be described as: 1) the cognitive process of the physiotherapist; and 2) the relational process of the collaborative partnership between the physiotherapist and the patient. A contrastive analysis shows how the cognitive and relational perspectives are developed through the relationships among three dimensions of clinical reasoning: 1) problem-solving; 2) context of working; and 3) own learning. CONCLUSION By identifying the critical variation in students' conceptions of clinical reasoning, focus can be placed on pedagogical arrangements to facilitate students' progression toward a person-centered approach.
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Affiliation(s)
- Madeleine Abrandt Dahlgren
- Department of Medicine, Health and Caring Sciences, Medical Education, Linköping University, Linköping, SE, Sweden
| | - Karin Valeskog
- Department of Medicine, Health and Caring Sciences, Division of Physiotherapy Linköping University, Linköping, SE, Sweden
| | - Kajsa Johansson
- Department of Medicine, Health and Caring Sciences, Division of Physiotherapy Linköping University, Linköping, SE, Sweden
| | - Samuel Edelbring
- School of Health Sciences, Örebro University, Örebro, SE, Sweden
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Gray MM, Dadiz R, Izatt S, Gillam-Krakauer M, Carbajal MM, Falck AJ, Bonachea EM, Johnston LC, Karpen H, Vasquez MM, Chess PR, French H. Value, Strengths, and Challenges of e-Learning Modules Paired with the Flipped Classroom for Graduate Medical Education: A Survey from the National Neonatology Curriculum. Am J Perinatol 2021; 38:e187-e192. [PMID: 32276279 DOI: 10.1055/s-0040-1709145] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE This study aimed to determine the value, strengths, and challenges of implementing an e-learning based flipped classroom (FC) educational modality as part of the standardized physiology National Neonatology Curriculum (NNC), created for neonatal-perinatal medicine (NPM) fellow learners and faculty educators. STUDY DESIGN This is a cross-sectional study of NPM fellows and faculty educators who utilized at least one of the e-learning based NNC FC respiratory physiology programs between May and September 2018. Participants were surveyed anonymously regarding their experiences participating in the NNC, including measures of preparation time. A combination of descriptive statistics and proportion comparisons were used for data analysis. RESULTS Among 172 respondents, the majority of fellow and faculty respondents reported positive attitudes toward the educational content and case discussions, and the majority supported national standardization of NPM physiology education (92%). Fellows reported greater preclass preparation for their FC compared with previous didactic lectures (30-60 vs. 0-15 minutes, p < 0.01). Faculty facilitators reported less preparation time before facilitating a FC compared with the time required for creating a new didactic lecture (median: 60 vs. 240 minutes, p < 0.01). Both fellows and faculty respondents preferred the FC approach to traditional didactics, with fellows showing a greater degree of preference than faculty (68 vs. 52%, respectively, p = 0.04). CONCLUSION Fellows and faculty educators supported the FC learning, reporting peer-to-peer learning, and the establishment of a learning community which promotes adult learning and critical thinking skills. A national physiology curriculum creates equitable and engaging educational experiences for all NPM fellows while reducing individual program burden of content creation. Our findings further supported the development of an NNC using a flipped classroom modality.
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Affiliation(s)
- Megan M Gray
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Rita Dadiz
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Susan Izatt
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| | - Maria Gillam-Krakauer
- Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Melissa M Carbajal
- Section of Neonatology, Department of Pediatrics, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas
| | - Alison J Falck
- Department of Pediatrics, University of Maryland, Baltimore, Maryland
| | | | - Lindsay C Johnston
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
| | - Heidi Karpen
- Department of Pediatrics, Emory Children's Pediatric Institute, Atlanta, Georgia
| | - Margarita M Vasquez
- Department of Pediatrics, University of Texas Health San Antonio, San Antonio, Texas
| | - Patricia R Chess
- Division of Pediatrics and Biomedical Engineering, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Heather French
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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16
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Learning from Problem-Based Projects in Cross-Disciplinary Student Teams. EDUCATION SCIENCES 2021. [DOI: 10.3390/educsci11060259] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper explores how Engineering students and Work and Welfare students reflect upon their own engagement in a one-week cross-disciplinary project. To develop a better understanding of what unfolds during these activities we collected data through anonymous surveys two consecutive years. Data from these 141 respondents were analysed using a learning history approach and are presented as narratives. Results show major disruptions and conflicts driving the student projects, exposing inviting confrontations, social identity threats, managing diversity, and friction of ideas. Whereas this in many cases led to new and better project solutions, these real-world experiences raise awareness of the need for tools and methods for training students. The aim of the paper is to learn from students’ experiences through narrative distance, and fill a gap in the literature between problem-based learning (PBL) and the learning history method. Discussing different experiences of cross-disciplinary teamwork through the explanations of these theories, we also lay out potential questions for future research on the topic.
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17
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Jhou HJ, Ou-Yang LJ, Lin MH, Chen PH, Ho CL, Lee CH. Different pedagogies for acquisition of knowledge and skill: a systematic review and network meta-analysis. Postgrad Med J 2021; 98:604-609. [PMID: 33931555 DOI: 10.1136/postgradmedj-2021-140076] [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] [Received: 03/05/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND This network meta-analysis aimed to assess the efficacy of different educational methods for healthcare professionals. METHODS A systematic literature search was conducted to identify relevant randomised controlled trials. The standardised mean difference (SMD) with 95% CI was estimated using network meta-analysis for knowledge acquisition and skill performance, and ranked the effects of different educational methods using the surface under the cumulative ranking area (SCURA) technique. RESULTS Fifty-five randomised controlled trials including of 4292 participants were identified. Compared with no intervention, the results demonstrated all education methods achieved significant improvements in knowledge acquisition (SMD 1.73-2.66). Only education methods involving high fidelity virtual patient simulation reported significantly better skill performance (SMD 1.25-1.81). High fidelity virtual patient simulation plus self-directed learning was the most effective educational method both in terms of knowledge acquisition (SMD 2.66, 95% CI 1.4 to 4.12, SCURA 0.78) and skill performance (SMD 1.81, 95% CI 0.42 to 3.2, SCURA 0.89). CONCLUSIONS Our study demonstrates all educational methods have positive effects on knowledge acquisition, but education methods involving high fidelity virtual patient simulation are better at improving skill performance than other methods.
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Affiliation(s)
- Hong-Jie Jhou
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Liang-Jun Ou-Yang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ming-Hsun Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Po-Huang Chen
- Department of General Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ching-Liang Ho
- Division of Hematology and Oncology Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Cho-Hao Lee
- Division of Hematology and Oncology Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Shimizu I, Matsuyama Y, Duvivier R, van der Vleuten C. Contextual attributes to promote positive social interdependence in problem-based learning: a focus group study. BMC MEDICAL EDUCATION 2021; 21:222. [PMID: 33879160 PMCID: PMC8059308 DOI: 10.1186/s12909-021-02667-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/13/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Problem-based learning (PBL) is classified as a collaborative learning approach, wherein students learn while contributing meaning to experiences and interactions with others. An important theoretical fundament of PBL is social interdependence theory (SIT) because positive social interdependence within a group has been found to be key to better learning performance and future attitudes towards team practice. However, most previous studies in health professions education focused on cognitive outcomes, and few studies have focused on collaborative behaviors in PBL groups. The lack of this empirical insight makes implementation of PBL difficult, especially in contexts where there is limited experience with collaborative learning. Therefore, the aim of this study was to elucidate what promotes or hinders positive social interdependence and how the attributes work during PBL. METHODS We conducted four focus groups among clinical year medical students (n = 26) who participated in PBL tutorials in the formal curriculum. We asked semi-structured questions that corresponded with the overall concept of SIT. We analyzed the transcript using constructivist grounded theory and developed a model to explain contextual attributes that promote or hinder positive social interdependence in PBL. RESULTS Two contextual attributes of "academic inquisition" and "desire for efficiency" affect social interdependence among a student group in PBL. Academic inquisition is students' desire to engage in their academic learning, and desire for efficiency is students' attitude toward learning as an imposed duty and desire to complete it as quickly as possible. These attributes are initially mutually conflicting and constructing social interdependence through multiple steps including inquisition from a case, seeking efficient work, sharing interest in problem solving, expecting mutual contributions, and complementing learning objectives. CONCLUSION These findings will contribute to understanding collaborative learning environments in PBL and may help explain contexts where PBL is less successful. The model can also be used as a tool to support innovation of PBL as collaborative learning.
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Affiliation(s)
- Ikuo Shimizu
- Center for Medical Education and Clinical Training, Shinshu University, 3-1-1 Asahi, Matsumoto, 3908621 Japan
| | - Yasushi Matsuyama
- Medical Education Centre, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi Japan
| | - Robbert Duvivier
- Center for Educational Development and Research in Health Sciences (CEDAR), University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Cees van der Vleuten
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 60, 6229 ER Maastricht, The Netherlands
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19
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Rezende AB, de Oliveira AGF, Vale TC, Teixeira LAS, Lima ARA, Lucchetti ALG, Lucchetti G, Tibiriçá SHC, Ezequiel OS. Comparison of Team-Based Learning versus Traditional Lectures in Neuroanatomy: Medical Student Knowledge and Satisfaction. ANATOMICAL SCIENCES EDUCATION 2020; 13:591-601. [PMID: 31626726 DOI: 10.1002/ase.1926] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 10/08/2019] [Accepted: 10/14/2019] [Indexed: 05/20/2023]
Abstract
Neuroanatomy is often considered a difficult subject to teach, due to its broad scope, multitude of terms, and high degree of complexity. Thus, newer educational strategies that facilitate learning while also stimulating students by allowing increased student autonomy and group discussions should be carefully considered. This study aimed to evaluate the impact of introducing team-based learning (TBL) in the traditional discipline of neuroanatomy and to measure student knowledge acquisition and perception relative to traditional lectures (TL). A quasi-experimental, nonrandomized study was performed using two consecutive TBL classes (intervention group, n = 157 students, 25% content using TBL) with a TL class (control group, n = 76). Team-based learning sessions included all stages according to the classic description of the method. Student knowledge acquisition was assessed in regularly scheduled tests during the discipline, and their perception regarding TBL was evaluated using a questionnaire (developed by the authors). The groups presented a similar sociodemographic profile (sex and age) and the same performance in another anatomy discipline before the study. Team-based learning was significantly associated with greater acceptance, higher motivation, better student perception, and feelings that the methodology was able to integrate clinical and basic sciences. Nevertheless, according to tests, knowledge acquisition was similar between the TBL and lectures. In conclusion, since TBL is comparable to TL for knowledge acquisition, TBL seems to be a promising strategy to improve the teaching of neuroanatomy in medical schools. It fosters group discussions and increases satisfaction and the perception of integration between clinical and basic sciences.
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Affiliation(s)
- Alice B Rezende
- Department of Anatomy, Federal University of Juiz de Fora, Juiz de Fora, Brazil
- Department of Medical Education, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | | | - Thiago C Vale
- Department of Internal Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Luciana A S Teixeira
- Department of Internal Medicine, Federal University of the Triângulo Mineiro, Uberaba, Brazil
| | - Alba R A Lima
- Department of Molecular Biology, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, Brazil
| | - Alessandra L G Lucchetti
- Department of Medical Education, Federal University of Juiz de Fora, Juiz de Fora, Brazil
- Department of Internal Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Giancarlo Lucchetti
- Department of Medical Education, Federal University of Juiz de Fora, Juiz de Fora, Brazil
- Department of Internal Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Sandra H C Tibiriçá
- Department of Medical Education, Federal University of Juiz de Fora, Juiz de Fora, Brazil
- Department of Internal Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Oscarina S Ezequiel
- Department of Medical Education, Federal University of Juiz de Fora, Juiz de Fora, Brazil
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20
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Parmelee D, Roman B, Overman I, Alizadeh M. The lecture-free curriculum: Setting the stage for life-long learning: AMEE Guide No. 135. MEDICAL TEACHER 2020; 42:962-969. [PMID: 32644866 DOI: 10.1080/0142159x.2020.1789083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In this AMEE Guide we propose that instruction in health sciences education transform to 'lecture-free.' We present rationale for this proposal, guidance on approaches and strategies to achieve the goal, likely challenges, and what we consider the value-added outcomes. We are supported by a confluence of factors: advances in the science of learning and the learning of science and clinical reasoning, incontrovertible evidence that active and engaged learning strategies have better outcomes, current and emerging technology infrastructure in and out of the classroom, and best-practice instructional design.
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Affiliation(s)
- Dean Parmelee
- Department of Medical Education, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - Brenda Roman
- Department of Medical Education, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - Irina Overman
- Department of Medical Education, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - Maryam Alizadeh
- Faculty Development Unit, Education Development Center, Tehran University of Medical Sciences, Tehran, Iran
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Wu D, Xiang Y, Wu X, Yu T, Huang X, Zou Y, Liu Z, Lin H. Artificial intelligence-tutoring problem-based learning in ophthalmology clerkship. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:700. [PMID: 32617320 PMCID: PMC7327320 DOI: 10.21037/atm.2019.12.15] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background Artificial intelligence (AI) is an increasingly popular tool in medical investigations. However, AI’s potential of aiding medical teaching has not been explored. This study aimed to evaluate the effectiveness of AI-tutoring problem-based-learning (PBL) in ophthalmology clerkship and to assess the student evaluations of this module. Methods Thirty-eight Grade-two students in ophthalmology clerkship at Sun Yat-Sen University were randomly assigned to two groups. In Group A, students learned congenital cataracts through an AI-tutoring PBL module by exploring and operating an AI diagnosis platform. In Group B, students learned congenital cataracts through traditional lecture given with the same faculty. The improvement in student performance was evaluated by comparing the pre- and post-lecture scores of a specific designed test using paired-T tests. Student evaluations of AI-tutoring PBL were measured by a 17-item questionnaire. Results The post-lecture scores were significantly higher than the pre-lecture scores in both groups (Group A: P<0.0001, Group B: P<0.0001). The improvement of group A in the part of sign and diagnosis test (Part I) was more significant than that of group B (P=0.016). However, there was no difference in the improvement in the part of treatment plan test (Part II) between two groups (P=0.556). Overall, all respondents were satisfied and agreed that AI-tutoring PBL was helpful, effective, motive and beneficial to help develop critical and creative thinking. Conclusions The application of AI-tutoring PBL into ophthalmology clerkship improved students’ performance and satisfaction. AI-tutoring PBL teaching showed advantage in promoting students’ understanding of signs of diseases. The instructors play an indispensable role in AI-tutoring PBL curriculum.
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Affiliation(s)
- Dongxuan Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yifan Xiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Tongyong Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiucheng Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yuxian Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Czeskleba A, Holzhausen Y, Peters H. Clinical reasoning for acute dyspnoea: comparison between final-year medical students from discipline- and competency-based undergraduate programmes. BMC MEDICAL EDUCATION 2020; 20:161. [PMID: 32429955 PMCID: PMC7238574 DOI: 10.1186/s12909-020-02055-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/29/2020] [Indexed: 06/11/2023]
Abstract
UNLABELLED Clinical reasoning for acute dyspnoea: Comparison of final-year medical students from discipline- and competency-based undergraduate programmes. BACKGROUND The global shift to competency-based medical education aims to improve the performance of its trainees, including in the key competency domain of clinical reasoning. However, research on whether such education actually improves clinical reasoning is sparse. The purpose of this study is to compare assessed clinical reasoning performance in digitally presented cases of acute dyspnoea between final-year medical students from a traditional, discipline-based and those from an integrated, competency-based undergraduate programme. METHODS A total of 60 medical students in their final-year clerkships participated in the study; 30 were from a discipline-based programme, and 30 were from a competency-based programme of the same faculty. The students completed a knowledge test consisting of 22 single choice items and a computer-based test of clinical reasoning with six video-based case scenarios with different underlying diseases leading to dyspnoea. The operationalized measures of clinical reasoning were the number and relevance of the diagnostic tests chosen, time to diagnosis and diagnostic accuracy. RESULTS The two groups did not differ in their knowledge of the acute dyspnoea content domain. With regard to clinical reasoning, the selection of relevant tests, time required to make a diagnosis and accuracy of the diagnosis varied across the six case scenarios in both groups. However, the results from the measures of the clinical reasoning process did not differ between the students from the two types of undergraduate medical programmes. No significant differences were found with regard to the selection of relevant diagnostic tests (M = 63.8% vs. M = 62.8%), the time to a diagnosis (M = 128.7 s vs. M = 136.4 s) or the accuracy of diagnosis (M = 82.2% vs. M = 77.0%). CONCLUSIONS Key indicators of the clinical reasoning process, when assessed with objectively measured parameters, did not differ between final-year medical students from a traditional, discipline-based and those from an integrated, competency-based undergraduate programme in the domain of acute dyspnoea. The results substantiate and expand those of previous studies based on subjective assessor ratings that showed limited change in the clinical reasoning performance of medical students with competency-based undergraduate education.
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Affiliation(s)
- Anja Czeskleba
- Dieter Scheffner Centre for Medical Education and Educational Research, Dean’s Office of Study Affairs, Charité – Universitätsmedizin Berlin, Charité Platz 1, 10117 Berlin, Germany
| | - Ylva Holzhausen
- Dieter Scheffner Centre for Medical Education and Educational Research, Dean’s Office of Study Affairs, Charité – Universitätsmedizin Berlin, Charité Platz 1, 10117 Berlin, Germany
| | - Harm Peters
- Dieter Scheffner Centre for Medical Education and Educational Research, Dean’s Office of Study Affairs, Charité – Universitätsmedizin Berlin, Charité Platz 1, 10117 Berlin, Germany
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Grasl MC, Kremser K, Breckwoldt J, Gleiss A. Does the tutors' academic background influence the learning objectives in problem-based learning? GMS JOURNAL FOR MEDICAL EDUCATION 2020; 37:Doc8. [PMID: 32270022 PMCID: PMC7105758 DOI: 10.3205/zma001301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/10/2019] [Accepted: 10/14/2019] [Indexed: 06/11/2023]
Abstract
Background: Problem-based learning (PBL) is an essential element of the curriculum of the Medical University of Vienna (MUV) and is performed in an eight steps model with: clarifying, defining, analysing, shifting & sorting, identifying learning objectives, going to learn and coming back to talk and feedback. With an annual intake of up to 740 students the MUV has to recruit PBL tutors from various academic backgrounds including undergraduate near-peer students. Therefore, we were interested to see whether a tutor's academic background had an influence on the resulting PBL sessions as reflected by the percentage of learning objectives (LOs) which were actually achieved in relation to the intended LOs. Methods: For each PBL session "intended learning objectives" (ILOs) were defined. ILOs were communicated to all tutors by means of PBL session guides in order to provide homogenous learning opportunities to all students. However, it was not mandatory to reach all ILOs. The PBL coordination regarded a range of two thirds to three quarters of ILOs as a desirable goal. For analysis we retrieved data concerning ILOs, characteristics of tutors and PBL groups from the institution's PBL quality assurance system. Results: From 2012-2014, 216 PBL groups were facilitated by 106 tutors with different academic backgrounds. On average, 70.8% (95% CI: 69.2-72.5%) of the ILOs were achieved; MUV clinicians reached 74.3% (70.8-77.8%), MUV non-clinicians 74.2% (71.7-76.6%), external faculty (clinicians and non-clinicians) 68.6% (64.4-72.8%), and near-peer students 64.7% (61.8-67.7%). Statistically significant differences were found between near-peer students and MUV clinicians (p<.001) as well as MUV non-clinicians (p<.001). Conclusions: ILOs were reached within a satisfactory range. However, groups taught by near-peer students reached significantly fewer ILOs than groups taught by MUV faculty tutors. This finding raises the question whether tutor training for near-peer students should be intensified. Also, further research is needed to explore the group dynamics of student-led PBL groups.
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Affiliation(s)
- Matthaeus C. Grasl
- Medical University of Vienna, Department of Otorhinolaryngology, Vienna, Austria
| | - Karl Kremser
- Medical University of Vienna, Teaching Center, Vienna, Austria
| | - Jan Breckwoldt
- University of Zurich, Medical Faculty, Institute of Anesthesiology, Zurich, Switzerland
| | - Andreas Gleiss
- Medical University of Vienna, Center for Medical Statistics, Informatics, and Intelligent Systems, Section for Clinical Biometrics, Vienna, Austria
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Frambach JM, Talaat W, Wasenitz S, Martimianakis MAT. The case for plural PBL: an analysis of dominant and marginalized perspectives in the globalization of problem-based learning. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2019; 24:931-942. [PMID: 31624967 PMCID: PMC6908557 DOI: 10.1007/s10459-019-09930-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 10/07/2019] [Indexed: 06/10/2023]
Abstract
The globalization of problem-based learning (PBL) in health professions education has been both celebrated and criticized. Using a critical narrative review approach, underpinned by our archive of global PBL literature and a targeted literature search, we analyze these dominant global discourses of PBL in health professions education. More precisely, we explore what is missed when the globalization of PBL is theorized either as a positive consequence of standardization, or a problematic spread of Western educational ideals and values around the world. We make visible how two dominant global discourses, a universalist and culturalist discourse, have emerged in the global proliferation of PBL. We also discuss the limitations of the two discourses by demonstrating how they either ignore contextual and cultural diversity or see it as problematic. We then turn to a perspective that has been marginalized in the PBL literature that emphasizes the global origins of PBL, transcending the dichotomy between West and non-West. We make a case for relating to PBL as a plural construct in order to learn from the cultural and situational nuances of educational activities labeled PBL around the world. We argue that PBL as a singular and universal concept has no global future, yet versions of PBL may continue to thrive locally. Finally, we propose avenues for future research that may help elucidate the global and local values that underpin our curricula, as well as the socio-political factors that perpetuate neo-colonialist views and practices in the uptake and implementation of PBL approaches across the globe.
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Affiliation(s)
- Janneke M Frambach
- School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Wagdy Talaat
- Medical Education Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Stella Wasenitz
- Department of Arts and Humanities, Teachers College, Columbia University, New York City, USA
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AlSheikh MH, Iqbal MZ. Student Perceptions Regarding Group Learning Activities in a Hybrid Medical Curriculum. MEDICAL SCIENCE EDUCATOR 2019; 29:1221-1228. [PMID: 34457606 PMCID: PMC8368608 DOI: 10.1007/s40670-019-00817-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Problem- and team-based learning strategies have been introduced in the revised integrated curriculum of our medical college. This study aims to assess perceptions of students regarding recently introduced group learning activities into our hybrid curriculum. MATERIALS AND METHODS This descriptive cross-sectional study has used a pre-validated questionnaire to find out the perceptions of medical students studying at College of Medicine, Imam Abdulrahman Bin Faisal University (IAU). The response of students on the questionnaire was recorded by using a 5-point Likert scale. The data was analyzed by using one-way ANOVA. Mean and standard deviation were calculated. Additionally, three open-ended questions were asked to assess the merits and demerits of these newly implemented group learning approaches. RESULTS Out of 736 students, 190 (25.81%) completed the questionnaire. Among the 190 respondents, 64 were from second year, 65 were from third, and 61 were from fourth. Overall, the results show a positive response of students and that they favor the introduction of group learning instructional design in the hybrid curriculum. Students perceived group learning to be helpful in developing their critical thinking, socialization, motivation, and communication skills. CONCLUSION This study concludes that group learning activities introduced in a hybrid curriculum have remained successful in promoting group dynamics and overall satisfaction of students toward group learning. However, some issues have been reported too. The views of the students recorded in this study might be helpful in evaluating the implemented hybrid curricula and in optimizing the group environment and function.
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Affiliation(s)
- Mona Hmoud AlSheikh
- Medical Education Department, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd University Hospital, Dammam, Saudi Arabia
| | - Muhammad Zafar Iqbal
- Medical Education Department, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd University Hospital, Dammam, Saudi Arabia
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Santos MZD, Otani MAP, Tonhom SFDR, Marin MJS. Degree in Nursing: education through problem-based learning. Rev Bras Enferm 2019; 72:1071-1077. [PMID: 31432967 DOI: 10.1590/0034-7167-2018-0298] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 09/06/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe how undergraduate courses in Nursing are using the problem-based learning (PBL). METHOD Integrative literature review, from searches in the databases Education Resources Information Center (ERIC), Latin American and Caribbean Health Sciences Literature (Lilacs), and PubMed, from 2010 to 2015. 36 articles were analyzed. RESULTS A teaching method used in all continents, the PBL enables improvement of the critical thinking, autonomy, motivation for learning, active search attitude, ability to work in teams, and problem-solving. Difficulties and challenges relate to the training of students and teachers to understand the principles of the method. FINAL CONSIDERATIONS The benefits of PBL coincide with the needs of nursing training, but its applicability demands constant review in seeking to develop the skills necessary for this training.
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Self-directed learning and practice of Italian osteopathic students during summer break: a cross-sectional survey. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:201. [PMID: 31387572 PMCID: PMC6683383 DOI: 10.1186/s12906-019-2619-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 07/25/2019] [Indexed: 11/30/2022]
Abstract
Background Self-directed learning is a student-centered approach based on the students’ evaluation about their own learning needs. Self-directed practice is a component of the self-directed learning which focus on achieving manual and practical skills. Given the abundance of manual skills that students need to develop in the osteopathic curriculum, self-directed practice has become an attractive methodology. Most of the Italian osteopathic educational institutions recognize two types of educational curriculum: T1, for students without a healthcare background; and T2 for students who are already healthcare professionals. The aim of the present study is to investigate the attitudes of Italian osteopathic students toward self-directed practice during the summer break highlighting the possible differences between T1 and T2 students. Methods A web-based closed-ended survey was administered to the students attending one of the Italian osteopathic educational institutions which accepted to participate in the research. Results Two hundred sixty-eight students on 2549 participated to the survey. 64.92% of the students reported to have performed self-directed practice during the summer break. The main difficulty encountered by students in approaching self-directed practice was ‘lack of people to exercise with’. Most of the students performed self-directed practice between 1 to 5 h per week. The most common clinical condition encountered was Low Back Pain. The anatomical area most approached was lumbar spine. The most commonly simulated tests were the articular mobility tests. The techniques in which students trained the most were muscle energy techniques. Significant difference was found in self-engagement to the self-directed practice between T1 and T2 students (p = 0.026), and in the reasons to perform self-directed practice (p = 0.027). Conclusions The results of this study could be useful to reveal some aspects of students’ academic education and future clinical practice. Therefore this paper can be a useful tool for the institutions to develop strategies to overcome the reported problems students have towards self-directed practice. For example it should be discussed the possibility for the students to observe some senior osteopaths during their practice or to plan to maintain an open tutored didactic environment during the summer break as an extracurricular activity.
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Pu D, Ni J, Song D, Zhang W, Wang Y, Wu L, Wang X, Wang Y. Influence of critical thinking disposition on the learning efficiency of problem-based learning in undergraduate medical students. BMC MEDICAL EDUCATION 2019; 19:1. [PMID: 30606170 PMCID: PMC6318932 DOI: 10.1186/s12909-018-1418-5] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 12/03/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND Problem-based learning (PBL), a pedagogical approach, is widely accepted in medical education. Manipulated by many factors, the internal motivation of learner is the most crucial determinant that affects the nature of the outcome, in which the influences of critical thinking (CT) remained elusive. METHODS One hundred two third-year undergraduate medical students at Peking University were involved in this study. A Chinese version of the Critical Thinking Disposition Inventory (CTDI-CV) was used to assess the CT disposition, and the performance scores of students in PBL tutorials were compiled. A parametric bivariate correlation analysis was performed between the students' CT scores and their PBL average scores. The PBL scores were compared between the strong and weak CT disposition groups using independent t-test. The analysis of numerical data was conducted using SPSS 16.0. RESULTS CT disposition of third-year undergraduate medical students at Peking University was at a positive level, with an average score of 297.72. The total CT scores had a positive correlation with the scores of the PBL performance and its five dimensions significantly. In the majority, students with Strong-CT disposition obtained higher scores in PBL tutorials compared with students with Weak-CT disposition. The performance of these two groups was significantly different in the Late-Half but not in the Early-Half PBL tutorials. Furthermore, a significant improvement was observed in the students with strong CT but not weak CT dispositions. CONCLUSION CT disposition positively correlates to a students' PBL performance. Students with stronger CT dispositions perform better in the PBL process and obtain higher scores. Our work suggested that the open-mindedness of the CT disposition is the primary factor that determines the improvement of the preparation dimensions in the PBL process.
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Affiliation(s)
- Dan Pu
- Office of Education, Peking University School of Basic Medical Sciences, Beijing, 100083 China
| | - Juhua Ni
- Department of Biochemistry and Molecular Biology, Peking University School of Basic Medical Sciences, Beijing, 100083 China
| | - Demao Song
- Department of Physiology and Pathophysiology, Peking University School of Basic Medical Sciences, Beijing, 100083 China
| | - Weiguang Zhang
- Department of Anatomy, Peking University School of Basic Medical Sciences, Beijing, 100083 China
| | - Yuedan Wang
- Department of Immunology, Peking University School of Basic Medical Sciences, Beijing, 100083 China
| | - Liling Wu
- Department of Physiology and Pathophysiology, Peking University School of Basic Medical Sciences, Beijing, 100083 China
| | - Xian Wang
- Department of Physiology and Pathophysiology, Peking University School of Basic Medical Sciences, Beijing, 100083 China
| | - Yun Wang
- Department of Neurobiology, Peking University School of Basic Medical Sciences, Beijing, 100083 China
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Yoo DM, Cho AR, Kim S. Satisfaction with and suitability of the problem-based learning program at the Catholic University of Korea College of Medicine. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2019; 16:20. [PMID: 31327181 PMCID: PMC6702123 DOI: 10.3352/jeehp.2019.16.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 07/19/2019] [Indexed: 05/21/2023]
Abstract
PURPOSE This study was conducted to identify suggestions for improving the effectiveness and promoting the success of the current Problem-based learning (PBL) program at the Catholic University of Korea College of Medicine according to professor and student awareness survey result. METHODS A survey was carried out by sending out mobile Naver Form survey pages via text messages 3 times in December 2018, to 44 medical students and 74 professors of College of Medicine, The Catholic University of Korea. In addition, relevant official documents from the school administration were reviewed. The collected data were analyzed to identify the achievement of educational goals, overall satisfaction with, and operational suitability of the PBL. RESULTS The overall satisfaction scores for the PBL program were neutral range (students: 3.27 ± 0.95 vs. professors: 3.58 ± 1.07, P=0.118). Regarding the achievement of educational goals, the integration of basic and clinical medicine and encouragement of learning motivation was ranked lowest. Many respondents expressed negative opinions about the modules (students: 25.0%, professors: 39.2%) and tutors (students: 54.5%, professors: 24.3%). The students and professors agreed that the offering timing of program and length of phase were suitable, while opinions expressed in greater detail pointed to issues such as the classes being held too close to exams and their alignment with regular course units. CONCLUSION Issues with modules and tutors were the most pressing. Detailed and appropriate modules should be developed on the basis of advice from professors with experience in PBL tutoring. Inconsistencies in tutoring should be reduced by standardization and retraining.
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Affiliation(s)
- Dong Mi Yoo
- Department of Medical Education, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - A Ra Cho
- Department of Medical Education, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sun Kim
- Department of Medical Education, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Corresponding
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Decloedt EH, Schalkwyk S. Students shooting videos to learn pharmacology. CLINICAL TEACHER 2018; 16:490-496. [DOI: 10.1111/tct.12963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Eric H Decloedt
- Division of Clinical PharmacologyDepartment of MedicineFaculty of Medicine and Health SciencesStellenbosch University South Africa
| | - Susan Schalkwyk
- Centre for Health Professions EducationFaculty of Medicine and Health SciencesStellenbosch University South Africa
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Gou W, Sun W, Chen D, Zhang Z, Zhao J, Zhang Y, Liu J, Zhang W. Coping self-efficacy of nursing undergraduates with problem-based curricula. Contemp Nurse 2018; 55:288-302. [PMID: 30369293 DOI: 10.1080/10376178.2018.1537719] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: Few studies have examined whether nursing undergraduates can cope with a problem-based learning curriculum and its associated factors.Objectives: We studied nursing undergraduates' evaluations and attitudes related to the problem-based learning teaching method and their associated factors in the Chinese context, and evaluated their self-efficacy for coping with the problem-based learning curricula.Methods: A purposely designed 20-item questionnaire was used to quantify how nursing undergraduates evaluated the problem-based learning mode and their associated factors. Coping self-efficacy was measured with a modified Chinese version of the scale.Results: The total coping self-efficacy score of nursing undergraduates was 53.32 ± 5.238 (M ± SD).Conclusions: The coping self-efficacy of nursing undergraduates was moderate, making them better qualified to cope with a problem-based learning curriculum. To increase nursing undergraduates' coping self-efficacy, we should take measures to decrease nursing undergraduates' stress regarding problem-based learning curricula and give them more opportunities to obtain abundant periodicals through the internet.
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Affiliation(s)
- Weihui Gou
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Weijia Sun
- Nursing School of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Dandan Chen
- Nursing School of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Zhen Zhang
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Jingxia Zhao
- Nursing School of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Yue Zhang
- Nursing School of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Jingquan Liu
- Nursing School of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Wei Zhang
- Nursing School of Jilin University, Changchun, Jilin Province, People's Republic of China.,School of Public Health of Jilin University, Changchun, Jilin Province, People's Republic of China
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Taylor DCM. Response to: Prevalence of depressive symptoms among medical students taught using problem-based learning versus traditional methods. MEDICAL TEACHER 2018; 40:1082. [PMID: 29944020 DOI: 10.1080/0142159x.2018.1473952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- David C M Taylor
- a Director of the Liverpool BEME International Collaborating Centre, University of Liverpool, UK and Professor of Medical Education , Gulf Medical University , Ajman , United Arab Emirates
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Saqr M, Fors U, Nouri J. Using social network analysis to understand online Problem-Based Learning and predict performance. PLoS One 2018; 13:e0203590. [PMID: 30235227 PMCID: PMC6147410 DOI: 10.1371/journal.pone.0203590] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 08/23/2018] [Indexed: 11/19/2022] Open
Abstract
Social network analysis (SNA) may be of significant value in studying online collaborative learning. SNA can enhance our understanding of the collaborative process, predict the under-achievers by means of learning analytics, and uncover the role dynamics of learners and teachers alike. As such, it constitutes an obvious opportunity to improve learning, inform teachers and stakeholders. Besides, it can facilitate data-driven support services for students. This study included four courses at Qassim University. Online interaction data were collected and processed following a standard data mining technique. The SNA parameters relevant to knowledge sharing and construction were calculated on the individual and the group level. The analysis included quantitative network analysis and visualization, correlation tests as well as predictive and explanatory regression models. Our results showed a consistent moderate to strong positive correlation between performance, interaction parameters and students' centrality measures across all the studied courses, regardless of the subject matter. In each of the studied courses, students with stronger ties to prominent peers (better social capital) in small interactive and cohesive groups tended to do better. The results of correlation tests were confirmed using regression tests, which were validated using a next year dataset. Using SNA indicators, we were able to classify students according to achievement with high accuracy (93.3%). This demonstrates the possibility of using interaction data to predict underachievers with reasonable reliability, which is an obvious opportunity for intervention and support.
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Affiliation(s)
- Mohammed Saqr
- Department of Computer and System Sciences (DSV), Stockholm University, Kista, Stockholm, Sweden
| | - Uno Fors
- Department of Computer and System Sciences (DSV), Stockholm University, Kista, Stockholm, Sweden
| | - Jalal Nouri
- Department of Computer and System Sciences (DSV), Stockholm University, Kista, Stockholm, Sweden
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Berkhout JJ, Helmich E, Teunissen PW, van der Vleuten CPM, Jaarsma ADC. Context matters when striving to promote active and lifelong learning in medical education. MEDICAL EDUCATION 2018; 52:34-44. [PMID: 28984375 DOI: 10.1111/medu.13463] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 04/05/2017] [Accepted: 08/14/2017] [Indexed: 05/11/2023]
Abstract
UNLABELLED WHERE DO WE STAND NOW?: In the 30 years that have passed since The Edinburgh Declaration on Medical Education, we have made tremendous progress in research on fostering 'self-directed and independent study' as propagated in this declaration, of which one prime example is research carried out on problem-based learning. However, a large portion of medical education happens outside of classrooms, in authentic clinical contexts. Therefore, this article discusses recent developments in research regarding fostering active learning in clinical contexts. SELF-REGULATED, LIFELONG LEARNING IN MEDICAL EDUCATION Clinical contexts are much more complex and flexible than classrooms, and therefore require a modified approach when fostering active learning. Recent efforts have been increasingly focused on understanding the more complex subject of supporting active learning in clinical contexts. One way of doing this is by using theory regarding self-regulated learning (SRL), as well as situated learning, workplace affordances, self-determination theory and achievement goal theory. Combining these different perspectives provides a holistic view of active learning in clinical contexts. ENTRY TO PRACTICE, VOCATIONAL TRAINING AND CONTINUING PROFESSIONAL DEVELOPMENT: Research on SRL in clinical contexts has mostly focused on the undergraduate setting, showing that active learning in clinical contexts requires not only proficiency in metacognition and SRL, but also in reactive, opportunistic learning. These studies have also made us aware of the large influence one's social environment has on SRL, the importance of professional relationships for learners, and the role of identity development in learning in clinical contexts. Additionally, research regarding postgraduate lifelong learning also highlights the importance of learners interacting about learning in clinical contexts, as well as the difficulties that clinical contexts may pose for lifelong learning. However, stimulating self-regulated learning in undergraduate medical education may also make postgraduate lifelong learning easier for learners in clinical contexts.
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Affiliation(s)
- Joris J Berkhout
- Center for Evidence-Based Education, Academic Medical Center (AMC-UvA), University of Amsterdam, Amsterdam, The Netherlands
| | - Esther Helmich
- Center for Research and Innovation in Medical Education, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Pim W Teunissen
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Obstetrics and Gynecology, VU University Medical Center, VU University Amsterdam, Amsterdam, The Netherlands
| | - Cees P M van der Vleuten
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - A Debbie C Jaarsma
- Center for Research and Innovation in Medical Education, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Vogt K, Pelz J, Stroux A. Refinement of a training concept for tutors in problem-based learning. GMS JOURNAL FOR MEDICAL EDUCATION 2017; 34:Doc38. [PMID: 29085882 PMCID: PMC5654112 DOI: 10.3205/zma001115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 08/21/2016] [Accepted: 09/23/2016] [Indexed: 06/07/2023]
Abstract
The use of problem-based learning (PBL) in the Charité Berlin Human Medicine model curriculum requires the annual training of 80 to 100 new PBL tutors using PBL tutor training (PTT). Therefore, the following three measures were taken: The existing traditional PTT (Trad-PTT) was further developed into an interactive PTT (Inter-PTT), which is using more interactive teaching tools. Both PTT concepts ran for 12 months, respectively. The review of the Inter-PTT was significantly better, as the PBL tutors understood their tasks within the PBL process better and felt more motivated. A follow-up survey after the initial experience with PBL confirmed almost all the positive aspects of the Inter-PTT. In addition, the Inter-PTT was also offered to non-clinicians and other scientific staff to make the training interdisciplinary. PTT made it possible to communicate beyond specialist boundaries; however, the interdisciplinary idea was no longer detectable in the follow-up survey. In order to increase the number of available PBL tutors, a self-commitment was introduced for the departments. This increased the number of "involuntary" participants for PTT, but reduced the amount of necessary training courses. The fulfilment of self-commitment succeeded in almost all departments. A PTT tailored to the needs of the tutors is a basic prerequisite in order to excite teachers about PBL and to familiarise them with their role as learning facilitators. The increase of interactive teaching forms led to a joint interdisciplinary learning process within PTT. The excellent review of Inter-PTT makes it a solid basis for further training concepts.
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Affiliation(s)
- Konstanze Vogt
- Charité Medical University Berlin, Dieter Scheffner Centre for Higher Medical Education, Vice Deanship of Studies and Education, Berlin, Germany
| | - Jörg Pelz
- Charité Medical University Berlin, Dieter Scheffner Centre for Higher Medical Education, Berlin, Germany
| | - Andrea Stroux
- Charité Medical University Berlin, Institute of Biometry and Clinical Epidemiology, Berlin, Germany
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Frambach JM, Martimianakis MAT. The discomfort of an educator's critical conscience: the case of problem-based learning and other global industries in medical education. PERSPECTIVES ON MEDICAL EDUCATION 2017; 6:1-4. [PMID: 28050880 PMCID: PMC5285285 DOI: 10.1007/s40037-016-0325-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- Janneke M Frambach
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands.
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Amin M, Zulla R, Gaudet-Amigo G, Patterson S, Murphy N, Ross S. Dental Students’ Perceptions of Learning Value in PBL Groups with Medical and Dental Students Together versus Dental Students Alone. J Dent Educ 2017. [DOI: 10.1002/j.0022-0337.2017.81.1.tb06248.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Maryam Amin
- Division of Pediatric Dentistry; School of Dentistry; University of Alberta; Canada
| | | | | | | | | | - Shelley Ross
- Department of Family Medicine; University of Alberta; Canada
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Zeng F, Deng G, Wang Z, Chang S, Chen X, Qi L, Zu X, Liu L. Strategies for improvement of WeChat-PBL teaching: experience from China. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2016; 7:382-384. [PMID: 27893409 PMCID: PMC5135389 DOI: 10.5116/ijme.582e.015a] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 11/17/2016] [Indexed: 05/25/2023]
Affiliation(s)
- Furong Zeng
- Xiangya Medical School ,Central South University, China
| | | | - Zhao Wang
- Xiangya Hospital, Central South University, China
| | - Shi Chang
- Xiangya Hospital, Central South University, China
| | - Xiang Chen
- Xiangya Hospital, Central South University, China
| | - Lin Qi
- Xiangya Hospital, Central South University, China
| | - Xiongbing Zu
- Xiangya Hospital, Central South University, China
| | - Longfei Liu
- Xiangya Hospital, Central South University, China
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Iqbal M, Velan GM, O’Sullivan AJ, Balasooriya C. Differential impact of student behaviours on group interaction and collaborative learning: medical students' and tutors' perspectives. BMC MEDICAL EDUCATION 2016; 16:217. [PMID: 27549085 PMCID: PMC4994313 DOI: 10.1186/s12909-016-0730-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 08/08/2016] [Indexed: 05/13/2023]
Abstract
BACKGROUND Collaboration is of increasing importance in medical education and medical practice. Students' and tutors' perceptions about small group learning are valuable to inform the development of strategies to promote group dynamics and collaborative learning. This study investigated medical students' and tutors' views on competencies and behaviours which promote effective learning and interaction in small group settings. METHODS This study was conducted at UNSW Australia. Five focus group discussions were conducted with first and second year medical students and eight small group tutors were interviewed. Data were transcribed verbatim and thematic analysis was conducted. RESULTS Students and tutors identified a range of behaviours that influenced collaborative learning. The main themes that emerged included: respectfulness; dominance, strong opinions and openness; constructiveness of feedback; active listening and contribution; goal orientation; acceptance of roles and responsibilities; engagement and enthusiasm; preparedness; self- awareness and positive personal attributes. An important finding was that some of these student behaviours were found to have a differential impact on group interaction compared with collaborative learning. This information could be used to promote higher quality learning in small groups. CONCLUSION This study has identified medical students' and tutors' perceptions regarding interactional behaviours in small groups, as well as behaviours which lead to more effective learning in those settings. This information could be used to promote learning in small groups.
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Affiliation(s)
- Maha Iqbal
- School of Public Health and Community Medicine, UNSW Medicine, UNSW Australia, Sydney, 2052 Australia
| | - Gary M. Velan
- Educational Research and Development Unit at the School of Medical Sciences, UNSW Medicine, University of New South Wales, Sydney, Australia
| | - Anthony J. O’Sullivan
- St. George and Sutherland Clinical School and Program Authority, UNSW Medicine, University of New South Wales, Sydney, Australia
| | - Chinthaka Balasooriya
- Medical Education Development, School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, Australia
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Gaupp R, Körner M, Fabry G. Effects of a case-based interactive e-learning course on knowledge and attitudes about patient safety: a quasi-experimental study with third-year medical students. BMC MEDICAL EDUCATION 2016; 16:172. [PMID: 27400872 PMCID: PMC4940690 DOI: 10.1186/s12909-016-0691-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 06/29/2016] [Indexed: 05/23/2023]
Abstract
BACKGROUND Patient safety (PS) is influenced by a set of factors on various levels of the healthcare system. Therefore, a systems-level approach and systems thinking is required to understand and improve PS. The use of e-learning may help to develop a systems thinking approach in medical students, as case studies featuring audiovisual media can be used to visualize systemic relationships in organizations. The goal of this quasi-experimental study was to determine if an e-learning can be utilized to improve systems thinking, knowledge, and attitudes towards PS. METHODS A quasi-experimental, longitudinal within- subjects design was employed. Participants were 321 third-year medical students who received online surveys before and after they participated in an e-learning course on PS. Primary outcome measures where levels of systems thinking and attitudes towards PS. Secondary outcome measures were the improvement of PS specific knowledge through the e-learning course. RESULTS Levels of systems thinking showed significant improvement (58.72 vs. 61.27; p < .001) after the e-learning. Student's attitudes towards patient safety improved in several dimensions: After the course, students rated the influence of fatigue on safety higher (6.23 vs. 6.42, p < .01), considered patient empowerment more important (5.16 vs. 5.93, p < .001) and realized more often that human error is inevitable (5.75 vs. 5.97, p < .05). Knowledge on PS improved from 36.27 % correct answers before to 76.45 % after the e-learning (p < .001). CONCLUSIONS Our results suggest that e-learning can be used to teach PS. Attitudes towards PS improved on several dimensions. Furthermore, we were able to demonstrate that a specifically designed e-learning program can foster the development of conceptual frameworks such as systems thinking, which facilitates the understanding of complex socio-technical systems within healthcare organisations.
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Affiliation(s)
- Rainer Gaupp
- Medical Faculty, Medical Psychology and Medical Sociology, Freiburg University, D-79104 Freiburg, Germany
| | - Mirjam Körner
- Medical Faculty, Medical Psychology and Medical Sociology, Freiburg University, D-79104 Freiburg, Germany
| | - Götz Fabry
- Medical Faculty, Medical Psychology and Medical Sociology, Freiburg University, D-79104 Freiburg, Germany
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Kiesewetter J, Kollar I, Fernandez N, Lubarsky S, Kiessling C, Fischer MR, Charlin B. Crossing boundaries in interprofessional education: A call for instructional integration of two script concepts. J Interprof Care 2016; 30:689-92. [PMID: 27309966 DOI: 10.1080/13561820.2016.1184238] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Clinical work occurs in a context which is heavily influenced by social interactions. The absence of theoretical frameworks underpinning the design of collaborative learning has become a roadblock for interprofessional education (IPE). This article proposes a script-based framework for the design of IPE. This framework provides suggestions for designing learning environments intended to foster competences we feel are fundamental to successful interprofessional care. The current literature describes two script concepts: "illness scripts" and "internal/external collaboration scripts". Illness scripts are specific knowledge structures that link general disease categories and specific examples of diseases. "Internal collaboration scripts" refer to an individual's knowledge about how to interact with others in a social situation. "External collaboration scripts" are instructional scaffolds designed to help groups collaborate. Instructional research relating to illness scripts and internal collaboration scripts supports (a) putting learners in authentic situations in which they need to engage in clinical reasoning, and (b) scaffolding their interaction with others with "external collaboration scripts". Thus, well-established experiential instructional approaches should be combined with more fine-grained script-based scaffolding approaches. The resulting script-based framework offers instructional designers insights into how students can be supported to develop the necessary skills to master complex interprofessional clinical situations.
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Affiliation(s)
- Jan Kiesewetter
- a Institute for Medical Education , University Hospital of LMU Munich , Munich , Germany
| | - Ingo Kollar
- b Department of Psychology , University of Augsburg , Augsburg , Germany
| | - Nicolas Fernandez
- c Department of Education and Specialized Training , University of Quebec at Montreal , Montreal , Quebec , Canada
| | - Stuart Lubarsky
- d Centre for Medical Education , McGill University , Montreal , Quebec , Canada
| | - Claudia Kiessling
- e Assessment Department , Medical University of Brandenburg , Neuruppin , Germany
| | - Martin R Fischer
- a Institute for Medical Education , University Hospital of LMU Munich , Munich , Germany
| | - Bernard Charlin
- f Centre of Pedagogy Applied to Health Sciences (CPASS) , University of Montreal , Montreal , Quebec , Canada
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Joseph N, Rai S, Madi D, Bhat K, Kotian SM, Kantharaju S. Problem-Based Learning as an Effective Learning Tool in Community Medicine: Initiative in a Private Medical College of a Developing Country. Indian J Community Med 2016; 41:133-40. [PMID: 27051088 PMCID: PMC4799636 DOI: 10.4103/0970-0218.177535] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Knowledge of community medicine is essential for health care professionals to function as efficient primary health care physicians. Medical students learning Community Medicine as a subject are expected to be competent in critical thinking and generic skills so as to analyze community health problems better. However, current teaching by didactic lectures fails to develop these essential skills. Problem-based learning (PBL) could be an effective strategy in this respect. This study was hence done to compare the academic performance of students who were taught Community Medicine by the PBL method with that of students taught by traditional methods, to assess the generic skills of students taught in a PBL environment and to assess the perception of students toward PBL methodology. MATERIALS AND METHODS This study was conducted among seventh-semester final-year medical students between June and November 2014. PBL was introduced to a randomly chosen group of students, and their performance in an assessment exam at the end of postings was compared with that of the remaining students. Generic skills and perception toward PBL were also assessed using standardized questionnaires. RESULTS A total of 77 students took part in the brainstorming session of PBL. The correlation between self-assigned scores of the participants and those assigned by the tutor in the brainstorming session of PBL was significant (r = 0.266, P = 0.05). Out of 54 students who took part in the presentation session, almost all 53 (98.1%) had good perception toward PBL. Demotivational scores were found to be significantly higher among males (P = 0.024). The academic performance of students (P < 0.001) and success rates (P = 0.05) in the examination were higher among students who took part in PBL compared to controls. CONCLUSION PBL helped improve knowledge of students in comparison to those exposed only to didactic lectures. As PBL enabled students to identify the gaps in their knowledge and enhanced their group functioning and generic skills, we recommend PBL sessions: They would help optimize the training in Community Medicine at medical schools. Good correlation of tutor and self-assessment scores of participants in the brainstorming session suggests that the role of tutors could be restricted to assessment in presentation sessions alone. Demotivation, which hinders group performance in PBL, needs to be corrected by counselling and timely feedback by the tutors.
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Affiliation(s)
- Nitin Joseph
- Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Sharada Rai
- Department of Pathology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Deepak Madi
- Department of Internal Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Kamalakshi Bhat
- Department of Paediatrics, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Shashidhar M Kotian
- Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Supriya Kantharaju
- Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
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Gerhardt-Szep S, Kunkel F, Moeltner A, Hansen M, Böckers A, Rüttermann S, Ochsendorf F. Evaluating differently tutored groups in problem-based learning in a German dental curriculum: a mixed methods study. BMC MEDICAL EDUCATION 2016; 16:14. [PMID: 26768131 PMCID: PMC4714523 DOI: 10.1186/s12909-015-0505-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 12/07/2015] [Indexed: 05/31/2023]
Abstract
BACKGROUND It is still unclear to what extent the PBL tutor affects learning in PBL-sessions. This mixed-methods study (Part 1 and 2) evaluated the effects of facilitative (f) versus non-facilitative (nf) tutoring roles on knowledge-gain and group functioning in the field of endodontics. METHODS Part 1 was a quantitative assessment of tutor effectiveness within a prospective, experimental, single-blind, stratified, randomized, two-group intervention study. Participants attended PBL in the context of a hybrid curriculum. A validated questionnaire was used and knowledge assessments were conducted before and after the intervention. External observers rated tutor performance. Part 2 was a qualitative assessment of tutor effectiveness and consisted of semi-structured expert interviews with tutors and focus group discussions with students. RESULTS Part 1: f tutors obtained significantly higher scores than nf tutors with respect to learning motivation and tutor effectiveness (p ≤ 0.05). nf tuition resulted in a slightly larger knowledge gain (p = 0.08). External observers documented a significantly higher activity among facilitative tutors compared to non-facilitative tutors. Part 2: Tutors found the f role easier although this led to a less autonomous working climate. The students rated f tutoring as positive in all cases. CONCLUSIONS With respect to PBL-group performance, students felt that groups guided in a non-facilitative fashion exhibited a higher level of independence and autonomy, especially with increasing PBL experience. In addition, students reported that more preparation was necessary for sessions guided by a non-facilitative tutor. Tutors were able to modify their role and influence group processes in a controlled manner. Results are useful for future "Train-the-Teacher" sessions.
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Affiliation(s)
- Susanne Gerhardt-Szep
- Department of Operative Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Medical Faculty, Goethe University of Frankfurt am Main, Theodor-Stern-Kai 7, Building 29, 60596, Frankfurt am Main, Germany.
| | - Florian Kunkel
- Private Practice, Bergerstraße 159, 60385, Frankfurt am Main, Germany.
| | - Andreas Moeltner
- Competence Center for Assessment in Medicine, Medical Faculty, University of Heidelberg, Im Neuenheimer Feld 346, 69120, Heidelberg, Germany.
| | - Miriam Hansen
- Institute of Psychology, Interdisziplinäres Kolleg Hochschuldidaktik (IKH), Goethe University of Frankfurt am Main, Senckenberganlage 15, 60325, Frankfurt am Main, Germany.
| | - Anja Böckers
- Medical Faculty, Institute of Anatomy and Cell Biology, University in Ulm, Albert-Einstein Allee 11, 89081, Ulm, Germany.
| | - Stefan Rüttermann
- Department of Operative Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Medical Faculty, Goethe University of Frankfurt am Main, Theodor-Stern-Kai 7, Building 29, 60596, Frankfurt am Main, Germany.
| | - Falk Ochsendorf
- Medical Faculty, Institute of Dermatology, Goethe University of Frankfurt am Main, Theodor-Stern-Kai 7, Building 28, 60596, Frankfurt am Main, Germany.
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Okubo Y, Matsushita S, Takakuwa Y, Yoshioka T, Nitta K. Longitudinal PBL in Undergraduate Medical Education Develops Lifelong-Learning Habits and Clinical Competencies in Social Aspects. TOHOKU J EXP MED 2016; 238:65-74. [PMID: 26725844 DOI: 10.1620/tjem.238.65] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Problem-based learning (PBL) is popular in medical education in Japan. We wished to understand the influence of PBL on the clinical competence of medical residents, using self-assessment and observer assessment. Tokyo Women's Medical University (TWMU) implemented PBL longitudinally (long-time) for four years, and on this basis we analyzed whether long-time PBL education is useful for clinical work. A self-assessment questionnaire was sent to junior and senior residents who were alumni of several schools, and an observation-based assessment questionnaire to senior doctors instructing them. Respondents were asked if they had used the PBL process in daily clinical tasks, and if so in what processes. Senior doctors were asked whether TWMU graduates perform differently from graduates of other schools. TWMU graduates answered "used a lot" and "used a little" with regard to PBL at significantly higher rates than other graduates. As useful points of PBL, they mentioned extracting clinical problems, solving clinical problems, self-directed leaning, positive attitude, collaboration with others, presentation, doctor-patient relations, self-assessment, and share the knowledge with doctors at lower levels and students. Observer assessments of TWMU graduates by senior doctors represented them as adaptive, good at presenting, good at listening to others' opinions, practical, selfish, and eager in their instructional practice. Longitudinal PBL can be a good educational method to develop lifelong-learning habits and clinical competencies especially in terms of the social aspect.
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Affiliation(s)
- Yumiko Okubo
- Department of Medical Education, Tokyo Women's Medical University
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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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Schauber SK, Hecht M, Nouns ZM, Kuhlmey A, Dettmer S. The role of environmental and individual characteristics in the development of student achievement: a comparison between a traditional and a problem-based-learning curriculum. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2015; 20:1033-52. [PMID: 25616720 DOI: 10.1007/s10459-015-9584-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 01/19/2015] [Indexed: 05/19/2023]
Abstract
In medical education, the effect of the educational environment on student achievement has primarily been investigated in comparisons between traditional and problem-based learning (PBL) curricula. As many of these studies have reached no clear conclusions on the superiority of the PBL approach, the effect of curricular reform on student performance remains an issue. We employed a theoretical framework that integrates antecedents of student achievement from various psychosocial domains to examine how students interact with their curricular environment. In a longitudinal study with N = 1,646 participants, we assessed students in a traditional and a PBL-centered curriculum. The measures administered included students' perception of the learning environment, self-efficacy beliefs, positive study-related affect, social support, indicators of self-regulated learning, and academic achievement assessed through progress tests. We compared the relations between these characteristics in the two curricular environments. The results are two-fold. First, substantial relations of various psychosocial domains and their associations with achievement were identified. Second, our analyses indicated that there are no substantial differences between traditional and PBL-based curricula concerning the relational structure of psychosocial variables and achievement. Drawing definite conclusions on the role of curricular-level interventions in the development of student's academic achievement is constrained by the quasi-experimental design as wells as the selection of variables included. However, in the specific context described here, our results may still support the view of student activity as the key ingredient in the acquisition of achievement and performance.
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Affiliation(s)
- Stefan K Schauber
- Institute of Medical Sociology and Rehabilitation Science and Department for Assessment, Charité - Universitätsmedizin Berlin, Luisenstraße 57, 10117, Berlin, Germany.
| | - Martin Hecht
- Institute for Educational Quality Improvement, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Germany
| | - Zineb M Nouns
- Institute of Medical Education, University of Bern, Konsumstrasse 13, 3010, Bern, Switzerland
| | - Adelheid Kuhlmey
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Luisenstraße 57, 10117, Berlin, Germany
| | - Susanne Dettmer
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Luisenstraße 57, 10117, Berlin, Germany
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Rimal J, Paudel BH, Shrestha A. Introduction of problem-based learning in undergraduate dentistry program in Nepal. Int J Appl Basic Med Res 2015; 5:S45-9. [PMID: 26380211 PMCID: PMC4552066 DOI: 10.4103/2229-516x.162276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 07/06/2015] [Indexed: 11/04/2022] Open
Abstract
Context: Problem-based learning (PBL) is a methodology widely used in medical education and is growing in dental education. Initiation of new ideas and teaching methods requires a change in perception from faculty and institute management. Student-centered education is a need of the day and PBL provides the best outlet to it. Aim: To introduce PBL, assess feasibility and challenges in undergraduate dentistry program and evaluate the impact on their learning. Settings and Design: PBL was used as a teaching methodology on 37 students in 2nd year BDS program. The PBL was duplicated as that of MBBS program. PBL was spread over 5 days. Pre- and post-test questions along with different questionnaires were designed for the students and tutors/faculty to be administered after PBL session. Subjects and Methods: Case with temporomandibular joint and muscles of mastication and occlusion was designed as a module with five triggers given to students who were divided into five groups over two tutorials facilitated by tutor. Resource sessions were held by involved departments (Oral Biology, Oral Pathology, Oral Medicine and Radiology, Orthodontics, and Oral Surgery). Students were allotted time for search, research and discover to search literature. Statistical Analysis Used: Descriptive statistics. Results: Pre and post-test comparison showed that the knowledge increased immensely following PBL sessions. Students’ assessment by tutors following two PBL tutorials showed a mean score of 34.9 ± 4.01 and 35.5 ± 3.86, respectively. Students’ feedback showed that most of them preferred PBL because they found it interactive, collaborative, goal and research oriented. Students were motivated to learn new topic because learning objectives were formulated by themselves and they developed self-directed learning skills. The tutors learned to design cases. Conclusions: PBL encouraged students to use more interactive methods of learning which possibly will make them lifelong learners.
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Affiliation(s)
- Jyotsna Rimal
- Department of Oral Medicine and Radiology, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Bishnu Hari Paudel
- Department of Basic and Clinical Physiology, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Ashish Shrestha
- Public Health Dentistry, BP Koirala Institute of Health Sciences, Dharan, Nepal
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Wood SJ, Woywodt A, Pugh M, Sampson I, Madhavi P. Twelve tips to revitalise problem-based learning. MEDICAL TEACHER 2015; 37:723-729. [PMID: 25401407 DOI: 10.3109/0142159x.2014.975192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The role of the problem-based learning (PBL) facilitator has seen different interpretations ever since PBL first gained widespread use. What has remained unchanged is the challenge for facilitators to use their knowledge and expertise sparingly and to use their interpersonal skills to improve group dynamics. Medical undergraduates attending PBL sessions have also changed in their skill sets, expectations and the use of technology. Based on the published literature and a recent faculty workshop, we provide PBL facilitators and institutions with 12 tips on how to make PBL more vibrant and interesting. We discuss our tips with reference to published literature and International Academy of Medical Education (AMEE) guidance. Our tips help students to engage with PBL, avoid monotony and make this teaching format more vibrant and fun for all involved. Introducing greater variety to the PBL process may also help with group dynamics by catering for a broader audience with different learning styles.
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Affiliation(s)
- Sarah J Wood
- a The University of Manchester , UK
- b Lancashire Teaching Hospitals NHS Foundation Trust , UK
- c Royal Manchester Children's Hospital , UK
| | | | - Mark Pugh
- b Lancashire Teaching Hospitals NHS Foundation Trust , UK
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Kerdijk W, Cohen-Schotanus J, Mulder BF, Muntinghe FLH, Tio RA. Cumulative versus end-of-course assessment: effects on self-study time and test performance. MEDICAL EDUCATION 2015; 49:709-716. [PMID: 26077218 DOI: 10.1111/medu.12756] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 09/06/2014] [Accepted: 03/26/2015] [Indexed: 06/04/2023]
Abstract
CONTEXT Students tend to postpone preparation for a test until the test is imminent, which raises various risks associated with 'cramming' behaviours, including that for suboptimal learning. Cumulative assessment utilises spaced testing to stimulate students to study more frequently and to prevent procrastination. This randomised controlled study investigated how cumulative assessment affects time spent on self-study and test performance compared with end-of-course assessment. METHODS A total of 78 undergraduate medical students in a Year 2 pre-clinical course were randomly assigned to either of two conditions. Students in the cumulative assessment condition were assessed in weeks 4, 8 and 10. Students in the end-of-course assessment condition were assessed in week 10 only. Each week, students reported the number of hours they spent on self-study. RESULTS Students in the cumulative assessment condition (n = 25) spent significantly more time on self-study than students in the end-of-course assessment condition (n = 37) in all weeks of the course except weeks 5, 9 and 10. Overall, the cumulative assessment group spent 69 hours more on self-study during the course than did the control group, although the control group spent 7 hours more in studying during the final week of the course than did the cumulative assessment group. Students in the cumulative assessment condition scored slightly higher on questions concerning the content of the last part of the course. CONCLUSIONS Cumulative assessment encourages students to distribute their learning activities over a course, which leaves them more opportunity to study the content of the last part of the course prior to the final examination. There was no evidence for a short-term effect of cumulative assessment on overall knowledge gain. We hypothesise that larger positive effects might be found if retention were to be measured in the long term.
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Affiliation(s)
- Wouter Kerdijk
- Centre for Research and Innovation in Medical Education, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
- Department of Public and Individual Oral Health, Centre for Dentistry and Oral Hygiene, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Janke Cohen-Schotanus
- Centre for Research and Innovation in Medical Education, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - B Florentine Mulder
- Institute for Medical Education, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Friso L H Muntinghe
- Institute for Medical Education, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
- Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - René A Tio
- Institute for Medical Education, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
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Abstract
BACKGROUND Problem-based learning (PBL) sessions consist of a brainstorming phase, search phase, individual study, and reporting phase. At the Xavier University School of Medicine, Aruba, PBL is a new learning modality first introduced in May 2013. AIMS PBL processes have not been studied previously at the Xavier University School of Medicine, hence the present study was carried out to obtain information about the PBL processes and note differences, if any, among different groups of students. METHOD The study was conducted among first- to fourth-semester undergraduate medical students during July 2014 using a previously validated PBL processes instrument developed by van den Hurk et al. Information about gender, semester, weekly hours of study, and learning resources used was obtained. Respondents' agreement with a set of 23 statements was noted using a Likert-type scale, which was scored as 1=totally disagree with the statement, 2=disagree, 3=neutral, 4=agree, and 5=totally agree with the statement. Mean scores were compared among different groups of respondents. RESULTS Fifty-one of the 58 students (87.9 per cent) participated. The weekly average study time was 29.9 hours. Lecture handouts and textbooks were commonly used information sources. The mean scores (scale 1 to 5) for learning-issue-driven searching, and extensiveness of searching were 3.49 and 3.45, respectively. The score for explanation-oriented preparation was 3.94, while those for breadth and depth of discussion were 3.75 and 3.62, respectively. Most scores were higher among second-semester students, but the difference was not significant. CONCLUSION The self-reported scores were comparable to those reported in previous studies done using the same PBL processes instrument in other medical schools. At Xavier University School of Medicine interactive lectures are the major teaching method and topics covered during PBL are also likely to be covered during lectures, which could influence the scores. The findings of our study providing information about how students function during PBL brainstorming and presentation sessions and how they use different learning resources would be of interest to other medical schools worldwide following a hybrid curriculum. Further studies are required.
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